Surplus people and expendable children: The structure of apartheid and the mortality crisis in South Africa
South Africa’s apartheid scheme is considered as a paradigm case for the creation and maltreatment of a putatively surplus population. Both active and passive policies are identified that are utilized to contain the numbers of the black population of the nation. Of particular significance is a strategy of neglect that has led to exceptionally high infant and child mortality rates in the “homelands.” In addition, the South African authorities’ efforts to destabilize neighboring regimes in Angola and Mozambique has had similarly adverse repercussions on mortality rates there.
Contradiction and Uneven Development in South Africa: the Constrained Allocation of African Labour-Power
In the post-World War II period, South African capitalism is considered by many to have been reproduced on the basis of ‘cheap’ African labour-power. This is generally understood to mean that the prosperity of capitalism in the Republic depended on the poverty of the African majority. On the one hand, between 1950 and 1979, gross domestic product grew (in constant 1970 prices) from R4·4 billion to R15·5 billion. On the other hand, Africans on average earned wages that were below subsistence levels as defined by such minimal indices as the poverty datum line, and that were only 5 to 25 per cent as large as those earned on average by whites – see Tables 1 and 2. As generally analysed, both overall growth and the absolute and relative poverty of Africans were the direct result of the apartheid policies of the régime, in particular those responsible for the so-called cheap labour system.
Nurse responsiveness to cancer patient expressions of emotion.
OBJECTIVE
This theoretically based study examined nurse responses to cancer patient expressions of emotion using a videotaped, simulated cancer patient.


METHODS
This study used an experimental crossover design with a videotaped patient expressing anger, sadness, and neutral emotion to elicit nurse responses. Seventy-four nurses from eight sites participated. Responses were coded using Roter interaction analysis system. Correlations explored relationships between variables that impact communication (age, gender, work experience, trait anxiety, work stress, self-efficacy). Regression models explored the effect of variables on nurse affective responsiveness.


RESULTS
Patient expressions of sadness elicited more affective responses than anger. Expressions of anger or neutral emotion elicited more instrumental behaviors than sadness. Variables such as age, work stress and work experience were significantly correlated. No variables predicted affective responsiveness to patient expressions of anger or sadness.


CONCLUSION
Nurse communication showed significant variation in response to patient emotional expressions. Understanding the relationships between demographic, personality, and work variables, and identification of new variables that influence nurse-patient communication, has implications for interventional studies.


PRACTICE IMPLICATIONS
Over 90% of the participants indicated that the videotape simulation would be a useful method for teaching and practicing communication skills with patients expressing emotions.