COVID-19-related alcohol sales bans and stay-at-home orders prompted the alcohol industry in South Africa to increase their online alcohol sales promotions. We investigated changes in alcohol-related behaviour and the drivers of illegal alcohol sales through a self-reported Facebook survey that ran from July to November 2020. Questions included socio-demographics and comparison of alcohol purchasing behaviour and intake during 2019 and 2020. Statistical tests were applied to find associations between illegal alcohol purchasing and alcohol-related behaviours. A total of 792 participants took part in the survey, 69.7% of whom were female. During lockdown periods, most participants (55.3%) bought alcohol illegally from illegal outlets or friends. Online alcohol-delivery marketing increased by 20 percentage points from 2019 to 2020, with participants stating that they saw a lot of advertisements per day and 80% of persons under 25 years were not asked to verify their age in 2020 upon delivery. Home-brewed beer and vodka intake increased in 2020 during the alcohol sales bans. Men from the Western Cape who engaged in daily or weekly heavy episodic drinking were more prone to purchase alcohol illegally. The Western Cape, which is South Africa's most prolific wine-producing region, had the highest odds of people buying alcohol illegally, with wine being found to be the most frequently bought alcohol online and consumed by these participants. There is a need for further research into the differences in alcohol-related behaviour affecting illegal alcohol purchasing according to income group, proximity to alcohol producers and underage alcohol sales and marketing through online applications. SIGNIFICANCE: • Alcohol sales bans have the potential to reduce and stop the alcohol intake of moderate drinkers, but may make heavy episodic drinkers drink more than usual. • During COVID-19 lockdown, illegal alcohol sales were taking place through unlicenced alcohol outlets and friends, and not through licenced online applications. • Unlicenced alcohol outlets need to be addressed to prevent future illegal alcohol sales. • Stricter regulations aimed at legal online alcohol sales applications should be put in place to prevent alcohol sales to minors and those who have already consumed too much alcohol. • There should be a ban on marketing of addictive substances, such as alcohol.

Drought is one of the most hazardous natural disasters in terms of the number of people directly affected. An important characteristic of drought is the prolonged absence of rainfall relative to the long-term average. The intrinsic persistence of drought conditions continuing from one month to the next can be utilized for drought monitoring and early warning systems. This study sought to better understand drought probabilities and baselines for two agriculturally important rainfall regions in the Western Cape, South Africa - one with a distinct rainfall season and one which receives year-round rainfall. The drought indices, Standardised Precipitation and Evapotranspiration Index (SPEI) and Standardised Precipitation Index (SPI), were assessed to obtain predictive information and establish a set of baseline probabilities for drought. Two sets of synthetic time-series data were used (one where seasonality was retained and one where seasonality was removed), along with observed data of monthly rainfall and minimum and maximum temperature. Based on the inherent persistence characteristics, autocorrelation was used to obtain a probability density function of the future state of the various SPI start and lead times. Optimal persistence was also established. The validity of the methodology was then examined by application to the recent Cape Town drought (2015-2018). Results showed potential for this methodology to be applied in drought early warning systems and decision support tools for the province.

Damage caused by soils subject to change in volume beneath light structures, particularly low-cost housing units of masonry construction, is unacceptably frequent. It has led to the demolition of many such units within a small fraction of their design lifespan. Perhaps the most spectacular such failure is Lerato Park in Kimberley, where the development was demolished within four years. The reason for this failure is examined in Stott and Theron (2016). The normal ways of attempting to reduce heave damage have involved increasing the strength and stiffness of foundations, together with reducing masonry panel size through movement joints and increasing the strength of the panels. While these measures have improved the situation somewhat, they are expensive and have proved to be only partially successful. This investigation examines the possibility of increasing the ability of masonry panels themselves to accommodate significant distortion without sustaining unacceptably serious cracking. The existing specifications in SANS 10164 (SANS 10164 2000) are shown to allow considerably greater inherent flexibility than current practice allows. This is dependent on the specified quality of sand (frequently ignored) and water demand requirements, as specified in South African standards, being adhered to.

The global emphasis on conserving energy resources has led to the adoption of hybrid power systems in vehicles. Optimally applied, hybrid systems can save up to 40% on fuel costs. To optimally manage a hybrid vehicle's energy flow it is necessary to know, in real time, all the energy requirements to complete a given route. The energy consumption depends mainly on the vehicle mass, speed profile, and route topography. Of these, the topographic profile is the one factor that is only route-dependent and not influenced by the vehicle or driving styles. The heading vs. distance profile is also an example of a route characteristic not influenced by the vehicle or driving style. In this study the topographic and heading profiles are used to identify routes, and are easily measured by means of digital barometric pressure and compass sensors. Correlations between the current route and previously travelled/stored routes are performed based on their topographic and heading profiles in a point-by-point manner. Above-ground tests were first performed using a road vehicle and six routes to evaluate the system. The system consistently and correctly identified a 20 km route within the first 4 km. It also proved to function correctly in underground tests through the implementation of an instrumented hand-held surveyor's wheel. This system finds direct practical application in optimizing the energy management of an underground hybrid locomotive used by the mining industry in South Africa, but can also be of benefit in applications where route identification is required and using GPS is not feasible.

The food supply chain is a significant contributor to climate change. By following a climate-friendly diet, consumers have the potential to significantly reduce the effects of climate change. However, despite the growing awareness of the climate-friendly food options that are available, consumers still choose foods with a high carbon footprint. Following a survey design, this study aimed to determine the extent to which four psychological processes (denial, conflicting goals and aspirations, tokenism, and interpersonal influence) limited climate-friendly food choices in a sample of adult consumers residing in Gauteng, South Africa. Data were collected from 146 participants using the Climate-friendly Food Choices Scale and the Psychological Barriers Scale. Results indicated that, overall, the barriers were negatively associated with climate-friendly food choices. Regression analysis indicated that the four psychological barriers explained 10.S % of the variance in climate-friendly food choices. Conflicting goals and aspirations and denial were identified as the two main psychological barriers to climate-friendly food choices. It is therefore essential to consider the psychological processes that could have a limiting effect on the adoption of climate-friendly food choices in our approach to encourage pro-environmental change.

BACKGROUND: Tenofovir disoproxil fumarate (TDF) is classified as a nucleoside reverse transcriptase inhibitor (NRTI). TDF is integral to several first-line treatment regimens for HIV and post-exposure prophylaxis. This case details an example of severe tenofovir-induced osteopaenia. We hope to raise awareness of this side effect so that it may be screened for more effectively and to provide an approach to management in secondary care. CASE REPORT: We present the case of an HIV-positive, 52-year-old woman who had been on TDF treatment for over ten years. She presented complaining of progressively worsening weakness, bone pain and immobility and sustained spontaneous fractures of multiple long bones. Tenofovir-induced hypophosphaetemic osteomalacia and osteopaenia was diagnosed based on clinical, radiographic and laboratory findings. DISCUSSION: The patient was successfully treated through the fixation of her long bone fractures with intramedullary nails and prophylactic nailing of the remaining long bones in her lower extremities. She received calcium and phosphate supplementation, and the causative agent was stopped. CONCLUSION: HIV-positive patients on TDF should be screened routinely for renal function, and symptoms such as bone pain should not be ignored. Cessation of the causative agent and correct supplementation are critical adjuncts to surgical intervention for improved outcomes in these patients. In cases of severe osteopaenia, orthopaedic surgeons should consider prophylactic fixation of long bones and use intramedullary fixation where possible. Level of evidence: Level XX

Materials delivered on public works project sites deviate from technical specifications, with detrimental implications for the quality of the construction process and product. When delivered materials differ from specifications, quality issues such as defects and re-work ensue at greater cost to the clients. The inadequate application of concepts and techniques of quality improvement also appears to perpetuate the problems. This study aims to find answers as to which quality improvement protocol would ensure that materials are delivered on construction sites as specified by the engineers. A case-based design with multiple data-collection techniques and points was expedited in the study. The primary data collected through a semi-structured, self-administered questionnaire, semi-structured interviews, and purposive sampling from the Department of Public Works and Infrastructure's technical personnel provided the platform for compiling a quality improvement protocol contextualised for the Department of Public Works and Infrastructure in the Free State, which constituted the case study. The statistical and textual data outlined how the department could address quality planning, quality control, and quality improvement concerning materials delivery for public works projects. The article's contribution is the proposed quality improvement protocol that should guide the specification and delivery of construction materials for projects.

Materiaal wat gelewer word vir openbare werke projekte wyk af van tegniese spesifikasies met nadelige gevolge vir die kwaliteit van die konstruksieproses en produk. Met aflewering variëer materiale van spesifikasies, en gehalte kwessies soos defekte en addisionele werk volg, met die kliënt wat addisionele kostes ervaar. Hierdie probleme dui op 'n gebrek aan kwaliteit tydens beide die ontwerp en konstruksieproses rakende materiaalbestuur. Die onvoldoende toepassing van kwaliteitverbetering konsepte en tegnieke blyk ook by te dra tot die bogenoemde probleme. Die doel van die studie is dus om 'n gepaste kwaliteitverbeteringsprotokol te vind wat sal verseker dat afgelewerde materiale voldoen aan die nodige ingenieurs-spesifikasies. 'n Gevallestudie-gebaseerde ontwerp met veelvuldige data-insamelingstegnieke is gebruik om die studie te bespoedig. Dit is gebaseer op pragmatisme as navorsingsfilosofie wat daarop gemik is om werklike probleme op te los. Die primêre data is versamel met behulp van 'n semi-gestruktureerde, self-geadministreerde vraelys, semi-gestruktureerde onderhoude en dokumentontleding. Dit het die platform verskaf vir die samestelling van 'n kwaliteitsverbeteringsprotokol wat gekontekstualiseer is vir die Departement van Openbare Werke en Infrastruktuur in die Vrystaat provinsie. Die statistiese en geskrewe data toon hoe die departement die kwessies rakende kwaliteit-beplanning, -beheer, en -verbetering met betrekking tot materiaallewering op Openbare Werke projekte kan aanspreek. Die artikel se bydrae is die voorgestelde gehalteverbeteringsprotokol rakende die spesifikasie en aflewering van konstruksiemateriale.

One hundred and twelve cross- and purebred pasture-reared lambs were slaughtered at optimal backfat thickness (4 mm). Selected slaughter, carcass, and meat quality characteristics of these animals were assessed. Slaughter age, but not weight, was influenced by genotype, whereas rams were younger and heavier at slaughter than ewes. Throughout, the crossbred genotypes were younger at slaughter than their purebred contemporaries. Merinos had a lower dressing percentage (40.74%) than Dohne Merinos (43.89%), which in turn dressed out substantially lower than all crossbred combinations (~47%). Genotype did not influence the fat or bone percentage in the carcass, but differences existed for the meat percentage. Meat from all groups could be described as very tender (<32.96 N) and acceptable even to consumers not preferring pasture-produced lamb. The reduced slaughter age of crossbred lambs presents the possibility of shortening the production cycle of lamb while simultaneously increasing carcass yields.

BACKGROUND: Energy-dense, nutrient-poor snacks are associated with an increased risk of non-communicable diseases (NCDs) and the double burden of malnutrition, especially among poor communities. AIM: To determine and compare the snacking preferences and consumption frequency of children and adults from a low SES community in South Africa. SETTING: A preschool, primary school, and an elderly centre in Gauteng. METHODS: A cross-sectional study with a convenience sample of 90 children (3-8 years) and 100 adults (≥ 18 years) to assess snack consumption frequency and preferences of children and adults by means of a snack survey. Mann-Whitney U test was used to determine the differences in preferences and snack consumption frequency of children and adults. RESULTS: The most preferred and consumed snacks included fruits, potato chips, corn chips, sweets, and cookies. Children frequently ate more potato chips (p < 0.001), corn chips (p < 0.001), cheese curls (p < 0.001), and muffins (p = 0.024) than adults. In contrast, adults frequently consumed more peanuts or nuts (p = 0.024), savoury biscuits (p = 0.048) and biltong (p < 0.001) than children. CONCLUSION: Apart from fruits, the most preferred and frequently consumed snacks by the sample were highly processed snacks, which are low in fibre and high in added sugars, saturated fat, and sodium. CONTRIBUTIONS: Findings from this study highlight current snack trends and can guide future nutrition education interventions on healthy snacking and in developing nutritious snacks for the South African community.

ABSTRACT Left atrioventricular valve aneurysm is a rare condition. Here we present a rare case of partial atrioventricular septal defect with an extremely thin left atrioventricular valve aneurysm mimicking valve perforation. Preoperative echocardiography demonstrated severe left sided atrioventricular valve regurgitation on the “cleft” and leaflet perforation. But we discovered a left sided atrioventricular valve aneurysm instead of a valve perforation. The “cleft” edge and the aneurysm were closed. condition perforation cleft “cleft closed

BACKGROUND: To improve maternal health, studies of maternal morbidity are increasingly being used to evaluate the quality of maternity care, in addition to studies of mortality. While South Africa (SA) has a well-established confidential enquiry into maternal deaths, there is currently no structure in place to systematically collect and analyse maternal near-misses (MNMs) at national level OBJECTIVES: To synthesise MNM indicators and causes in SA by performing a systematic literature search, and to investigate perceived needs for data collection related to MNMs and determine whether the MNM tool from the World Health Organization (WHO-MNM) would require adaptations in order to be implemented METHODS: The study used a mixed-methods approach. A systematic literature search was conducted to find all published data on MNM audits in SA. Semi-structured interviews were conducted virtually with maternal health experts throughout the country who had been involved in studies of MNMs, and main themes arising in the interviews were synthesised. A method for MNM data collection for SA use was discussed with these experts RESULTS: The literature search yielded 797 articles, 15 of which met the WHO-MNM or Mantel et al. severe acute maternal morbidity criteria. The median (interquartile range) MNM incidence ratio in SA was 8.4/1 000 (5.6 - 8.7) live births, the median maternal mortality ratio was 130/100 000 (71.4 - 226) live births, and the median mortality index was 16.6% (11.7 - 18.8). The main causes of MNMs were hypertensive disorders of pregnancy and obstetric haemorrhage. Eight maternal health experts were interviewed from May 2020 to February 2021. All participants focused on the challenges of implementing a national MNM audit, yet noted the urgent need for one. Recognition of MNMs as an indicator of quality of maternity care was considered to lead to improved management earlier in the chain of events, thereby possibly preventing mortality. Obtaining qualitative information from women with MNMs was perceived as an important opportunity to improve the maternity care system. Participants suggested that the WHO-MNM tool would have to be adapted into a simplified tool with more clearly defined criteria and a number of specific diagnoses relevant to the SA setting. This 'Maternal near-miss: Inclusion criteria and data collection form' is provided as a supplementary file CONCLUSION: Adding MNMs to the existing confidential maternal death enquiry could potentially contribute to a more robust audit with data that may inform health systems planning. This was perceived by SA experts to be valuable, but would require context-specific adaptations to the WHO-MNM tool. The available body of evidence is sufficient to justify moving to implementation

Young adults are often scapegoated for not complying with COVID-19 mitigation strategies. While studies have investigated what predicts this population's compliance and non-compliance, they have largely excluded the insights of African young people living in South African townships. Given this, it is unclear what places young adult South African township dwellers at risk for not complying with physical distancing, face masking and handwashing, or what enables resilience to those risks. To remedy this uncertainty, the current article reports a secondary analysis of transcripts (n=119) that document telephonic interviews in June and October 2020 with 24 emerging adults (average age: 20 years) who participated in the Resilient Youth in Stressed Environments (RYSE) study. The secondary analysis, which was inductively thematic, pointed to compliance being threatened by forgetfulness; preventive measures conflicting with personal/collective style; and structural constraints. Resilience to these compliance risks lay in young people's capacity to regulate their behaviour and in the immediate social ecology's capacity to co-regulate young people's health behaviours. These findings discourage health interventions that are focused on the individual. More optimal public health initiatives will be responsive to the risks and resilience-enablers associated with young people and the social, institutional, and physical ecologies to which young people are connected. SIGNIFICANCE: • Emerging adult compliance with COVID-19 mitigation strategies is threatened by risks across multiple systems (i.e. young people themselves; the social ecology; the physical ecology). • Emerging adult resilience to compliance challenges is co-facilitated by young people and their social ecologies. • Responding adaptively to COVID-19 contagion threats will require multisystem mobilisation that is collaborative and transformative in its redress of risk and co-championship of resilience-enablers.

Abstract We investigate how competing forces interdiscursively manifest in Japan-based higher education through a critical discourse analysis (Fairclough, 1993, 1995). Higher education job advertisements are constitutive of institutions’ public images that are targeted toward academics in specific fields. They are discursive spaces where marketized discourse has colonized previously dominant discourses of universities as independent authorities (Fairclough, 1993, 1995). Such marketized discourses within higher education express neoliberal ideologies and free-market conventions (Ball, 1998; Pack, 2018). However, the international extent of university discourse marketization is largely implicitly assumed rather than empirically examined, hence we investigate these forces with respect to Japanese higher education.

The failure of tailings storage facilities (TSFs) results in the discharge of significant quantities of hazardous waste material into the natural environment. Research studies relating to slope instability have identified physical mechanisms such as rainfall-induced erosion, liquefaction, and shear failure as the main triggers. The generation of transient pressure waves and the mobilization of pre-event water in the unsaturated zone have been found to trigger shallow landslides in natural hillslopes. In this paper we review these physical mechanisms, known as groundwater ridging (GWR) and the Lisse effect (LE), from other studies. Previous researchers have explained both these phenomena through field and laboratory observations, numerical modelling, as well as conceptual discussions. These case studies demonstrate the impact of rainfall characteristics on the generation of transient pressure waves that rapidly increase the phreatic surface and change pore water suction. Reference is also made to the influence and behaviour of physical porous medium characteristics on the establishment of a continuous water phase that facilitates the transmission of an induced pressure head. However, previous studies fail to recognize the possibility that the pressure increase in pre-event water through pore air propagation could cause slope instability in tailings dams. The authors suggest that the physical properties and hydraulic behaviour of unsaturated porous tailings media make it susceptible to GWR and the LE, resulting in the creation of a potential failure plane.

In South Africa, environmentally and socio-economically sustainable wine grape production is promoted by governmental and private initiatives. All the initiatives contribute to establishing a scientifically based response strategy of agro-systems to ensure sustainable production under future expected climate conditions. South African wine grape producers would probably have to cultivate their grapevines under higher atmospheric CO2 levels and in warmer, mostly drier, conditions. Due to the projected increase in climatic variability, an effort must be made to improve the resilience of vines against these environmental conditions. Whole-vine functioning and balances should be considered when adjustments are made to current long and short term cultivation practices. All practices should be aimed at promoting the development of a deep, dense and buffered root system that is able to support a well-developed canopy with optimal microclimate that would sustain a high yield of good quality. Mitigation and adaptation strategies would most likely have to be region specific, and small scale terroir data, (which should include both climate and terrain/soil information) may play a critical role in decision-making.