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South Africa's basic education system is dysfunctional. It scores last or close to last in a myriad of metrics and delivers learners with some of the worst literacy and numeracy competencies worldwide. A bimodal distribution in the results exists when learners from the richest socioeconomic quintile are performing adequately well, while learners from the poorest quintiles are failing. This paper presents a system dynamics simulation model to describe the causal linkages between improved early childhood and pre-school learning practices on the education system as a whole. The paper investigates the difference in performance between rich and poor communities. Three interventions explore the research question of whether it is the number of enrolments into early childhood development programs that increases a cohort's school readiness, or rather the quality of the early childhood development programs into which they were enrolled. The results answer the research question for the Western Cape province by showing that increasing the quality of the formal ECD programs leads to a greater percentage of school-ready five year olds than increasing the percentage of enrolled children, but that decreasing community poverty leads to better results than either intervention. The results show the simulation model to be a powerful tool to assist with policy setting and intervention testing for any other province or country by simply changing the input data and calibration.

The compression strength of a corrugated board box is a direct measure of its stacking strength. The edgewise compression strength of corrugated board is the major contributor to the box stacking strength. This relation can be further extended to the critical strength properties of paper substrates. It was, therefore, the aim of this study to establish predictive mathematical correlations between corrugated board and paper compression properties after exposure to certain climate conditions. This would allow packaging technologists in the field to select adequate paper substrates, with certain strength characteristics, to manufacture corrugated board with the necessary compression strength for achieving a desired carton performance for certain climate conditions. The results of this study were used to determine the linear regression constants in the Maltenfort model by correlating the measured board edgewise compression strength (ECT) with the predicted strength, using the paper components' compression strengths, measured with the short-span compression test (SCT) and the ring crush test (RCT) methods. The obtained predictive mathematical models were as follows: ECT = 0.6982 (SCTL1 + SCTL2 + SCTL3 + α1SCTF1 + α2SCTF2) and ECT = 1.028 (RCTL1 + RCTL2 + RCTL3 + α1RCTF1 + α2RCTF2). The obtained models showed very high coefficients of determination (R²SCT = 0.9758, R²RCT = 0.9625), which confirmed that they can be used successfully to predict the compression strength of corrugated board, using the measured paper compression strength (SCT or RCT) after exposure to constant climatic conditions. The results also indicated that the obtained plant-specific predictive mathematical models compared well to the overall linear models and that no major difference existed between the plants' capabilities to convert the paper compression strength into corrugated board edgewise crush strength. This suggested that a single set of predictive mathematical models can be utilised with a good degree of confidence in the South African corrugating industry. [ABSTRACT FROM AUTHOR]

Many engineering subjects rely on the interpretation of symbolic, numeric and graphic representations. Engineering students have challenges pertaining to their mathematical understanding of their actions with a computer algebra system (CAS). We investigated how a mathematical modelling task could mediate varied levels of mathematical understanding. When engineering students are exposed to a CAS environment, they habitually engage in programming activities without considering the computerised outputs. The purpose of this paper was to ascertain South African engineering students' actions that can mediate broader levels of mathematical understanding in a CAS by utilising the Pirie-Kieren model of growth in mathematical understanding. Thirteen participants agreed to engage collaboratively in a mathematical modelling task. The task was analysed by means of content analysis following a deductive research approach. The findings disclosed that engineering students interdepend on paper-and-pen, computerised and reflective actions in their growth of mathematical understanding. Engineering students can be assisted in mediated and folding-back actions in order to fluctuate back and forth on their way to a more sound mathematical understanding. Explicit planning and sequence of subtasks can support engineering students to merge new levels of mathematics understanding with past comprehensions. Thoroughly planned modelling tasks can mediate novel levels of mathematical understanding when engineering students learn with a CAS.

This paper reports on empirical results about the influence of two different teaching designs on the development of tertiary students' modelling competency and attitudes towards modelling. A total of 144 first year engineering students were exposed to a diagnostic entrance test, a modelling unit consisting of five lessons with ten tasks, enframed by a pre- and a post-test, and at the end a questionnaire on attitudes towards mathematical modelling. Similar to the German DISUM study, in the modelling unit, one group of participants followed an independence-oriented teaching style, aiming at a balance between students' independent work and teacher's guidance, while two other groups were taught according to a more traditional teacher-guided style. Linear mixed regression models were used to compare pre- and post-test results. The results show that all groups had significant learning progress, although there is much room for further improvement, and that the group taught according to the independence-oriented design had the biggest competency growth. In addition, this group exhibited more positive attitudes than the other groups in five of six attitudinal aspects.

This paper proposes a transdisciplinary framework to allow for a multifocal exploration of classroom talk practices. It draws on data from a broader study of talk in South African Grade 4 mathematics classrooms where the language of teaching and learning (English) was the home language for neither the teachers nor their students. Lesson transcript data from one teacher's lessons on fractions are used to demonstrate how working with three strands of conceptual insight from the disciplines of psychology, sociology and linguistics conduces to a potentially richer understanding of a teacher's use of classroom talk in mediating her students' mathematical understanding. By drawing on elements of Vygotsky's sociocultural psychology, we make visible in the lesson data the ways in which this teacher used the 'everyday' in trying to navigate her students' towards more 'scientific' conceptualizations of unit fractions. By then taking up aspects of Bernstein's sociological work, we articulate, and make visible, how societal circumstances impinge on students' access to exploratory mathematical discourse needed for epistemological access to abstract and generalized mathematical concepts. Finally, through Halliday's work on the power of particular linguistic registers for meaning-making, we highlight challenges in learning mathematics in and through a second language and reveal the constraints placed on students' opportunity to maximally exploit the distinct forms of meaning contained within the mathematics register.

The article focuses on a three-parameter mathematical model which offers conceptual advantages in describing the particle size distribution in a water sample. It notes the potential of the proposed model to allow the calculation of total particle number and volumes over any random size interval. Furthermore, it cites the comparison of Ceronio and variable-ß models using 321 water samples from a large water utility in South Africa.

Background: Globally, mothers have identified work as one of the main obstacles to exclusive and continued breastfeeding. The support a woman receives in her workplace in terms of workplace arrangements can be critical to enable women to continue breastfeeding. This study aimed to develop and assess the face validity of a practice model to support exclusive and continued breastfeeding in workplaces in the Western Cape, South Africa. Methods: An explanatory, sequential, mixed-method research design, was conducted (June 2017 to March 2019) in three distinct phases. Phase one employed a quantitative, descriptive, cross-sectional study design. Phase 2 used a qualitative, multiple case study. Phase three involved the development and face validity of a practice model to support exclusive breastfeeding in workplaces. The face validity included two Delphi rounds for experts to provide input on the draft practice model. This paper will only report on phase 3 of the study. The practice model was developed, drawing on the analysis of data from phases one and two and using programme theory approaches and a logic model. Results: The practice model was positively perceived. Participants viewed it as informative, well designed and easy to follow, even for those not knowledgeable about the subject. It was viewed as an ideal tool, if accompanied by some training. Participants were positive that the model would be feasible and most commended the tiered approach to implementation. They felt that workplaces would be more open to a step-by-step approach to implementation and if only a few activities are implemented it would be a start to make the work environment more conducive for breastfeeding employees. There were mixed opinions regarding commitment; a few participants mentioned commitment as a challenge they anticipated in the male-dominant environments in which they worked. The provision of space for breastfeeding at the workplace was also highlighted as a potential challenge. Conclusions: Advocacy around creating an enabling workplace environment for breastfeeding is needed. The practice model has the potential to be internationally relevant, locally applied and may be of particular use to workplaces that want to initiate and/or strengthen breastfeeding support. [ABSTRACT FROM AUTHOR]

Early in South Africa's HIV/AIDS crisis, entertainment education emerged as a powerful vehicle for communicating health and social messaging to combat the epidemic. Applied theatre now accounts for the majority of arts-based HIV interventions in sub-Saharan Africa, and continues a history of theatre for social change in South Africa in particular. While much has been written about the dramaturgical and communication theories that support such interventions, the role of music, a formidable tool in the applied theatre intervention arsenal, has received considerably less attention within applied arts intervention scholarship. This paper draws from Durkheim's collective effervescence to propose a theoretical approach to music within the creation and maintenance of effervescent assemblies that is being employed by HIV/AIDS interventions to encourage participation in HIV testing. The theoretical model of musical effervescence is situated within ethnographic fieldwork conducted while accompanying an applied HIV/AIDS theatre company on a national tour of South Africa. [ABSTRACT FROM AUTHOR]

Purpose A healthcare system in any country is rarely the product of one logical policy-making experience, but rather a manifestation of many years of historical development. The purpose of this paper is to examine the characteristics, components, and variables of South Africa’s healthcare system in the context of global patterns. It leverages a dynamic period in South Africa since 1994, and applies a comparative health systems analysis to explain where the country’s healthcare system is, and where it is potentially going.Design/methodology/approach This paper reviews literature related to South Africa’s healthcare system, outlines its historical development, and discusses three fundamental challenges experienced in the country. This paper also reviews the literature on healthcare system typologies and identifies three framework models that have been used to categorise national healthcare systems since the 1970s. This paper then discusses the categorisation of South Africa’s healthcare system in these models, in comparison to Canada and the USA.Findings This paper finds that the framework models are useful tools for comparative analysis of healthcare systems. However, any use of such typologies should be done with the awareness that national healthcare systems are not isolated entities because they function within a larger context. They are not static, since they are constantly evolving with many nuances, even with very similar healthcare system categorisations.Originality/value This paper charts the trajectory of change in the South African healthcare system, and demonstrates that the change process must keep internal conditions in mind if the outcome is to be successful. Imitating policies of countries with well-functioning systems, without regard to local realities, may not work, as the government attempts to usher in changes within a short span of time. [ABSTRACT FROM AUTHOR]

INTRODUCTION The health consequences of smoking are serious and have been frequently detailed. A reduction in tobacco-related mortality hinges upon the ability to reduce tobacco usage. There is overwhelming evidence that higher cigarette prices reduce the demand for cigarettes, but little is known about the combined effect of price and non-price policies. This paper seeks to extend the analysis of price elasticities by estimating the combined effect of changes in price and non-price legislations in South Africa. METHODS Annual time-series data from 1961 to 2016 are used, with a policy index constructed to capture the instances of non-price tobacco legislation. We estimate the combined impact of changes in tobacco control policy on cigarette consumption using a vector error correction model (VECM) and a two-stage least squares (2SLS) model. RESULTS The estimated long-run own-price elasticities lie between -0.55 and -0.72, while the income elasticities lie between 0.39 and 0.49. The coefficients of the changing tobacco control policies and the changing market structure show that they contribute to a modest reduction in cigarette consumption. The short-run deviations from the steady state are presented using the error correction term (ECT). CONCLUSIONS Cigarette demand is responsive to cigarette prices and non-pricing policies but failure to control for non-pricing policies overstates the price effect. This suggests that both cigarette prices and non-pricing legislation are effective in reducing cigarette consumption. [ABSTRACT FROM AUTHOR]

This paper explores the prospects of commercial producers who would be willing to exit voluntarily in the near future to make land available in the market. In addition, it also considers what factors are restricting the acceleration of this rate of exit from a land-supply perspective with respect to barriers to exit. The prospect of structural change from such acceleration is also explored using three scenarios. An agent-based mathematical model is used to implement the three scenarios. This model is constructed from a dataset of 450 commercial producers across South Africa. The results suggest that a reasonable amount of arable land could be available for redistribution, with only modest structural change regarding animal production, despite drastic alterations in veld. These results provide some guidelines on how assistance for struggling producers can make land available for efficient producers, which could make the sector stronger. All potential exiting commercial producers have common reasons for doing so, which could be used to initiate a positively inclined, structured discussion on land supply. [ABSTRACT FROM AUTHOR]

In this paper, we provide a brief survey of mathematical modelling of malaria and how it is used to understand the transmission and progression of the disease and design strategies for its control to support public health interventions and decisionmaking. We discuss some of the past and present contributions of mathematical modelling of malaria, including the recent development of modelling the transmission-blocking drugs. We also comment on the complexity of the malaria dynamics and, in particular, on its multiscale character with its challenges and opportunities. We illustrate the discussion by presenting a curve fitting using a 95% confidence interval for the South African data for malaria from the years 2001-2018 and provide projections for the number of malaria cases and deaths up to the year 2025. [ABSTRACT FROM AUTHOR]

Developed with a strong awareness of past injustices, South Africa’s progressive constitution emphasises a full spectrum of human rights. While the constitution celebrates many languages and cultures, speech-language pathologists (SLPs) face challenges in translating these values into practice with a diverse clientele. Similarly, Article 19 of the Universal Declaration of Human Rights focuses on freedom of expression in one’s language of choice, but is often perceived as a “Cinderella” right (i.e. one that is frequently neglected). This paper presents a literature review undertaken in association with the Health Professions Council of South Africa to produce guidelines to support SLPs in their practice with diverse linguistic and cultural groups. The aim was to identify key points for inclusion in a set of human rights-driven guidelines. Specific objectives were to critique: (1) current guidelines for SLPs working with diverse cultural and linguistic groups; and (2) equivalent guidelines for related professions. Content analysis of the datasets revealed key themes which formed the basis of an initial skeleton, to be further developed through a consultative process and discussion, ultimately aiming to provide supportive, practical guidelines to better equip South African SLPs to serve all the people of the country. [ABSTRACT FROM PUBLISHER]

A comprehensive study about the spread of COVID-19 cases in Turkey and South Africa has been presented in this paper. An exhaustive statistical analysis was performed using data collected from Turkey and South Africa within the period of 11 March 2020 to 3 May 2020 and 05 March and 3 of May, respectively. It was observed that in the case of Turkey, a negative Spearman correlation for the number of infected class and a positive Spearman correlation for both the number of deaths and recoveries were obtained. This implied that the daily infections could decrease, while the daily deaths and number of recovered people could increase under current conditions. In the case of South Africa, a negative Spearman correlation for both daily deaths and daily infected people were obtained, indicating that these numbers may decrease if the current conditions are maintained. The utilization of a statistical technique predicted the daily number of infected, recovered, and dead people for each country; and three results were obtained for Turkey, namely an upper boundary, a prediction from current situation and lower boundary. The histograms of the daily number of newly infected, recovered and death showed a sign of lognormal and normal distribution, which is presented using the Bell curving method parameters estimation. A new mathematical model COVID-19 comprised of nine classes was suggested; of which a formula of the reproductive number, well-poseness of the solutions and the stability analysis were presented in detail. The suggested model was further extended to the scope of nonlocal operators for each case; whereby a numerical method was used to provide numerical solutions, and simulations were performed for different non-integer numbers. Additionally, sections devoted to control optimal and others dedicated to compare cases between Turkey and South Africa with the aim to comprehend why there are less numbers of deaths and infected people in South Africa than Turkey were presented in detail. [ABSTRACT FROM AUTHOR]

This paper reports part of the findings from a 2014 audit of shelters for street children conducted in four provinces of South Africa. The paper focuses on the assessment of the types, structure and implementation of the programmes, as well as on the adequacy of resources necessary for implementing the programmes. The overall picture that emerged from the assessment was that all shelters draw on a comprehensive and enabling legislative and policy framework to offer some elements of developmental, therapeutic and recreational programmes at the early intervention level. Overall, however, the implementation of the programmes does not effectively take into consideration the varied and interconnected factors that, within and across multiple social systems, impel children to the streets. It was thus apparent that the programmes do not adequately address the risks and opportunities of street children in South Africa, specifically within the eco‐developmental framework. Recommendations are offered for social work policy and practice to further enhance the quality and impact of programmes offered in the shelters. [ABSTRACT FROM AUTHOR]

The United Nations estimates that 79% of teenage girls trafficked globally every year are forced into involuntary prostitution. About 247 000 South African children work in exploitative conditions; about 40 000 South African female teenagers work as prostitutes. This paper investigates lifestyles and routine activities of teenagers at risk of being trafficked for involuntary prostitution. The key concepts involuntary prostitution, intergenerational sex and exploitative conditions are defined in relation to the lifestyles and routine activities of South African female teenagers. Human trafficking for involuntary prostitution is described, based on a literature review. Lifestyle exposure and routine activities theories help to explain the potential victimisation of these teenagers in human trafficking for involuntary prostitution. Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are discussed as factors that make teens vulnerable to such trafficking. This paper recommends that human trafficking prevention efforts (awareness programmes and information campaigns) be directed at places frequented by human traffickers and teenagers in the absence of a capable guardian to reduce victimisation, as traffickers analyse the lifestyles and routine activities of their targets. South Africa should also interrogate entrenched practices such as intergenerational sex. [ABSTRACT FROM AUTHOR]

It is timely to have this kind of study in South Africa as the country has an increasing number of people living with HIV and AIDS. While an extensive literature has documented factors associated with HIV and AIDS, psychosocial variables associated with the health of persons living with HIV (PLH) have only begun to receive attention recently. The objective of this paper was to explore the views of a group of people living with HIV and AIDS regarding HIV and AIDS and Self-Forgiveness. Theoretical base: To examine the role of self-forgiveness in people living with HIV and AIDS, George Engel's Biopsychosocial Model was adopted. Methods: Individual In-depth Interviews were conducted with 10 purposefully-selected participants in Ekurhuleni. Outcomes: Results showed that self-forgiveness has a huge role in the lives of people living with HIV and AIDS. For instance, it has been found that self-forgiveness leads to acceptance of HIV status, promote infected people to seek medical care, and eventually gain the confidence to disclose to friends and families. Work implications: In conclusion, self-forgiveness has micro, messo and macro implications as it promotes good health of people living with HIV and AIDS; enhance HIV status self-disclosure and adherence to HIV treatment. [ABSTRACT FROM AUTHOR]

Employees in public hospitals in South Africa work under dreadful conditions and are at risk of developing psychological stress and occupational diseases as well as occupational injuries. These poor working conditions translate to poor service delivery and as a result, the patients are the ones who suffer the most while under the care of these healthcare professionals. Despite these poor working conditions in public hospitals, there are limited studies that have dealt with this important topic in South Africa. The purpose of this paper was to describe a conceptual model which can be used as a framework of reference to improve the working conditions and the health and safety of employees at selected public hospitals in South Africa. A descriptive, explorative and theory construction research design was used to construct a conceptual model for improving the working conditions in public hospitals in the specific province in South Africa. The model suggests that improvement of working conditions, employee health and safety and quality patient care can only be achieved if employees and managers work interdependently for the betterment of the working conditions of their hospitals. Improvement should focus on enablers such as leadership commitment, infrastructure, resources, safety and security communications, decision-making, interpersonal relationships, support, and education and training. The implication for the managers and employees is that the model can be used as a framework for improving working conditions in hospitals, to promote the health and safety of employees and to improve quality patient care. [ABSTRACT FROM AUTHOR]

In this paper, we develop and analyze a malaria model with seasonality of mosquito life‐history traits: periodic‐mosquitoes per capita birth rate, ‐mosquitoes death rate, ‐probability of mosquito to human disease transmission, ‐probability of human to mosquito disease transmission, and ‐mosquitoes biting rate. All these parameters are assumed to be time dependent leading to a nonautonomous differential equation system. We provide a global analysis of the model depending on two threshold parameters R0 and R¯0<1 (with R0≤R¯0). When R0<1, then the disease‐free stationary state is locally asymptotically stable. In the presence of the human disease‐induced mortality, the global stability of the disease‐free stationary state is guarantied when R¯0<1. On the contrary, if R0>1, the disease persists in the host population in the long term and the model admits at least one positive periodic solution. Moreover, by a numerical simulation, we show that a sub‐critical (backward) bifurcation is possible at R0=1. Finally, the simulation results are in accordance with the seasonal variation of the reported cases of a malaria‐epidemic region in Mpumalanga province in South Africa. [ABSTRACT FROM AUTHOR]

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This paper analyses data from the World Health Organization's Study on Global AGEing and Adult Health (SAGE) on the prevalence of reported fear of crime at home and on the street among older people in China, Ghana, India, Mexico, Russia and South Africa. SAGE provides nationally representative data for 35,125 people aged 50 and over. These reveal large national variations in reported crime fear: for example, 65 per cent of older South Africans felt unsafe on the street, compared to only 9 per cent of older Ghanaians. The paper examines factors potentially associated with crime fear, including age, socio-economic status and frailty, and relates these to different theoretical models of crime fear. Female sex and frailty are associated with higher rates of crime fear across the study countries. Other associations are less consistent, e.g. urban residence is associated with higher levels of fear in some countries and lower levels in others. The paper considers the potential effects of crime fear on mobility beyond the home, health status and quality of life. A strong association is found for mobility, but effects on health and quality of life are harder to interpret as the direction of causality can be two-way. Overall, the paper demonstrates the potential impact of crime fear on older people's wellbeing and highlights a need for further, more contextualised research. [ABSTRACT FROM PUBLISHER]

The mental health care environment is a stressful environment, especially among student nurses. The purpose of the study was to develop a model of emotional support for student nurses working in the mental health care environment. The objectives were set in two phases: Phase one -- identification of concepts; Phase two -- development of a model of emotional support for student nurses. A theory-generating design, based on a qualitative, explorative and descriptive research approach, was used to meet the aim of the study. Data was purposively collected from 40 nursing students using (n=6) focus group discussions and eight educators and nine clinical staff by way of semi-structured interviews. Data was analysed by means of Tesch's method of data analysis. The model was developed by means of the four steps of which the first two are discussed in this paper as step three and four will be discussed elsewhere. Step one is the concept development consisting of concept identification and concept definition. A total of 22 concepts were identified, which were synthesised into six main concepts, namely, positive self-concept, positive work environment, academic and professional development, effective communication, formal and informal supportive interventions, and collaboration between the higher education institution and the mental health care setting. Step two is the model development during which the main concepts were placed in relation to one another, which formed an emotional support model for students working in mental health care settings. This paper gives an account of the methodological processes that were utilised to meet the aim and objectives of the study. [ABSTRACT FROM AUTHOR]

Purpose Nearly 200m people in the world experience considerable functioning difficulties. Also, more than three-fourth of the population aged 50 years and over is suffering from some kind of disability in India, China, Ghana, Russia, Mexico and South Africa. Despite the compelling nature of this issue, evidence on socioeconomic disparity in the occurrence of disability is lacking throughout the world and particularly in the aforementioned countries. The purpose of this paper is twofold – first, to examine the socioeconomic inequalities in the prevalence of disability in the selected countries; and second, to investigate the cross-country differentials in the prevalence of disability by socioeconomic characteristics.Design/methodology/approach The authors use data from the Study on Global Ageing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia and South Africa during 2007–2010. Disability scores have been constructed using Item Response Theory Partial Credit Model based on eight health and functioning domains. Bivariate analysis, concentration curves, concentration indices and multivariate regressions have been used in the analysis presented in this paper.Findings The authors find that the prevalence of disability varied considerably across sociodemographic groups. Moreover, this variation is not uniform across all countries. Also, age, Sex, work status, years of schooling and economic status emerged out as significant predictors of disability among the studied countries.Originality/value This is perhaps the first study which examines the socioeconomic inequality in disability conceptualized in a comprehensive manner among older adults spread across low to upper middle income countries. The alarming level of prevalence of disability among sociodemographic disadvantage groups calls for immediate attention in terms of detailed study of risk factors, effective policy and timely intervention. [ABSTRACT FROM AUTHOR]

Comparison of the movements in the VIX index, the rand - dollar exchange rate and South African CPI inflation reveals a striking resemblance between them, raising the question as to whether or not there is an empirical relationship among them. The aim of this paper is to determine whether or not changes in market uncertainty, as reflected in the VIX index, influence South African inflation. Given that the VIX index reflects market uncertainty, its impact on the inflation rate may differ between times of heightened uncertainty and normality, thus suggesting the presence of multiple regimes. To cater for this possibility, the analysis first uses the general-to-specific procedure (including squared and cubed values of dependent and independent variables) with impulse indicator saturation dummies to look for non-linear behaviour in the form of statistically significant squared and cubed variables and clustered periods of outlier dummies that might reflect an alternative regime. Finding such periods, the analysis next uses a Markov-switching model to model this non-linear behaviour explicitly. The results show that market volatility as measured by the VIX indeed explains South African inflation. Moreover, as shown by the second regime of the Markov-switching model, when market volatility is elevated, its influence on inflation also increases. [ABSTRACT FROM AUTHOR]

Improving the practice environment, quality of care and patient safety are global health priorities. In South Africa, quality of care and patient safety are among the top goals of the National Department of Health; nevertheless, empirical data regarding the condition of the nursing practice environment, quality of care and patient safety in public hospitals is lacking. Aim This study examined nurses' perceptions of the practice environment, quality of care and patient safety across four hospital levels (central, tertiary, provincial and district) within the public health sector of South Africa. Methods This was a cross-sectional survey design. We used multi-phase sampling to recruit all categories of nursing staff from central (n = 408), tertiary (n = 254), provincial (n = 401) and district (n = 244 [large n = 81; medium n = 83 and small n = 80]) public hospitals in all nine provinces of South Africa. After ethical approval, a self-reported questionnaire with subscales on the practice environment, quality of care and patient safety was administered. Data was collected from April 2021 to June 2022, with a response rate of 43.1%. ANOVA type Hierarchical Linear Modelling (HLM) was used to present the differences in nurses' perceptions across four hospital levels. Results Nurses rated the overall practice environment as poor (M = 2.46; SD = 0.65), especially with regard to the subscales of nurse participation in hospital affairs (M = 2.22; SD = 0.76), staffing and resource adequacy (M = 2.23; SD = 0.80), and nurse leadership, management, and support of nurses (M = 2.39; SD = 0.81). One-fifth (19.59%; n = 248) of nurses rated the overall grade of patient safety in their units as poor or failing, and more than one third (38.45%; n = 486) reported that the quality of care delivered to patient was fair or poor. Statistical and practical significant results indicated that central hospitals most often presented more positive perceptions of the practice environment, quality of care and patient safety, while small district hospitals often presented the most negative. The practice environment was most highly correlated with quality of care and patient safety outcomes. Conclusion There is a need to strengthen compliance with existing policies that enhance quality of care and patient safety. This includes the need to create positive practice environments in all public hospitals, but with an increased focus on smaller hospital settings. [ABSTRACT FROM AUTHOR]

Achieving accurate estimations of recoverable tonnage relies on a robust geological modelling process. To ensure this accuracy, it is crucial to incorporate information from exploration, grade control, and sampling, considering well-identified mineralization controls. However, modelling the geology of complex orebodies, especially veins, poses challenges due to their intricate mineral accumulation processes and variable structural complexities. Fairview Mine's Main Reef Complex (MRC) reef is highly discontinuous, with most of the valuable mineralized zone concentrated within localized ore shoots that intersect various lithologies, exemplifying these challenges. This study aimed to improve the modelling of veins at the mine, striving for a more accurate representation of the mineralization zones. To achieve this, a hybrid approach was employed, combining a deterministic method based on minimum curvature interpolation with a probabilistic method using anisotropic inverse distance weighting for categorical/discrete variables. The subsequent tonnage estimates showed a robust correlation with actual production output. The initial deterministic model established the large-scale geological trend, providing a foundation for estimating a probabilistic model. The iterative nature of probabilistic modelling allowed for the analysis of various probable options, facilitating the selection of the model that best captured the underlying geology. This approach enabled robust mathematical modelling while incorporating valuable input from geological knowledge and expectations. [ABSTRACT FROM AUTHOR]

Purpose:This paper proposes practice guidelines to evaluate community-based rehabilitation (CBR) programs. Method:These were developed through a rigorous three-phase research process including a literature review on good practices in CBR program evaluation, a field study during which a South Africa CBR program was evaluated, and a Delphi study to generate consensus among a highly credible panel of CBR experts from a wide range of backgrounds and geographical areas. Results:The 10 guidelines developed are summarized into a practice model highlighting key features of sound CBR program evaluation. They strongly indicate that sound CBR evaluations are those that give a voice and as much control as possible to the most affected groups, embrace the challenge of diversity, and foster use of evaluation processes and findings through a rigorous, collaborative and empowering approach. Conclusions:The practice guidelines should facilitate CBR evaluation decisions in respect to facilitating an evaluation process, using frameworks and designing methods.Implications for rehabilitationTen practice guidelines provide guidance to facilitate sound community-based rehabilitation (CBR) program evaluation decisions. Key indications of good practice include:• being as participatory and empowering as possible;• ensuring that all, including the most affected, have a real opportunity to share their thoughts;• highly considering mixed methods and participatory tools;• adapting to fit evaluation context, local culture and language(s);• defining evaluation questions and reporting findings using shared CBR language when possible, which the framework offered may facilitate. [ABSTRACT FROM AUTHOR]

Background: The general practitioner contracting initiative (GPCI) is a health systems strengthening initiative piloted in the first phase of national health insurance (NHI) implementation in South Africa as it progresses towards universal health coverage (UHC). GPCI aimed to address the shortage of doctors in the public sector by contracting-in private sector general practitioners (GPs) to render services in public primary health care clinics. This paper explores the early inception and emergence of the GPCI. It describes three models of contracting-in that emerged and interrogates key factors influencing their evolution. Methods: This qualitative multi-case study draws on three cases. Data collection comprised document review, key informant interviews and focus group discussions with national, provincial and district managers as well as GPs (n = 68). Walt and Gilson's health policy analysis triangle and Liu's conceptual framework on contracting-out were used to explore the policy content, process, actors and contractual arrangements involved. Results: Three models of contracting-in emerged, based on the type of purchaser: a centralized-purchaser model, a decentralized-purchaser model and a contracted-purchaser model. These models are funded from a single central source but have varying levels of involvement of national, provincial and district managers. Funds are channelled from purchaser to provider in slightly different ways. Contract formality differed slightly by model and was found to be influenced by context and type of purchaser. Conceptualization of the GPCI was primarily a nationally-driven process in a context of high-level political will to address inequity through NHI implementation. Emergence of the models was influenced by three main factors, flexibility in the piloting process, managerial capacity and financial management capacity. Conclusion: The GPCI models were iterations of the centralized-purchaser model. Emergence of the other models was strongly influenced by purchaser capacity to manage contracts, payments and recruitment processes. Findings from the decentralized-purchaser model show importance of local context, provincial capacity and experience on influencing evolution of the models. Whilst contract characteristics need to be well defined, allowing for adaptability to the local context and capacity is critical. Purchaser capacity, existing systems and institutional knowledge and experience in contracting and financial management should be considered before adopting a decentralized implementation approach. [ABSTRACT FROM AUTHOR]

In order to achieve optimal benefits of antiretroviral therapy (ART), caregivers of children receiving ART are required to attend routine clinic visits monthly and administer medication to the child as prescribed. Yet, the level of adherence to these behaviours varies considerably in many settings. As a way to achieve optimal adherence in rural KwaZulu-Natal, caregivers are required to attend routine counselling sessions at HIV treatment clinics that are centred on imparting information, motivation, and behavioural skills related to medication administration. According to the information-motivation-behavioural skills model, information related to adherence, motivation, and behavioural skills are necessary and fundamental determinants of adherence to ART. The purpose of the study was to observe and document the content of adherence counselling sessions that caregivers attending rural clinics in KwaZulu Natal receive. We observed 25 adherence counselling sessions, which lasted on average 8.1 minutes. Counselling typically consisted of counsellors recording patient attendance, reporting CD4 count and viral load results to caregivers, emphasising dose times, and asking caregivers to name their medications and dosage amounts. Patients were seldom asked to demonstrate how they measure the medication. They were also not probed for problems regarding treatment, even when an unsuppressed VL was reported to a caregiver. This paper calls attention to the sub-optimal level of counselling provided to patients on ART and the urgent need to standardise and improve the training, support, and debriefing provided to counsellors. [ABSTRACT FROM PUBLISHER]

Background: Setting priorities is important in health research given the limited resources available for research. Various guidelines exist to assist in the priority setting process; however, priority setting still faces significant challenges such as the clear ranking of identified priorities. The World Health Organization (WHO) proposed a Disability Adjusted Life Year (DALY)-based model to rank priorities by research area (basic, health systems and biomedical) by dividing the DALYs into 'unavertable with existing interventions', 'avertable with improved efficiency' and 'avertable with existing but non-cost-effective interventions', respectively. However, the model has conceptual flaws and no clear methodology for its construction. Therefore, the aim of this paper was to amend the model to address these flaws, and develop a clear methodology by using tuberculosis in South Africa as a worked example.Methods: An amended model was constructed to represent total DALYs as the product of DALYs per person and absolute burden of disease. These figures were calculated for all countries from WHO datasets. The lowest figures achieved by any country were assumed to represent 'unavertable with existing interventions' if extrapolated to South Africa. The ratio of 'cost per patient treated' (adjusted for purchasing power and outcome weighted) between South Africa and the best country was used to calculate the 'avertable with improved efficiency section'. Finally, 'avertable with existing but non-cost-effective interventions' was calculated using Disease Control Priorities Project efficacy data, and the ratio between the best intervention and South Africa's current intervention, irrespective of cost.Results: The amended model shows that South Africa has a tuberculosis burden of 1,009,837.3 DALYs; 0.009% of DALYs are unavertable with existing interventions and 96.3% of DALYs could be averted with improvements in efficiency. Of the remaining DALYs, a further 56.9% could be averted with existing but non-cost-effective interventions.Conclusions: The amended model was successfully constructed using limited data sources. The generalizability of the data used is the main limitation of the model. More complex formulas are required to deal with such potential confounding variables; however, the results act as starting point for development of a more robust model. [ABSTRACT FROM AUTHOR]

Lockdown is one of the drastic measures implemented by governments to curtail the spread of the Covid-19 pandemic and save lives. However, it has caused unprecedented damages to the economy. This paper provides a quantitative approach to assess the impact of a gradual, post-lockdown context concerning the spread of the disease. We propose to create a special class of individuals called "protected" who are risk-free to be infected. Such individuals could also be the vaccinated when an effective vaccine will be available. We developed a mathematical epidemic model for Covid-19 which describes the interactions between susceptible and infected individuals. We investigate the various and optimal strategies to curtail the spread of the infection at a minimum cost. As a case study on South Africa, the sensitivity analysis shows that investing on the special class "protected" is a better approach to reducing new secondary infections as opposed to reducing the contact rate between susceptible and infected individuals, or having more recovered patients. The simulations reveal that the peak could be reached in September 2020. This is consistent with the projection of the South African government as the winter season is expected to be over in mid August. Moreover, if 1 out of 1000 susceptible (cumulatively) join the special class, we project a maximum of 400,000 active cases. The number of infected and deaths could drastically increase as the proportion of individuals joining the special class decreases. [ABSTRACT FROM AUTHOR]

Leadership support has been identified as an essential component of successful workplace health promotion (WHP) programs. However, there is little research in this area and even less theoretical conceptualization on ways in which leadership support for WHP is related to improved employee wellbeing. In this paper, we developed and tested a model of leadership support for WHP and employee wellbeing outcomes using employer and employee data gathered from 71 South African organizations. A theoretical model based on social exchange theory was developed. It was hypothesized that perceptions of company commitment to health promotion mediates the relationship between leadership support, the provision of WHP facilities and employee wellbeing. A hierarchical structural equation modeling technique was used to test the model. We determined that leaders' support for WHP was important insofar as they also provided health promotion facilities to their employees. No direct relationship was found between leadership support alone and employee wellbeing. [ABSTRACT FROM AUTHOR]

Purpose: Based on the bioecological model by Bronfenbrenner, this paper will provide a broad perspective on factors that need to be taken into account in order to facilitate communication and participation in preliterate children making use of electronic Augmentative and Alternative Communication (AAC) systems accessed through eye gaze. Method: Two case studies of children who have been provided with the technology described are presented. The case studies were analysed using the four nested systems of the ecology as a framework to describe not only the environment, but also the processes and interactions between the persons and their context. Results: Risk and opportunity factors are evident at all levels of the ecology. Conclusions: While a good fit between the person and the technology is an essential starting point, additional factors pertaining to the partner, the immediate environment as well as meso-, exo- and macrosystemic issues (such as societal attitudes and funding sources) have a significant influence on benefits derived. In resource-limited environments, the lack of support at more distal levels of the ecology (meso-, exo- and marosystemic levels) seems to be a factor that differentiates these environments from more resourced ones. [ABSTRACT FROM AUTHOR]

The paper proposes a normative management instrument to help environmental managers in the field of outdoor recreation and conservation limit the impact of sport climbing, bouldering in particular, as an action-sport activity. Evidence of the rising popularity of the bouldering sport and its associated impacts on natural-resource areas is presented. The model is applied to and tested in the Rocklands bouldering area of South Africa to demonstrate its efficacy. The instrument uses 58 test criteria to account for the maintenance of a resource's market appeal and resource sensitivity by capturing these aspects at three spatial scales: the bouldering area as a whole, its sub-fields and the individual boulders. The model should aid conservation authorities, owners of private climbing areas and the organised climbing fraternity to ensure long-term sustainability of the use of climbing resources. The research concludes that the instrument provides the means to manage a natural resource sustainably within local and even international contexts. [ABSTRACT FROM AUTHOR]

This paper assesses the different models, in conjunction with the different theories surrounding the distinction and interdependencies between space- and capital markets. First, the theory of space- and capital markets is discussed with reference to two models, the FDW and the REEFM models. The FDW model provides a diagrammatic explanation of the behaviour of the property market, while the REEFM is an econometric model based on statistical principles that are able to forecast property-market behaviour by interpreting specific given variables. The REEFM model as the perceived more sophisticated model, untested in South Africa, was then analysed to test its applicability in the South African context. The findings confirmed the applicability of the model, although one part is not confirmed and is suggested for further research. [ABSTRACT FROM AUTHOR]

The use of religion and spirituality in psychotherapy has been a contentious issue for decades. This paper explores and describes whether psychologists would use religion and spirituality in psychotherapy as well as enablers and barriers in this regard. A qualitative exploratory descriptive method was followed using purposive sampling to obtain a sample of clinical and counselling psychologists. The focus group strategy was used to collect the data, and Tesch's model of content analysis was used to analyse the qualitative findings. Most participants expressed a willingness to discuss religion and spirituality with their clients. Participants also highlighted specific enablers and barriers to incorporating religion and spirituality in psychotherapy. This article has the potential to influence professional training in psychology and psychotherapy. [ABSTRACT FROM AUTHOR]

ABSTRACT The assimilation of refugees into their host community economic structures is often problematic. The paper investigates the ability of refugees in rural South Africa to accumulate assets over time relative to their host community. Bayesian spatial-temporal modelling was employed to analyse a longitudinal database that indicated that the asset accumulation rate of former Mozambican refugee households was similar to their host community; however, they were unable to close the wealth gap. A series of geo-statistical wealth maps illustrate that there is a spatial element to the higher levels of absolute poverty in the former refugee villages. The primary reason for this is their physical location in drier conditions that are established further away from facilities and infrastructure. Neighbouring South African villages in close proximity, however, display lower levels of absolute poverty, suggesting that the spatial location of the refugees only partially explains their disadvantaged situation. In this regard, the results indicate that the wealth of former refugee households continues to be more compromised by higher mortality levels, poorer education, and less access to high-return employment opportunities. The long-term impact of low initial asset status appears to be perpetuated in this instance by difficulties in obtaining legal status in order to access state pensions, facilities, and opportunities. The usefulness of the results is that they can be used to sharpen the targeting of differentiated policy in a given geographical area for refugee communities in rural Africa. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: Over the last four decades the development of frameworks for integrated coastal management (ICM) and models for ICM implementation have received much attention from researchers and practitioners alike. This has resulted in a proliferation of implementation models, many of which embody results-based approaches, with the primary focus being on identifying coastal issues and then addressing these by implementing specific projects or programmes. Despite explicitly recognising the importance of cooperative governance early on, ICM implementation still faces the challenge that governance systems remain largely sector-based. In this paper we explore the implementation of ICM within a sector-based governance system in South Africa. First, we draw on international best practice and situated knowledge to develop a prototype ICM implementation model designed to accommodate sector-based programmes within an overarching ecosystem-based approach. Next, we assess the usability of the prototype and the compatibility with a sector-based governance system using empirical information derived from South Africa''s National Programme of Action to protect the marine environment from land-based activities. We conclude that integrated management of the coast is possible in a sector-based governance system and propose the ICM implementation model developed in this paper as a potentially suitable model for countries with similar coastal management milieus to South Africa. [Copyright &y& Elsevier]

This paper evaluates the potential impact of tourism on poverty in South Africa on the basis of recent survey data on international tourism spending patterns. It looks at three scenarios, using an applied general equilibrium model. The main finding is that the poor benefit very little in the short term from additional tourism income. A further finding is that domestic and international tourist expenditure affect the economy differently; both markets are therefore important. In essence, the research confirms that tourism receipts can be used as a tool to alleviate poverty, but in South Africa this must be supported by policies that focus on the labour market and human resource development. [ABSTRACT FROM PUBLISHER]

Determining the potential range of invasive alien species under current conditions is important. However, we also need to consider future distributions under scenarios of climate change and different management interventions when formulating effective long-term intervention strategies. This paper combines niche modelling and fine-scale process-based modelling to define regions at high risk of invasion and simulate likely dynamics at the landscape scale. Our study species is Schinus molle (Peruvian pepper tree; Anacardiaceae), a native of central South America, introduced to South Africa in about 1850 where it was widely planted along roads. Localities of planted and naturalized trees were mapped along 5380 km of roads - a transect that effectively samples a large part of western South Africa. Correlative modelling was used to produce profiles of present and future environmental conditions characterizing its planted and naturalized ranges. A cellular-automata simulation model was used to estimate the dynamics of S. molle under future climates and different management scenarios. The overall potential range of S. molle in the region is predicted to shrink progressively with predicted climate change. Some of the potential range of S. molle defined based on current conditions (including areas where it is currently highly invasive) is likely to become less favourable. The species could persist where it is well established long after conditions for recruitment have deteriorated. Some areas where the species is not widely naturalized now (notably the fynbos biome) are likely to become more favourable. Our modelling approach allows for the delineation of areas likely to be invaded in future by considering a range of factors at different scales that mediate the interplay of climatic variables and other drivers that define the dimensions of human intervention such as distance from planted trees and the density of planted plants, both of which affect propagule pressure. [ABSTRACT FROM AUTHOR]

This paper shows how two publicly available epidemiological modelling packages, namely the Spectrum AIDS Impact Model and the ASSA2003 AIDS and Demographic Model, predict very different impacts from rolling out highly active antiretroviral treatment (HAART) on new HIV infections. Using South Africa as a case study, it shows that the ASSA2003 model predicts a significant drop in new HIV infections as HAART is rolled out, whereas the Spectrum model assumes that HAART does not have a preventative impact (and in fact generates a small increase in new HIV infections). Users will thus draw different conclusions about the public health benefits of HAART depending on which modelling package they use. Despite being presented as a policy-oriented modelling tool capable of exploring 'what if' questions about the impact of different policy choices, the Spectrum model is illequipped to do so with regard to a HAART rollout. Unlike Spectrum, ASSA2003 is more flexible and its assumptions are clear. Better modelling and more information (including about the relationship between HAART and sexual risk behaviour) is required to develop appropriate public-policy modelling for the HAART era. [ABSTRACT FROM AUTHOR]

Investigations of extreme rainfall events in the southern African region are limited by the paucity of the observational network. Furthermore, the lack of full radar coverage for South Africa makes quantitative precipitation estimation difficult. Therefore, numerical modeling represents the most effective method for improving the understanding of the mechanisms that contribute to extreme rainfall events in this region with the caveat that accurate validation of model simulations is hampered by the limited observations in the region. This paper describes an intense cutoff low event over South Africa that led to record rainfall and flash flooding along the south coast of the country and adjoining hinterland. Analyses from the Global Forecast System model showed that the cutoff aloft was accompanied by a strong low-level jet (LLJ) impinging onto the south coast where rainfall was heaviest, and that lapse rates were steep in the lower troposphere. Simulations of the event were carried out using a numerical model [i.e., the fifth-generation Pennsylvania State University–National Center for Atmospheric Research Mesoscale Model (MM5)], which showed that severe convection occurred over the ocean on the right-hand side of the LLJ, and at its leading edge where it impinged on the coastal topography. This topography was also very important in providing additional forcing for the ascent of moist air. A factor separation technique was used to show that surface heat fluxes from the warm sea surface temperature (SST) of the Agulhas Current were important in enhancing low-level cyclogenesis, and that topography was important in maintaining the position of the low-level coastal depression, which led to favorable conditions for rainfall remaining in the same area for an extended period of time. It is suggested that improved representation of the tight topographic and SST gradients of the southern African region in NWP models or postprocessing systems would help to provide more accurate forecasts of the amount and location of heavy precipitation during cutoff low events where surface forcing is important. [ABSTRACT FROM AUTHOR]

Mathematical modeling of real world conditions should be part ofl mathematics classroom activities. In this paper I argue that when real world problems are taught at schools learners are not able to cope on their own, without the assistance of their educator. There is very little or no emphasis placed on this aspect of mathemtics at schools, although it is just beginning to make an appearance in our new Outcomes Based Curriculum. I also discuss an experiment conducted with Grade 10 learners (15 year old) and their responses to real world problems and the conditions that need to be considered. There is ample evidence that a lot of work on mathematical modeling of real world problems has been done elsewhere in the world, but not much has been done in South Africa. This experiment was fully conducted using Sketchpad as a mediating tool. This in itself was a difficult task because our learners have not been really exposed to dynamic geometry environments. [ABSTRACT FROM AUTHOR]

In this paper the fairness of some methods of allocating seats in a proportional representation (PR) voting system is investigated. Different PR systems are in use throughout the democratic world, but the primary focus here is the method used in South Africa, namely the largest remainder method with a Droop quota. It is shown that as the number of parties increases, the number of lost votes (votes not used to allocate seats) increases when using this method. Other existing allocation methods are discussed and compared with each other as well as with three optimisation methods (based on mathematical programming) introduced in this paper. Applying these mathematical programming methods results in allocations that are more fair than the existing methods of seat allocation, if South African voting data are used. These mathematical models attempt to minimise a number of different measures of the deviation between the actual percentage of votes received and the percentage of seats allocated to a certain party. Ideally this deviation should be zero, but due to the discrete nature of seats this is virtually impossible to achieve. [ABSTRACT FROM AUTHOR]