The quality of rapid HIV testing in South Africa: an assessment of testers’ compliance.

Background: The aim of this study was to assess the quality of rapid HIV testing in South Africa. Method: A two-stage sampling procedure was used to select HCT sites in eight provinces of South Africa. The study employed both semi-structured interviews with HIV testers and observation of testing sessions as a means of data collection. In total, 63 HCT sites (one HIV tester per site) were included in the survey assessing qualification, training, testing practices and attitudes towards rapid tests. Quantitative data was analysed using descriptive statistics and qualitative data was content analysed. Results: Of the 63 HIV testers, 20.6% had a nursing qualification, 14.3% were professional counsellors, 58.7% were lay HIV counsellors and testers and 6.4% were from other professions. Most HIV testers (87.3%) had had a formal training in testing, which ranged between 10-14 days, while 6 (9.5%) had none. Findings revealed sub-standard practices in relation to testing. These were mainly related to non-adherence to testing algorithms, poor external quality control practices, poor handling and communication of discordant results. Conclusion: Quality of HIV rapid testing may be highly compromised through poor adherence to guidelines as observed in our study.

The revolving door of mental, neurological, and substance use disorders re-hospitalization in rural KwaZulu-Natal Province, South Africa.

Objective: Little is known about the extent of mental, neurological and substance-use (MNS) disorders re-hospitalization in South Africa. We examined the extent of one-year MNS re-hospitalization (MNS-R) in a rural South African primary health care facility (PHCF). Methods: We conducted a retrospective analysis of hospital administrative data from 10,525 adults discharged from a rural PHCF in KwaZulu-Natal Province, South Africa. Chi-squared tests were utilized to describe MNS-R within one year of an index hospital admission in individuals with MNS, with a sub-analysis also being conducted to describe schizophrenia re-hospitalization (S-R). Results: The prevalence of MNS and schizophrenia recorded at an index hospitalization was 5% and 1%, respectively. A total of 44/67 (66%) individuals with a diagnosis of MNS at the index hospitalization were classified as having MNS-R during oneyear follow-up period. Half of those diagnosed with schizophrenia at the index hospitalization (6/12 patients) were classified as having S-R during one-year follow-up period. There was a significant association between re-hospitalization outcomes (MNS-R and S-R) and MNS (p<0.01) or schizophrenia diagnosis (p<0.01) at index baseline hospitalization. Conclusion: The extent of MNS-R and S-R remains relatively high in rural South Africa, and needs further health systems strengthening to prevent revolving door occurrences.

Planification en contexte mégaévénementiel et reconversion urbaine : le cas du Green Point Urban Park à Cape Town en Afrique du Sud


Depuis les années 2000, nous observons de plus en plus de pays en développement (PED) hôtes de mégaévénements. En accueillant un mégaévénement en leur sol, les PED espèrent améliorer leur cadre urbain et attirer des investissements étrangers. Ceci étant dit, les retards en termes d’infrastructures et d’équipements que connaissent ces pays et les stricts cadres normatifs imposés par des organismes internationaux comme la FIFA, nous amènent à questionner la possibilité d’intégrer les aménagements mégaévénementiels, à leur contexte local. En ce sens, le processus de planification, dans lequel les cadres normatifs externes et locaux sont négociés, peut être vu comme un moment charnière ayant une incidence sur le potentiel de reconversion. Dans le cadre de ce mémoire, nous avons entamé une réflexion à ce sujet en examinant le processus de planification d’un aménagement mégaévénementiel, le Green Point Urban Park (GPUP) à Cape Town, et son incidence sur son potentiel de reconversion. Plus précisément, nous allons, en premier lieu, décrire le processus de planification du site, nous allons par la suite évaluer son potentiel de reconversion, puis nous allons faire ressortir des liens entre le processus de planification et le potentiel de reconversion des aménagements mégaévénementiels. En somme, notre travail met en évidence une relation entre, d’une part, la prépondérance du cadre normatif imposé par l’organisme international et la dynamique du système d’acteurs au moment de la planification du GPUP et, d’autre part, la difficile reconversion de ce dernier après la Coupe du monde de 2010.

An unbridgeable gap? Comparing the HIV/AIDS epidemics in Australia and sub-Saharan Africa

OBJECTIVE: To compare the HIV/AIDS epidemics in Australia and sub-Saharan Africa, to outline reasons for differences, and to consider implications for the Asia and Pacific region. METHODS: Comparison of key indicators of the epidemic in Australia, and Africa viewed largely through the experience of the Hlabisa health district, South Africa. RESULTS: To the end of 1997, for all Australia, the estimated cumulative number of HIV infections was approximately 19,000, whereas in Hlabisa 31,000 infections are estimated to have occurred. Compared with the low and declining incidence of HIV in Australia (<1%), estimated incidence in Hlabisa rose to 10% in 1997. In all, 94% of Australian infections have been amongst men; in Hlabisa equal numbers of males and females are infected. Consequently, whereas 3000 children were perinatally exposed to HIV in Hlabisa in 1998 alone, 160 Australian children have been exposed this way. In Australia, HIV-related disease is characterised by opportunistic infection whereas in Hlabisa tuberculosis and wasting dominate. Surveys among gay men in Sydney and Melbourne indicate >80% of HIV infected people receive antiretroviral therapy whereas in Hlabisa these drugs are not available. IMPLICATIONS: It seems possible that Asia and the Pacific will experience a similar HIV/AIDS epidemic to that in Africa. Levels of HIV are already high in parts of Asia, and social conditions in parts of the region might be considered ripe for the spread of HIV. As Australia strengthens economic and political ties within the region, so should more be done to help Pacific and Asian neighbours to prevent and respond to the HIV epidemic.

Transformation of wealth produced into quality of life: analysis of the social efficiency of nation-states with the DEA's triple index approach

Although an essential condition for the occurrence of human development, economic growth is not always efficiently converted into quality of life by nation-states. Accordingly, the objective of this study is to measure the social efficiency-the ability of a nation-state to convert its produced wealth into quality of life-of a set of 101 countries. To achieve this goal, the Data Envelopment Analysis method was used in its standard, cross-multiplicative and inverted form, by means of a new approach called 'triple index'. The main results indicated that the former Soviet republics and Eastern European countries stood out in terms of social efficiency. The developed countries, notwithstanding their high social indicators, did not excel in efficiency; however, the countries of south of Africa, despite having the worst social conditions, were also the most inefficient.

Elites or middle classes? : lessons from transnational research for the study of social stratification in Africa

In diesem Arbeitspapier will ich zur künftigen Forschung über soziale Stratifikation in Afrika beitragen, indem ich die theoretischen Implikationen und empirischen Herausforderungen der Konzepte "Elite" und "Mittelklasse" untersuche. Diese Konzepte stammen aus teilweise miteinander konkurrierenden Theorietraditionen. Außerdem haben Sozialwissenschaftler und Historiker sie zu verschiedenen Zeiten und mit Bezug auf verschiedene Regionen unterschiedlich verwendet. So haben Afrikaforscher und -forscherinnen soziale Formationen, die in anderen Teilen der Welt als Mittelklasse kategorisiert wurden, meist als Eliten aufgefasst und tun dies zum Teil noch heute. Elite und Mittelklasse sind aber nicht nur Begriffe der sozialwissenschaftlichen Forschung, sondern zugleich Kategorien der sozialen und politischen Praxis. Die Art und Weise, wie Menschen diese Begriffe benutzen, um sich selbst oder andere zu beschreiben, hat wiederum Rückwirkungen auf sozialwissenschaftliche Diskurse und umgekehrt. Das Arbeitspapier setzt sich mit beiden Aspekten auseinander: mit der Geschichte der theoretischen Debatten über Elite und Mittelklasse und damit, was wir aus empirischen Studien über die umstrittenen Selbstverortungen sozialer Akteure lernen können und über ihre sich verändernden Auffassungen und Praktiken von Elite- oder Mittelklasse-Sein. Weil ich überzeugt bin, dass künftige Forschung zu sozialer Stratifikation in Afrika außerordentlich viel von einer historisch und regional vergleichenden Perspektive profitieren kann, analysiert dieses Arbeitspapier nicht nur Untersuchungen zu afrikanischen Eliten und Mittelklassen, sondern auch eine Fülle von Studien zur Geschichte der Mittelklassen in Europa und Nordamerika sowie zu den neuen Mittelklassen im Globalen Süden.

Increasing profits and reducing risks in crop production using participatory systems simulation approaches

The development of cropping systems simulation capabilities world-wide combined with easy access to powerful computing has resulted in a plethora of agricultural models and consequently, model applications. Nonetheless, the scientific credibility of such applications and their relevance to farming practice is still being questioned. Our objective in this paper is to highlight some of the model applications from which benefits for farmers were or could be obtained via changed agricultural practice or policy. Changed on-farm practice due to the direct contribution of modelling, while keenly sought after, may in some cases be less achievable than a contribution via agricultural policies. This paper is intended to give some guidance for future model applications. It is not a comprehensive review of model applications, nor is it intended to discuss modelling in the context of social science or extension policy. Rather, we take snapshots around the globe to 'take stock' and to demonstrate that well-defined financial and environmental benefits can be obtained on-farm from the use of models. We highlight the importance of 'relevance' and hence the importance of true partnerships between all stakeholders (farmer, scientists, advisers) for the successful development and adoption of simulation approaches. Specifically, we address some key points that are essential for successful model applications such as: (1) issues to be addressed must be neither trivial nor obvious; (2) a modelling approach must reduce complexity rather than proliferate choices in order to aid the decision-making process (3) the cropping systems must be sufficiently flexible to allow management interventions based on insights gained from models. The pro and cons of normative approaches (e.g. decision support software that can reach a wide audience quickly but are often poorly contextualized for any individual client) versus model applications within the context of an individual client's situation will also be discussed. We suggest that a tandem approach is necessary whereby the latter is used in the early stages of model application for confidence building amongst client groups. This paper focuses on five specific regions that differ fundamentally in terms of environment and socio-economic structure and hence in their requirements for successful model applications. Specifically, we will give examples from Australia and South America (high climatic variability, large areas, low input, technologically advanced); Africa (high climatic variability, small areas, low input, subsistence agriculture); India (high climatic variability, small areas, medium level inputs, technologically progressing; and Europe (relatively low climatic variability, small areas, high input, technologically advanced). The contrast between Australia and Europe will further demonstrate how successful model applications are strongly influenced by the policy framework within which producers operate. We suggest that this might eventually lead to better adoption of fully integrated systems approaches and result in the development of resilient farming systems that are in tune with current climatic conditions and are adaptable to biophysical and socioeconomic variability and change. (C) 2001 Elsevier Science Ltd. All rights reserved.

Measures of health and disease in Africa: are current methods giving us useful information about trends in cardiovascular diseases?

An enormous burst of interest in the public health burden from chronic disease in Africa has emerged as a consequence of efforts to estimate global population health. Detailed estimates are now published for Africa as a whole and each country on the continent. These data have formed the basis for warnings about sharp increases in cardiovascular disease (CVD) in the coming decades. In this essay we briefly examine the trajectory of social development on the continent and its consequences for the epidemiology of CVD and potential control strategies. Since full vital registration has only been implemented in segments of South Africa and the island nations of Seychelles and Mauritius - formally part of WHO-AFRO - mortality data are extremely limited. Numerous sample surveys have been conducted but they often lack standardization or objective measures of health status. Trend data are even less informative. However, using the best quality data available, age-standardized trends in CVD are downward, and in the case of stroke, sharply so. While acknowledging that the extremely limited available data cannot be used as the basis for inference to the continent, we raise the concern that general estimates based on imputation to fill in the missing mortality tables may be even more misleading. No immediate remedies to this problem can be identified, however bilateral collaborative efforts to strength local educational institutions and governmental agencies rank as the highest priority for near term development.

Sense of coherence and job characteristics in predicting burnout in a South African sample

Orientation: Research that considers the effects of individual characteristics and job characteristics jointly in burnout is necessary, especially when one considers the possibility of curvilinear relationships between job characteristics and burnout. Research purpose: This study examines the contribution of sense of coherence (SOC) and job characteristics to predicting burnout by considering direct and moderating effects. Motivation for this study: Understanding the relationships of individual and job characteristics with burnout is necessary for preventing burnout. It also informs the design of interventions. Research design, approach and method: The participants were 632 working adults (57% female) in South Africa. The measures included the Job Content Questionnaire, the Sense of Coherence Questionnaire and the Maslach Burnout Inventory. The authors analysed the data using hierarchical multiple regression with the enter method. Main findings: Job characteristics and SOC show the expected direct effects on burnout. SOC has a direct negative effect on burnout. Job demands and supervisor social support show nonlinear relationships with burnout. SOC moderates the effect of demands on burnout and has a protective function so that the demands-burnout relationship differs for those with high and low SOC. Practical/managerial implications: The types of effects, the shape of the stressor-strain relationship and the different contributions of individual and job characteristics have implications for designing interventions. Contribution/value add: SOC functions differently when combined with demands, control and support. These different effects suggest that it is not merely the presence or absence of a job characteristic that is important for well-being outcomes but how people respond to its presence or absence.

La reintegración social y económica de los grupos armados ilegales en Colombia: reflexiones a partir de la trayectoria de nueve excombatientes

Esta investigación toma como marco general la Política de Reintegración Social y económica de personas y grupos alzados en armas en Colombia, en donde tras el estudio de las trayectorias en el conflicto de un grupo de 9 excombatientes, se aborda la relación existente entre los beneficios otorgados por dicha política y aquello que facilitó y motivó el ingreso, la permanencia y desmovilización de los grupos armados. Se presenta una caracterización e interpretación conceptual de las denominadas trayectorias en el conflicto, son establecidas relaciones y diferencias entre las organizaciones ilegales FARC y las AUC, se revisan las percepciones que frente a los beneficios del programa de reintegración tienen excombatientes y profesionales de la entidad que lidera dicho proceso y a partir de ello, es argumentada la incidencia que sobre el éxito de esta política tienen las características individuales y particulares, tanto de los excombatientes como de las organizaciones armadas ilegales.

Promoting mother–infant book sharing and infant attention and language development in an impoverished South African population: a pilot study

The low rates of child literacy in South Africa are cause for considerable concern. Research from the developed world shows that parental sharing of picture books with infants and young children is beneficial for child language and cognitive development, as well as literacy skills. We conducted a pilot study to examine whether such benefits might extend to an impoverished community in South Africa, by evaluating the impact of training mothers in book sharing with their 14–18 month old infants. Seventeen mothers received book sharing training; and 13 mothers did not, but instead received a comparison training in toy play. We assessed the mothers’ behavior during both book sharing and toy play before and after training, and we also assessed infant attention and language. Mothers receiving book sharing training engaged well with it, and they also benefited from it; thus, compared to the comparison group mothers, they became more sensitive, more facilitating, and more elaborative with their infants during book sharing, and they also became more sensitive to their infants during toy play. In addition, infants whose mothers received the book sharing training showed greater benefits than the comparison group infants in both their attention and language. Training in book sharing for families living in conditions of marked socio-economic adversity in South Africa has the potential to be of considerable benefit to child developmental progress. A large scale controlled trial is required to confirm this.

The ebbing hegemon? An evolutionary perspective on the emergence of holistic governance and the efficient role of Institutional Investors in Environmental, Social and Governance issues (ESG)

This paper seeks to chronicle the roots of corporate governance form its narrow shareholder perspective to the current bourgeoning stakeholder approach while giving cognizance to institutional investors and their effective role in ESG in light of the King Report III of South Africa. It is aimed at a critical review of the extant literature from the shareholder Cadbury epoch to the present day King Report novelty. We aim to: (i) offer an analytical state of corporate governance in the Anglo-Saxon world, Middle East and North Africa (MENA), Far East Asia and Africa; and (ii) illuminate the lead role the king Report of South Africa is playing as the bellwether of the stakeholder approach to corporate governance as well as guiding the role of institutional investors in ESG.

Are we there yet? Exploring empowerment at the microscale in the South African wine industry

Empowerment is a standard but ambiguous element of development rhetoric and so, through the socially complex and contested terrain of South Africa, this paper explores its potential to contribute to inclusive development. Investigating micro-level engagements with the national strategy of Broad-Based Black Economic Empowerment (B-BBEE) in the South African wine industry highlights the limitations, but also potential, of this single domain approach. However, latent paternalism, entrenched interests and a ‘dislocated blackness’ maintain a complex racial politics that shapes both power relations and the opportunities for transformation within the industry. Nonetheless, while B-BBEE may not, in reality, be broad-based its manifestations are contributing to challenging racist structures and normalising changing attitudes. This paper concludes that, to be transformative, empowerment needs to be re-embedded within South Africa as a multi-scalar, multi-dimensional dialogue and, despite the continuation of structural constraints, positions the local as a critical scale at which to initiate broader social change.

O consumidor brasileiro de marcas de luxo : uma descrição e segmentação psicográfica por valores

O campo desta dissertação é o Marketing aplicado às marcas de luxo, descrevendo e segmentando os consumidores das marcas de luxo de vestuário e acessórios em seus traços psicográficos. A psicografia é utilizada para entender os mercados e avaliar em profundidade os segmentos (Blackwell, Miniard, Engel, 2005), indo além das usuais variáveis demográficas. A psicografia utiliza características subjetivas dos consumidores, tais como estilo de vida, personalidade, atitude, atividades, interesses, valores (Tomanari, 2003). Aqui se utilizou, como traços psicográficos, os valores do consumidor. Valores são propriedades humanas que dificilmente mudam, sendo influenciadores do comportamento. Ademais, são em algum grau compartilhados pelos indivíduos que pertencem a uma mesma cultura e variam de acordo com as especificidades culturais (Hemzo, Silva, 2009). Dessa forma, os traços psicográficos baseados em valores são menos universais e mais necessários estudá-los dentro de uma cultura em particular (a brasileira, nessa dissertação). No Brasil, o consumo das marcas de luxo, a partir da década de 2000, teve diversas causas. As condições econômicas e a inserção no mercado global facilitaram a compra de produtos importados. Todavia, o fenômeno do luxo difere nos seus mercados tradicionais (França e Itália). Isso leva a considerar que, nos mercados emergentes, o luxo passa por outras definições e simbologias, por vezes divergentes daquelas dos países de origem das marcas. Logo, uma segmentação baseada nos traços psicográficos dos consumidores pode auxiliar a gestão dessas marcas no Brasil, o que essa dissertação aborda.