BACKGROUND: Transmission of entrepreneurial legacies in family-owned businesses has received increased attention. There is still uncertainty, however, whether families pass down the knowledge and skills onto their children. AIM: This study explored how families transmit entrepreneurial knowledge and skills as part of occupational legacy to their children METHODS: This narrative qualitative research was conducted with five families who owned business in the Western Cape and Mpumalanga Provinces. Twelve participants were selected through purposive sampling. Semi-structured interviews were conducted with the participants using a face-face approach and telephone calls were audio-recorded, transcribed verbatim then thematically analysed in a credible manner. FINDINGS: Four themes captured the qualitative evidence of how the families transmit entrepreneurial knowledge and skills to the children consists of Theme 1: Parental family traditions; Theme 2: Inherited entrepreneurial knowledge and skills; Theme 3: Experiences of the entrepreneurial occupations; and Theme 4: We need to let go and let them carry on. CONCLUSION: Overall, this study indicates that through enacted togetherness, transitions and adaptations allowed families to engage in entrepreneurial occupations that facilitated inculcation of knowledge and skills needed for family-owned businesses. The social implication of this study is that families transmitted the legacy of social security of their communities. IMPLICATIONS FOR PRACTICE: This study suggests that occupational therapists should consider the needs of older generations who are prone to imposter syndrome due to handing over their family-owned businesses to the younger generations. Greater efforts are needed to ensure that older and younger generations have mental and emotional capacity to deal with the psychological and environmental factors that can influence transmission of entrepreneurial legacies. Therefore, occupational therapists may design intervention strategies to facilitate transition, resilience, productivity and wellness.

Problems arise when a lawfully appointed surrogate decision-maker wishes to decide on a course of action on behalf of a mentally incompetent patient that is against the patient's best interests. This may arise: (i) where there is no advance directive, and the decision is made by the surrogate decision-maker on religious grounds; (ii) where the medical practitioners are of the opinion that the surrogate decision-maker's decision is not in the best interests of the patient; (iii) where the close relatives of the patient do not agree with the decision by the surrogate decision-maker; and (iv) where the surrogate decision-maker asks the medical practitioners to undertake treatment or a procedure on the patient that is unlawful or unethical. Suggestions are made regarding what doctors should do when faced with each of these situations.

Abstract Objective To evaluate the postoperative functional and radiographic outcomes of the shoulder of patients submitted to transosseous suturing of a greater tuberosity fracture (GTF) through an anterolateral route and the influence of the glenohumeral dislocation on these outcomes. Methods We conducted a retrospective study and functional assessment using the Constant-Murley score. The distance between the greater tuberosity and the joint surface of the proximal humerus (in true anteroposterior radiographs) after the union was calculated. We used the Fisher exact test for the categorical independent variables, and the Student t or Mann-Whitney test for the non-categorical variables. Results In total, 26 patients met the inclusion criteria, and 38% of the sample presented an association between glenohumeral dislocation and GTF. The mean Constant-Murley score was of 82.5 + 8.02 points. The presence of an associated dislocation did not alter the functional outcome. The mean distance between the greater tuberosity of the humerus and the joint surface of the humeral head after the union was of 9 + 4.3 mm below the articular line of the humeral head. The dislocation led to a lower level of reduction, but this did not influence the Constant-Murley score. Conclusion The cases of GTF submitted to surgical treatment with transosseous sutures had good functional outcomes. The presence of dislocation made the anatomical reduction of the greater tuberosity difficult. However, it did not influence the Constant-Murley score.

Resumo Objetivo Avaliar os resultados funcional e radiográfico pós-operatórios do ombro, em pacientes submetidos a sutura transóssea de fratura da tuberosidade maior (FTM) por acesso anterolateral, e a influência da luxação glenoumeral nesses resultados. Métodos Realizou-se estudo retrospectivo e avaliação funcional (pela escala de Constant-Murley). Calculou-se a distância entre a tuberosidade maior e a superfície articular do úmero proximal (por meio de radiografia em incidência anteroposterior verdadeira) após a consolidação. Usou-se o teste Exato de Fisher para as variáveis independentes categóricas, e os testes tde Student ou de Mann-Whitney para as não categóricas. Resultados Ao todo, 26 pacientes preencheram os critérios de inclusão. A associação de luxação glenoumeral com FTM foi observada em 38% da amostra. A média da pontuação na escala de Constant-Murley foi de 82,5 + 8,02. A presença de luxação associada não alterou o resultado funcional. A distância média da consolidação da tuberosidade maior do úmero em relação à superfície articular da cabeça umeral foi de 9 + 4,3 mm abaixo da linha articular da cabeça umeral. Pacientes com luxação associada evoluíram com redução menor, mas isso não influenciou na pontuação na escala de Constant-Murley. Conclusão As FTMs submetidas ao tratamento cirúrgico com sutura transóssea evoluíram com bom resultado funcional. A presença de luxação dificultou a redução anatômica da tuberosidade maior. Entretanto, isso não influenciou na pontuação na escala de Constant-Murley.

The Limpopo MEC for Health, during a hospital visit, was recently shown in a video to have humiliated a vulnerable undocumented Zimbabwean woman patient, resulting in the hospital workers present laughing at the unfortunate patient. The patient had arrived at a hospital in the province that was short-staffed and under-resourced because of failings on the part of the Department of Health. She wished to give birth to her child in a safe environment, because the shortage of proper facilities in Zimbabwe posed a threat to her and her unborn child. The conduct of the MEC is measured against the patient's rights under the Constitution of South Africa and the National Health Act 61 of 2003, and her conduct is discussed in the light of the Health Professions Act 56 of 1974 and the Ethical Rules of Conduct of the Health Professions Council of South Africa (HPCSA). The conclusion reached is that the MEC had breached the Constitution, the National Health Act, the Health Professions Act and the Ethical Rules of Conduct of the HPCSA, and should be disciplined by the HPCSA, as required by the Health Professions Act.

Le 10e anniversaire du Journal of Student Affairs in Africa (JSAA) constitue une bonne occasion de demander de quelle manière les rédacteurs du JSAA estiment avoir contribué à la réalisation de l'objectif de la revue visant à professionnaliser les Œuvres Estudiantines dans les universités africaines. En utilisant quatre récits réflexifs de six rédacteurs de la revue, cet article analyse les réflexions des rédacteurs sur leur parcours professionnel et le rôle joué par la revue dans celui-ci; comment ils contribuent au développement professionnel de leurs pairs grâce à leur poste de rédacteur ; les défis auxquels ils sont confrontés et les leçons qu'ils ont apprises ; et les visions qu'ils ont pour l'avenir de la revue. En appliquant les notions de professionnalisme d'Evetts (2003), nous identifions différents types de professionnalisme exprimés dans les récits réflexifs. Nous constatons que l'action des rédacteurs combine les normes, l'éthique et les procédures opérationnelles de publication avec des principes et des engagements propres aux services aux étudiants africains. À cet égard, le processus de professionnalisation dirigé par le JSAA combine à la fois des éléments de professionnalisme « de l'intérieur » et « de l'extérieur ». Nous soulignons en outre les engagements des rédacteurs envers le bien-être (des étudiants, du personnel et des communautés), le développement professionnel et l'excellence, l'inclusion délibérée et la justice sociale, ainsi que l'accent mis sur la pertinence dans le contexte des services aux étudiants africains.

The 10th anniversary of the Journal of Student Affairs in Africa (JSAA) is a good occasion to ask in what ways the editors of JSAA think they have contributed to achieving the journal's aim to contribute to professionalizing student affairs in Africa. Using four reflective accounts of six editors of the journal, this article analyses the editors' reflections on their professional pathways and the role the journal played in them; how they contribute to the professional development of their peers by means of their editorship; the challenges they encounter and lessons they have learned; and the visions they have for the future of the journal. By applying Evetts' (2003) notions of professionalism, we identify different types of professionalism signified in the reflective accounts. We find that the agency of the editors combines standards, ethics, and operating procedures of publishing with principles and commitments indigenous to African student affairs. In this regard, the JSAA-led professionalization process combines both elements of professionalism 'from within' and 'from outside'. We further highlight commitments of the editors to well-being (of students, staff, and communities), professional development and excellence, deliberate inclusivity and social justice, and a focus on relevance in the African student affairs context.

A hypothetical scenario is presented in which a female patient is admitted to a private hospital to undergo a mastectomy and breast reconstruction. The surgeons and anaesthetists conducting the different procedures charge three times the medical aid rates. When the patient asks what the co-payments are likely to be, she is informed by the doctors' accounts section that they can only provide this information after each procedure. The patient's medical scheme also advises her that it cannot determine the likely co-payments unless she completes the assessment form sent to her. The form requires her to include the costs reflected against the relevant ICD10 codes. The patient cannot complete the form because the doctors' accounts sections have not informed her about the proposed procedures and the likely costs of each. This article builds on a previous article discussing doctors' overarching responsibility to disclose medical treatment costs in advance. The present article outlines the legal requirements in the South African Constitution, the National Health Act and the Health Professions Act, and refers to the Promotion of Access to Information Act and Consumer Protection Act. Similar to the earlier article, this article addresses the ethical requirements of the Health Professions Council of South Africa and the internationally recognised biomedical ethical principles. Furthermore, it also refers to the National Patients Charter, the government's policy document on health care services.

ABSTRACT Hydrological modeling in decision-making is particularly challenging in tropical countries such as Brazil. There are numerous modeling tools; however, many applications have focused on watersheds with a total area of <20,000km2. Here we tailored a customized SWAT (Soil and Water Assessment Tool) ecohydrological model application using the SWAT CUP tool for calibration and validation of the Rio das Velhas, a relatively large, complex Brazilian basin (~28,000km2). The Rio das Velhas is the longest tributary of the São Francisco River and contains heterogeneous landforms, soils, vegetation, and land uses. A multisite calibration method obtained specific regionalized parameters for each sub-basin group for successfully simulating Rio das Velhas streamflows. Our results showed a suitable adjustment of the model. Nash-Sutcliff (NS) model performance values were 0.73-0.97 (calibration) and 0.51-0.98 (validation). The percent bias (PBIAS) was -11.3 to 19.4 (calibration) and -18.6 to 24.6 (validation), and the coefficient of determination values (R2) were >0.6 in all sub-basins on a monthly basis. We also explored how four contrasting land use scenarios affected four water-flow variables (surface runoff, base flow, percolation, and total streamflow). Our results show that by using multiple flow-monitoring stations and multisite calibration approaches, ecohydrological models can be useful for managing basin-extent water resources in countries of continental dimensions such as Brazil.

RESUMO O uso de ferramentas de modelagem hidrológica na tomada de decisão é particularmente desafiador em países tropicais como o Brasil. Existem inúmeras ferramentas de modelagem disponíveis; entretanto muitas aplicações destas ferramentas são focadas em bacias hidrográficas com área total <20.000 km2. Neste trabalho, adotamos e customizamos o modelo ecohidrológico SWAT (Soil and Water Assessment Tool) usando a ferramenta SWAT CUP para calibração e validação do Rio das Velhas, uma relativamente grande e complexa bacia brasileira (~ 28.000 km2). O Rio das Velhas é o maior afluente da bacia do rio São Francisco e contém formas de relevo, solos, vegetação e usos da terra heterogêneos. Usando um método de calibração multi-site, parâmetros regionalizados específicos foram obtidos para cada grupo de sub-bacias para simular com sucesso as vazões do Rio das Velhas. Nossos resultados mostraram um bom ajuste do modelo. Os valores do coeficiente de performance Nash-Sutcliff (NS) foram 0,73-0,97 (calibração) e 0,51-0,98 (validação). A porcentagem de viés (PBIAS) foi de -11,3 a 19,4 (calibração) e -18,6 a 24,6 (validação) e os valores do coeficiente de determinação (R2) foram >0,6 em todas as sub-bacias considerando uma escala mensal. Também exploramos as maneiras pelas quais quatro cenários contrastantes de uso da terra impactam às quatro variáveis de vazões avaliadas (escoamento superficial, fluxo de base, percolação e fluxo total). Nossos resultados mostram que, usando múltiplas estações de monitoramento de vazão e abordagens de calibração multi-site, os modelos ecohidrológicos podem de fato ser úteis para gerenciar os recursos hídricos da extensão da bacia em países de dimensões continentais como o Brasil.

ABSTRACT Environmental degradation from human pressures includes the conversion of native vegetation cover into pastures and cropland, as well as riparian deforestation, leading to river siltation, biotic homogenization, and loss of ecosystem services. The objective of our study was to evaluate water quality and benthic macroinvertebrate assemblage structure in response to changes in land use at local and buffer spatial extents. We assumed that human disturbances negatively affect water quality and macroinvertebrate assemblage condition. Greater human influence was observed at the local extent (Local Disturbance Index – LDI) than at the buffer (Buffer Disturbance Index – BDI) extent. Likewise, biological metric responses were stronger relative to the LDI than to the BDI or to the Integrated Disturbance Index (IDI). These results support establishing a biomonitoring program for assessing water body quality in the Doce River basin to facilitate conserving aquatic biodiversity and ecosystem services in the upper Graipu River.

RESUMO A degradação ambiental causada por pressões antrópicas inclui a conversão de cobertura vegetal nativa em pastagens e terras agrícolas, bem como o desmatamento de zonas ripárias, levando ao assoreamento de rios, à homogeneização biótica e à perda de serviços ecossistêmicos. O objetivo do nosso estudo foi avaliar a qualidade de água e a estrutura de assembleia de macroinvertebrados bentônicos em resposta a mudanças no uso da terra em extensões espaciais locais e de microbacia (buffer). Para tanto, assumimos que os distúrbios humanos afetam negativamente a qualidade de água e a assembleia de macroinvertebrados bentônicos. Maior influência humana foi observada na escala local (Índice de Distúrbio Local – LDI) do que na escala de buffer (Índice de Distúrbio Buffer – BDI). Da mesma forma, as respostas das métricas biológicas foram mais correlacionadas ao LDI do que ao BDI ou o Índice Integrado de Distúrbio (IDI). Esses resultados apoiam o estabelecimento de um programa de biomonitoramento para avaliar a qualidade de corpos hídricos na bacia do rio Doce, fomentando a conservação de biodiversidade aquática e serviços ecossistêmicos no alto ribeirão Graipu.

Resumo O debate sobre o poder do banco central para controlar a inflação e estabilizar o ciclo de negócios foi reaberto recentemente. Este documento argumenta que a política monetária funciona mudando a disposição dos bancos ao invés de alterar a taxa de juros, e que não há “mestres” dos bancos centrais que conhecem o segredo da manutenção do pleno emprego e da estabilidade de preços. A transmissão das taxas de juros não funciona como os livros didáticos supõem. As evidências empíricas mostram que a taxa de juros do Fed não afeta as taxas de juros de longo prazo e que o investimento empresarial depende das condições de crédito e não tanto do custo dos fundos emprestados. No mundo real, não há mercados em que se troquem as mercadorias de hoje pelas mercadorias de amanhã; há mercados de crédito. A taxa de juros não mede o preço relativo do consumo presente versus consumo futuro, mas o trade-off entre renda versus liquidez e segurança.

Abstract The debate over the power of central banking to control inflation and stabilize the business cycle has recently been reopened. This brief argues that monetary policy works by changing the disposition of banks rather than by altering the interest rate, and that there are no central banking "masters" who know the secret of maintaining full employment and price stability. Interest rate pass-through does not work as the textbooks assume. Empirical evidence shows that the Fed's interest rate does not affect long-term interest rates, and that business investment depends on credit conditions and not so much on the cost of loanable funds. In the real world, there are no markets in which you exchange today's goods for tomorrow's goods; there are credit markets. The interest rate does not measure the relative price of present consumption versus future consumption, but the trade-off between income versus liquidity and security.

Resumen En los últimos tiempos se ha reabierto el debate sobre el poder de la banca central para controlar la inflación y estabilizar el ciclo económico. Este escrito argumenta que la política monetaria funciona modificando la disposición de los bancos más que alterando la tasa de interés, y que no existen "maestros" de la banca central que conozcan el secreto de mantener el pleno empleo y la estabilidad de precios. La transmisión de las tasas de interés no funciona como suponen los libros de textos. La evidencia empírica muestra que la tasa de interés de la Fed no afecta las tasas de interés de largo plazo, y que la inversión de las empresas depende de las condiciones crediticias y no tanto del costo de los fondos prestables. En el mundo real no existen mercados en los que intercambien bienes de hoy por bienes de mañana; existen mercados de crédito. La tasa de interés no mide el precio relativo del consumo presente versus el consumo futuro, sino la disyuntiva entre ingresos frente a liquidez y seguridad.

The case involving Dr Tim De Maayer in Gauteng Province, South Africa (SA), raises the question whether there is a legal and ethical duty on public sector doctors whose complaints to hospital administrators have been ignored, to inform the public about harm to child patients due to intentional maladministration, negligence or indifference by the local and provincial authorities. An analysis of the SA Constitution, the National Health Act No. 61 of 2003, the Children's Act No. 38 of 2005, the Health Professions Act No. 56 of 1974 and the Rules and Guidelines of the Health Professions Council of South Africa (HPCSA) established in terms of the Health Professions Act indicates that Dr De Maayer acted both legally and ethically to protect the child patients at Rahima Moosa Hospital. As the complaints of harm caused to the patients because of conditions in the hospital were raised three times with the official functionaries concerned, and ignored by them, he was fully justified to try other measures to protect the patients. It seems that he hoped that by bringing the conditions at the hospital to the attention of the media, the public reaction would be such as to pressurise the administrators to redress the situation. The irony is that the officials who sought to discipline him were themselves guilty of violating the Constitution, the National Health Act and the Children's Act, and should be disciplined. Furthermore, if they are registered with the HPCSA, they should be reported and disciplined for violating the HPCSA's Ethical Rules of Conduct and its Ethical Guidelines on good practice.

Resumen La Escala de Bienestar Subjetivo (EBS-20) y su versión corta (EBS-8) fueron desarrolladas y validadas para medir en población hispanohablante la satisfacción con la vida y el afecto positivo. El objetivo del presente estudio fue obtener evidencias adicionales de validez para la EBS-8. Para ello, se aplicó la escala en tres estudios sucesivos a un total de 2259 mexicanos de 12 a 81 años. Los resultados del primer estudio permitieron confirmar la estructura unifactorial (CMIN/DF = 2.336; CFI = .996; RMSEA = .047) y la adecuada confiabilidad de la escala (a = .958, co = .957); en el segundo se probó su invarianza de medición por sexo, grupo social y edad (A%2 p > .05, ACFI < .004, ARMSEA < .014); y en el tercer estudio se encontró, mediante la calibración de sus reactivos bajo la TRI, que la escala estima satisfactoriamente el constructo evaluado (a > 1.69; P1 entre -2.78 y -2.35). A partir de los índices psicométricos obtenidos, se concluye que la EBS-8 es un excelente instrumento breve construido en español para evaluar el bienestar subjetivo en adolescentes, jóvenes, adultos y adultos mayores.

Abstract The Subjective Well-Being Scale (EBS-20) and its short version (EBS-8) were developed and validated to measure life satisfaction and positive affect in a Spanish-speaking population. The aim of the present study was to obtain additional evidence of validity for the EBS-8. To this end, the scale was applied in three successive studies to a total of 2259 Mexicans aged 12 to 81 years. The results of the first study allowed us to confirm its unifactorial structure (CMIN/DF = 2.336; CFI = .996; RMSEA = .047) and its adequate reliability (a = .958, co = .957); in the second its measurement invariance by sex, social group and age was tested (A%2 p >. 05, ACFI < .004, ARMSEA < .014); and in the third study it was found, by calibrating its items under IRT, that the scale satisfactorily estimates the construct assessed (a > 1.69; b1 between -2.78 and -2.35). From the psychometric indices obtained, it is concluded that the EBS-8 is an excellent brief instrument constructed in Spanish to assess subjective well-being in adolescents, young people, adults and older adults.

The South African (SA) government's roll-out of the COVID-19 vaccine is behind its target, largely owing to concerns about the side-effects and the effectiveness of the vaccines, and because they have been developed over a very short time frame. Another factor is a lack of trust in government policies regarding COVID-19 and its running of public health. One survey has indicated that for persons seeking a vaccination, the preferred vaccine site would be general practitioners (GPs). GPs have been used in Australia, the UK and elsewhere. In Australia, with a scattered rural population, 5 600 GPs have been vaccinating over one million patients weekly. Calls have been made by the South African Medical Association, among others, for GPs to be allowed to assist with the government's roll-out programme. If ~8 000 GPs in SA participated in a properly administered roll-out programme, and each GP were to vaccinate only 10 people a day, this would yield 400 000 vaccinations a week or ~1.6 million a month. The GPs could invite their patients and others to visit their room for a COVID-19 vaccination, as they do with the annual influenza vaccine.

Doctors' organisations have called for special legislation regarding the criminal charging of doctors for culpable homicide, and the need for special medical malpractice courts to deal with the huge increase in the number of medical malpractice cases. However, there are very few criminal prosecutions, because the prosecuting authorities generally accept that doctors do not intend to kill their patients, and are only likely to charge them for intentional or very serious deviations from the standard of a reasonably competent doctor in their profession. Doctors are also generally not held liable for mere errors of judgement. Although the call is for special legislation, the issues concerned can generally be dealt with administratively by existing legislation. For instance, the requirement of mediation before litigation could be introduced by the Chief Justice. Doctors need not fear making admissions during mediation proceedings in civil matters, because legislation provides that such admissions and evidence may not be used in subsequent civil actions. The Chief Justice can also issue a practice directive that all presiding officers must appoint medicolegal experts as assessors in medical malpractice cases. The medical profession can assist the process by arranging a panel of such experts who can be called upon to serve as assessors by the courts.