AUDIT-C as a possible source of referral during the COVID-19 pandemic for participants presenting patterns of high-risk alcohol consumption in a South African township.

BACKGROUND: Unhealthy alcohol use is a leading contributor to premature death and disability worldwide. The World Health Organization's Global Status Report on Alcohol and Health ranked South Africa as having one of the riskiest patterns of alcohol consumption, which calls for intervention. Recognising the need for effective primary care interventions, particularly in the absence of appropriate alcohol-related harm reduction policies at national and local levels, this paper highlights the opportunities and challenges associated with a two-pronged, community-centred approach to the identification of unhealthy alcohol use and interventions. METHODS: This approach included the use of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) as a means of screening to identify individuals at moderate (score of 5-7) to high risk (score of 8 +) alcohol use, raising awareness, and investigating the potential utility of brief advice and referrals as a means of reducing risk. RESULTS: Of the 54,187 participants, 43.0% reported engaging in moderate-risk alcohol consumption, with 22.1% reporting high-risk alcohol consumption. Resistance to brief advice was observed to increase with higher AUDIT-C scores. Similarly, participants engaging in high-risk alcohol consumption were resistant to accepting treatment referrals, with fewer than 10% open to receiving a referral. CONCLUSIONS: While men were most likely to report patterns of high-risk alcohol consumption, they were more resistant to accepting referrals. Additionally, participants who were willing to receive brief advice were often resistant to taking active steps to alter their alcohol use. This study highlights the need to consider how to prevent harmful patterns of alcohol use effectively and holistically, especially in low socioeconomic settings through primary health care and community services.

Lay counsellors' experiences of administering the AUDIT-C as a brief screening tool in a South African township.

BACKGROUND: South Africa presents one of the riskiest patterns of alcohol consumption, with per capita consumption above the African regional average. Globally, there has been an increased focus on the potential of appointing lay counsellors to administer alcohol intervention strategies in resource-limited contexts. Given the increasing need for relevant and efficient intervention strategies in response to high-risk alcohol consumption, screening instruments such as the AUDIT-C have gained increased attention. METHODS: This paper explores the experiences of 15 lay counsellors in response to the training received on how to administer the AUDIT-C instrument, as well as provide interventions such as brief advice or an appropriate referral, in the resource-limited South African township of Alexandra, Johannesburg. A focus group was facilitated for this purpose and, thereafter, a thematic content analysis was applied to identify the themes most central to the lay counsellors' experiences. RESULTS: The research findings suggest that the lay counsellors perceived the training to be adequate in preparing them for administrating the AUDIT-C and for providing any relevant interventions, and that their confidence in administering the instrument developed as the project progressed. However, recruitment and administration challenges were experienced in primary healthcare and community settings, and lay counsellors perceived home visits to be more appropriate with respect to issues related to confidentiality and stigmatisation. CONCLUSION: Overall, while lay counsellors feel that the training they received on the tool and the tool itself is useful for effectively implementing the AUDIT-C in low-resource communities, the availability and efficiency of alcohol treatment services in Alexandra Township need to be improved.

Chromite chemistry of a massive chromitite seam in the northern limb of the Bushveld Igneous Complex, South Africa: correlation with the UG-2 in the eastern and western limbs and evidence of variable assimilation of footwall rocks.

The Bushveld Igneous Complex (BIC) is known for its laterally extensive platinum group element-bearing layers, the most famous being the Merensky Reef and the UG-2 chromitite in the eastern and western limbs of the complex. In the northern limb, the Platreef mineralization and a thick chromitite seam below it (referred to as the "UG-2 equivalent" or UG-2E) have been proposed to be the stratigraphic equivalents of the Merensky Reef and the UG-2, respectively. In this study, we compare a suite of UG-2E samples from the Turfspruit project with a UG-2 reference suite from the western limb using petrography, electron probe microanalysis, laser ablation-inductively coupled plasma-mass spectrometry, and Mössbauer spectroscopy. The results show that (a) in Mg# vs. Cr# diagrams, UG-2E chromites have a distinct compositional field; however, when samples of similar chromite modal abundance (≥ 80%) are used, the UG-2E chromites overlap the field that characterizes UG-2 chromites; (b) the UG-2E is more variable in chromite modal abundance than the UG-2; and (c) variations in Mg# and Fe3+/ΣFe in the UG-2E indicate contamination of the magma by metasedimentary rocks of the Duitschland Formation (Transvaal Supergroup) during emplacement, followed by partial re-equilibration of chromite grains with a trapped melt. Thus, we conclude that for chromite modes higher than 80%, the chromite composition retains enough information to allow correlation and that the UG-2E in the northern limb is very likely the UG-2 chromitite.

"You see this thing is hard ey, this thing is painful": The burden of the provider role and construction of masculinities amongst Black male mineworkers in Marikana, South Africa.

In this paper we examine men's insights on how migration and minework affect their perceptions and performances of masculinity in the settings of minework and in their "real home" communities and explore the potential consequences of masculinity constructions for their own and their family's health. This study used qualitative methodology. Findings are based on 13 in-depth interviews conducted over two phases of data collection with adult men who were either working or seeking work in the mines in North-West province, South Africa. Data suggest that for these men, migration to and working in the mines meant they must straddle the temporal space of work and the rural home space. For these men, the role of provider was an inescapable demand and, resulting from migration for work, their experience of fatherhood was solely centred on material provision with little or no emotional involvement with their children. Findings further illustrate the impact of minework on men's health and livelihoods-resulting in some men reimagining and seeking to create alternative career paths for their children. There is pressing need for labour reforms on the employment conditions of low-paid mine workers to enable them to reinforce their livelihoods and secure better futures for their families. Gender-transformative interventions which aim to transform ideas of masculinity that emphasize providing rather than emotional involvement with children are also needed.

The second wave of violence scholarship: South African synergies with a global research agenda.

Violence is a serious public health and human rights challenge with global psychosocial impacts across the human lifespan. As a middle-income country (MIC), South Africa experiences high levels of interpersonal, self-directed and collective violence, taking physical, sexual and/or psychological forms. Careful epidemiological research has consistently shown that complex causal pathways bind the social fabric of structural inequality, socio-cultural tolerance of violence, militarized masculinity, disrupted community and family life, and erosion of social capital, to individual-level biological, developmental and personality-related risk factors to produce this polymorphic profile of violence in the country. Engaging with a concern that violence studies may have reached something of a theoretical impasse, 'second wave' violence scholars have argued that the future of violence research may not lie primarily in merely amassing more data on risk but rather in better theorizing the mechanisms that translate risk into enactment, and that mobilize individual and collective aspects of subjectivity within these enactments. With reference to several illustrative forms of violence in South Africa, in this article we suggest revisiting two conceptual orientations to violence, arguing that this may be useful in developing thinking in line with this new global agenda. Firstly, the definition of our object of enquiry requires revisiting to fully capture its complexity. Secondly, we advocate for the utility of specific incident analyses/case studies of violent encounters to explore the mechanisms of translation and mobilization of multiple interactive factors in enactments of violence. We argue that addressing some of the moral and methodological challenges highlighted in revisiting these orientations requires integrating critical social science theory with insights derived from epidemiology and, that combining these approaches may take us further in understanding and addressing the recalcitrant range of forms and manifestations of violence.

Contested multiple voices of young masculinities amongst adolescent boys in Alexandra Township, South Africa.

OBJECTIVE: In this paper, the author explores how adolescent boys negotiate multiple voices of masculinity in Alexandra Township, a historically working-class and black community in Gauteng, South Africa. METHOD: Thirty adolescent boys were recruited and provided with disposable cameras to take 27 photos under the theme 'my life as a boy' in the new South Africa. Arrangements were made for photos to be collected and processed. In the follow-up interviews, boys were asked to give a description of each photo and why and how they had decided to take that photo to represent aspects of their masculinity. Results Some of the photos taken depict books, cars, boys smoking, gambling, fighting and reading books at school. CONCLUSION: This study reveals that being a boy is not a homogeneous phenomenon. All the participants agreed that there are different ways of being a boy and that some boys are more popular than others, which often depends on the context in which the boys find themselves. The interviews revealed recurring allusions to different 'types' of boys at schools in Alexandra Township-namely, tsotsi boys and academic boys. However, it is important to note that boys do not fit neatly into each of these categories. The findings of the study reveal some interesting complexities on how adolescent boys simultaneously accept and reject certain practices of township masculinity in their daily lives, depending on the time and space in which they find themselves. Some positions are more dominant than others and this reveals how adolescent boys 'police' each other as part of a process of conforming to idealised norms of township masculinity as lived out in the township context of Alexandra.