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Preferences of South African adolescents living with HIV in the Western Cape Province regarding the use of digital technology for self-management
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Weyers, Leonie; Crowley, Talitha; Tokwe, Lwandile
Adolescents living with HIV (ALHIV) face significant challenges in self-managing their chronic condition. Digital health technology (DHT) has become increasingly common and understanding ALHIVs’ preferences is essential for developing interventions tailored to this unique population. This study aimed to explore the preferences of ALHIV regarding the use of DHT for self-management. A qualitative research approach with an exploratory and descriptive design was used. Participants were recruited using a purposive sampling method. Data were gathered through six nominal focus groups with 29 participants at two Community Health Centers in the Western Cape Province, South Africa. The participants were ALHIV aged 15–24 years. Discussions focused on current technology usage and the ranking of desired DHT features. The transcripts were analyzed using thematic analysis. Three main themes emerged: (1) everyday usage of digital technology where participants frequently used digital devices for communication, social media, and finding information; (2) the role of digital technology in self-management; a strong interest in digital technology that provides medication reminders, health education, and peer support; and (3) factors influencing digital technology, including the cost of data, limited connectivity, and issues of privacy related to participants’ HIV status. The ALHIV showed a strong willingness to use digital platforms for health information, reminders, and peer support, although concerns about connectivity, data cost, and privacy remain. These findings underscore the need for flexible, user-centered approaches when designing DHT interventions for self-management in South Africa.
A conceptual model for strengthening family capabilities through a process of care
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Reid, James; Johannes, Chanté; Wareley, Shenaaz; Ngadhi, Collen; Nginase, Avukonke; Roman, Nicolette Vanessa
Family capabilities shape the well-being of individuals and families, particularly in diverse sociocultural contexts. However, existing frameworks often fail to capture the complexities of family dynamics, particularly in South Africa. This limitation is addressed in this study by developing a new conceptual model, through an ethic of care lens, to understand family. A Human-Centered Design strategy is employed, utilizing workshops to gather and deductively interpret data. A sample of 53 participants is recruited from two communities in South Africa. The Listening Guide approach is used to analyze the data, alongside thematic analysis, to identify overarching themes. The findings reveal tangible needs (material and physical requirements), as well as intangible needs (emotional and psychological support). The relation between these needs and harms highlights how care is shaped in families. While families endeavor to meet intangible needs, many fail to communicate these intangible needs, which also leads to harm. This is exacerbated when the primary caregiver within the family, the ‘glue’, has needs for care that are not met. In addition, the findings reveal the interrelatedness of care in family dynamics among family members, and help to explore the boundaries, capacities, and capabilities of what families do and how they care.
Using machine learning to predict resilience among nurses in a South African setting
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Chipps, Jennifer; Cromhout, Amanda; Tokac, Umit
Nursing is a stressful profession. Stress can affect the mental health of nurses. A positive response to stress, resilience, is known to be a protective factor against mental health issues. This study aimed to use machine learning with secondary data from five survey studies, conducted between 2022 and 2023, to identify factors predicting high versus low levels of resilience in South African nursing samples from the Western Cape Province, South Africa. The sample included (1134 records (male = 250, 22.0%, female = 874, 77.1%, and other = 10 (0.9%) included all data on all categories of nursing staff (student nurses (567, 50%), professional registered nurses (315, 27.8%), and non-professional nurses (246, 21.7%) who completed a survey using a response to stress scale. We used random forest analysis, demographic variables, years of experience, and a brief 4-item screen of resilience to predict resilience. The model yielded limited added value from demographic groupings in this model, but the brief screening had an overall classification accuracy of 86.41% (95% CI: 0.810; 0.908).
Population-level toggling of T cell immune escape at human leukocyte antigen anchor residues in SARS-CoV-2 Spike proteins, in an ethnically diverse population region
(Public Library of Science, 2025) Ngandu, Nobubelo; Fielding, Burtram; van Heusden, Peter; Harkins, Gordon
There is currently limited understanding of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) adaptation to the human leukocyte antigen (HLA) proteins which mediate CD8 (HLA-I) and CD4 (HLA-II) T cell immune responses. We investigated population-level T cell immune escape in SARS-CoV-2 Spike protein at amino acid binding positions (the anchor motifs) preferred by the highly restrictive peptide binding grooves of the HLA. SARS-CoV-2 Spike protein sequences isolated in South Africa from January 2020 until June 2022, were used. All possible 9-mer and 15-mer peptides in the sequence alignment were scanned for matches to HLA-I and HLA-II anchor motifs, respectively. Peptide positions with matched anchor motifs and ≥1% mismatched sequences were investigated for immune escape using immunoinformatic prediction methods and directional evolution along the phylogenetic tree. Toggling of short-lived immune escape mutations at HLA-I anchor motifs was observed in 17 peptides across Spike. Eight of these overlapped with HLA-II escape mutations. Six mutations were related to zoonotic adaptation. All 17 sites were under significant directional evolution along the phylogenetic tree, and 16/17 are within published confirmed or inferred T cell epitopes. Immune escape predictions for HLA- A*66:01/A*68:01 were common (n = 7/17). HLA- A*02:05, A*03:01, B*07:02, B*08:01, B*58:01, DRB1*04:01 and DQA1*01:02-DQB1*06:02 were each associated with at least two escape mutations. This immunoinformatic prediction of T cell immune escape at HLA anchor motifs: (i)shortlisted potentially understudied population-specific HLA and immune escape (ii)revealed a footprint of underlying toggling of short-lived immune escape mutations, and (iii)has potential to cost-effectively guide pre-clinical research questions on the inclusion of partially conserved but dominant epitopes in vaccine immunogens.
The effect of disaggregated country risk on foreign portfolio Investment flows in South Africa
(University of Ljubljana School of Economics and Business, 2025) Muzindutsi, Paul Francois; Govender, Tristan Kyle; Nkwanyana, Nokwanda; Zulu, Sanelisiwe; Myeni, Nondumiso; Khuzwayo, Sinegugu; Dube, Fikile
This study explores the relationship between disaggregated country risk and foreign portfolio investment (FPI) flows in South Africa, focusing on both the long-run and short-run effects of economic, financial, and political country risk measures on net foreign purchases of shares (NFPS) and net foreign purchases of bonds (NFPB) during the period from 1995 to 2019. We employed autoregressive distributed lag (ARDL) and nonlinear autoregressive distributed lag (NARDL) models to assess the relationships between the variables. The results indicate that all disaggregated country risk measures have a long-run effect on NFPS and NFPB, and the impacts of these risks are asymmetric. Specifically, low levels of economic risk are associated with a decline in foreign equity flows and an increase in foreign bond investments in the long run, while high levels of economic risk correlate with a rise in both foreign equity and bond investment flows. Conversely, both high and low levels of financial and political risk lead to a decrease in NFPS and NFPB. Notably, financial risk was the only country risk measure found to significantly impact NFPB in the short run. The findings highlight the importance for policymakers to understand these complex relationships in order to implement strategies that foster a mutually beneficial economic, political, and financial climate in South Africa, encouraging FPI while maintaining sovereignty. © 2025 School of Economics and Business University of Ljubljana.