Corrie Uys

Background/Objectives: Patient-level factors strongly influence antimicrobial resistance (AMR) through the pressure applied to healthcare professionals to prescribe antibiotics even for self-limiting viral infections, enhanced by knowledge and attitude concerns. This includes Africa, with high levels of AMR. However, validated measurement tools for African primary healthcare (PHC) are scarce. This study evaluated the reliability, structural validity, and interpretability of the Community Antimicrobial Use Scale (CAMUS) in South Africa. Methods: A cross-sectional survey was conducted with 1283 adults across 25 diverse public PHC facilities across two provinces. The 30-item theory-based tool underwent exploratory and confirmatory factor analysis (EFA/CFA), reliability, and validity testing. Results: EFA identified a coherent five-factor structure: (F1) Understanding antibiotics; (F2) Social and behavioural norms; (F3) Non-prescribed use; (F4) Understanding of AMR; and (F5) Attitudes. Internal consistency was strongest for knowledge and misuse domains (alpha approximation 0.80). Test–retest reliability was good-to-excellent (ICC: 0.72–0.89). CFA confirmed acceptable composite reliability (CR ≥ 0.63). Although average variance extracted (AVE) was low for broader behavioural constructs, indicating conceptual breadth, it was high for AMR knowledge (0.737). Construct validity was supported by positive correlations with health literacy (r = 0.48) and appropriate use intentions (r = 0.42). Measurement error metrics (SEM = 1.59; SDC = 4.40) indicated good precision for group-level comparisons. Conclusions: CAMUS demonstrated a theoretically grounded structure with robust performance in knowledge and misuse domains. While social and attitudinal domains require refinement, we believe the tool is psychometrically suitable for group-level antimicrobial use surveillance and programme evaluation in South African PHC settings and wider to help with targeting future educational programmes among patients.

Objectives: This systematic review aims to investigate whether good medication adherence in adults with chronic conditions is associated with a lower mortality risk compared to poor adherence within published literature, and the extent to which this relationship is represented within South African policy and legislation. Methods: A systematic search of three electronic databases—PubMed, MEDLINE (Ovid) and Scopus—was conducted. Only primary research articles published in English after March 2004 and with study populations >18 years of age were considered. South African health legislation and professional guidelines from 2014 onwards were sourced using search terms aligned with the systematic review strategy and systematically analysed. Results: Twenty‐six articles were included in the systematic review. Effect measures included hazard ratios (HR), incidence rate ratios (IRRs) and odds ratios (OR), where values greater than 1 indicate a higher risk of mortality. The effect measures from individual studies were categorized according to adherence levels: good, intermediate, poor and non‐adherent. A total of 17 effect measures were reported for good adherence, only one of which was greater than 1. There were 44 effect measures reported for intermediate, poor and non‐adherence categories, all of which were greater than 1. Pooled estimates for poor adherence and non‐adherence had the highest HRs (HR = 1.63; 95% confidence interval [CI]: 1.36–1.96 and HR = 2.77; 95% CI: 2.3–3.34 respectively). Review of South African health legislation and professional guidelines showed a dominance of mortality‐related terms (1.323 and 2.98 matches per 1000 words for ‘mortality’ and ‘death’, respectively) compared with adherence‐related terms (0.053–2.98 matches per 1000 words). Co‐occurrence between medication adherence‐related search terms (MARS, adherence, medication adherence, adhere, non‐adherence and medication compliance) and mortality‐related search terms (death, mortality and survival) was low within all documents analysed. Conclusion: The systematic review demonstrates a clear relationship between good adherence to chronic medication and a lower mortality risk. However, the review of legislative and policy documents suggests that government efforts are focused primarily on surveillance, rather than strategy or preventative measures. This strong evidence should motivate incorporating adherence‐based risk assessments into clinical and legal frameworks.

Ports in South Africa face numerous environmental challenges. This study focuses on the port of Cape Town. Without understanding the port user’s perception in relation to pollution, it is likely that current practices will continue, despite standards and legislation in place. The objectives of the study were to determine the perceptions of port users regarding pollution management and identify the potential barriers and opportunities for the port as it pertains to pollution management. Data was collected using questionnaires that were distributed to selected managerial and non-managerial employees of the TNPA, tenants, contractors, and waste license permit holders. This study suggests that pollution is managed differently in different parts of the Port of Cape Town, better in some parts than others. Although respondents generally perceive that fines are enforced to manage pollution issues, many still agree that pollution management is a problem at the port. As the landlord, the Ports Authority is not empowered to issue environmental fines, and there are also unpromulgated environmental legislations related to ports. Therefore, enforcement does not necessarily effectively address pollution management issues. Another concern is that many of the employees were unsure whether pollution management is a problem and whether penalties for pollution management enforcement have the desired effect. This seems to be due to certain employees not receiving the appropriate training and awareness programs at the time of this investigation. The GIS was one of the opportunities the Port of Cape Town could consider incorporating for monitoring and managing complex environmental challenges as continuous improvement.

In this paper we map new ways of supporting and capacitating novice supervisors. During the COVID 19 pandemic, we hosted weekly online collaborative workshops designed to reflect on a process of common learning, in which established and novice supervisors engaged with and discussed their individual supervisory needs. This process revealed, with particular clarity, the complexities of mentoring supervisors at a University of Technology (UoT) and enabled the development of the Sisonke Supervision Mentoring Programme (SSMP). This new identification of key aspects offers insight and benefit to similar programmes. The Community of Practice (CoP) theory was appropriate for this context since it allowed the construction of mentoring spaces in which people could engage mutually in activities to improve their supervisory practices. Using an interpretivist paradigm and inductively and qualitatively analysing transcripts revealed four key subjects for discussion: learning should be non-hierarchical; collaboration and reflection take place in in CoPs; care rather than competition should be paramount; and mentorship supervision is a joint responsibility.

The central objectives of this study are to investigate the mitigating measures, put in place during the COVID-19 pandemic in the construction industry in South Africa, as well as their effect on lower-level professionals’ performance from their own perspective. An empirical analysis was undertaken using data, collected from active construction sites. A total of 104 respondents, essentially construction workers and, to a lesser extent, project managers, completed a three-part Likert scale questionnaire, administered on a voluntary basis. The data was analyzed using Excel and SPSS statistics softwares. The results from descriptive statistics, Spearman’s correlation, and the analysis of variance revealed that, firstly, the top five measures implemented include sanitization and hygiene, on-site access control using advanced technologies, keeping physical distance, training, and flexible working hours. Secondly, the findings suggest that direct health measures, such as sanitization, wearing personal protective equipment, keeping physical distance, and training, implemented by construction companies’ managers are the measures that improved their performance the most. However, the participants also indicated that actions, such as partial salary cuts and working in confine spaces, had a detrimental influence on their productivity. The limitation of the study is the use of a convenient sample that hinders the generalizability of the findings. The key contribution of this study is the identification of new factors that enhanced, other than remote work, or were an impediment to fieldworkers’ performance in the construction industry during the recent global health crisis. These outcomes might help to further understand the psychological effect of COVID-19 measures and the resulting influence on job performance. Another possible implication of the findings could be for the construction company decision-makers to consider as paramount the maximum utility of their field workers in order to preserve the overall productivity and strengthen the resilience of their businesses in times of health crises.

Qualitative data analysis software (QDAS) packages that support live data extraction are a relatively recent innovation. Little has been written concerning the research implications of differences in such QDAS packages’ functionalities, and how such disparities might contribute to contrasting analytical opportunities. Consequently, early-stage researchers may experience difficulties in choosing an apt QDAS for Twitter analysis. In response to both methodological gaps, this paper presents a software comparison across the four QDAS tools that support live Twitter data imports, namely, ATLAS.ti™, NVivo™, MAXQDA™ and QDA Miner™. The authors’ QDAS features checklist for these tools spotlights many differences in their functionalities. These disparities were tested through data imports and thematic coding that was derived from the same queries and codebook. The authors’ resultant QDAS experiences were compared during the first activity of a broad qualitative analysis process, ‘organising data’. Notwithstanding large difference in QDAS pricing, it was surprising how much the tools varied for aspects of qualitative research organisation. Notably, the quantum of data extracted for the same query differed, largely due to contrasts in the types and amount of data that the four QDAS could extract. Variations in how each supported visual organisation also shaped researchers’ opportunities for becoming familiar with Twitter users and their tweet content. Such disparities suggest that choosing a suitable QDAS for organising live Twitter data must dovetail with a researcher’s focus: ATLAS.ti accommodates scholars focused on wrangling unstructured data for personal meaning-making, while MAXQDA suits the mixed-methods researcher. QDA Miner’s easy-to-learn user interface suits a highly efficient implementation of methods, whilst NVivo supports relatively rapid analysis of tweet content. Such findings may help guide Twitter social science researchers and others in QDAS tool selection. Future research can explore disparities in other qualitative research phases, or contrast data extraction routes for a variety of microblogging services.

Background: For more than two decades, many municipalities have failed to render services effectively because of lack of competency and budget management skills to manage budgets. This has resulted in either over or under expenditure, which ultimately leads to poor service delivery.Aim: This study aimed to develop a budget management model to improve public service in South African municipalities.Setting: Three municipalities in the Western Cape, Eastern Cape and Free State are the areas where data were collected by researchers.Methods: A quantitative research approach was employed and an online questionnaire was used for data collection from 261 participants in three municipalities. A structural equation modelling approach was used to develop the budget management model.Results: The results revealed that risk management (RM), cash flow management (CFM) from employee perceptions have a positive impact on budget management; whereas CFM from general compliance with legislative consideration (LC) have a negative impact, budget planning (BP) and revenue and expenditure management (REM) have low impact on budget management for public service.Conclusion: The study highlights the key factors (i.e. RM, BP, CFM, LC and REM) as a result of which managers at various levels fail to manage budgets effectively. The proposed model adds new insights to respond to budget management challenges. It is recommended that municipalities must improve their budget management skills for an effective public service. Findings from this study contribute to the existing body of knowledge by proposing a budget management model for public service in South Africa.

There have been expectations across the developing world that information and communications technologies (ICTs) will deliver benefits to marginalised people. Despite many programmes related to the promotion of Internet uptake and usage amongst poorer communities, evidence regarding such benefit is lacking, and there is little agreement in respect of frameworks and metrics to evaluate the benefits thereof. This paper reports on a case study that investigated the nature of a public access information and communication technologies for development (ICT4D) programme and presents a framework for assessing the associated benefits in the South African context. The capability approach is used as a lens to assess the process of providing opportunities to ordinary citizens through ICT access and use. By operationalising agency and conversion factors, the study identified inhibitors and enhancers of opportunities and choices in realising benefits. Through the application of a critical realism paradigm and a mixed method analytical approach, perceptions of a changed life, aspirations for a better life, and “hope” emerged as key intangible benefits. The paper presents an ICT benefits framework, which serves as an important contribution to the ICT4D evaluation field. A novel outcome of the study is that it provides evidence of constructs that to date have been considered as intangible benefits in the literature.

Notwithstanding massive injections into broadband infrastructure, large sectors of the world’s population remain without access to the internet. One of the strategies employed by Government and the private sector to address the digital divide has been to provide basic computing services and internet access to communities in the form of public access centres (PACs) or otherwise known as telecentres. Over the years PAC related interventions have been subjected to much introspection, and critique, given a number of examples of failures. This paper examines a PAC program in South Africa which has been running with success for ten years. The paper reports on a study which includes data collected from more than two thousand four hundred users of PACs. The findings provide critical insights into the value proposition of PACs for communities in impoverished areas and whether this is still relevant from a policy perspective to tackle the digital divide. The findings also provide insights into the profile of users; the factors which impact on their choice of a PAC as an internet access point; and the extent to which there is a reliance on PACs. The most revealing finding from the study indicates that PACS provided the average user with something more than just an internet access point. The study has determined that PACs have a significant effect on the hopefulness a citizen has for his or her self, community and country.

Predicting outcome in severe traumatic brain injury using a simple prognostic model