POSITIVE LIVING STRATEGIES THAT CAN BE LEARNED FROM STUDIES ON NEAR-DEATH EXPERIENCES AND LIFE-THREATENING ILLNESSES

This article addresses the two related issues of near-death experience and life-threatening illness with a view to helping survivors and helping professionals appreciate how to make sense of the experience whilst considering future living and future service provision. The article is based on two related research studies, citing literature from different disciplines of nursing, women’s health, spirituality and near death. This research was undertaken in the light of these experiences affecting so many aspects of life and living. The need to “dialogue with death” (Easwaran, 2008: Foreword) and life-threatening illness is the key message as opposed to shunning what is not readily understood and appreciate

DATING AND SEXUAL CHALLENGES FACED BY HIV-POSITIVE PEOPLE IN KWAZULU-NATAL, SOUTH AFRICA

According to the 2010 UNAIDS Report, an estimated 320 000 (or 20%) fewer people died of AIDS-related causes in 2009 when compared to figures in 2004 in sub-Saharan Africa, when antiretroviral therapy was markedly expanded (UNAIDS, 2010). This decreased mortality rate offers hope for HIV-infected people to plan a future, part of which will include dating and sexual relationships. The Report cites KwaZulu-Natal in South Africa as being at the heart of the HIV/AIDS epidemic; this article is based on research on dating and sexuality among HIV-positive people in KwaZulu-Natal.Dating and sexuality are an integral part of living. Yet HIV-positive persons are denied intimacy at a time when this is most needed (Kasiram in Kasiram, Partab & Dano, 2006). Little is known about the full range of sexual adaptations that HIV-infected individuals choose (Schiltz & Sandfort, 2000). Kasiram, Partab, Dano and Van Greunen (2003:9) cite interaction and intimacy among HIV-positive persons as a neglected research focus, while Painter (2001) adds that insufficient attention is afforded to couple relationships for infected people.An important reason that motivated this study on dating and sexual challenges faced by HIV-positive people was the first author’s (the main researcher’s) personal experience of being HIV positive and counselling and life coaching HIV-positive people. She is confronted regularly with variations of the question “Will I be normal?”, which often translates to: “Will I be able to date and have se

Influence of fluidity and Hausner’s ratio in the process behaviour of P/M of Al -% wt Cu Composite

The term ‘P/M’ covers the art of producing objects from metal powders or without adding any non metallicconstituents and without completely melting material. In order to produce engineering material one shouldstudy the flow of the powder. Because the powders may be pressed to the desired form in a suitable die andsubsequently heated to produce a welded alloyed or coalesced mass. The wide spread use of powders in theP/M industry has generated a variety of methods for characterizing the powder flow. Hence this paperdescribes the role of flow rate and fluidity of the powder composition which is taken for the investigationpurpose. The study helps the material may then be suitable for immediate use or may be further worked byconventional methods. Because the strength of finished engineering product depends on the flow rate of thepowder. Moreover the fluidity offers best article production with unique properties which is not obtained byother methods. The best example is bearings and filters with controlled porosity. For investigation purposevarious compositions of Al-Cu powder is used. With small variation the result is obtained. It is understoodthat the composition of Al –Cu is neither pyrophoric nor toxic in nature

Assessing and serving families and communities responsibly: challenges posed in an urban, marginalised setting

Service provision to families and communities has long been recognised as a complex undertaking involving a multiplicity of role players and systems of care. Systems theory and ecological theory provide useful frameworks for understanding and servicing families and communities, yet there is a clear absence of literature and research on how to converge microsystemic with macrosystemic interventions. Using Rojano\'s1 community family therapy model, which is applicable to South American communities, and Kasiram and Oliphant\'s2 strategies for changing traditional family therapy to suit broader contexts in South Africa, the authors used developmental research within a qualitative framework to develop an indigenous community family therapy model in an urban setting in KwaZulu-Natal, South Africa. The authors utilised nursing students as fieldworkers and service providers in this study. The research process involved several steps: a state-of-the-art review of the family and community, achieved through an assessment of the family and community through community profiling and an epidemiological study of the community; family assessment of families with one child under the age of five years; best practice and model development to intervene at the family and community levels, achieved with the help of community and school meetings and workshops to identify and prioritise needs and problems, followed by bio-psychosocial interventions; refining the model achieved by an evaluation of the interventions through report assessment and on-site assessment and recommending model adjustments based on the evaluation. In designing a community family therapy model, the state-of-the-art review of community needs established several core issues requiring services/interventions. These were problems relating to HIV/AIDS; a lack of knowledge of the immunisation programme in South Africa and of the Road to Health chart; teenage pregnancy and its relationship to risky behaviours, HIV/AIDS, poverty and crime; and a lack of communication within the family. The development of the model involved determining interventions with families and the community, using macrosystemic approaches, such as community meetings and workshops, where priorities were established and joint strategies were planned to address the identified problems. Individual and small-group discussions enriched the understanding of problems/needs, which, combined with macrosystemic approaches such as media coverage and community meetings and workshop/events, worked in synchrony to effectively assess and then service the families and communities. The goal of developing a community family therapy model was achieved. Combining microsystemic and macrosystemic approaches to assess and serve families and communities is particularly helpful in the face of apathy. However, once momentum is achieved in securing a community spirit, it needs to be sustained or else it is lost and may require more effort to reclaim in the future. Thus, if services are provided by educational institutions, it would be in the best interests of both future students and the community if there is funding to support service outside of the academic year..South African Family Practice Vol. 49 (9) 2007: pp. 4-

CHILDREN’S HOMES AND FOSTER CARE: CHALLENGING DOMINANT DISCOURSES IN SOUTH AFRICAN SOCIAL WORK PRACTICE

The dominant view in South Africa and internationally, supported by various legislative tools, isthat vulnerable children are best cared for in foster homes as compared to Children’s Homes(Kiraly, 2001; Long, 2007; McKay, 2002; Morei, 2002). Legislation in South Africa pertainingto the care and protection of children is presently under review. The Children’s Bill consists oftwo sections: Section 75 and Section 76. Section 75 of the Bill was signed by President Mbeki inJune 2006, and is called the Children’s Act 38/2005 and Section 76 of the Bill remains beforeparliament, being referred to as the Children’s Amendment Bill [B19-2006]. The Children’s Act38/2005 is not operational as yet and social service providers are still using the Child Care Act74/1983. It is envisioned that the Children’s Act 38/2005 will replace the Child Care Act74/1983 in 2008 (Jacobs, Shung-King & Smith, 2005). Should alternative care be necessary fora vulnerable child, the Children’s Act 38/2005 prioritises a foster care placement over a childand youth care centre, of which a Children’s Home is a part (Section 46(1)(a)). Given the steadydecline in traditional family living as a result of, amongst other factors, HIV/AIDS, poverty andunemployment in South Africa, the dominant view of family care being prioritised may notalways be a feasible option. Of course, sound social work practice, where individual needsmatch placement, must always predominate in the decision on the placement of the child. Thearticle critically reviews two alternative care options from an ecological and structural socialwork framewor

THE STATUS OF SOCIAL WORK AS PERCEIVED BY KEY HUMAN SERVICE PROFESSIONALS

First-hand experience in various practice settings points to large-scale misunderstanding,ignorance and undervaluing of social work. In fact, it may be argued that the social worker isoften confused, lacks confidence and has a weak voice when compared to other professionals.Barter (cited in Shera, 2003:203) adds that the profession is indeed actively marginalised and islosing ground to nurses, health workers and occupational therapists. Dane and Simone (cited inDittrich, 1994:19) also mention this marginality and token status that is generally attributed tosocial workers in secondary settings such as hospitals, schools, legal aid offices, nursinghomes, business and industry. Their explanation for this perception is that, where socialworkers are few in number but their visibility high, this may lead to their decisions beingconstantly scrutinised, thereby undervaluing and undermining their worth. To add to thiscomplexity these writers introduce the dimension of gender into the undervaluing of theprofession, stating that social work may be “devalued as women’s work in such settings that arepredominantly male in inspiration” (Dittrich, 1994:20)

EXPERIENCES OF SOUTH AFRICAN SOCIAL WORKERS IN THE UNITED KINGDOM

This article forms the third phase of a research study conducted to explore the exodus of socialworkers from South Africa to the United Kingdom (UK). Already reported in a previous article(Naidoo & Kasiram, 2003) are phases one and two of the study wherein the views of two samplegroups were explored on relocation in South Africa. This third phase explored the needs, problemsand benefits experienced by social workers working in the UK. Social workers abroad were askedabout the following questions:· What made social work practice in South Africa problematic?· Was their South African education and training relevant?· What were the benefits of working in the UK?· What were the challenges to working in the UK?· What suggestions did they have for the survival of social work in South Africa

UNDERSTANDING THE SEXUALITY OF PERSONS WITH INTELLECTUAL DISABILITY IN RESIDENTIAL FACILITIES: PERCEPTIONS OF SERVICE PROVIDERS AND PEOPLE WITH DISABILITIES

The sexual expression of persons with intellectual disability is a neglected area, more particularly in residential facilities. This article is based on research to explore the perceptions of sexuality of persons with disability in residential facilities in Gauteng, South Africa. Results pointed to stereotyping, infantilisation and the sexuality of persons with disability not being prioritised at institutions, as evidenced in oppressive practices and policies pertaining to lack of privacy, denial of intimate relationships, lack of sexuality policies and paucity of sexual health education programmes at the residential facilities

Treatment for Substance Abuse in the 21st century: A South African Perspective

Background: It has become increasingly difficult to assist an individual to maintain long-term recovery from substance abuse. Irre-spective of which treatment centre the individual has been to, none guarantees a successful recovery. This is frustrating to individuals, their families and service providers. The reason for this trend is not absolutely clear. Many treatment centres are rigid in the use of their programmes and depend on aftercare to improve recovery rates.1 Service providers are increasingly acknowledging that there is no one “best treatment” option, as there are too many variations and complexities in reaching the goal of freedom from dependence and social reintegration.2 Hence the focus of this article is on research that has been undertaken to identify the strengths and weak- nesses of the different models/programmes used in different residential treatment centres in South Africa with a view to recommen-ding changes to accommodate such complexities and sustain recovery. Methods: Qualitative methodology was used to assess the strengths and weaknesses of programmes at three key residential rehabilitation centres in South Africa. The sample comprised both patients and service providers at each centre and the research instrument was focus group discussions with the former and individual, semi-structured interviews with the latter. Non-probability criterion sampling was employed to secure the participation of the required categories3 of treatment centres, and probability sampling was used thereafter, based on availability of respondents (both patients and staff) and easy access to them. Results: Despite tradition dictating a fairly rigid programme, most of the centres' staff and patients requested attention to the full biopsychosocial self of the patient, instead of being unidimensional such as paying more attention to one aspect at the expense of another such as to the physical as in the case of the disease model. A key finding was the need for a paradigm shift away from the disease model, with its accompanying helplessness, to that of a holistic approach that emphasises empowerment, embraces alternative strategies such as massage, sauna for detoxification, dietary improvements and physical activity, and uses language that is consistent with power and control. The centres also employed a multidisciplinary team, consistent with a focus on the “mind, body and spirit”, albeit requesting additional staff to comprehensively and effectively address all aspects of the holistic approach. Thus, they accorded importance to the spiritual dimension of the patient, although this did not always translate to action or programme content. Conclusion: The weakness of existing programmes was clearly found to lie in a unidimensional philosophy and a programme that was repetitive and unchanging. Staff and students identified the need for more holistic, comprehensive and creative approaches. These had to complement traditional strategies, rather than replace them, in accordance with the multi-faceted and multi-layered complexities of substance abuse. In keeping with this finding was the call for in-depth interventions to make the transition from being an addict and substance dependent to a person who is empowered and free from dependence. Users must not be viewed as victims of their circumstances, but be encouraged to reclaim an inner locus of control. South African Family Practice Vol. 50 (6) 2008: pp. 44-44

LIVING IN FOSTER CARE AND IN A CHILDREN’S HOME: VOICES OF CHILDREN AND THEIR CAREGIVERS

Foster care is clearly seen as the preferred option in alternate care of the vulnerable child inSouth Africa and internationally (Kiraly, 2001; Long, 2007; McKay, 2002; Morei, 2002). TheChildren’s Act 38/2005 clearly prioritizes a foster care placement over a child and youth carecentre of which a Children’s Home is a part (Section 46(1)(a) – Children’s Act 38/2005 –(http://www.acts.co.za). Given the steady decline in traditional family living due to amongstother factors HIV/AIDS, poverty and unemployment in South Africa, the dominant view offamily care being prioritized may not always be feasible. This paper provides researchedevidence of lived experiences in both alternative care placements to deepen understanding ofbest practice options for alternate care planning and management.The objectives of the research study were:• to explore children’s experiences of foster care and the Children’s Home placement.• to explore experiences and challenges of foster parents and caregivers in Children’s Homesin caring for vulnerable children