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Item A biostatistical support system in health sciences is this sustainable in a resourcerestricted environmentLibhaber, Elena ; Chirwa, Tobias ; Kramer, BeverleyBackground: Training in biostatistics is important for strengthening capacity in health research. This is particularly true for Africa, where research output in the health sciences has been low. Training initiatives for the continent are therefore essential. The aim of the present study was to analyse the quality and financial sustainability of the expanded biostatistical support system at a South African health sciences institution between 2013 and 2017. Methods: A cross-sectional investigation of the initiatives created between the years 2013 and 2017 in the University of the Witwatersrand, Faculty of Health Sciences Research Office was undertaken. An assessment of the one-on-one consultations carried out by postgraduate students and staff, financial costs of the support system and the number of postgraduate student graduations were analysed. Results: The number of statistical consultations increased over the period examined. The consultations were highly recommended by the postgraduate students and staff (consulters). A clear rise in the number of Masters and PhD student graduates and an increase in research units were observed from 2013 to 2017, although these cannot be solely associated with the biostatistical support system. The finances for maintaining the support system are cost effective as the number of graduates increases. The total cost to the Research Office is US$ 225 per graduate per annum. Conclusions: The expansion of the biostatistical support system has indirectly contributed to an increased number of graduates and research publication units in the institution. While the current finances support the system, any increases in enrolments or growth in diversification of biostatistical requirements may place a strain on the financial sustainability. This service is of value to developed and developing countries.Item A long walk to freedom: the epidemiology of penetrating trauma in South Africa- analysis of 4 697 patients over a six year period at Chris Hani Baragwanath Academic HospitalBhana, Malini; Fru, Pascaline; Plani, FrancoBackground: Despite the city of Johannesburg having one of the highest rates of crime in the world, no national databank for trauma exists. This study profiles the victims of penetrating trauma and identifies geographical areas in which it occurs, while describing the outcomes and patterns of injury. Methods: A retrospective study including penetrating trauma patients triaged as Priority 1, presenting at the Chris Hani Baragwanath Academic Hospital's (CHBAH) trauma department over a six-year period (2011-2016). Results: A total of 4 697 patients were included. The majority of victims were Black African males (92.1%) between the ages of 29-40 years, and stabbings were the most common mechanism of injury (71.8%), followed by gunshots. The commonest body area affected was the thorax, with a consequent haemothorax the most likely result. Weekends accounted for over 48% of all presentations - the last weekend of the month being the busiest. Region D was the area in Johannesburg with the highest trauma incidence (51.9%), with the oldest townships in Soweto found to be "hot spots". Conclusion: Penetrating trauma is inherently linked to alcohol abuse and interpersonal violence in South Africa,1 primarily affecting its young economic, working-class citizens. The data provided some insight into the burden, structure and challenges of our trauma system. These should be regarded as opportunities to implement change and improve our surveillance and prevention, beginning with a national trauma databankItem ABBV744 as a potential inhibitor of SARSCoV2 main protease enzyme against COVID19(Nature Research) Zeynab Fakhar; Shama Khan; Afrah Alkhuriji; Suliman Y. AlOmar; Aijaz AhmadA new pathogen severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) has spread worldwide and become pandemic with thousands new deaths and infected cases globally. To address coronavirus disease (COVID‑19), currently no effective drug or vaccine is available. This necessity motivated us to explore potential lead compounds by considering drug repurposing approach targeting main protease (Mpro) enzyme of SARS‑CoV‑2. This enzyme considered to be an attractive drug target as it contributes significantly in mediating viral replication and transcription. Herein, comprehensive computational investigations were performed to identify potential inhibitors of SARS‑CoV‑2 Mpro enzyme. The structure‑based pharmacophore modeling was developed based on the co‑crystallized structure of the enzyme with its biological active inhibitor. The generated hypotheses were applied for virtual screening based PhaseScore. Docking based virtual screening workflow was used to generate hit compounds using HTVS, SP and XP based Glide GScore. The pharmacological and physicochemical properties of the selected lead compounds were characterized using ADMET. Molecular dynamics simulations were performed to explore the binding affinities of the considered lead compounds. Binding energies revealed that compound ABBV‑744 binds to the Mpro with strong affinity (ΔGbind −45.43 kcal/mol), and the complex is more stable in comparison with other protein–ligand complexes. Our study classified three best compounds which could be considered as promising inhibitors against main protease SARS‑CoV‑2 virusItem Accurate hyperspectral imaging of mineralised outcrops: An example from lithium-bearing pegmatites at Uis, Namibia(Elsevier Inc, 2021) Booysen, René; Nex, Paul A.M.; Lorenz, Sandra; Thiele, Samuel T.; Fuchsloch, Warrick C.; Marais, Timothy; Gloaguen, RichardEfficient, socially acceptable and rapid methods of exploration are required to discover new deposits and enable the green energy transition. Sustainable exploration requires a combination of innovative thinking and new technologies. Hyperspectral imaging (HSI) is a rapidly developing technology and allows for fast and systematic mineral mapping, facilitating exploration of the Earth’s surface at various scales on a variety of platforms. Newly available sensors allow data capture over a wide spectral range, and provide information about the abundance and spatial location of ore and pathfinder minerals in drill-core, hand samples and outcrops with mm to cm precision. Conversely, the complex geometries of the imaged surfaces affect the spectral quality and signal-to-noise ratio (SnR) of HSI data at these very narrow spatial samplings. Additionally, the complex mineral assemblages found in hydrothermally altered ore deposits can make interpretation of spectral results a challenge. In this contribution, we propose an innovative approach that integrates multiple sensors and scales of data acquisition to help disentangle complex mineralogy associated with lithium and tin mineralisation in the Uis pegmatite complex, Namibia. We train this method using hand samples and finally produce a three-dimensional (3D) point cloud for mapping lithium mineralisation in the open pit. We were able to identify and map lithium-bearing cookeite and montebrasite at outcrop scale. The accuracy of the approach was validated by drill-core data, XRD analysis and LIBS measurements. This approach facilitates efficient mapping of complex terrains, as well as important monitoring and optimisation of ore extraction. Our method can easily be adapted to other minerals relevant to the mining industry.Item Adjudicating affirmative action within a normative framework of substantive equality and the Employment Equity Act – an opportunity missed?(Juta and Co, 2015) Albertyn, CatherineThe development of a constitutionally informed legal standard to test employment equity plans and affirmative action measures will always be troubled in a country that has seen racial classification serve as the basis for oppression and subordination, and now seeks to use it in achieving a ‘non-racial’ democracy. Contestation over how to secure redress, restitution and substantive equality are inevitable. The Barnard judgment demonstrates a common commitment to restitution and transformation, and, indeed, a common outcome. However, between that commitment and the outcome lie important differences in philosophical and legal approaches to equality, to s 9 of the Constitution and s 6 of the Act (and the relationship between them), to the standard of justification for positive measures and to the need for courts to engage substantively with crucial issues in our democracy. In this case-note, after setting out the case history and judgments in some detail, I explore the contrasting ideas of equality that underpin the different approaches to positive measures and discuss which is best suited to our constitutional project. I then suggest how this normative framework can inform the adjudication of employment equity plans and affirmative action measures under the Employment Equity Act. No single judgment in Barnard achieves this.Item The administration of justice(Juta, 2003) Klaaren, Jonathan; Marcus, Gilbert; Davis, DennisOverview and analysis of the year's legal developments in the field of administration of justice. Includes references to legislation, cases and journal articles.Item The administration of justice(Juta, 2002) Klaaren, Jonathan; Marcus, Gilbert; Davis, DennisThe Immorality Amendment Act 2 criminalized prostitution in 1998. It did so by the insertion of s 20(1)(aA) into the principal Act, which it renamed the Sexual Offences Act 23 of 1957.Item Africanity and Orality in the Films/Videos of Women Filmmakers of the African Diaspora(Deep Focus: A Film Quarterly, 1998) Ebrahim, HaseenahIn this essay, I consider the role of African cultural heritage and of oral tradition in selected films/videos by women filmmakers of the African Diaspora. for practical purposes, I limit the scope of my analysis to the works of a handful of filmmakers in the United States and the Caribbean: Julie Dash (USA), Euzhan Palcy (Martinique/France), Zeinabu irene Davis (USA), and Gloria Rolando (Cuba).Item Afrocuban religions in Sara Gomez's one way or another and Gloria Ronaldo's Oggun(The Western Journal of Black Studies, 1998) Ebrahim, HaseenahThis paper explores the depiction of Afrocuban religions in two films - Sara Gomez's One way or another(1974/1977) and Gloria Rolando's Oggun: Forever present(1991).A (Western) feminist's analysis of Gomez's One way or another characterizes Abakua and Santeria as "voodoo" - not only collapsing three different Afro-Carribean religious traditions, but also reflecting Marxistbiases that exclude (ironically) a recognition that Gomez's depictions of Abakua and Santeria reflect a gendered perspective.Rolando's Oggun reflects a recent trend in Cuban cinema to celebrate Afrocuban religious practices.Oggun's stunning visuals, compelling song and dance sequences, and fascinating mythology provoke a desire to understand the role and impact of this remarkable religious tradition in Cuban society.Item An all-oral 6-month regimen for multidrug resistant Tuberculosis: A multicenter randomized controlled clinical trial (the Next Study)Esmail, Aliasgar ; Oelofse, Suzette ; Lombard, Carl ; Perumal, Rubeshan ; Variava, Ebrahim ; Martinson, NeilRationale: Improving treatment outcomes while reducing drug toxicity and shortening the treatment duration to 6 months remains an aspirational goal for the treatment of multi drug resistant /rifampicin-resistant tuberculosis(MDR/RR-TB). Objectives: To conduct a multicenter randomized controlled trial in adults with MDR/RR-TB(i.e., without resistance to fluoroquinolones or aminoglycosides) . Methods: Participants were randomly assigned(1:1ratio)to a 6 month all-oral regimen that included levofloxacin, bed aquiline, and linezolid or the standard-of-care(SOC)>9-month World Health Organization(WHO)-approved injectable-based regimen. The primary endpoint was a favorable WHO-defined treatment outcome (which mandates that prespecified drugs substitution is counted as an unfavorable outcome)24 months after treatment initiation. The trial was stopped prematurely when bed aquiline-based therapy became the standard of care in South Africa. Measurements and Main Results: In total,93 of 111 randomized participants(44 in the comparator arm and 49 in the intervention alarm) were included in the modified intention-to-treatanalysis;51(55%)were HIV coinfected(medianCD4count,158cells/ml).Participants in the intervention arm were 2.2 times more likely to experience a favorable 24-month outcome than participants in the SOC arm(51%[25of49]vs. 22.7%[10of44];riskratio,2.2[1.2–4.1];P=0.006).Toxicity-related drug substitution occurred more frequently in the SOC arm(65.9%[29of44] vs.34.7%[17of49];P=0.001)],82.8%(24of29)owing to kanamycin (mainly hearing loss; replaced by bed aquiline) in the SOC arm, and 64.7% (11of17) owing to fluoroquinolones or aminoglycosides (mainly anemia) in the intervention alarm. Adverse event–related treatment discontinuation in the safety population was more common in the SOC arm(56.4%[31of55]vs.32.1%[17of 56];P=0.007).However, grade 3 adverse events were more common in the intervention alarm(55.4%[31of56]vs.32.7[18of55];P=0.022). Culture conversion was significantly better in the intervention arm (hazardratio,2.6[1.4–4.9];P=0.003)after censoring those with bed aquiline replacement in the SOC arm(and this pattern remained consistent after censoring for drug replacement in both arms ;P=0.01). Conclusions: Compared with traditional injectable-containing regimens, an all-oral 6-month levofloxacin, bed aquiline, and linezolid–containing MDR/RR-TB regimen was associated with a significantly improved 24-month WHO-defined treatment outcome (predominantly owing to toxicity-related drugs substitution).However, drug toxicity occurred frequently in both arms. These findings form strategies to develop future regimens for MDR/RR-TB. Clinical trial registered with www.clinicaltrials.gov (NCT02454205).Item Analysis of surgical mortalities using the fishbone model for quality improvement in surgical disciplinesMoeng, Maeyane S.; Luvhengo, Thifhelimbilu E.Background: The healthcare industry is complex and prone to the occurrence of preventable patient safety incidents. Most serious patient safety events in surgery are preventable. Aim: This study was conducted to determine the rate of occurrence of preventable mortalities and to use the fishbone model to establish the main contributing factors. Methods: We reviewed the records of patients who died following admission to the surgical wards. Data regarding their demography, diagnosis, acuity, comorbidities, categorization of death and contributing factors were extracted from the Research Electronic Data Capture (REDCap) database. Factors which contributed to preventable and potentially preventable mortalities were collated. The fishbone model was used for root cause analysis. The study received prior ethical clearance (M190122). Results: Records of 859 mortalities were found, of which 65.7% (564/859) were males. The median age of the patients who died was 49 years (IQR: 33–64 years). The median length of hospital stay before death was three days (IQR: 1–11 days). Twenty-four percent (24.1%) of the deaths were from gastrointestinal (GIT) emergencies, 18.4% followed head injury and 17.0% from GIT cancers. Overall, 5.4% of the mortalities were preventable, and 41.1% were considered potentially preventable. The error of judgment and training issues accounted for 46% of mortalities. Conclusion: Most surgical mortalities involve males, and around 46% are either potentially preventable or preventable. The majority of the mortality were associated with GIT emergencies, head injury and advanced malignancies of the GIT. The leading contributing factors to preventable and potentially preventable mortalities were the error of judgment, inadequate training and shortage of resources.Item Analysis of urban sprawl dynamics using machine learning, CA-Markov chain, and the Shannon entropy model: a case study in Mbombela City, South Africa(SpringerOpen, 2024) Mhangara, Paidamwoyo; Gidey, Eskinder; Rabia ManjooOver half of the world’s population resides in urban areas. We anticipate that this pattern will become more evident, notably in South Africa. Therefore, research on urban spirals, both past and projected, is necessary for efficient urban land use planning and management. This study aims to assess the spatio-temporal urban sprawl dynamics from 2003 to 2033 in Mbombela, South Africa. We employed robust approaches such as machine learning, the cellular automata-Markov chain, and the Shannon entropy model to look at how urban sprawl changes over time using both the Landsat 4–5 Thematic Mapper and the 8 Operational Land Imagers. We conducted this study to bridge the gaps in existing research, which primarily focuses on past and current urban growth trends rather than future trends. The findings indicated that the coverage of built-up areas and vegetation has expanded by 1.98 km2 and 13.23 km2 between the years 2003 and 2023. On the other hand, the amount of land continues to decrease by -12.56 km2 and − 2.65 km2 annually, respectively. We anticipate an increase in the built-up area and vegetation to a total of 7.60 km2 and 0.57 km2, respectively, by the year 2033. We anticipate a total annual decline of -7.78 km2 and − 0.39 km2 in water bodies and open land coverage, respectively. This work has the potential to assist planners and policymakers in improving sustainable urban land-use planning.Item The anatomy of ‘race trouble’ in online interactions(Taylor & Francis, 2014-01) Cresswell, Catherine; Whitehead, Kevin A; Durrheim, KevinSouth Africa has a long history of race-related conflicts in a variety of settings, but the use of the concept ‘racism’ to analyse such conflicts is characterized by theoretical and methodological difficulties. In this article, we apply the alternative ‘race trouble’ framework developed by Durrheim, Mtose, and Brown (2011) to the examination of racialized conflicts in online newspaper forums. We analyse the conflicts using an approach informed by conversation analytic and discursive psychological techniques, focusing in particular on the emergence and use of race and racism as interactional resources. Our findings reveal some mechanisms through which the continuing salience of race in South Africa comes to be reproduced in everyday interactions, thereby suggesting reasons why race continues to garner social and cultural importance. Disagreements over the nature of racism were also recurrent in the exchanges that we examined, emonstrating the contested and shifting meanings of this concept in everyday interactions.Item Antiplatelet Therapy Combined with Anastrozole Induces Features of Partial EMT in Breast Cancer Cells and Fails to Mitigate Breast-Cancer Induced Hypercoagulation(MDPI, 2021-04-16) Xulu, Kutlwano R.; Augustine, Tanya N.Thromboembolic complications are a leading cause of morbidity and mortality in cancer patients. Cancer patients often present with an increased risk for thrombosis including hypercoagulation, so the application of antiplatelet strategies to oncology warrants further investigation. This study investigated the effects of anastrozole and antiplatelet therapy (aspirin/clopidogrel cocktail or atopaxar) treatment on the tumour responses of luminal phenotype breast cancer cells and induced hypercoagulation. Ethical clearance was obtained (M150263). Blood was co-cultured with breast cancer cell lines (MCF7 and T47D) pre-treated with anastrozole and/or antiplatelet drugs for 24 h. Hypercoagulation was indicated by thrombin production and platelet activation (morphological and molecular). Gene expression associated with the epithelial-to-mesenchymal transition (EMT) was assessed in breast cancer cells, and secreted cytokines associated with tumour progression were evaluated. Data were analysed with the PAST3 software. Our findings showed that antiplatelet therapies (aspirin/clopidogrel cocktail and atopaxar) combined with anastrozole failed to prevent hypercoagulation and induced evidence of a partial EMT. Differences in tumour responses that modulate tumour aggression were noted between breast cancer cell lines, and this may be an important consideration in the clinical management of subphenotypes of luminal phenotype breast cancer. Further investigation is needed before this treatment modality (combined hormone and antiplatelet therapy) can be considered for managing tumour associated-thromboembolic disorder.Item Applying upstream interventions for interpersonal violence prevention: An uphill struggle in low- to middle-income contexts(Health Policy, 2010) Matzopoulos, Richard; Bowman, Brett; Mathews, Shanaaz; Myers, JonnyIn South Africa’s Western Cape province, interpersonal violence was identified among the key prevention priorities in the provincial government’s Burden of Disease (BoD) Reduction project. To date, there are no adequate systematic reviews of the full range of potential intervention strategies. In response, available data and the literature on risk factors and prevention strategies for interpersonal violence were reviewed with a view to providing policy makers with an inventory of interventions for application. Given the predominance of upstream factors in driving the province’s rates of interpersonal violence, efforts to address its burden require an intersectoral approach. Achievable short-term targets are also required to offset the long-term nature of the strategies most likely to affect fundamental shifts. Documentation and evaluation will be important to drive long-term investment, ensure effectiveness and enable replication of successful programmes and should be considered imperative by interpersonal violence prevention policymakers in other low- to middle-income contexts.Item Aqueous extract of moringa (Moringa oleifera) leaf (AEMOL) on the growth, sensory and histology parameters of broiler chickens(ALÖKI Kft, 2020-07) Mbajiorgu, Ejikeme F.; Alabi, O. J.; Ng’Ambi, J. W.A completely randomized design experiment was used to determine the effects of aqueous extract of Moringa oleifera leaf (AEMOL) on growth, sensory and histology parameters of broiler chickens. Treatment 1 served as the control (antibiotics), Treatment two was given ordinary water (AEMOL0). Treatments 3, 4, 5 and 6 contained 30, 60, 90 and 120 ml of AEMOL per litre of water per day, respectively. Data obtained were analyzed using one-way analysis of variance and mean separation was done using Duncan’s test for multiple comparisons. Results showed that the extract influenced (P < 0.05) the feed intake and water intake at the broiler starter phase WHILE birds on the control diet had higher values. Finisher phase results showed that final weight, weight gain, feed intake, FCR and water intake were influenced (P < 0.05) by the extract with birds treated with 60 ml/l of AEMOL doing better for most parameters except the FCR. All the digestibility and sensory parameters measured were also influenced (P < 0.05) by the extract. However, histological parameters measured were not affected (P > 0.05) by the extract. It could be concluded that the extract inclusion levels up to 90 ml/l can be used to replace antibiotic growth promoter without compromising the advantages of antibiotic growth promoter.Item Are the "boys" at Pixar afraid of little girls?(Journal of Film and Video, 2015) Ebrahim, HaseenahThe notion that American animated films are somehow excluded from ideological concerns, that they are “ideologically empty,” so to speak, reflects a widespread perception within both the USA and South Africa that children’s films are just innocent, escapist, fun. Walt Disney himself was known to perpetuate this perception by, somewhat disingenuously, remarking that “we just make the pictures, and let the professors tell us what they mean” (quoted in Bell, Haas and Sells 1). Although sometimes tongue-in-cheek, I examine Pixar’s construction of little girls within the context of a brand image of Pixar’s animator-directors as “boys at heart”--that is, as Peter Pan types who have never really grown up. I explore whether Pixar’s films reflect a certain apprehension about little girls that can, perhaps, be likened to the way young boys often display a notable ambivalence toward girls. Pixar’s little girls—Hannah, Molly, Boo, Darla and Bonnie and Daisy—are not always so “sugar and spice and everything nice,” but rather embody toxicity to varying degrees (though not always seriously), becoming a source of fear, pain, or humiliation to a number of male characters in several Pixar films. What initially appears to suggest an aversion to little girls emerges as a more complex construction of little girls by the “boys” at Pixar.Item Beyond ‘supply and demand’: moving from skills ‘planning’ to seeing skills as endogenous to the economy(2022-11) Allais, Stephanie MatselengThis article questions the notion of supply and demand of skills, and, accordingly, the rules and tools that have been developed for skills anticipation in South Africa. I argue that there is nowhere ‘outside’ of the economy where skills are produced. Rather, a society and an economy need to be seen as an organism, where skill formation is a complex set of moving parts. The concept of supply and demand is unhelpful to think about skill formation because it directs our attention towards specific moving parts in isolation from the broader factors that shape them. This explains why, despite the existence of extensive tools and institutions for skills anticipation, and numerous institutions for social dialogue and stakeholder engagement, researchers and policy-makers argue that South Africa has an inadequate supply of the skills that are needed in the workplace and concomitant skills mismatches. The article also presents more specific problems with the rules and tools, particularly in the way the systems and institutions for understanding labour market demand interact with the systems and tools for the supply of skills – especially those tools that govern and shape skills provision. It argues further that, whereas there are real problems with these rules and tools, and while they can certainly be improved, the broad goals that they are intended to achieve will not be attained even with better tools, but that different conceptual lenses are required instead.Item Blood pressure measurements in the ankle are not equivalent to blood pressure measurements in the arm(2014-12) Goldstein, L.N.; Wells, M.; Sliwa, K.Background. Blood pressure (BP) is often measured on the ankle in the emergency department (ED), but this has never been shown to be an acceptable alternative to measurements performed on the arm. Objective. To establish whether the differences between arm and ankle non-invasive BP measurements were clinically relevant (i.e. a difference of ≥10 mmHg). Methods. This was a prospective cross-sectional study in an urban ED making use of a convenience sample of 201 patients (18 - 50 years of age) who were not in need of emergency medical treatment. BP was measured in the supine position on both arms and ankles with the correct size cuff according to the manufacturer’s guidelines. The arm and ankle BP measurements were compared. Results. There was a clinically and statistically significant difference between arm and ankle systolic BP (SBP) and mean arterial pressure (MAP) (–13 mmHg, 95% confidence interval (CI) –28 - 1 mmHg and –5 mmHg, 95% CI –13 - 4 mmHg, respectively), with less difference in diastolic BP (DBP) (2 mmHg, 95% CI –7 - 10 mmHg). Only 37% of SBP measurements and 83% of MAP measurements were within an error range of 10 mmHg, while 95% of DBP measurements agreed within 10 mmHg. While the average differences (or the bias) were generally not large, large variations in individual patients (indicating poor precision) made the prediction of arm BP from ankle measurements unreliable. Conclusion. Ankle BP cannot be used as a substitute for arm BP in the ED.Item Bridging risk and enactment: the role of psychology in leading psychosocial research to augment the public health approach to violence in South Africa(2014) Bowman, Brett; Stevens, Garth; Eagle, Gillian; Maztopoulos, RichardIn the wake of apartheid, many in the South African health and social sciences shifted their orientation to understanding violence. Rather than approaching violence as a criminal problem, post-apartheid scholarship surfaced violence as a threat to national health. This re-orientation was well aligned with a global groundswell that culminated in the World Health Assembly’s 1996 declaration of violence as a public health problem. In response, researchers and other stakeholders have committed to the public health approach to violence in South Africa. Despite some unquestionable successes in applying this approach, violence remains a critical social issue and its recalcitrantly high rates signal that there is still much work to be done. One avenue for more focussed research concerns understanding the mechanisms by which upstream risk factors for violence are translated into actual enactments. We argue that South African psychology is well placed to provide greater resolution to this focus. We begin by providing a brief overview of the public health approach to violence. We then point to three specific areas in which the limits to our understanding of the way that downstream psychological and upstream social risk factors converge in situations of violence, compromise the theoretical and prevention traction promised by this approach and chart several basic psychosocial research coordinates for South African psychology. Steering future studies of violence by these coordinates would go some way to addressing these limits and, in so doing, extend on the substantial gains already yielded by the public health approach to violence in South Africa.