\r\n\tRadiation monitoring deals with the sampling and measurement of different products found in different radiation pathways from the environment ending with consumption in humans. Gamma-spectroscopy is the main tool for measurement of these radiations.
\r\n\r\n\tThe aim of this book is to investigate the radionuclide concentrations in the most consumable food products, air, water and soil. Particularly, it is essential to investigate the radiations level in the surroundings of a nuclear facility.
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According to Zimbabwe National Statistics Agency ([2], p. 18), Zimbabwe has an estimated population of 13 million people with approximately three to four million currently living in foreign countries due to the socio-economic and political challenges that have rocked the country from the early 2000s to date unabated. The population composition of the Zimbabwean population comprises 98% Africans (Shona 82%, Ndebele 14%, and others 2%), Asian 1% and Whites less than 1% ([2], p. 19). Zimbabwe’s socio-economic glory was celebrated in the first 10 years of its attainment of independence, despite the tribal-ethnic war between the Ndebele and the Korean-trained Fifth Brigade Mugabe military wing, which ruthlessly claimed the lives of more than 20000 civilians in the Matabeleland province of Zimbabwe ([1], p. 1). The foregoing genocidal incidence, compounded with other socio-economic and politically motivated policies and events which were subsequently introduced to extricate the colonial legacy tainted the image of the political leaders of Zimbabwe at the international level.
According to Makina [1], a typical example of some of the socio-economic incidence that fast-tracked the deterioration or collapse of the once-celebrated economy of Zimbabwe include the Black Friday of 14 November 1997. This is the day when Mugabe the former president of Zimbabwe unilaterally declared that the Reserve Bank of Zimbabwe gives all the war veterans $50,000 each as compensation for their involvement in the liberation struggle. This was followed 2 years later by a gross infringement of the rule of law in 2000 precipitated by the state-sanctioned White farm invasion, which saw most of the Whites people brutally killed whiles others left the country. These unfortunate events coupled with the 2008 electorate malpractice, human rights violations, succession battles in the ruling Zimbabwe African National Union-Patriotic Front (ZANU-PF) political part, which culminated in the November 2017 coup that removed Mugabe from power, global pandemics such as HIV/AIDS ushered Zimbabwe in an unprecedented socio-economic melt-down. As such, these events affected more the rural communities and the vulnerable people than the urban communities and the working class in Zimbabwe.
In the past three decades, Zimbabwe, like other developing countries, has been severely affected by the HIV and AIDS pandemic which has exceeded wars in terms of cumulative deaths, morbidity, and social disintegration of families at the household level [3]. Statistically, the number of children in Zimbabwe has been estimated to be approximately 5.6 million, of which 1.3 million are orphans ([4], p. 2). The National AIDS Council ([4], p. 1) further estimated that there are approximately 48,000 child-headed households in Zimbabwe, housing approximately 100,000 children. In addition to the foregoing statistics, UNAIDS [5] indicates that there is approximately 165 ‘orphans’ and ‘vulnerable’ children living with HIV and AIDS in Zimbabwe which aggravate the challenges of the caregivers to cope with the ‘orphans’ and ‘vulnerable’ children’s problems at the household level. The studies carried out recently in Zimbabwe on the care and support of ‘orphans’ and ‘vulnerable’ children by Mugumbate & Chereni [6] and Ringson [3] show that whilst there are several residential care centres in Zimbabwe, the rural communities are predominantly espousing the extended safety nets and other traditional ‘orphans’ and ‘vulnerable’ children care and support systems.
Zimbabwe as a signatory to the United Nations Convention on the Rights of the Child (UNCRC) and the African Charter on the Rights and Welfare of the Child (ACRWC) promulgated governing policies and blueprints for child care and support which include the Zimbabwe Orphan Care Policy, the Zimbabwe National AIDS Strategic Policy, National Action Plan for Orphans and Vulnerable Children (NAP for OVC) and National Gender Policy (NGP) to mitigate the challenges of ‘orphans’ and ‘vulnerable’ children. However, despite the presence of these governing policies of childcare and support, there remains a gap regarding the capacitating and empowerment of caregivers at the household level. Chizororo [7] argues that the government policies are putting more emphasis on ‘orphans’ and ‘vulnerable’ children relegating the caregivers who are also vulnerable due to the increased number of ‘orphans’ and ‘vulnerable’ children. The government of Zimbabwe in partnership with non-governmental organisations is directing extensive resources towards the care and upbringing of ‘orphans’ and ‘vulnerable’ children and not towards the economic empowerment of the caregivers. The same effort is not being made towards capacitating caregivers of ‘orphans’ and ‘vulnerable’ children at the household level, especially in rural areas.
The absence of these socio-economic empowerment programmes for the caregivers, not only in Zimbabwe but around the world, has contributed to the complexities found in ‘orphans’ and ‘vulnerable’ children care and support [6]. The studies conducted by Chizororo [7], Hove [8] and Ringson [9] revealed that the economic meltdown and unemployment in Zimbabwe have significantly contributed to the caregivers’ burden of ‘orphans’ and ‘vulnerable’ children needing care and support in the rural communities. Although, these studies were carried out at different times, there is convergency of the findings that unemployment and the socio-economic exclusion of the rural communities have posed serious challenges to the caregivers in their endeavour to support ‘orphans’ and ‘vulnerable’ children in Zimbabwe. Premised in the foregoing, this study seeks to examine the challenges faced by the caregivers in coping with the challenges concerning ‘orphans’ and ‘vulnerable’ children at the household level with special emphasis on caregivers in the Gutu District of Zimbabwe.
Gutu District was consciously considered for this study because it is one of the marginalised rural communities that has been affected by HIV/AIDS and political polarisation. The Gutu District is a tribal-based community predominantly with people of the same dynasty except for the minority that migrated based on different socio-economic and political factors. A study conducted by Ringson in 2017 showed that the Gutu District is one of the most poverty and HIV/AIDS-stricken rural community [9]. This finding was predominantly evidenced with several child-headed households, rampant OVC under the guardian of their relatives and grandparents. The study, therefore, focuses only on the household level. In this context, the household level refers to a family or social unit of people living together as relatives. These households of families absorb their deceased’s relatives’ orphans according to their cultural values that upon the demise of the family member, the remaining relatives took over the custodianship of their relative’s children. Similarly, these households also absorb their incapacitated relative’s vulnerable children due to chronic illness, disability and living in abject poverty. Thus, the vulnerable children can either be children of the caregivers deceased relative (s) or of their incapacitated relatives. This study focuses on the vulnerable children within the purposively sampled household and not those outside the households. Within that context, this study was guided by the following two objectives:
To assess the challenges faced by caregivers in the care and support of ‘orphans’ and ‘vulnerable’ children at the household level.
To identify strategies adopted by caregivers to mitigate the challenges they face in caring for and supporting ‘orphans’ and ‘vulnerable’ children at the household level.
The paper commences with the context of the study, and the conceptualization of orphans and vulnerable children based on traditional and contemporary understanding. The study also examines the conceptualization of caregivers within the context of the ‘orphans’ and ‘vulnerable’ children in the rural communities of Zimbabwe. Subsequently, a thorough review of the ubuntu child-care model and the ACRWC and its dichotomous conflicting mandate stipulates that child have independence rights as well as emphasising that these rights must be executed in respect of the African culture and tradition. These fundamental stages were followed by the methodology, presentation, and discussion of findings, concluding with the implications of the study for social work and the recommendations.
The UNAIDS [10] defines orphans as children under the age of 18 years whose parent(s) have died, while vulnerable children are children with unfulfilled rights. This definition is in line with the Zimbabwe National Orphan Care Policy (ZNOCP) [11] which defines orphans as those aged 0–18 whose parent(s) have died. Vulnerable children are defined as children with unfulfilled rights and mainly identified as children with one parent deceased, children with disabilities and affected and/or infected by HIV and AIDS. Concurrently, the National Action Plan ([12], p. 8) adds that vulnerable children may also include abused children (sexually, physically, and emotionally), abandoned children, children living in the streets and married children. In addition, the National Action Plan [12] included neglected children, children with chronically ill parent(s), child parents and the destitute as vulnerable children in need of care and support in Zimbabwe, to cite but a few.
This definition, though widely adopted, has inherent limitations, especially in the context of resource-constrained environments in which many ‘orphans’ and ‘vulnerable’ children live. For instance, the use of the chronological age ignores many young persons above the age of 18 years whose parents are deceased and who are exposed to intense vulnerability contexts devoid of any family or external support. As noted by Killian [13], the definition implies that by merely attaining the age of 18 years, one is automatically weaned from the ‘orphans’ and ‘vulnerable’ children category to the non-orphan-hood and vulnerability regime. As a result, this transition renders ‘orphans’ and ‘vulnerable’ children as individuals no longer needing care and support. However, his/her plight may not be any different from those below the age of 18 who live with him/her in a similar environment. Put simply, while the secondary caregivers who include the government, close friends or extended families and NGOs, to mention but a few, presume that the post-18 years of age era means that a young person can look after himself and herself, in real terms, this is very often not the case. This assertion was further supported in the Situational Analysis of ‘orphans’ and ‘vulnerable’ children (SAOVC) in Zimbabwe by UNICEF [14] which revealed that the use of age as a criterion in aiding for education was penalising teenagers who started school late by excluding them from continued educational support once they turned 18 years of age. This poses more challenges to household caregivers who will mandatorily oblige to support and care for them through their limited resources.
Ringson [15] defined a caregiver as the person above the 18 who is either employed with an organisation or voluntarily offers his/her services to an organisation to take care of the elderly or children in residential care or ‘orphans’ and ‘vulnerable’ children. Hermanns and Smith-Mastel [16] in Ringson ([15], p. 504) assert that “the act of caregiving is not unfamiliar, but the term ‘caregiving’ is relatively new, with the first recorded use of the word in 1966.” Caregiving is a hybridised compound word where caring and giving were combined to bring about a new meaning. Etymologically, the term “care” was derived from an Old English term “wicim” which means mental suffering, mourning, sorrow, or trouble. The term “give” was also derived from an Old English term which means to “bestow gratuitously”. Premised on the etymological analysis of caregiving as a concept, the Oxford English Dictionary defines caregiving as an act characterised by attention being given to the needs of others, especially those who are unable to look after themselves adequately, such as children under the age of 18 and elderly persons.
Further to the foregoing conceptualization of caregiving, it is important to note that caregiving is multidimensional. It involves caring for children under the age of 18 with special needs (i.e., orphans and vulnerable children), elderly care, and parental care (referring to caring for parents with special needs). In this context, caregiving is focusing on the care of ‘orphans’ and ‘vulnerable’ children. The caregivers, in this case, are the extended family which entail the father, mother, grandparents, sisters/brothers, and uncles/aunts. Within the African indigenous ‘orphans’ and ‘vulnerable’ children care and support approach, Chizororo [7] argues that it is the right of ‘orphans’ and ‘vulnerable’ children to be absorbed by an immediate family when both parents are deceased or when their biological parents are living in poverty. However, in the case of losing one parent, the orphaned children are to be rightfully placed under the guardianship of the living parents. Thus, Ringson [15] defined a household as a family and social unit of people of the same lineage. A household is therefore a family unit of the closest relatives of the orphans’ deceased parents and the vulnerable children’s parents. This paper, therefore, examines the challenges faced by bringing up ‘orphans’ and ‘vulnerable’ children in the Gutu District of Zimbabwe with special emphasis on the caregivers’ experiences, feelings and views.
Traditionally, within the Zimbabwean context orphans were absorbed with the extended families that would carry the responsibility to care for and support them. Similarly, vulnerable children would also be absorbed by the extended families and the community care and support networks [9]. According to Mugumbate and Chereni [6], ubuntu serves as the spiritual foundation of many African communities and cultures. It is a multidimensional concept that represents the core value of African ontology—such as respect for human beings, human dignity and human life, collective sharedness, obedience, humility, solidarity, caring, hospitality, interdependence, and communalism. The ubuntu version can be translated as “I am human because I belong”. Thus, ubuntu is a radical reflection of shared humanity and has a universal appeal of traditional community values ([17], p. 1). Premised in the foregoing, ubuntu as a socio-economic framework can be analogically interpreted as the veins of the society that uphold human solidarity.
The recent study carried out by Ringson [15] asserts that most of the African communities and especially rural communities are holding on to their cultural ways of childcare, and as a result, there is a collision course with the contemporary human rights approaches. Notwithstanding the efficacy of the child rights approaches promulgated by the UNCRC, Van Breda [18] contentiously argues that ubuntu childcare modelling has somehow been submerged by Western models. Thus, a plethora of challenges faced by the caregivers within the rural communities in upbringing their OVCs is because of their reluctance to transform from their traditional ways of caring for children embedded in ubuntu philosophy.
The ubuntu model of childcare would be seen in the willingness of the community and extended families to take care of and support the deceased’s children and other vulnerable children in the community. As such, the terms ‘orphans’ and ‘vulnerable’ children in many parts of African communities are regarded as a distortion of the traditional values in childcare and parenthood entrenched in the ubuntu childcare model [19]. In the context of the above argument, Van Doore [20] avers that the problem of the commodification of children being manufactured as ‘orphans’ and ‘vulnerable’ and used to generate profit in orphanages and by other non-governmental organisations is global. Whilst it is commonplace in a Western model for an ‘orphan’ or ‘vulnerable’ child to be taken to an orphanage or residential care where they are being commodified, the ubuntu parenthood model of childcare absorbs a child within his/her relatives, families, and communities for the preservation of dignity, cultural values, and posterity.
Based on the ubuntu childcare model and parenthood, a child despite his/her status is valued as the symbol of posterity and wealth. Concurrently, Tigere [21] exhibited that a child within an African context— be it an ‘orphan’ or ‘vulnerable’— is the central focus of the community and the families. In this context, in a situation where the uncle, aunt or any other close relative of a child is alive and is willing to take care of the child, the child was not considered to be an ‘orphan’ or ‘vulnerable’. Instead, from the ubuntu parenthood model of childcare, the nomenclature ‘orphan’ and ‘vulnerable’ in this milieu becomes discriminatory and creates a negative social image of a child. However, in some exceptional cases, that have been rare in African communities, where an ‘orphan’ and ‘vulnerable’ child has no living relatives, then the nomenclature would suffice [22]. In her assertion, Pillay was complemented by Tigere [21] who argues that labelling of a child as an ‘orphan’ and ‘vulnerable’ in the African context is not only stigmatising of the child but a direct insult to those participants in the social network providing care and support to the child.
In this case, the predominant form of extended families in Zimbabwe is that of kinship including the frontline relatives such as paternal uncles and aunts, including the paternal and maternal grandparents. These frontline relatives are traditionally responsible for assuming the care and support of orphans upon the death of one or both parents and vulnerable children in cases of abandonment or otherwise. Ordinarily, one member of the extended family network assumes the primary caregiver role while others may periodically contribute resources as secondary caregivers. Despite the shortcomings of the ubuntu childcare model due to the depletion of the African social fabric because of Western expansionism, they continue to espouse and uphold traditional approaches in childcare [23]. According to Ringson [15], these shortcomings of ubuntu childcare and support include but are not limited to child labour, mutilation of sexual organs in the name of culture, child pledging in marriage, usurpation of the orphans’ right to the deceased parents’ estate, beating as a form of punishment and religious or culture sexual abuse tantamount to gross infringement of child rights.
Studies conducted within the different contexts of Africa such as by Ringson [15]; Pillay [22] and Shanalingigwa [23] confirm that these abuses continue in some African communities despite prevailing child rights enforcements. Thus, many caregivers with the traditional arrangements and within the rural communities are failing to uphold child rights and absolve their cultural tendencies. As a result, this presents numerous challenges to caregivers in their attempts to provide care and support to ‘orphans’ and ‘vulnerable’ children as prescribed by the UNCRC framework.
The shortcomings previously explained of the unregulated ubuntu childcare model precipitated the adoption of the UNCRC by the General Assembly of the United Nations in 1989, signalling the establishment of concrete contemporary measures to address child maltreatment and abuse at the international level [22]. Whilst the UNCRC’s requirements appear to be sound in principle, its shortcomings were evident in the lack of holistically embracing and respecting the wealth of Africanism in childcare and support. As such, the ACRWC was adopted by the Assembly of the Heads of State and Government of the Organisation of African Unity in July 1990 and was brought into force in November 1999 ([24], p. 1).
Arguably, the adoption of an ACRWC in place of the UNCRC was not meant to change the objectives but appropriate and facilitate the execution of the rights of children in an African context without abrogating its norms and traditions. Put simply, Olowu [24] points out that African member states were of the view that the UNCRC missed the important socio-cultural and economic realities of African experiences in childcare. Thus, in the analysis of these two pieces of legislation, it may be seen that they are complementary, and both seek to provide the framework through which the children’s needs are met within the cultural settings.
The main challenge of the ACRWC is that it stipulates those children who are independent subjects and have rights while it simultaneously emphasises the need to include African cultural values and experience in considering issues about the rights of children in Africa [25]. Closely looking into the aspects of upholding the independence of the child’s rights and respecting African values and experiences in childcare encounters a conflict of interest between an African caregiver in the rural areas and a contemporary human rights protagonist. In further review of the foregoing statement, the caregivers in the rural communities of Zimbabwe might experience challenges to balance respect for the independence of the child’s rights apart from their cultural dictates and experiences in childcare and support.
Ringson [15] in his study on child rights cultural contestations in Zimbabwe found that the traditional and contemporary approaches in childcare within the rural communities contributed to a disconnect within the conscience of the rural communities that always want to espouse their indigenous cultural values in the provision of care and support to their children. Olowu [24] and Pillay [22] posit that instead of the ACRWC explaining the difference in the culturally-based rights and experiences to be upheld by the caregivers in caring for their ‘orphans’ and ‘vulnerable’ children, it was left in the provision of child rights which include but are not limited to the right to life, participation, food, identity and shelter. The way these rights are implemented in the perspective of African culture differs from the contemporary western approach. In trying to uphold their culture and tradition as stipulated by the ACRWC, the caregivers encroach and infringe on the rights of children as stipulated by the UNCRC. This article, therefore, examines the caregivers’ lived experiences in trying to balance the two contentious clauses of the ACRWC and the UNCRC in providing care and support to ‘orphans’ and ‘vulnerable’ children within the Gutu rural community of Zimbabwe.
This phenomenological qualitative study seeks to gather in-depth information about the perceptions and lived experiences of the caregivers in coping with orphans and vulnerable children in Zimbabwe. The phenomenological methodology was considered appropriate in this study because it draws on the lived experiences, perceptions, feelings, and views of the participants [26]. According to Husserl [27], in the process of developing the concept of phenomenological philosophy, phenomenology was defined as a philosophy of experience and hence this study is an examination of the lived experiences of the community leaders, caregivers and ‘orphans’ and ‘vulnerable’ children within the local rural community of the Gutu District of Zimbabwe. Gutu District is one of the largest, most marginalised, and poverty-stricken rural communities in Zimbabwe.
A total number of 20 participants, which included 15 caregivers and 5 ‘orphans’ and ‘vulnerable’ children, was purposively selected to participate in this study. In-depth information was obtained through in-depth interviews about their experiences, feelings, perceptions, and views of the challenges they face in the care and support of ‘orphans’ and ‘vulnerable’ children in Zimbabwe. Purposive sampling was used to select the most appropriate information-rich sources for this study. Patton [28] posits that purposive sampling is the most appropriate method of selecting information-rich sources with small numbers of individuals or groups in a qualitative study.
Tongco [29] similarly observes that through purposive sampling, it is the researcher who decides the individual participants or groups that provide the study with enough information on the human perceptions concerning the social phenomenon under investigation. The criteria used in selecting the caregivers was that they were people living in the Gutu District, taking care of ‘orphans’ and ‘vulnerable’ children and members of Batanai HIV/AIDS Service Organisation. Similarly, the ‘orphans’ and ‘vulnerable’ children were chosen on the condition that they were either orphans or vulnerable children under the age of 18 living with a caregiver within the Gutu District of Zimbabwe. On that premise, a typical example of the questions which were posed to the participants include the following:
In your own experience as a caregiver or ‘orphans’ and ‘vulnerable’ children, what are the main challenges you are facing in ‘orphans’ and ‘vulnerable’ children care and support in food and nutrition, education, shelter, psychosocial support, and health?
In your view as a caregiver or ‘orphans’ and ‘vulnerable’ children, what can your stakeholders in ‘orphans’ and ‘vulnerable’ children care and support do to help you to deal with the challenges of food and nutrition, shelter, psychosocial support, and health?
To mitigate the challenge related to language use, the indigenous language was used to collect data and was then translated into English by linguistic experts for accuracy. The data transcripts were anonymised first before the data were coded and analysed, to make sure that the readers of the papers will not be able to identify the interviewees. Braun and Clarke’s [30] thematic data analysis was used to present and analyse data in this study. Thematic analysis was used because it provides an accessible and flexible approach to analysing qualitative data. Braun and Clarke [30] indicated that the thematic analysis process involves the researcher’s familiarisation with the data, reviewing themes and defining themes. As such, an inductive method of theme development was undertaken based on the content of the data. Lincoln and Guba [31] explain that the trustworthiness of the study is enhanced by triangulation of sites and sources, using purposive sampling, and providing a detailed description of the methods used.
Regarding ethics, pertinent ethical issues were considered and resolved before the commencement of the study. In this case, ethical approval from the relevant department such as the National University of Science and Technology and the Social Welfare Department was required. Furthermore, the proxy consents and approvals for the minor ‘orphans’ and ‘vulnerable’ children were established and consent for the adult caregivers was also sought before the study commenced. The information leaflet about the researcher and purpose of the study was written and comprehensively explained to the participants to assist them to understand their position about issues of voluntarism, confidentiality, and anonymity.
Since this study touches on sensitive issues, precautions were taken to ensure that the focus was on eliciting information about coping strategies and avoiding as much as possible discussing emotional issues such as the loss of parents or other loved ones. In addition, prior arrangements for the services of a professional psychologist and a social worker were made in case of any emotional and traumatic challenges during the research. Legal guardians of minors accompanied their minors to the hospital if the need for psychological counselling arose. Before the interview session of the OVC, the social worker was requested to give counselling to the children, and it contributed to the commendable outcome of the interview sessions. All costs related to travel, accommodation and food incurred during such trips to the hospital would be provided for by the researcher. However, during this study, there was no incidence regarding the emotional challenges of the OVC happened, despite the supportive measures put in place. Thus, no costs were incurred towards the hospitalisation of any of the participants as was anticipated. It is also important to mention that since the study purposively sampled caregivers from Batanai HIV/AIDS Service Organisation Support groups, the participants were requested to meet at a central place in the Gutu Mpandawana growth point where the interviews were to be conducted. This environment was very conducive for the interviews because all the participants were used to hold their meetings and support group workshops. Lastly, questions in the study tools were focused on the topic and as far as possible, nothing outside the scope of the study was discussed.
This section presents the findings from the study regarding challenges that families are facing in providing care to ‘orphans’ and ‘vulnerable’ children. The findings from both the caregivers and ‘orphans’ and ‘vulnerable’ children predominantly revealed food and nutrition and psychosocial support as the main challenges faced by caregivers in their endeavours to support ‘orphans’ and ‘vulnerable’ children within their households in Zimbabwe. Although, this research is predominantly qualitative, for this data presentation, the views of the participants were quantitatively presented. This exercise was informed by Sandelowski [32] who argues that frequency rate reporting and counting are integral to the analysis process and numbers in qualitative studies are used to establish the significance of findings. They are also used to recognise patterns and to make analytic generalisations from data. Figure 1 below shows the distribution of the views of the 20 participants who participated in this study.
Distribution of views of the participants on caregivers’ challenges.
As illustrated in the figure above, the distribution of the views of the participants shows that 40% of the participants indicated that the caregivers are exposed to the psychosocial related challenges of themselves and the OVC under their custodianship. This was followed by 30% of the participants who said the caregivers often face the food and nutritional-related challenges of themselves and the OVC their jurisdiction. Furthermore, 20% of the participants emphasised that the caregivers are more exposed to the educational related challenges of themselves and their OVCs. Lastly, 10% of the participants indicated that the caregivers are often facing shelter and clothing-related challenges. Whilst all the above challenges are a true reflection of the challenges that the caregivers are facing in the Gutu District of Zimbabwe in their commitment to sustain the livelihood of the OVC within their custodianship, the findings predominantly show that the psychosocial support and the food and nutritional related challenges are more outstanding than the other challenges. Thus, for analysis and discussion of these findings, the two predominant themes (psychosocial challenges, and food nutritional challenges) have been subsequently analysed and discussed.
Food and nutrition emerged as one of the critical challenges that the caregivers face in attempting to adequately care for and support the ‘orphans’ and ‘vulnerable’ children in the Gutu District of Zimbabwe. The findings show that despite the efforts made by caregivers in the care and support of ‘orphans’ and ‘vulnerable’ children, the food and nutrition-related challenges constantly affect both their ‘orphans’ and ‘vulnerable’ children and their household livelihoods. Regarding the challenges of food and nutrition, one of the participants from the Department of Health remarked:
What the health official implies here is that in the case of food and nutrition, the caregivers in their capacity within the rural communities are not able to meet this critical basic right of ‘orphans’ and ‘vulnerable’ children and their children, respectively. This assertion from the health official was corroborated by most of the caregivers who predominantly indicated that they are not satisfied with the care and support they provide to their ‘orphans’ and ‘vulnerable’ children and their biological children. Both from a right-based approach and the African traditional view, food and nutrition are basic rights that should be provided by the caregivers to the children and its scarcity traumatises both the caregiver and the children. In addition to that, another community-based health worker explained:
The quotes from the two health workers show that even the assistance that the caregivers receive from other ‘orphans’ and ‘vulnerable’ children’s stakeholders such as the non-governmental organisation operating in the said community is not sustainable. This is commensurate with the reality that the Gutu District is one of the rural areas in Zimbabwe that consistently experiences poverty more than other rural communities in Zimbabwe. This view was clarified by one of the traditional leader participants who observed:
In the foregoing sentiment, the traditional leader as steward and custodian of the local rural communities is affirming that food and nutrition is one of the critical challenges that caregivers face in their support of the ‘orphan’s and ‘vulnerable’ children within their jurisdiction. In addition, the caregivers revealed that due to chronic poverty they could not afford to buy food to supplement the local food they grow in their fields to the World Health Organisation’s food standards. It was interesting to note, however, that although caregivers were experiencing difficulties in meeting the feeding and dietary needs of their children including the ‘orphans’ and ‘vulnerable’ children under their guardianship, they did not blame themselves but the community leaders who failed to stand with them. One of the grandparents explained:
One of the grandparents had this to say when asked how they are coping with the burden:
Overworking of children was confirmed by local leaders as a prevalent practice. It was noted that children are overworked against their will in a bid to raise the extra resources needed for the well-being of the household. One of the community leaders when interviewed explained that:
When this question was further explored with the ‘orphans’ and ‘vulnerable’ children they corroborated what their caregivers and the community leaders had noted, that to a certain extent they are being used as cheap labour with their caregivers despite their young age. Whilst the caregivers explained that this has provided a form of training to their children to work, the findings indicated that they were infringing the child labour laws. Such exploitation would be done under the pretext of producing food and other material substance for the upkeep of the ‘orphans’ and ‘vulnerable’ children within their jurisdiction. Furthermore, it was also reported that some widows and single mothers were involved in prostitution as a coping strategy. For instance, one of the single mothers indicated that prostitution is one of her coping strategies. She explained that this was her business during the night while her children are asleep and during the day she would buy and sell vegetables in a market. In summary, the coping strategies revealed by respondents included getting the ‘orphans’ and ‘vulnerable’ children to work in the gardens, fields and for others to supplement food, buying and selling of vegetables, fruits and cross-border trading and prostitution even though some were not prepared to reveal this as a strategy because of its illegality.
Regarding psychosocial support and emotional care, it was generally acknowledged that caregivers lacked the knowledge and skills to diagnose and effectively address the psychosocial needs of the ‘orphans’ and ‘vulnerable’ children in their care. Instead, they considered emotional and psychosocial needs within a broader realm of care that ‘orphans’ and ‘vulnerable’ children received. This may have a profound impact on the future of these children since the nature of the response to the psychosocial needs of these ‘orphans’ and ‘vulnerable’ children may have a far-reaching impact on their social and emotional development. Caregivers reported great challenges associated with the upbringing of the children. In a household where ‘orphans’ and vulnerable’ children were under the care of other relatives, not their biological parents, efforts were made to ensure that they are brought up in the same way as the caregivers’ children. In this regard, one of the caregivers remarked that:
The participant shows that within the rural areas social workers and professional counsellors are not easily accessible to provide their services in case their ‘orphans’ and ‘vulnerable’ children develop emotional challenges or in the case of any misunderstandings between the caregivers and the ‘orphans’ and ‘vulnerable’ children at the household level. This was further confirmed by one of the caregivers who observed that:
This participant reveals that the caregivers have challenges in discerning what emotionally and psychologically traumatises their ‘orphans’ and ‘vulnerable’ children and hence, they do not have the information to deal with those psychosocial challenges. The ‘orphans’ and ‘vulnerable’ children may have shelter, food, school fees and medication but without the provision of psychosocial services, the other assistance may be rendered useless. When asked why these children behaved in that way, it was discovered that even the caregivers did not know why these children behaved that way. However, when triangulated, one of the ‘orphans’ and ‘vulnerable’ children when asked why they feel discriminated against explained that:
The study revealed that psychosocial support was a critical need but due to lack of skills to appropriately diagnose and respond to it, it was largely neglected. It was evident from the study that while caregivers were expected to be the main source of psychosocial support for ‘orphans’ and ‘vulnerable’ children, they also need emotional support to address challenges in providing care for ‘orphans’ and ‘vulnerable’ children in a context of limited resources. In their response, most caregivers indicated that they do nothing in case of an emotional challenge. However, caregivers who had a strong spiritual orientation indicated that they turn to prayer and singing as a way of dealing with stressful situations. This was verified by another respondent who explained:
When asked, most of the caregivers indicated that they predominantly pray or go to church as a coping strategy regarding emotional challenges. There was also a significant portion of caregivers who indicated that they do nothing, while others resorted to strategies such as drinking, scolding children, or simply keeping quiet. This could reflect poor access or lack of awareness about psychosocial services in the study area. The ultimate impact could be that caregivers could become burned out which could have severe long-term implications on the welfare of ‘orphans’ and ‘vulnerable’ children in their care.
In corroboration of what the ‘orphans’ and ‘vulnerable’ children and the caregivers explained above, the community leaders and stakeholders who include the traditional leaders, faith-based organisational leaders and non-governmental organisational representatives, explained that they have had several experiences where ‘orphans’ and ‘vulnerable’ children in Gutu District reported cases of abuse, exploitation, and assault by their caregivers. The community leaders within their different roles in the rural communities concerning the ‘orphans’ and ‘vulnerable’ children confirmed that there are always conflicts between the ‘orphans’ and ‘vulnerable’ children and their caregivers in the district because the caregivers lack the psychosocial support training to help their ‘orphans’ and ‘vulnerable’ children and the services of the professional counsellors and social workers are not readily available other than through sporadic visits of the non-governmental organisations’ representatives.
Evidence from the findings has shown that caregivers were struggling to adequately provide for the needs of their ‘orphans’ and ‘vulnerable’ children as stipulated in both the UNCRC and ACRWC. Whilst several challenges were mentioned regarding challenges related to the data, food and nutrition and psychosocial support predominantly emerged as the major recurring themes of the participants. The findings concurred with Ringson [9] and Chizororo [7] who assert that psychosocial support and material needs recently became the major needs for ‘orphans’ and ‘vulnerable’ children. It is also important to be aware that children have the right despite their status to be adequately fed, a right that is supported by the UNCRC. As such, depriving children of nutritious food is an infringement of their rights. Because of the challenge posed by this material need, the caregivers confirmed that they were initially able to feed their ‘orphans’ and ‘vulnerable’ children with locally produced food such as wild fruits, vegetables, maize and sweet potatoes. However, the type of food that is recommended by authorities and demanded by children is now different because of modern shifts and improved knowledge of nutrition. Furthermore, due to the high population density in the study area, the land shortage was acute especially for those living in the Gutu rural communities. As a result, involvement in gardening had begun to negatively impact the household capacity to produce adequate food. In some instances, caregivers would pledge their children for marriages in the communities or churches for them to be given a piece of land, cattle, or food in return. This resonates with Ringson [15] who argued that some children’s rights as stipulated in both the UNCRC and ACRWC conflict with some African cultural perspectives of child upbringing. The caregivers experienced this as a setback in their attempts to balance the conventional children’s rights and the traditional rights in the ubuntu parenthood childcare model.
It was clear from the findings that the ‘orphans’ and ‘vulnerable’ children who lack quality food at home do not perform well at school and are susceptible to destructive emotional challenges. In this regard, Pillay [22] emphasises that the lack of food as a fundamental right of the children may influence them to make poor decisions in their lives such as early marriages or being abused sexually, abusing drugs, or stealing. Generally, the community leaders attributed the food shortages to chronic poverty, which grossly affected the people’s agricultural activities in Zimbabwe, and which were exacerbated by destructive political decisions as highlighted by Chigora and Guzura [33] and Hove [8]. By implication, these findings converged with the finding that caregivers were generally unable to meet the conventional requirements and standards for feeding the children, especially in most of the developing countries due to chronic poverty. Some strategies were applied by the caregivers of ‘orphans’ and ‘vulnerable’ children at the household level to address their food and nutrition needs. To cope with increased family sizes or to accommodate the loss of adult labour, children were found to have assumed greater roles in food production. The need for children to provide agricultural labour was widely reported by caregivers as one of the primary reasons why children were kept in public schools near their homes, despite their reservations on the quality of education offered in those schools. In a traditional African family setting, children constitute a strong source of labour for agriculture. Hence, this was considered predominantly as a legitimate coping strategy, assuming that children are supported to acquire agricultural experience and skills in the long term. However, some respondents indicated that there were instances where children were indeed overworked as a coping strategy to supplement livelihoods at the household level.
Regarding the challenges related to psychosocial support, it was revealed that the caregivers do not have the skills to help their children during their sporadic or protracted times of emotional agony. Evidence from the findings shows that some ‘orphans’ and ‘vulnerable’ children have emotional challenges emanating from the loss of their parents, being exposed to discriminatory child labour, stigma and verbal and sexual abuse at the household level, community level and schools. Whilst all these are crimes and infringements of children’s rights according to the UNCRC and ACRWC, the children will continue to be victims emotionally and physically because of the lack of knowledge around psychosocial support of their caregivers. In some instances, the caregivers are now afraid of reprimanding their ‘orphans’ and ‘vulnerable’ children fearing that they might have to account to the law enforcement authorities for their actions [9, 21]. By implication, what this means is that if the caregivers continue to implement their culturally based rights in caring for ‘orphans’ and ‘vulnerable’ children in contravention of the conventional rights of children, psychosocial support challenges in form of verbal and sexual abuses and child labour in the name of culture will not end, especially within the rural communities of Zimbabwe.
The study further asserts that without proper psychosocial support mechanisms, orphans often spend most of their time and energy trying to create some type of order and security for themselves out of unpredictable situations and struggle with their identity problems. Because of the above, Killian [13] posits that the long-term consequences for children who experience profound loss, grief, hopelessness, fear, and anxiety are psychosomatic disorders, chronic depression, low self-esteem, low levels of life skills, learning disabilities, and disturbed social behaviour. This study found that such psychosocial challenges are still rampant within the rural communities and the ignorance and scarcity of the social workers and professional psychologists to help with professional counselling poses a lot of challenges to the caregivers, ‘orphans’ and ‘vulnerable’ children and the community at large.
Following the prevalence of these effects, the psychosocial support of caregivers is an acknowledged need because they are often stressed whenever they engage with children who are regularly exposed to painful experiences. From the empirical analysis of this study, it can be determined that grandparents, children caring for younger children, and caregivers who provide care for many children often find it difficult to cope. They may blame themselves for not being able to do enough, even though they must also deal with their grief and sadness. They further indicated that many caregivers struggle to meet their children’s needs, such as food, clothes, health care and schooling, and give them love and attention in conditions of financial hardship and without the necessary practical medical and social support, they suffer psychosocial ill-effects. In that context, for critical children’s rights to be complied with, especially within the rural communities, there is a need for the caregivers to be regularly trained and empowered to understand the difference between their culturally-oriented approaches in childcare and the conventional approaches. Thus, Ringson [9] asserts that the ubuntu parenthood child-care model alone without being blended with the conventional modern approaches will sufficiently help both the caregivers and their children in attaining sustainable livelihood within their communities.
This study has established that due to the incapacity of the caregivers to offer sustainable and holistic care and support to OVC, there is a gross infringement of the basic rights of the OVCs in Zimbabwe. These basic rights include, but are not limited to, food and nutrition, shelter, clothing, psychosocial support, and education. The study also revealed that despite the escalating socio-economic challenges and structural transformation, the family remains the strongest and most prominent unit of care and support of OVC. The foregoing view was exhibited by the fact that all the ‘orphans’ and ‘vulnerable’ children who participated were living with their blood relatives caregivers. This attests to the strength and resilience of the extended family and its continued prominence within the overall OVC response in Zimbabwe as explained by Ringson and Chereni [19] in their recent studies. By implication, this may be interpreted to mean that in the foreseeable future, households’ families will remain the major asset to be drawn upon in addressing the challenges associated with OVC care and support.
The study further revealed that psychosocial care for both OVC and caregivers was largely an overlooked and limited service in the study area. Due to lack of skills and the preoccupation with survival needs, there was little emphasis on either attempting to diagnose or addressing the psychosocial problems of the OVC and their caregivers. Hence, the long-term impact of psychosocial problems is that children may grow up with low self-esteem, depression and in extreme cases, psychosomatic disorders. Thus, the quality of motivation for caregivers to care for OVC will deteriorate and may in extreme cases translate into various forms of child abuse. In response, caregivers and OVC initiated several strategies to address their needs, particularly raising incomes to meet the extra needs. However, the study indicated that these strategies remained haphazard and reactive to the immediate needs rather than long-term needs and survival of OVC. For instance, selling vegetables and fruits, prostitution and working for others do not generate sustainability of livelihoods in the long term.
In conclusion, this study recommends that if social workers, social administrators, and government continue to empower the children while overlooking and thereby undermining the caregivers, both the caregivers and their children are unlikely to be able to address their challenges.
I would like to appreciate the Gutu District Department of Education, Social Welfare and Batanai HIV/AIDS support groups for their acceptance to participate in this study. I would also like to thank the University of Johannesburg for awarding me a Global Excellence Stature stipend to cater to my livelihood during my Post-Doctoral Research Fellowship.
I would like to declare that this study is my original work, I am the sole author of this study, and I did not receive any funding for this study. Thus, there is no conflict of interest whatsoever in the ownership and copyright of this study.
Word retrieval deficits remain one of the enduring symptoms in most PWAs [1]. Word retrieval deficits are events where the individual exhibits word-finding difficulty in conversation or while conveying their ideas or thoughts. The prevailing literature on word retrieval failures suggests that this deficit varies in their cognitive and neural underpinnings among discrete variants of aphasia. The SLP treating word retrieval deficits firstly needs to understand the nature of word retrieval breakdown (semantic or phonemic). These are ascertained
The word retrieval process is an intricate process requiring two critical stages—semantic and phonologic [2, 3]. The retrieval process is strongly influenced by the modality in which they receive the input. For instance, confrontation picture naming involves object recognition as the primary input mechanism, followed by activation of the semantic system. The semantic system aids in storing the meaning and has associated information about the activated word. Finally, the semantic system activates modality-specific output lexicons for spoken, written words, and actions. With respect to spoken naming, lexical phonological output systems are activated. Subsequent to semantic and phonologic lexical retrieval stages, the post-lexical and articulatory process aids in the planning and execution of the verbal responses. These complex processes involved in word retrieval are likely to be affected in individuals with brain insult resulting in word retrieval impairment.
The word retrieval breakdown associated with PWAs is mediated by a distributed left hemisphere neural network (Hart & Kraut, 2007). There is a large body of evidence that suggests a lesion in the inferior temporal cortex is responsible for word retrieval impairments. Indeed, these impairments may vary with respect to the grammatical class and the impairments may be more for nouns than for verbs [4, 5, 6]. The lexical phonological output is mediated
Most of the treatment protocols developed for discrete variants of aphasia address the domains of linguistic deficit in aphasia. This implies that the protocol would be merely beneficial for semantically related deficits or phonological-based deficits. Traditionally, treatment rendered to PWAs relies on a symptomatic approach. Owing to the fact, aphasia is a multifaceted condition and entails the complex nature of the processing, and treatment for PWAs is explained along a continuum of naturalness [9].
One end of the continuum is the participation-based or socially oriented approach that primarily focuses on naturalness. Under this domain, the life participation approach [10] is streamlined as a socially oriented approach. LPAA aids in re-engagement of life to maximize an individual’s quality of life and communication skills. The other hand of the continuum is the impaired-based approach. The impaired-based approach works on the premise of enhancing individuals’ linguistic abilities. Subsequently, the treatment paradigms related to it were designed with the rationale of obviating the damaged processes.
Impaired-based word retrieval paradigms are deployed to maximize the word retrieval abilities in contexts of speech and conversation. In the recent past, various types of word retrieval paradigms have been meticulously developed to remediate retrieval deficits. These are some of the seminal word retrieval paradigms, for instance, cueing hierarchy, phonological component analysis (PCA), semantic feature analysis (SFA), and Verb Network Strengthening Treatment (VNeST).
In cueing hierarchy paradigm, the SLP renders a series of discrete and potent cues to facilitate the targeted word. When PWAs retrieve the desired target word, the clinician encourages to repeat the target word several times, or the clinician presents cues in reverse order until the PWA provides the desired response. While using cueing hierarchy in PWAs, SLPs must ensure the more and less effective cues pertaining to the individual. In this paradigm, the targeted word is elicited through both semantic and phonological cues.
However, few studies highlight the potent role of semantics over phonological cues or vice versa (e.g., [11, 12, 13]). A review study by Patterson (2001) was carried out to uncover the effectiveness of cueing hierarchy in remediating word retrieval failures. The consolidated reports by various studies posit that cueing hierarchy paradigm aids in showing ameliorated performance for the trained words with various levels of retrieval deficits (semantic or phonological).
There are few interesting studies, which appraised the effectiveness of cueing hierarchy paradigm by inculcating variations in the training. Marshall, Karow, Freed, and Babcock [14] compared the effect of personalized cues (i.e., a phrase developed by the individuals themselves) over phonological cues. The findings computed in the study showed that individuals using personalized semantic information (e.g., “Apple is red in color”? or the animal which eats flesh?) outperformed phonological cues alone. Furthermore, the cueing paradigm was trained and developed through software to provide more flexibility and to reach a large population who are deprived of receiving speech-language therapy services.
Over the recent decades, researchers have used a computerized version of cueing hierarchy paradigm. The finding of the study evinced ameliorated performance for the trained words in moderate–severe naming impaired individuals [15, 16].
PCA is one of the renowned treatment approaches to remediate word retrieval deficits [17]. This approach emphasizes the use of self-cueing. In PCA therapy, individuals are presented with a picture placing at the center of the chart, and then, they are asked to name the corresponding picture. Simultaneously, PWAs are asked to identify the phonological components such as rhyming words, the first sound, first sound associate, final sound, and the number of syllables with respect to the target word (Figure 1). While identifying the phonological cues, if individuals fail to produce desired responses, then they are given an array of choices (up to three choices). Out of these choices, individuals need to select one of the choices among three. Choices are presented
Flowchart depicting the procedure of phonological component analysis (PCA) treatment.
The impact of PCA treatment on word retrieval skills per se has been studied in many research studies. The evidences from these studies seem to be conducive as they manifest ameliorated performance in trained items in most of the studies [18, 19]. On the other hand, the findings for PCA on untrained stimuli seem to be less robust. Thus, researchers posit poor generalization skills following PCA treatment [11, 18].
SFA intends to manifest ameliorated performance in lexical retrieval abilities per se in PWAs. This treatment systematically trains the target word by activating the discrete semantic attributes, enhancing the semantic networks corresponding to the target word. In this treatment, the clinician places a target word picture card in the center of the chart. The chart comprises the discrete semantic features—superordinate category, use, action, physical properties, location, and association of the corresponding target word (Figure 2). In short, the clinician initially provides the target picture; subsequently, PWAs will be asked to retrieve the corresponding semantic attributes. If PWAs fail to name, then the clinician cues them to retrieve the desired responses. To provide semantic features, the clinician reads the printed cues and provides the relevant features both orally and in written forms. The semantic feature generation aids in distinguishing desired features versus undesired features of the target word. Initially, SFA training emphasizes maximal cueing by the clinician. Eventually, cueing is faded as the training progresses. The semantic features enhance the activation of the corresponding target word; consequently, PWAs name the items without any cues. If PWAs are not able to retrieve the target item and corresponding features, then the clinician delivers the name and features [20].
Flowchart depicting SFA treatment for noun.
Semantic feature analysis treatment for verbs follows a slightly distinct protocol compared to noun training. In this treatment, a picture of the target action will be placed at the center of the chart. The PWA will be asked to retrieve the corresponding action. If they fail, the clinician cues the action verb using the following semantic features—(a) the agent/experiencer of the action (“Who usually does this?”), the theme/patient (“On what/ by whom is it performed?”), the location (“Where does this action happen?”), the purpose of the action (“Why does this happen?”), the means of carrying out the action (“What part of the body or what tool is used to make this happen?”), and the related objects or actions that reminded the participant of the target verb (“What does it make you think of?”). These features were introduced one at a time and in the same order mentioned above. The PWA’s response will be noted down. If the PWA failed to provide the desired response, then the clinician prompts a response. The prompts can be either semantic or phonological. After generating all six semantic features, the PWAs are asked to name the target action without any prompts. Despite these prompts, if the PWA still fails to arrive at desired responses, then the clinician delivers the target action word. The PWA is asked to repeat the action word after the clinician models. Finally, they will be asked to construct a simple sentence using the verb; if they are unable to produce, then the clinician assists in constructing simple sentences or narrating the simple sentences for PWAs. The PWA is prompted to repeat after the clinician narrates the sentence (Figure 3).
Flowchart depicting SFA treatment for verbs.
Further, to document SFA treatment findings across various studies, a systematic review was conducted [21]. This review study pooled data from 21 studies consisting of 55 PWAs encompassed both fluent and nonfluent variants of aphasia. The findings revealed robust findings for 45 out of 55 PWAs for the trained items; 32 out of 55 PWAs were able to maintain the responses. In addition, 40% of PWAs were able to manifest generalization of response to the untrained stimuli. The SFA treatment manifested robust outcomes for fluent and mild–moderate severity of aphasia compared to nonfluent and severe forms of aphasia [22, 23, 24, 25]. Overall, SFA is deemed as a viable treatment approach in the diminution of word retrieval deficits. In light of these findings, future studies on SFA should focus on observing or noting the generalization on untrained stimuli. A future implication would be that the treatment approach can be extended by documenting the improvement in the discourse genre.
VNeST was developed on the premise that if treatment paradigms utilized verbs as the core element then it can aid in the activation of a wide array of semantic networks. In addition, it may assist in the construction of simple active sentences. VNeST protocol constitutes a total of six steps to remediate word retrieval deficits [26]. These steps are as follows:
To illustrate, to retrieve the verb “Baking,” the following semantic cues can be used: (a) This is usually done in the kitchen; (b) this is usually done using utensils/stove; (c) this is usually done to prepare bread, cake. For identification of the corresponding agent for the verb “Bake,” individuals will be provided with choices (written cards) of photographer, farmer, and chef. PWA will be asked to identify the corresponding agent for the verb “Bake.” Eventually, a similar cueing strategy will be carried out for the identification of the patient. In addition, PWA will be encouraged to produce agents and patients from their experiences. The rationale of step one is that eliciting a wide array of agent/patient pairs may promote the activation of discrete semantic networks corresponding to the verb.
The relevance of steps with respect to the activation system occurring in the VNeST protocol is depicted in Figure 4.
Activation of the semantic network using VNeST treatment protocol. Edmonds [
In order to understand the effectiveness of VNeST treatment, Edmonds [27] conducted a review study. A total of 19 English-speaking PWAs received VNeST treatment across different studies [26, 28, 29, 30]. These studies enrolled PWAs who evinced chronic aphasia with severity ranging between mild and severe form; PWAs showed no impairment or moderate impairment in cognitive-linguistic quick test and had good comprehension scores. Ten verbs were trained. The PWAs enrolled in these studies were trained for 4–15 weeks, twice a week (each session would last for 3–3.5 hours), wherein the majority of PWAs received training for 10 weeks on an average. On the other hand, Furnas and Edmonds [29] provided training thrice a week, with each session would last for 2 hours per session for the time interval of six weeks. Outcomes of this review study served as the preliminary evidence. These studies posit that VNeST training reinforces lexical retrieval at a single word, sentence, and discourse genre across discrete variants of aphasia and with different levels of severity.
In addition, these studies evinced improvement in functional communication, per se. The studies based on VNeST showed ameliorated performance in noun and verb naming, sentence production, and discourse genre across the trained and untrained conditions. Despite these prominent findings, more research is warranted to strengthen these findings. The majority of the studies showed mixed findings while gauging the generalization effect. Equivocal findings were also noted across fluent and nonfluent aphasia and across different levels of severity. These literatures failed to evince the specific pattern or mechanism responsible for showing improvement in specific types of aphasia. Thus, the VNeST training has to be assessed in detail for each type of aphasia.
This chapter focuses on some of the word retrieval treatment approaches. These approaches are mainly intended to ameliorate word representation and also to activate the phonological encoding stage of word retrieval. While gauging the effectiveness of any treatment approach, several factors are to be looked upon, namely—(1) maintenance of word retrieval skills per se followed by therapy; (2) response generalization to the untrained conditions and different treatment settings. The treatments discussed in this chapter discerned fairly good generalization and response maintenance in almost all the approaches. However, relatively poor generalization skills are noted in the PCA. Poor responses can be attributed to being surface-level training and redundancy of cues. In cases of more severe word retrieval deficits, the treatment paradigms discussed may not be suitable for the initial phase of treatment. Instead, the clinician must start the treatment with more direct facilitative treatment and gradually progress to the treatment that entails self-generation of words. Owing to this, speech-language pathologists should consider severity before selecting the specific word retrieval treatment.
Commonly raised concern in the treatment-related studies is the superiority of one treatment approach over the other or anyone specific treatment approach is engendered to show maximal benefits. The answers to these questions are still at preliminary levels, and these need to be documented by conducting various research on these lines. To our understanding, in the current scenario, no particular treatment approach is deemed as superior over other treatment approaches at a more advanced level. However, based on the prevailing evidence, the VNeST approach can be claimed as the streamlined approach compared to SFA and PCA at the surface level in remediating word retrieval deficits.
Word retrieval treatments needed to be selected meticulously, and their impact on functional communication needs to be looked into, as word retrieval deficits are engendered to evince a tremendous impact on the day-to-day conversation. In some word retrieval treatments, improvement may be confounded to trained conditions, or improvement may be generalized to few untrained conditions. Owing to this, treatment paradigms selected should include strategies that would aid the PWAs to show improvement even in the functional communication per se.
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Such processes, in turn, set off mass and heat transfer phenomena that influence not only the quality and quantity of crop production but also its environmental cost. While these processes have considerably been analyzed in separate, they strongly interact with one another. For instance, increased radiation (mainly thermal infrared) increases temperature, reduces humidity, consequently increases transpiration, and affects CO2 exchange as well as other reaction rates. Computational fluid dynamics (CFD) is a numerical tool with a solid physical basis which allows, through the construction of a computational model, to simulate the fluid flow environment. Heating, ventilation, and condensation have been analyzed in the greenhouse environment with CFD techniques. The current challenge is the interaction of these processes and their impact on the production system. The present work summarizes some CFD investigations carried out in this topic, in order to analyze the processes of heat and mass transfer in a greenhouse for agronomic purposes.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Cruz Ernesto Aguilar Rodriguez and Jorge Flores Velazquez",authors:[{id:"173578",title:"Dr.",name:"Jorge",middleName:null,surname:"Flores-Velazquez",slug:"jorge-flores-velazquez",fullName:"Jorge Flores-Velazquez"}]},{id:"66158",doi:"10.5772/intechopen.84706",title:"Numerical Solution to Two-Dimensional Freezing and Subsequent Defrosting of Logs",slug:"numerical-solution-to-two-dimensional-freezing-and-subsequent-defrosting-of-logs",totalDownloads:620,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"Two-dimensional mutually connected mathematical models have been created, solved, and verified for the transient non-linear heat conduction in logs during their freezing and subsequent defrosting. The models reflect the influence of the internal sources of latent heat of both the free and bound water on the logs’ freezing process and also the impact of the temperature on the fiber saturation point of wood species, with whose participation the current values of the thermo-physical characteristics in each separate volume point of the subjected to freezing and subsequent defrosting logs are computed. The chapter presents solutions of the models with explicit form of the finite-difference method and their validation towards own experimental studies. Results from experimental and simulative investigation of 2D non-stationary temperature distribution in the longitudinal section of beech and pine logs with a diameter of 0.24 m and length of 0.48 m during their many hours freezing in a freezer and subsequent defrosting at room temperature are presented, visualized, and analyzed.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Nencho Deliiski and Natalia Tumbarkova",authors:[{id:"43040",title:"Prof.",name:"Nencho",middleName:"Stanev",surname:"Deliiski",slug:"nencho-deliiski",fullName:"Nencho Deliiski"},{id:"284649",title:"Dr.",name:"Natalia",middleName:"Yordanova",surname:"Tumbarkova",slug:"natalia-tumbarkova",fullName:"Natalia Tumbarkova"}]},{id:"67626",doi:"10.5772/intechopen.86738",title:"The Boundary Element Method for Fluctuating Active Colloids",slug:"the-boundary-element-method-for-fluctuating-active-colloids",totalDownloads:920,totalCrossrefCites:0,totalDimensionsCites:2,abstract:"The boundary element method (BEM) is a computational method particularly suited to solution of linear partial differential equations (PDEs), including the Laplace and Stokes equations, in complex geometries. The PDEs are formulated as boundary integral equations over bounding surfaces, which can be discretized for numerical solution. This manuscript reviews application of the BEM for simulation of the dynamics of “active” colloids that can self-propel through liquid solution. We introduce basic concepts and model equations for both catalytically active colloids and the “squirmer” model of a ciliated biological microswimmer. We review the foundations of the BEM for both the Laplace and Stokes equations, including the application to confined geometries, and the extension of the method to include thermal fluctuations of the colloid. Finally, we discuss recent and potential applications to research problems concerning active colloids. The aim of this review is to facilitate development and adoption of boundary element models that capture the interplay of deterministic and stochastic effects in the dynamics of active colloids.",book:{id:"8416",slug:"non-equilibrium-particle-dynamics",title:"Non-Equilibrium Particle Dynamics",fullTitle:"Non-Equilibrium Particle Dynamics"},signatures:"William E. Uspal",authors:[{id:"279308",title:"Prof.",name:"William",middleName:null,surname:"Uspal",slug:"william-uspal",fullName:"William Uspal"}]},{id:"66487",doi:"10.5772/intechopen.85735",title:"Mean Aspects Controlling Supercritical CO2 Precipitation Processes",slug:"mean-aspects-controlling-supercritical-co-sub-2-sub-precipitation-processes",totalDownloads:736,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"The use of supercritical CO2 is an excellent alternative in extraction, particle precipitation, impregnation and reaction processes due to its special properties. Solubility of the compound in supercritical CO2 drives the precipitation process in different ways. In supercritical antisolvent process, mass and heat transfers, phase equilibria, nucleation, and growth of the compound to be precipitated are the main phenomena that should be taken into account. Mass transfer conditions the morphology and particle size of the final product. This transfer could be tuned altering operating conditions. Heat transfer in non-isothermal process influences on mixing step the size of generated microparticles. In rapid expansion of supercritical solution, phenomena as the phase change from supercritical to a CO2 gas flow, rapid mass transfer and crystallization of the compound, and expansion jet define the morphology and size of the final product. These phenomena a priori could be modulated tuning a large number of operating parameters through the experiments, but the correlations and modeling of these processes are necessary to clarify the relative importance of each one. Moreover, particle agglomeration in the expansion jet and CO2 condensation are determinant phenomena which should be avoided in order to conserve fine particles in the final product.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Antonio Montes, Clara Pereyra and Enrique J. Martínez de la Ossa",authors:[{id:"55991",title:"Mr.",name:"Antonio",middleName:null,surname:"Montes",slug:"antonio-montes",fullName:"Antonio Montes"},{id:"55992",title:"Dr.",name:"Clara",middleName:null,surname:"Pereyra",slug:"clara-pereyra",fullName:"Clara Pereyra"},{id:"55993",title:"Dr.",name:"Enrique",middleName:null,surname:"Martinez De La Ossa",slug:"enrique-martinez-de-la-ossa",fullName:"Enrique Martinez De La Ossa"}]},{id:"66317",doi:"10.5772/intechopen.85254",title:"Review Heat Transfer of Non-Newtonian Fluids in Agitated Tanks",slug:"review-heat-transfer-of-non-newtonian-fluids-in-agitated-tanks",totalDownloads:1001,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The heating and cooling of non-Newtonian liquids in tanks with mechanical impellers are operations commonly employed as chemical reactors, heat exchangers, distillers, extractors, thinners and decanters. In particular, the design of heat exchangers (jackets, helical coils, spiral coils and vertical tubular baffles) in tanks requires the prior knowledge of the rheology of the liquid for the calculation of the convection coefficients and the Reynolds number, in order to obtain the area thermal exchange. This chapter aimed to present the basic concepts of tanks with agitation, non-Newtonian liquids, hydrodynamics, heat transfer and, finally, with a practical design example for engineers and undergraduate students.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Vitor da Silva Rosa and Deovaldo de Moraes Júnior",authors:[{id:"187128",title:"Ph.D.",name:"Vitor",middleName:null,surname:"Rosa",slug:"vitor-rosa",fullName:"Vitor Rosa"},{id:"188792",title:"Dr.",name:"Deovaldo",middleName:null,surname:"Moraes Júnior",slug:"deovaldo-moraes-junior",fullName:"Deovaldo Moraes Júnior"}]}],mostDownloadedChaptersLast30Days:[{id:"66878",title:"Design of Industrial Falling Film Evaporators",slug:"design-of-industrial-falling-film-evaporators",totalDownloads:1753,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The high performance evaporators are important for process industries such as food, desalination and refineries. The falling film evaporators have many advantages over flooded and vertical tubes that make them best candidate for processes industries application. The heat transfer area is the key parameter in designing of an evaporator and many correlations are available to estimate the size of tube bundle. Unfortunately, most of the correlation is available only for pure water and above 322 K saturation temperatures. Out of these conditions, the areas are designed by the extrapolation of existing correlations. We demonstrated that the actual heat transfer values are 2–3-fold higher at lower temperature and hence simple extrapolated estimation leads to inefficient and high capital cost design. We proposed an accurate heat transfer correlation for falling film evaporators that can capture both, low temperature evaporation and salt concentration effectively. It is also embedded with unique bubble-assisted evaporation parameter that can be only observed at low temperature and it enhances the heat transfer. The proposed correlation is applicable from 280 to 305 K saturation temperatures and feed water concentration ranges from 35,000 to 95,000 ppm. The uncertainty of measured data is less than 5% and RMS of regressed data is 3.5%. In this chapter, first part summarized the all available correlations and their limitations. In second part, falling film evaporation heat transfer coefficient (FFHTC) is proposed and model is developed. In the last part, experimentation is conducted and FFHTC developed and compared with conventional correlations.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Muhammad Wakil Shahzad, Muhammad Burhan and Kim Choon Ng",authors:[{id:"174208",title:"Dr.",name:"Muhammad Wakil",middleName:null,surname:"Shahzad",slug:"muhammad-wakil-shahzad",fullName:"Muhammad Wakil Shahzad"},{id:"249811",title:"Dr.",name:"Muhammad",middleName:null,surname:"Burhan",slug:"muhammad-burhan",fullName:"Muhammad Burhan"},{id:"254696",title:"Prof.",name:"Kim Choon",middleName:null,surname:"Ng",slug:"kim-choon-ng",fullName:"Kim Choon Ng"}]},{id:"66102",title:"Heat and Mass Transfer of Additive Manufacturing Processes for Metals",slug:"heat-and-mass-transfer-of-additive-manufacturing-processes-for-metals",totalDownloads:1302,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Additive manufacturing (AM), a method in which a part is fabricated layer by layer from a digital design package, provides the potential to produce complex components at reduced cost and time. Many techniques (using many different names) have been developed to accomplish this via melting or solid-state joining. However, to date, only a handful can be used to produce metallic parts that fulfill the requirements of industrial applications. The thermal physics and weld pool behaviors in metal AM process have decisive influence on the deposition quality, the microstructure and service performance of the depositions. Accurate analysis and calculation of thermal processes and weld pool behaviors are of great significance to the metallurgy analysis, stress and deformation analysis, process control and process optimization etc. Numerical modeling is also a necessary way to turn welding from qualitative description and experience-based art into quantitative analysis- and science-based engineering branch. In this chapter, two techniques for producing metal parts are explored, with a focus on the thermal science of metal AM: fluid flow and heat transfer. Selective laser melting (SLM) is the one that is most widely used because it typically has the best resolution. Another is named metal fused-coated additive manufacturing (MFCAM) that is cost competitive and efficient in producing large and middle-complex components in aerospace applications.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Zhengying Wei and Jun Du",authors:[{id:"47614",title:"Prof.",name:"Zhengying",middleName:null,surname:"Wei",slug:"zhengying-wei",fullName:"Zhengying Wei"},{id:"282052",title:"Dr.",name:"Jun",middleName:null,surname:"Du",slug:"jun-du",fullName:"Jun Du"}]},{id:"66563",title:"Heat and Mass Transfer in Outward Convex Corrugated Tube Heat Exchangers",slug:"heat-and-mass-transfer-in-outward-convex-corrugated-tube-heat-exchangers",totalDownloads:1037,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Heat and mass transfer in outward convex corrugated tube heat exchangers is of significant importance for the optimization, fabrication, and application of outward convex corrugated tube heat exchangers. This chapter gives a deep investigation of the heat and mass transfer in outward convex corrugated tube heat exchangers. Based on the experimental setup developed, the performances of a novel outward convex corrugated tube heat exchanger are presented. Simulation methods are then used to detail the heat and mass transfer at tube side and shell side of the outward convex corrugated tube heat exchanger, and these include the flow structure, temperature distribution, and turbulence kinetic energy. Heat and mass transfer enhancements of the outward convex corrugated tube heat exchanger are also studied, and they are from tube side, shell side, and overall system aspects. Finally, multi-objective optimization of the outward convex corrugated tube heat exchanger is conducted to obtain the optimal performances through using Response Surface Methodology (RSM) and Non-dominated Sorting Genetic Algorithm (NSGA-II). Main conclusions and future outlook are then briefly stated and summarized. We firmly believe that the contents presented in this chapter can not only enrich the knowledge of heat exchangers but also develop methods for studying heat exchangers.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Huaizhi Han, Bingxi Li, Yaning Zhang, Quan Zhu and Ruitian Yu",authors:[{id:"23828",title:"Dr.",name:"Quan",middleName:null,surname:"Zhu",slug:"quan-zhu",fullName:"Quan Zhu"},{id:"148369",title:"Prof.",name:"Bingxi",middleName:null,surname:"Li",slug:"bingxi-li",fullName:"Bingxi Li"},{id:"196928",title:"Dr.",name:"Yaning",middleName:null,surname:"Zhang",slug:"yaning-zhang",fullName:"Yaning Zhang"},{id:"281875",title:"Prof.",name:"Huaizhi",middleName:null,surname:"Han",slug:"huaizhi-han",fullName:"Huaizhi Han"},{id:"282268",title:"Mr.",name:"Ruitian",middleName:null,surname:"Yu",slug:"ruitian-yu",fullName:"Ruitian Yu"}]},{id:"66317",title:"Review Heat Transfer of Non-Newtonian Fluids in Agitated Tanks",slug:"review-heat-transfer-of-non-newtonian-fluids-in-agitated-tanks",totalDownloads:1001,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The heating and cooling of non-Newtonian liquids in tanks with mechanical impellers are operations commonly employed as chemical reactors, heat exchangers, distillers, extractors, thinners and decanters. In particular, the design of heat exchangers (jackets, helical coils, spiral coils and vertical tubular baffles) in tanks requires the prior knowledge of the rheology of the liquid for the calculation of the convection coefficients and the Reynolds number, in order to obtain the area thermal exchange. This chapter aimed to present the basic concepts of tanks with agitation, non-Newtonian liquids, hydrodynamics, heat transfer and, finally, with a practical design example for engineers and undergraduate students.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Vitor da Silva Rosa and Deovaldo de Moraes Júnior",authors:[{id:"187128",title:"Ph.D.",name:"Vitor",middleName:null,surname:"Rosa",slug:"vitor-rosa",fullName:"Vitor Rosa"},{id:"188792",title:"Dr.",name:"Deovaldo",middleName:null,surname:"Moraes Júnior",slug:"deovaldo-moraes-junior",fullName:"Deovaldo Moraes Júnior"}]},{id:"65692",title:"Advances in Concentrated Solar Power: A Perspective of Heat Transfer",slug:"advances-in-concentrated-solar-power-a-perspective-of-heat-transfer",totalDownloads:1114,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Solar energy has the potential to reduce the dependence on the dwindling supply of fossil fuels through concentrated solar power (CSP) technology. CSP plants utilize solar thermal energy to produce electrical energy based on different thermodynamic power cycles. Solar collectors, reflectors, receivers, thermal fluid, and turbines are the main components of each CSP plant and involve intensive heat transfer at all stages. This chapter illustrates the thermal characteristics of the main components used in CSP technology. In addition, the solar thermal fluid characteristics and its stable operational ranges are discussed in this chapter. Heat capacity, vapor pressure, volume expansion, density and viscosity of the thermal fluid should not differ significantly at different temperatures during various operation stages because these variations can cause failure in the system, which is designed at the fixed material properties. Currently, CSP technology is associated with a higher cost compared to the electricity generated through gas power plants. Many efforts are made to search for sustainable and inexpensive materials to minimize the cost of CSP. One critical issue faced by CSP technology is the intermittent nature of the sun. Modern CSP plants integrate thermal energy storage (TES) unit to smoothen the power production or to shift the production from peak sunshine hours to peak demand hours.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Fadi Alnaimat and Yasir Rashid",authors:[{id:"151722",title:"Dr.",name:"Fadi",middleName:null,surname:"Alnaimat",slug:"fadi-alnaimat",fullName:"Fadi Alnaimat"},{id:"291252",title:"Mr.",name:"Yasir",middleName:null,surname:"Rashid",slug:"yasir-rashid",fullName:"Yasir Rashid"}]}],onlineFirstChaptersFilter:{topicId:"954",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:8,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:98,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:286,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:9,numberOfPublishedChapters:101,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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