Working toward effective anonymization for surveillance data: innovation at South Africa’s Agincourt Health and Socio-Demographic Surveillance Site

Linking people and places is essential for population-health-environment research. Yet, this data integration requires geographic coding such that information reflecting individuals or households can appropriately be connected with characteristics of their proximate environments. However, offering access to such geocoding greatly increases the risk of respondent identification and, therefore, holds the potential to breach confidentiality. In response, a variety of “geographic masking” techniques have been developed to introduce error into geographic coding and thereby reduce the likelihood of identification. We report findings from analyses of the error introduced by several masking techniques applied to data from the Agincourt Health and Socio-Demographic Surveillance System in rural South Africa. Using a vegetation index (Normalized Difference Vegetation Index (NDVI)) at the household scale, comparisons are made between the “true” NDVI values and those calculated after masking. We also examine the tradeoffs between accuracy and protecting respondent privacy. The exploration suggests that in this study setting and for NDVI, geomasking approaches that use buffers and account for population density produce the most accurate results. However, the exploration also clearly demonstrates the tradeoff between accuracy and privacy, with more accuracy resulting in a higher level of potential respondent identification. It is important to note that these analyses illustrate a process that should characterize spatially informed research but within which particular decisions must be shaped by the research setting and objectives. In the long run, we aim to provide insight into masking’s potential and perils to facilitate population-environment-health research.

     

Clients as Teachers: Reciprocal Influences in Therapy Relationships

The value of the continuing education industry for therapists is questioned, as is the usefulness of therapy books and journal articles, as a means of engaging therapists in life‐long learning. Instead, it is argued that our clients are our best teachers and that therapists learn most effectively from their clients. Drawing on research studies with prominent theoreticians and therapists, and on case studies from clinical work, a number of important themes are identified as ways in which therapists are influenced by their therapeutic encounters with their clients. The themes explored in this article include: (1) intimacy and high emotional arousal with clients as we witness profound change; (2) being challenged by clients; and (3) allowing for boundary ‘crossings’ in order to develop more flexible ways of working with clients. The implications for professional development are discussed.     

The Relationship Between Peer Victimization and Children's Humor Styles: It's No Laughing Matter!

This study assessed the concurrent and prospective (fall to spring) associations between peer victimization and four humor styles, two of which are adaptive (affiliative and self‐enhancing) and two maladaptive (aggressive and self‐defeating). Participants were 1234 adolescents (52 percent female) aged 11–13 years, drawn from six secondary schools in England. Self‐reports and peer reports of peer victimization were collected, as were self‐reports of humor styles. In cross‐sectional analyses, peer victimization was associated with all four humor styles, most strongly with self‐defeating and affiliative humor. Across the school year, peer victimization was associated with an increase in self‐defeating humor and a decrease in affiliative humor (and vice‐versa). These results have implications for models of humor development and how we understand the continuity of peer victimization.     

The Race for Education: Class,White Tone,and Desegregated Schooling in South Africa

In the early 1990s, privileged “white” South African public schools began to admit “black” pupils. Drawing on interviews, ethnography, and archival sources related to formerly‐white schools in Durban, this article addresses two main questions: first, why did white parents so enthusiastically vote for schooling desegregation when apartheid was still in place?; and second, why, over time, did intense competition emerge between schools, and become so focused on improving sports results? In addressing these questions this study takes an historical‐geographical approach, paying particular attention to two areas of Durban: the middle‐class central Berea area and the more working‐class areas in Durban's south. This story begins in the 1950s, a period of major schooling expansion and urban segregation, tracing how a hierarchy of white schools developed in relation to the city's uneven geographies of race and class. It is this schooling hierarchy and the way it became contested in the 1990s that is key to understanding the schools' shift from “cooperative desegregation” to “aggressive competition.” More broadly, the article argues that education provides a window into key post‐apartheid tensions – namely between the deracialization of privilege, the continued dividend of whiteness, and efforts to redistribute resources to the poor. Finally, in an age of mass education, it argues that the actions of schools play an important role in shaping raced and classed divisions in society.     

Exploring Perceptions of the Food Environment Amongst Congolese,Somalis and Zimbabweans Living in Cape Town

In low and middle‐income countries, the nutrition transition to highly processed, high‐sugar diets has been extraordinarily rapid. Yet in these same settings, obesity and hunger are often experienced within a single household. As part of a broader study of cross‐border migrants’ experiences of maternal and infant nutrition in Cape Town, in this article I explore the individual and collective meanings associated with foods in a specific migrant context, as well as their connections to changing food environments in Cape Town, South Africa. While there was relative silence over food scarcity, the food environment seemed to present constraints to dietary diversity. The migrants’ views and experiences suggest the relevance of improving the accessibility and affordability of already desirable, nutrient dense foods.     

The Economic and Gender Consequences of South Africa's Home‐based Care Policy

South Africa's approach to care provision in the era of HIV/AIDS is home‐ and community‐based care, but in reality care for ill people in the home is provided on an unpaid basis, predominantly by women. But how much do they spend on this care work, in time and money? And what economic consequences does this policy have, particularly for poorer women? This article is based on findings from a study that focuses on unpaid care provision within the home for those in late‐stage HIV/AIDS in KwaZulu‐Natal, South Africa, and specifically on the costs of such provision. The findings show that female caregivers are bearing the bulk of the costs of care provision for ill people within the home on an unpaid basis. Home‐based care is cost‐effective for the provincial government but not for unpaid caregivers who are subsidizing the provincial economy. While hospital care for people with HIV/AIDS has been capped, home‐based care services have not been increased to a commensurate level. Unpaid caregivers and ill people within the home are largely disconnected from the health system. The analysis clearly shows that the home‐based care policy is not resulting in appropriate or sufficient support for these individuals in need and needs to be revised.