Category: General Interest

Dating is Not Broken, but the Trajectories of Relationships have Changed

Photo by Mayur Gala on Unsplash

Despite many societal changes, including technology such as dating apps and young adults waiting longer to get married, two surveys of college students conducted 10 years apart showed that their expectations about romantic relationships have remained remarkably consistent, according to a new study led from the University of Illinois Urbana-Champaign

According to some popular culture writers and online posts by discouraged singles lamenting their inability to find romantic partners, dating is “broken,” fractured by the social isolation created by technology, pandemic lockdowns and potential partners’ unrealistic expectations.

Yet two studies of college students conducted a decade apart found that their ideas about romantic relationships have remained much the same, although the trajectories of their relationships have changed somewhat, according to study leader Brian Ogolsky, a professor of human development and family studies at the University of Illinois Urbana-Champaign.

“College students in our study did not share this perception of dating as a broken system, despite many massive cultural shifts during this decade,” Ogolsky said. “Their perspectives on relationships today aren’t that different from what they were 10 years ago — or even 10 years before that. Instead, young adults are taking more diverse and multifaceted pathways through romantic partnering and considering a broader range of outcomes.”

Ogolsky surveyed college students ages 18-29 in 2012 and in early 2022, asking them to describe their thoughts and experiences about the typical initiation and progression of romantic relationships.

Published in the journal Personal Relationships, the study was co-written by Jennifer L. Hardesty, a professor in the same department; psychology professor Kiersten Dobson of McMaster University; and U. of I. graduate students Matthew Rivas-Koehl and Ghada Kawas.

More than 250 students were surveyed, about half of whom said they had romantic partners at the time.

Based upon participants’ responses, the researchers identified four stages of romantic relationships. The first stage, which they called “flirtationship,” may occur online or in person and involves the first sparks of attraction, fanning those embers through flirtation and exploring common interests.

If the attraction and level of interest are mutual, the individuals test the waters for “relationship potential”  the second stage in relationship development  by spending increased time together, with a heavy focus on communicative activities that probe whether the relationship should move forward. Study participants repeatedly mentioned friendship as an important basis for romantic partnerships, and they most often mentioned dating in reference to this stage, the data indicated.

“Young adults clearly distinguish dating from being in a relationship,” Ogolsky said. “In our study, we used the term relationship development’ to describe the activities we were investigating, but it became clear that participants did not view early behaviors as part of being in a relationship per se. Instead, they viewed flirting and even dating as part of a broader pattern of interpersonal interaction that may or may not eventually lead to the formation of a relationship.”

If romance does blossom and the union progresses to the third stage  being in a relationship  defining their union becomes important to the partners, such as labeling their status as “official” and identifying themselves as significant others, the researchers said.

Although those in the first study were less likely to mention sexual activity, students in both studies were more likely to talk about it in the context of defining the relationship. And the researchers found that the majority of the students in both studies implied an expectation of exclusivity and monogamy from committed relationships.

Although many studies on young adults’ relationships have focused on hookup culture  casual sex without commitment  only nine of those in the more recent study mentioned it. And the researchers hypothesized that college students may use the term when referring to sexual activity in any context, even that which occurs within a predefined relationship.

Ogolsky said it was during the third stage that the greatest differences emerged between the two groups of students’ beliefs. Those in the 2012 study were more likely to believe that the typical relationship path was for partners to become engaged after becoming official. However, those in the 2022 study rarely mentioned engagement, saying instead that commitment proceeds in more diverse pathways such as moving in together.

“Another difference we found pertained to integrating romantic partners into one’s social circle,” Ogolsky said. “For the students in 2012, this process centered around introducing a new partner to family members. However, those in the more recent study viewed it as integrating the partner into one’s broader social networks of friends as well as family members.”

In the fourth relationship stage  called “commitment or bust”  Ogolsky said that participants described arriving at an eventual crossroads, where the partners either decide to marry or enter into another type of long-term legal commitment or go their separate ways.

Surprisingly, despite the rapid growth in social media, dating apps and other platforms for meeting potential partners that proliferated across the decade between the two surveys, technology did not play as big a role in the minds of the participants as expected, Ogolsky said.

“When we ask people about relationship prototypes, they’re not talking about technology,” he said. “They’re thinking about relationships in broad strokes. And we found it interesting that the centerpiece of relationships was not dating apps, artificial intelligence or robots or all the other things we may have predicted 25 or 40 years ago.”

Source: University of Illinois at Urbana-Champaign, News Bureau

Slow Traffic Pushes Commuters to Choose Fast Food

Photo by Why Kei on Unsplash

Ever notice how much more tempting it is to pick up fast food for dinner after being stuck in traffic? It’s not just you. New research shows that traffic delays significantly increase visits to fast food restaurants, leading to unhealthier eating.

“In our analysis focusing on Los Angeles County, unexpected traffic delays beyond the usual congestion led to a 1% increase in fast food visits. That might not sound like a lot, but it’s equivalent to 1.2 million more fast food visits per year in LA County alone. We describe our results as being modest but meaningful in terms of potential for changing unhealthy food choices,” said study author Becca Taylor, assistant professor at the University of Illinois Urbana-Champaign.

Taylor and her co-authors had access to more than two years’ of daily highway traffic patterns in Los Angeles, along with data showing how many cell phone users entered fast-food restaurants in the same time period.

With these data, the team created a computational model showing a causal link between unexpected traffic slow-downs and fast food visits. This pattern held at various time scales, including 24-hour cycles and by the hour throughout a given day. When analysed by the day, traffic delays of just 30 seconds per mile were enough to spike fast-food visits by 1%.

“It might not be intuitive to imagine what a 30-second delay per mile feels like,” Taylor said. “I think of it as the difference between 10a.m. traffic and 5p.m. traffic.”

When the researchers broke the day into hour-long segments, they found a significantly greater number of fast food visits when traffic delays hit during the evening rush hour. At the same time, grocery store visits declined slightly.

“If there’s traffic between 5 and 7p.m., which happens to be right around the evening meal time, we see an increase in fast food visits,” Taylor said.

“Drivers have to make a decision about whether to go home and cook something, stop at the grocery store first, or just get fast food.”

Considering every major city has both traffic and fast food restaurants lining highway feeder roads, it’s not a stretch to extrapolate the pattern beyond Los Angeles.

Taylor and her co-authors say the link between traffic and unhealthy food choices is just one more reason policymakers around the country and the globe should prioritize infrastructure reforms to ease congestion.

“Our results contribute to the literature suggesting time constraints are really important to the food choices people make. Any policies aimed at loosening time constraints – and traffic is essentially lost time – could help battle unhealthy eating,” Taylor said. “That could mean improvements in infrastructure to mitigate traffic congestion, expanding public transport availability, and potentially increasing work from home opportunities.”

Source: University of Illinois College of Agricultural, Consumer and Environmental Sciences

MMBCh Tops Applications as Wits University Welcomes First-year Students for 2025

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Among the 85 000 undergraduate applications for 2025 Wits received for 2025, the single most-applied for degree was for the Bachelor of Medicine and Bachelor of Surgery (MBBCh). Of these applications, the university could only register around 6000 first-year students. These students represent the best of the best, earning their place in one of Africa’s most competitive academic environments, with an average of over five distinctions per student in their matric results.

From KZN, Glenwood High School’s Brydyn Le’Jean Barnabas, who was offered a place to study MBBCh, says, “I’ve been hearing from friends and family that this is such a prestigious university. It’s not only backed by impressive statistics but also has a rich culture and heritage, having been around for decades. Compared to other universities, it’s truly a privilege to be here. When I received my acceptance letter, my heart dropped – not just with joy but with  gratitude for this opportunity.”

Bachelor of Pharmacy was also a popular degree, coming in at the fifth most applied-for.

Recent enrolment trend assessments indicate that the majority of students offered a place at Wits have achieved an Admission Point Score (APS) exceeding 30, with most scoring 34 or higher. The minimum APS required for degree programmes at Wits is 30, making entry into the university a significant accomplishment.

Wits continues to uphold its reputation as a hub for academic excellence and innovation, attracting top-performing students from across the country and the continent. The university remains committed to nurturing the next generation of leaders, thinkers, and innovators.

For more information about the experiences of first-year students and why they chose Wits, read more here: Wits News.

Healthcare Trends to Watch in 2025

AI image made with Gencraft using Quicknews’ prompts.

Quicknews takes a look at some of the big events and concerns that defined healthcare 2024, and looks into its crystal ball identify to new trends and emerging opportunities from various news and opinion pieces. There’s a lot going on right now: the battle to make universal healthcare a reality for South Africans, growing noncommunicable diseases and new technologies and treatments – plus some hope in the fight against HIV and certain other diseases.

1. The uncertainty over NHI will continue

For South Africa, the biggest event in healthcare was the signing into law of the National Health Insurance (NHI) by President Ramaphosa in May 2024, right before the elections. This occurred in the face of stiff opposition from many healthcare associations. It has since been bogged down in legal battles, with a section governing the Certificate of Need to practice recently struck down by the High Court as it infringed on at least six constitutional rights.

Much uncertainty around the NHI has been expressed by various organisation such as the Health Funders Association (HFA). Potential pitfalls and also benefits and opportunities have been highlighted. But the biggest obstacle of all is the sheer cost of the project, estimated at some R1.3 trillion. This would need massive tax increases to fund it – an unworkable solution which would see an extra R37 000 in payroll tax. Modest economic growth of around 1.5% is expected for South Africa in 2025, but is nowhere near creating enough surplus wealth to match the national healthcare of a country like Japan. And yet, amidst all the uncertainty, the healthcare sector is expected to do well in 2025.

Whether the Government of National Unity (GNU) will be able to hammer out a workable path forward for NHI remains an open question, with various parties at loggerheads over its implementation. Public–private partnerships are preferred by the DA and groups such as Solidarity, but whether the fragile GNU will last long enough for a compromise remains anybody’s guess.

It is reported that latest NHI proposal from the ANC includes forcing medical aid schemes to lower their prices by competing with government – although Health Minister Aaron Motsoaledi has dismissed these reports. In any case, medical aid schemes are already increasing their rates as healthcare costs continue to rise in what is an inexorable global trend – fuelled in large part by ageing populations and increases in noncommunicable diseases.

2. New obesity treatments will be developed

Non-communicable diseases account for 56% of deaths in South Africa, and obesity is a major risk factor, along with hypertension and hyperglycaemia, which are often comorbid. GLP-1 agonists were all over the news in 2023 and 2024 as they became approved in certain countries for the treatment of obesity. But in South Africa, they are only approved for use in obesity with a diabetes diagnosis, after diet and exercise have failed to make a difference, with one exception. Doctors also caution against using them as a ‘silver bullet’. Some are calling for cost reductions as they can be quite expensive; a generic for liraglutide in SA is expected in the next few years.

Further on the horizon, there are a host of experimental drugs undergoing testing for obesity treatment, according to a review published in Nature. While GLP-1 remains a target for many new drugs, others focus on gut hormones involved in appetite: GIP-1, glucagon, PYY and amylin. There are 5 new drugs in Phase 3 trials, expected variously to finish between 2025 and 2027, 10 drugs in Phase 2 clinical trials and 18 in Phase 1. Some are also finding applications beside obesity. The GLP-1 agonist survodutide, for example have received FDA approval not for obesity but for liver fibrosis.

With steadily increasing rates of overweight/obesity and disorders associated with them, this will continue to be a prominent research area. In the US, where the health costs of poor diet match what consumers spend on groceries, ‘food as medicine’ has become a major buzzword as companies strive to deliver healthy nutritional solutions. Retailers are providing much of the push, and South Africa is no exception. Medical aid scheme benefits are giving way to initiatives such as Pick n Pay’s Live Well Club, which simply offers triple Smart Shopper points to members who sign up.

Another promising approach to the obesity fight is precision medicine, which factors in many data about the patient to identify the best interventions. This could include detailed study of energy balance regulation, helping to select the right antiobesity medication based on actionable behavioural and phsyiologic traits. Genotyping, multi-omics, and big data analysis are growing fields that might also uncover additional signatures or phenotypes better responsive to certain interventions.

3. AI tools become the norm

Wearable health monitoring technology has gone from the lab to commonly available consumer products. Continued innovation in this field will lead to cheaper, more accurate devices with greater functionality. Smart rings, microneedle patches and even health monitoring using Bluetooth earphones such as Apple’s Airpods show how these devices are becoming smaller and more discrete. But health insurance schemes remain unconvinced as to their benefits.

After making a huge splash in 2024 as it rapidly evolved, AI technology is now maturing and entering a consolidation phase. Already, its use has become commonplace in many areas: the image at the top of the article is AI-generated, although it took a few attempts with the doctors exhibiting polydactyly and AI choosing to write “20215” instead of “2025”. An emerging area is to use AI in patient phenotyping (classifying patients based on biological, behavioural, or genetic attributes) and digital twins (virtual simulations of individual patients), enabling precision medicine. Digital twins for example, can serve as a “placebo” in a trial of a new treatment, as is being investigated in ALS research.

Rather than replacing human doctors, it is likely that AI’s key application is reducing lowering workforce costs, a major component of healthcare costs. Chatbots, for example, could engage with patients and help them navigate the healthcare system. Other AI application include tools to speed up and improve diagnosis, eg in radiology, and aiding communication within the healthcare system by helping come up with and structure notes.

4. Emerging solutions to labour shortages

Given the long lead times to recruit and train healthcare workers, 2025 will not likely see any change to the massive shortages of all positions from nurses to specialists.

At the same time, public healthcare has seen freezes on hiring resulting in the paradoxical situation of unemployed junior doctors in a country desperately in need of more doctors – 800 at the start of 2024 were without posts. The DA has tabled a Bill to amend the Health Professions Act at would allow private healthcare to recruit interns and those doing community service. Critics have pointed out that it would exacerbate the existing public–private healthcare gap.

But there are some welcome developments: thanks to a five-year plan from the Department of Health, family physicians in SA are finally going to get their chance to shine and address many problems in healthcare delivery. These ‘super generalists’ are equipped with a four-year specialisation and are set to take up roles as clinical managers, leading multi-disciplinary district hospital teams.

Less obvious is where the country will be able to secure enough nurses to meet its needs. The main challenge is that nurses, especially specialist nurses, are ageing – and it’s not clear where their replacements are coming from. In the next 15 years, some 48% of the country’s nurses are set to retire. Coupled with that is the general consensus that the new nursing training curriculum is a flop: the old one, from 1987 to 2020, produced nurses with well-rounded skills, says Simon Hlungwani, president of the Democratic Nursing Organisation of South Africa (Denosa). There’s also a skills bottleneck: institutions like Baragwanath used to cater for 300 students at a time, now they are only approved to handle 80. The drive for recruitment will also have to be accompanied by some serious educational reform to get back on track.

5. Progress against many diseases

Sub-Saharan Africa continues to drive declines in new HIV infections.  Lifetime odds of getting HIV have fallen by 60% since the 1995 peak. It also saw the largest decrease in population without a suppressed level of HIV (PUV), from 19.7 million people in 2003 to 11.3 million people in 2021. While there is a slowing in the increase of population living with HIV, it is predicted to peak by 2039 at 44.4 million people globally. But the UNAIDS HIV targets for 2030 are unlikely to be met.

As human papillomavirus (HPV) vaccination programmes continue, cervical cancer deaths in young women are plummeting, a trend which is certain to continue.

A ‘new’ respiratory virus currently circulating in China will fortunately not be the next COVID. Unlike SARS-CoV-2, human metapneumovirus (HMPV) has been around for decades, and only causes a few days of mild illness, with bed rest and fluids as the primary treatment. The virus has limited pandemic potential, according to experts.

From Sunbathing your Bottom to Crying over Crystals, South Africans Reflect on the Most Outrageous Wellness Trends from 2024

Photo by Darius Bashar on Unsplash

In a world where wellness sometimes feels like a circus act, Virgin Active South Africa conducted a survey at the end of 2024, revealing the most baffling wellness trends of the year*. With over 750 South Africans weighing in, it turns out that we’re not just stretching our bodies – our minds are doing some serious gymnastics trying to keep up with the latest fads. And let’s face it, some of these trends seem to have been invented after a few too many kombucha shots.

The wackiest trends that baffle the masses

First up on the bewildering list is the infamous perineum sunning, also known as “bum sunbathing,” which left 360 respondents scratching their heads (and maybe their backsides) and wondering how to apply sunblock to those hard to reach places. Following closely is Ozempic, a medicine for adults with type 2 diabetes and which has now become popular as a weight-loss medication amongst those without diabetes. 298 people found this more confusing than a goat at a dog park. Not far behind are crystal healing (267 baffled souls), the carnivore diet (280 confused veggie enthusiasts), and the adorable yet perplexing goat and puppy yoga (259, because who wouldn’t want a furry friend in downward dog?).

In fact, when asked which of these trends they would consider trying, only three brave souls expressed interest in perineum sunbathing. Clearly, South Africans would rather stick to the basics like intermittent fasting (144) and a good old 30-day ab challenge (131).

After all, who needs sun-kissed cheeks when you’ve got abs to show off?

So why try the strange?

When it comes to experimenting with these quirky trends, 276 respondents said they just wanted ‘a new way to improve my health and wellbeing’. Because, let’s face it, who wouldn’t want to feel healthier while sunning their bum? It’s the perfect combination of self-care and “I’m just gonna do me!”.

Social Media takes the number one podium position as ‘The Wellness Wild West’

With South Africans encountering between 1 to 5 wellness-related posts a day, it’s no wonder that confusion reigns supreme. A staggering 64.6% of respondents have never bought supplements based on influencer recommendations, proving that we’re more sceptical than starry-eyed when it comes to social media endorsements – despite the fact we’ve all been tempted to try that R5000 juice cleanse we read about on GOOP that comes with one of THOSE candles from Gwyneth Paltrow (I said what I said!).

“While social media can be a great source of motivation, it’s also a breeding ground for mixed messages,” says Leandre Kark, Head of Brand Marketing & Communications at Virgin Active. “We often see advice that’s contradicting, leaving people unsure about what really works.”

So, should we drink green juice or make friends with crystals? (Hint: Both are good for your soul, however the extent to which they’re good depends on your belief in them.  Well, that’s the case for crystals. Just don’t rely on them as substitutes for nutrition or mental health.)

When it comes to wellness, South Africans prefer to keep it real

When asked why they might try a quirky trend, those 276 respondents looking for a way to improve their health reflect a broader societal shift: South Africans are open to experimentation but remain discerning about what aligns with their personal health goals. After all, there’s no ‘one size fits all’ in wellness – unless you’re talking about a yoga mat, in which case, that’s actually very size-specific (a standard mat is about 70 cm wide and 173 to 183 cm long, you’re welcome).

Macro trends shaping South African wellness

The survey results also tap into larger wellness dynamics in South Africa:

  • Rising anxiety and stress levels: South Africa’s stress index ranks among the highest globally, making mental health solutions essential for many.
  • Economic pressures: With affordability in mind, consumers are increasingly selective about health-related spending, prioritising value over gimmicks (and who can blame them?).
  • Sustainability and the earth matter: Trends like crystal healing reflect a desire for connection with nature, even if its effectiveness is a bit… shady (pun intended).

Virgin Active believes these insights are crucial to shaping its role in helping South Africans navigate wellness trends while staying grounded in practices that deliver real results – and maybe, just maybe, finding a few new ones that don’t involve sunburnt bums.

Kark continues, “True wellness is rooted in balance, not in the latest trend. We tend to become obsessed with quick fixes and outlandish fads, rather than focusing on investing in a long-term journey towards better health. Sustainable habits such as regular exercise, mindful eating, and mental well-being are the foundation of lasting vitality. It requires an investment of time and energy rather that getting swept up in fleeting trends that promise quick-fixes. Instead, invest in a long-term, holistic plan of moderation and consistency, to nurture your body, mind, and spirit.”

Is every man and his bum going to trend again in 2025? Only time will tell

While the wellness world may be filled with head-scratchers, it’s comforting to know that Virgin Active remains committed to providing effective strategies that prioritise real health over fleeting fads. Whether you’re considering goat yoga or just squeezing in an extra workout, remember: wellness is about what works for you, not what’s trending on TikTok! (Though we’ll admit, a goat in downward dog definitely adds to the experience – but sadly, it’s not offered at Virgin Active clubs… yet. And we’re not kidding – see what we did there?)

For more information on the classes available at Virgin Active, head to the class tab on the website, and check out the website for other updates or drop by your nearest club.**

*Note: #NoGoatsWereHarmedInThisStudy

**Note: By “club,” we mean Virgin Active… although, who’s to say what happens post-workout?

Are Robots the Solution to Nursing Home Employee Turnover?

Photo by Alex Knight on Unsplash

Facing high employee turnover and an aging population, nursing homes have increasingly turned to robots to complete a variety of care tasks, but few researchers have explored how these technologies impact workers and the quality of care.

A new study from a University of Notre Dame expert on the future of work finds that robot use is associated with increased employment and employee retention, improved productivity and a higher quality of care. The research has important implications for the workplace and the long-term care industry.

Yong Suk Lee, associate professor of technology, economy and global affairs at Notre Dame’s Keough School of Global Affairs, was the lead author for the study, published in Labour Economics. Most studies of robots in the workplace have focused on manufacturing and the industrial sector, but Lee’s research broke new ground by analysing long-term care – and by looking at the different types of robots used in this setting. Researchers drew on surveys of Japanese nursing homes taken in 2020 and 2022.

“Our research focused on Japan because it is a super-aging society that provides a good example of what the future could entail elsewhere – a declining population, a growing share of senior citizens and a declining share of working-age people,” Lee said. “We need to be ready for this new reality.”

In 2022, for instance, more than 57 million U.S. residents were 65 or older, according to the National Council on Aging. The Census Bureau forecasts that by 2050, this number will grow to 88.5 million.

The impact on workers

In a future where there are more senior citizens requiring care, using robots in a targeted fashion could benefit workers and patients alike, Lee said. The study analyzed three types of robots that are increasingly used in assisted living facilities:

  • Transfer robots, which nurses use to lift, move and rotate patients in beds and around rooms.
  • Mobility robots, which patients use to move around and to bathe.
  • Monitoring and communication robots, which include technologies such as computer vision and bed sensors that can monitor patient data such as movement and share it with care providers.

“We found that robot adoption complements care workers by reducing quit rates,” Lee said. “This is important because turnover is a big concern in nursing homes. Workers typically experience a great deal of physical pain, particularly in their knees and back. The work is hard and the pay is low. So robot use was associated with employee retention.”

While robot use was associated with an overall employment increase, Lee said, the trend seems to have helped some workers more than others: It was associated with an increased demand for part-time, less experienced employees and with less demand for more experienced workers.

Improving patient care

Patients benefited in facilities that have used robots, according to the study. The nursing homes that Lee’s team studied reported a decrease in the use of patient restraints and in the pressure ulcers or bedsores that nursing home residents commonly suffer, largely because of a lack of mobility. Both metrics are widely used in the long-term care industry to measure patient outcomes, Lee said.

By removing the physical strain associated with certain tasks, Lee said, robots may have made room for care workers to focus on tasks better suited for human beings.

“Robots can improve productivity by shifting the tasks performed by care workers to those involving human touch, empathy and dexterity,” Lee said. “Ultimately, robots can help workers provide a higher level of patient care.”

Source: University of Notre Dame

Health in 2024: The Year in Fewer than 1000 Words

By Marcus Low and Adiel Ismail

From the NHI Act to major advances in HIV prevention, it has been another busy year in the world of healthcare. Spotlight editors Marcus Low and Adiel Ismail recap the year’s health developments and identify some key trends in fewer than 1000 words. 

For a few weeks in June, it seemed that the surprising outcome of South Africa’s national and provincial elections would usher in far-reaching political and governance changes in the country. As it turns out, some significant changes did come, but not in the health sector. 

Rather than a new broom, it was déjà vu as Dr Aaron Motsoaledi returned as Minister of Health – he was previously in the position from 2009 to 2019. In both Gauteng and KwaZulu-Natal – the country’s most populous provinces – ANC MECs for health from before the elections kept their jobs. The ANC garnered well under 50% of the votes in both of those provinces and nationally and accordingly had little choice but to form national and provincial coalitions. 

To be fair, five of the nine MECs appointed after the elections were new, but these changes were mainly in the less populous provinces. 

Policy-wise, the trajectory also remains much as it was a year ago. Two weeks before the elections, President Cyril Ramaphosa signed the National Health Insurance (NHI) Act into law (though most of it has not yet been promulgated). While Ramaphosa has since then asked Business Unity South Africa (BUSA), the country’s largest employer association, for new input on NHI and while talk of mandatory medical scheme cover had a moment in the headlines, there is no solid evidence that the ANC is open to changing course – if anything, Motsoaledi has doubled-down in the face of criticism. The Act is being challenged in various court cases. 

The sense of discord in healthcare circles was further deepened in August when several organisations distanced themselves from Ramaphosa’s updated Presidential Health Compact. The South African Medical Association, the South African Health Professionals Collaboration—comprising nine associations representing over 25 000 public and private healthcare workers—and BUSA all declined to sign the accord. BUSA accused government of “unilaterally” amending the compact “transforming its original intent and objectives into an explicit pledge of support for the NHI Act”.  

Away from these reforms, a trend of health budgets shrinking year-on-year in real terms continued this year. This funding crunch, together with well-documented shortages of healthcare workers, has meant that even well-run provincial health departments are having to make impossible trade-offs – that while governance in several provincial health departments remains chronically dysfunctional. This was underlined by a landmark report published in July that, among others, highlighted leadership instability, lack of transparency, insufficient accountability mechanisms, and pervasive corruption. New reports from the Auditor General also didn’t paint a pretty picture. 

Gauteng health has again been in the headlines for the wrong reasons. The provision of cancer services in the province remains mired in controversy as the year comes to an end, with plans to outsource some radiation services to the private sector apparently having stalled, despite the health department having the money for it. A deal between the department and Wits University was also inexplicably derailed. With high vacancy rates, serious questions over senior appointments, reports of corruption at Thembisa Hospital, and much more, it seems that, if anything, governance in the province has gotten even worse this year. 

In a precedent-setting inquest ruling in July, Judge Mmonoa Teffo found that the deaths of nine people moved from Life Esidimeni facilities to understaffed and under-equipped NGOs “were negligently caused by the conduct of” former Health MEC Qedani Mahlangu and former head of the provincial health department’s mental health directorate Dr Makgabo Manamela. 

Outside our borders, Donald Trump’s election victory in the United States is set to have far-reaching consequences. A return of the Global Gag Rule seems likely, as does major changes to the Food and Drug Administration, the President’s Emergency Plan for AIDS Relief, and the National Institutes of Health – the latter funds much HIV and TB research in South Africa. 

Away from politics and governance, the biggest HIV news of the year came in late June when it was announced that an injection administered every six months was extremely effective at preventing HIV infection. It will likely be several years before the jab becomes widely available in South Africa.

Another jab that provides two months of protection per shot is already available here, but only to a small number of people participating in implementation studies. 

It is estimated that around 50 000 people died of HIV related causes in South Africa in 2023 and roughly 150 000 were newly infected with the virus (reliable estimates for 2024 will only be available in 2025). A worrying one in four people living with HIV were not on treatment in 2023. There was an estimated 56 000 TB deaths and around 270 000 people fell ill with the disease. While these HIV and TB numbers have come down dramatically over the last decade, they remain very high compared to most other countries. 

There are some concerns that a new TB prevention policy published in 2023 is not being universally implemented. We have however been doing more TB tests, even while TB cases are declining – as we have argued, this is as it should be. Also positive, is that a massive trial of an TB vaccine kicked off in South Africa this year. 

With both TB and HIV, South Africa is making progress too slowly, but we are at least trending in the right direction. With non-communicable diseases such as diabetes, there are unfortunately signs that things are getting worse. As we explained in one of our special briefings this year, our diabetes data in South Africa isn’t great, but the little we have painted a worrying picture. As expected, access to breakthrough new diabetes and weight loss medicines remained severely constrained this year, largely due to high prices and limited supply. 

Ultimately then, at the end of 2024, South Africa is still faced with chronic healthcare worker shortages, severe governance problems in several provinces, and major uncertainties over NHI – all while HIV and TB remains major public health challenges, though a shift toward non-communicable diseases is clearly underway. 

Republished from Spotlight under a Creative Commons licence.

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How COVID Transformed Family Dinners for the Better

Photo by Vanessa Loring on Pexels

While the lockdowns associated with the COVID pandemic led many families to eat more meals at home, they had an additional benefit: an increase in the quality of family time during those dinners, according to research published by the American Psychological Association.

The study, published in the journal Couple and Family Psychology: Research and Practice, found that families who ate together more often during the pandemic also had more positive interactions, shared news and information, and even embraced technology such as videoconferencing to connect with distant family members.

“The predominance of past research on family dinners has focused on frequency as the key predictor of benefits for children and adolescents,” said lead author Anne Fishel, PhD, a clinician and researcher in family therapy at Massachusetts General Hospital. “This study highlights the importance of examining both frequency and quality to understand the full picture of how shared meals can impact families.”

Researchers examined data from a survey of 517 ethnically and socioeconomically diverse parents across the United States, administered in May 2021. Their aim was to investigate changes in family dinner frequency and quality during the COVID pandemic.

Participants were asked about dinner frequency, quality and post-pandemic expectations. The survey included questions about positive and negative interactions, family support and incorporation of the outside world. They were asked questions such as, “During the pandemic, did all or most of the people living in your home eat dinner together less, about the same, or more than compared to before the pandemic?” Participants then provided answers ranging on a scale of 1–5, 1 being “much less” and 5 being “much more.”

Over 60% of respondents reported eating dinner together more often during the pandemic compared with pre-pandemic times. There was also a significant increase in positive interactions (e.g, expressing gratitude, laughing or feeling connected) during family meals.

“Specifically, 56% said they increased talking about their days during dinner, 60% said they increased talking about their identity as a family, 60% said they increased expressing gratitude, 67% said they increased laughing together and 59% said they felt more connected to each other around the dinner table,” said Fishel. This positive association was evident across income levels, education, age, gender and race.

The pandemic introduced new aspects to family dinners, including remote dining with extended family members and more discussions about current events, according to Fishel. Many families turned to videoconferencing to connect with extended family, potentially strengthening a sense of belonging to a larger family unit. Most parents who increased the use of technology for remote dinners during the pandemic reported that they plan to continue this practice as the pandemic subsides.

The researchers also found an increase in families incorporating news and information from the outside world into their dinner conversations, potentially offering a safe space for children to discuss anxieties and questions with their parents.

Overall, this study suggests that the increased frequency of family dinners during the pandemic may have had lasting positive effects on family dynamics, according to Fishel.

Source: American Psychological Association

The High Cost of Having Too Few Pharmacists in SA

Photo by National Cancer Institute on Unsplash

By Chris Bateman

It’s acknowledged in key policy documents, well known at the coalface and much ventilated in the media: South Africa’s public healthcare system has too few healthcare workers, especially medical doctors, certain specialists, and theatre nurses. Less recognised however is the shortage of public sector pharmacists. We lift the lid on this until now largely hidden problem – and its impact.

There are too few public sector pharmacy posts across South Africa to deliver a comprehensive service, with no clear staffing norms, and an uneven distribution of pharmacists, especially in rural districts. This contributes in part to medicine stockouts and the emergence of deadly hospital-acquired drug-resistant infections.

This is according to Dr Andy Gray, a senior lecturer in the Division of Pharmacology at the University of KwaZulu-Natal’s School of Health Sciences and co-head of the World Health Organization Collaborating Centre for Pharmaceutical Policy and Evidence Based Practice. His views are echoed by at least two other key local stakeholder organisations.

Flagging the alarming rise in resistance to antimicrobials – an urgent global public health threat – driven by the misuse of antibiotics in hospitals and ambulatory care, Gray told Spotlight that there are not enough pharmacists to intervene if they see inappropriate use of medicines.

“This just continues without any effort to fix it. Inadequately trained and understaffed prescribers are working under immense stress, so they are prone to use the wrong medicines at the wrong time with the wrong doses,” he said. “There are also very few microbiologists and certainly not enough pharmacists at the bedside. They’re not doing what’s necessary to ensure the proper use of medicines – for example, better control over antimicrobials.”

The excessive dependence on antibiotics has resulted in the emergence of antibiotic-resistant bacteria, commonly known as superbugs. This is called bacterial resistance or antibiotic resistance. Some bacteria are now resistant to even the most powerful antibiotics available.

South Africa has been ranked 67th out of 204 countries for deaths – adjusted by age per 100 000 people – linked to antimicrobial resistance. It has been estimated that around 9 500 deaths in the country in 2019 were directly caused by antimicrobial resistance, while 39 000 deaths were possibly related to resistant infections.

The National Department of Health warned in a background document that rising antimicrobial resistance and the slow-down of new antibiotics could make it impossible to treat common infections effectively. This could also lead to an increase in the cost of healthcare because of the need for more expensive 2nd or 3rd line antimicrobial agents, as well as a reduced quality of life.

Low numbers

Gray said that while not matching the paucity of public sector doctors and nurses, pharmacists stand at 24% of the staffing levels calculated as necessary to deliver a comprehensive service.

“We need just over 50 pharmacists per 100 000 uninsured population as a target, but we’re sitting at around 12,” he said.

Gray said the SA Pharmacy Council (SAPC) has no data on the total number of pharmacists actually working in the country, or the number working in particular settings. A SAPC spokesperson said they had only provincial statistics, but could not track pharmacist movements.

“You can’t use their database to find out how many pharmacists are working where. The Health Systems Trust SA Health Review Indicator chapter has figures of public sector pharmacists per province and per 100 000 uninsured population,” Gray pointed out.

As at February 2024, there were 16 856 pharmacists registered in South Africa, (working and not working), excluding the 971 community service pharmacists.

The 5 958 pharmacists employed in the public sector represents the full complement of funded posts, but it is well below the number needed – and varies dramatically between provinces. While almost all funded posts are filled, Gray said the number of posts is less than needed to deliver a comprehensive, quality service.

Taken across South Africa’s population of around 62 million, there are around 28 registered pharmacists (working or not working), per 100 000 people (insured and uninsured). According to data from 2016, the mean global ratio stands at 73 per 100 000.

“We’re better than many other African countries, but that’s cold comfort,” said Gray.

Increases spread unevenly

There are some positives. The number of pharmacists in the public sector has grown since 2009, rising from five to 12 per 100 000 uninsured people by 2023. However, the ratio varies markedly by district – for example: from 15 in the best-served Western Cape district to a mere three in the poorest served Northern Cape district.

Gray said the more rural districts suffer the most when it comes to understaffing of pharmacists and this contributes to medicine stockouts. While the causes of medicine stockouts are complex, one of the major contributors is the refusal of suppliers to deliver any more stock until accounts are paid.

Understaffing of pharmacists often results in nurses managing patients without any pharmaceutical oversight, Pharmaceutical Society of South Africa Executive Director, Refiloe Mogale, told Spotlight. She associates such task-shifting with medicine misuse and inappropriate prescribing, noting that while it’s a vital strategy in budget-tight environments, medication errors are on the rise. This, she argues, could be solved by ensuring appropriate pharmaceutical personnel are placed to support primary healthcare facilities – such as pharmacist assistants.

“A Primary Care Drug Therapy (PCDT) trained pharmacist can diagnose, treat, and dispense medications. So, this is not as much about task-shifting as about the pharmacist providing comprehensive care. These PCDT pharmacists can do family planning, screening for diabetes, hypertension, and other clinical tasks that take the burden off doctors. We need more of them,” she said.

‘No clear staffing norm’

Addressing the human resources quandary, Gray said the core problem had always been that the number of pharmacist posts per hospital or clinic were not evenly distributed. “There’s been no clear staffing norm. The old ‘homeland’ hospitals are likely to be under resourced with pharmacists and pharmacists’ assistants. Posts are poorly distributed and by global standards, we’re nowhere near where we should be,” he said.

The National Department of Health’s most senior pharmacy official Khadija Jamaloodien agreed that pharmacy posts should be distributed better. But she said work protocols dictate that state pharmacists must visit each clinic in their district at least once per month. She said there are 3 000 primary healthcare facilities in the country and 6 000 (albeit maldistributed) public sector pharmacists.

Nhlanhla Mafarafara, President of the SA Association of Hospital and Institutional Pharmacists, told Spotlight too many of the almost 6 000 pharmacists in the public sector are doing stock management, dispensing, administration and management work in hospitals and pharmaceutical depots. He says the numbers do not necessarily reflect pharmacists in clinical or patient facing areas.

“The reality is that pharmacists are restricted to trying to get drug stock in and out,” Gray observed.

However, the lack of pharmacists and pharmacist assistants at clinics and hospitals means timely and/or knowledgeable ordering often results in shortages of essential medicines, something all experts interviewed for this article agreed on.

Mafarafara said that by defining what services a pharmacist should render and what’s needed to enable a quality service, more realistic staffing numbers could be reached. Pharmacies are central points in all hospitals, with closure for even an hour crippling a hospital. Thus, adequate staffing is critical to ensure uninterrupted access to good quality pharmaceutical care.

South Africa, Mafarafara added, was far behind many other countries in the effective use of pharmacists’ clinical expertise in leading evidence-based care in hospitals. “I’d even go so far as to say doctors should be stopped from dispensing in favour of pharmacists to improve quality of patient care,” he said.

‘If you don’t have a pharmacist, nothing gets done properly’

Jamaloodien said the cost of having too few pharmacists is more far-reaching than just antimicrobial resistance. “You can have stock outs because there’s nobody to manage the supply chain. In my experience, if you don’t have a pharmacist, nothing gets done properly,” she said.

Her solutions? Compliance with the “comprehensive and robust” evidence-based standard treatment guidelines, access to an updated and well-maintained cell phone-based application that gives everybody access to the latest information and medicine changes – and more attendance by all healthcare professionals of webinars held after every medicine’s committee meeting, plus clinicians regularly reading drug update bulletins to keep up with new medicines.

Republished from Spotlight under a Creative Commons licence.

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Researcher Discovers Ancient Egyptian Mugs Contained Hallucinogens

(a) Drinking vessel in shape of Bes head; El-Fayūm Oasis, Egypt; Ptolemaic-Roman period (4th century BCE − 3rd century CE), (courtesy of the Tampa Museum of Art, Florida). (b) Bes mug from the Ghalioungui collection, 10.7 × 7.9 cm (Ghalioungui, G. Wagner 1974, Kaiser 2003, cat. no. 342). (c) Bes mug inv. no. 14.415 from the Allard Pierson Museum, 11.5 × 9.3 cm (courtesy of the Allard Pierson Museum, Amsterdam; photo by Stephan van der Linden). (d) Bes mug from El-Fayum, dimensions unknown (Kaufmann 1913; Kaiser 2003, cat. no. 343). Credit: Scientific Reports, 2024

The first-ever physical evidence of hallucinogens in an Egyptian mug has been found, validating written records and centuries-old myths of ancient Egyptian rituals and practices. Through advanced chemical analyses, University of South Florida professor Davide Tanasi examined one of the world’s few remaining Egyptian Bes mugs.

Such mugs, including the one donated to the Tampa Museum of Art in 1984, are decorated with the head of Bes, an ancient Egyptian god or guardian demon worshiped for protection, fertility, medicinal healing and magical purification. Published in Nature’s Scientific Reports, the study sheds light on an ancient Egyptian mystery: The secret of how Bes mugs were used about 2000 years ago. 

“There’s no research out there that has ever found what we found in this study,” Tanasi said. “For the first time, we were able to identify all the chemical signatures of the components of the liquid concoction contained in the Tampa Museum of Art’s Bes mug, including the plants used by Egyptians, all of which have psychotropic and medicinal properties.”

The presence of Bes mugs in different contexts over a long period of time made it extremely difficult to speculate on their contents or roles in ancient Egyptian culture.

“For a very long time now, Egyptologists have been speculating what mugs with the head of Bes could have been used for, and for what kind of beverage, like sacred water, milk, wine or beer,” said Branko van Oppen, curator of Greek and Roman art at the Tampa Museum of Art. “Experts did not know if these mugs were used in daily life, for religious purposes or in magic rituals.”

Several theories about the mugs and vases were formulated on myths, but few of them were ever tested to reveal their exact ingredients until the truth was extracted layer by layer.

Tanasi, who developed this study as part of the Mediterranean Diet Archaeology project promoted by the USF Institute for the Advanced Study of Culture and the Environment, collaborated with several USF researchers and partners in Italy at the University of Trieste and the University of Milan to perform chemical and DNA analyses. With a pulverised sample from scraping the inner walls of the vase, the team combined numerous analytical techniques for the first time to uncover what the mug last held.

The new tactic was successful and revealed the vase had a cocktail of psychedelic drugs, bodily fluids and alcohol – a combination that Tanasi believes was used in a magical ritual re-enacting an Egyptian myth, likely for fertility. The concoction was flavoured with honey, sesame seeds, pine nuts, liquorice and grapes, which were commonly used to make the beverage look like blood.

“This research teaches us about magic rituals in the Greco-Roman period in Egypt,” Van Oppen said. “Egyptologists believe that people visited the so-called Bes Chambers at Saqqara when they wished to confirm a successful pregnancy because pregnancies in the ancient world were fraught with dangers. So, this combination of ingredients may have been used in a dream-vision inducing magic ritual within the context of this dangerous period of childbirth.”

“Religion is one of the most fascinating and puzzling aspects of ancient civilizations,” Tanasi said. “With this study, we’ve found scientific proof that the Egyptian myths have some kind of truth and it helps us shed light on the poorly understood rituals that were likely carried out in the Bes Chambers in Saqqara, near the Great Pyramids at Giza.”

The Bes mug is on display now at the Tampa Museum of Art and can be viewed in the exhibition, “Prelude: An Introduction to the Permanent Collection.” View a 3D model of the Bes mug produced by the USF Institute for Digital Exploration.