Enhanced Accessibility for People with Disabilities Living in Urban Areas

[Excerpt] People with disabilities constitute a significant proportion of the poor in developing countries. If internationally agreed targets on reducing poverty are to be reached, it is critical that specific measures be taken to reduce the societal discrimination and isolation that people with disabilities continue to face. Transport is an important enabler of strategies to fight poverty through enhancing access to education, employment, and social services. This project aims to further the understanding of the mobility and access issues experienced by people with disabilities in developing countries, and to identify specific steps that can be taken to start addressing problems. A major objective of the project is to compile a compendium of guidelines that can be used by government authorities, advocacy groups, and donor/loan agencies to improve the access of people with disabilities to transport and other services in urban areas

Prediking oor politieke sake - riglyne vanuit Romeine 12-15

Preaching on political issues is a very topical matter, especially in the current situation in South Africa. This matter is extensively dealt with in literature in the field of the Old and New Testament, Homiletics and Ethics. The aim with this article is to explore the Pauline paranesis in Romans 12-15 to discern concrete guidelines on handling political issues in preaching. As point of departure the expression God’s mercy (Romans 12:1) is investigated closely, as the concept of God’s mercy is the foundation stone of the total paranesis in Romans 12-15. Regarding preaching on political issues, the fact that the new aeon has already come and will finally come, leads to certain conclusions. The responsibility of the congregation to test and approve what God's will is - also in political matters - is stressed. The kingdom of God as the predominant kingdom, relativises earthly (political) kingdoms. The responsibility to equip the congregation to discern political issues in the light of Scripture is dealt with in this regard. Finally, perspectives are given on the relation between state and believer. In conclusion the command to Christians to love each other as believers, to live in peace with everyone and to love enemies is also highlighted

Association between healthy eating in pregnancy and allergic status of the offspring in childhood

During the past few decades there has been a steady increase in the prevalence of noncommunicable diseases, including allergic disease. Changing lifestyle and subsequent diet may explain this increase seen in the prevalence of atopic disease. Epidemiologic evidence also suggests that diet may be key in the prevention of allergic disease. [1] There are 3 important characteristics in terms of the maternal diet that have been investigated for the prevention of allergic disease: (1) the role of particular nutrients, such as vitamins (A, D, and E), zinc, and fatty acids; (2) the role of particular foods, such as fruits and vegetables and fish; and (3) the total dietary intake, such as a Mediterranean diet or a healthy diet. Research using the healthy eating index tool, specific to the pregnancy diet, found no association between overall healthy eating score and recurrent wheeze in infants at the age of 3 years. [2] However, maternal intake of celery and citrus fruit specifically has been associated with an increased risk of sensitization to food allergens in 2-year-olds. [3] One case-control study found no effect of consumption of fish, butter, and margarine on the development of atopic sensitization in the offspring of allergic mothers; however, a protective effect of fish intake (2–3 times a week or more) was identified in the nonallergic mothers' group with the risk of food sensitization in the offspring reduced by greater than a third. [4] Thus, the question is whether the associations seen are due to the individual nutrients or foods or whether it is part of an overall nutritional composition of the weaning diet. In this study, we aimed to investigate whether maternal diet, specifically seafood intake during pregnancy, is associated with the infant's allergic outcomes in a well-characterized birth cohort with allergy at 3 and 10 years of age

Evaluating African horse sickness virus in horses and field-caught Culicoides biting midges on the East Rand, Gauteng Province, South Africa

A prospective study was undertaken during 2013 and 2014, to determine the prevalence of African horse sickness virus (AHSV) in Culicoides midges and the incidence of infection caused by the virus in 28 vaccinated resident horses on two equine establishments on the East Rand, Gauteng Province, South Africa. Field caught Culicoides midges together with whole blood samples from participating horses were collected every two weeks at each establishment. Culicoides midges and blood samples were tested for the presence of AHSV RNA by real-time quantitative reverse transcription polymerase chain reaction. Nine immunised horses became infected with AHSV during the study period, although infections were subclinical. African horse sickness virus was also identified from a field-collected midge pool. The observations recapitulate previously published data in another setting, where further investigation is warranted to determine what role subclinical infection plays in the diseases epidemiology

Prevalence and cumulative incidence of food hyper-sensitivity in the first 10 years of life

Background - Prevalence, incidence and natural history of food hypersensitivity (FHS) and its trends in an unselected cohort of older children are unclear.Methods - A birth cohort born on the Isle of Wight (UK) between 2001 and 2002 was followed up prospectively. Children were clinically examined and skin prick tested at set times and invited for food challenges when indicated. At 10 years of age, children were also invited for a blood test.Results - A total of 969 children were recruited at 12 weeks of pregnancy, and 92.9%, 88.5%, 91.6% and 85.3% were assessed at 1, 2, 3 and 10 years. Prevalence of sensitization to any allergen over 10 years was 186 of 969 (19.2%; 95% CI: 16.84–21.8) and 108 of 969 (11.2%; 95% CI: 9.31–13.29) children were sensitized to at least one predefined food allergen. Excluding wheat (due to cross-reactivity with pollen), 40 of 969 (4.1%; 95% CI: 3.19–5.32) children were sensitized to a predefined food allergen. Using food challenges and/or a good clinical history, the cumulative incidence of food hypersensitivity (FHS) in the first decade of life was 64 of 947 (6.8%, 95% CI: 5.2–8.4), while the prevalence of FHS at 10 years was 30 of 827 (3.6%, 95% CI: 2.54–5.15). The vast majority, 25 of 827 (3.0%, 95% CI: 1.8–4.2), suffered from IgE-mediated food allergy, while 5 of 827 (0.6%, 95% CI: 0.07–1.3) had non-IgE-mediated food allergy/food intolerance.Conclusions - By the age of 10 years, 6.8% of children suffered from FHS based on food challenges and a good clinical history. There was a large discrepancy between reported and diagnosed FHS

Impact of urbanisation on Serum lipid profiles -the thusa survey

Objective. To examine the impact of urbanisation on lipid profiles of black South Africans, stratified for HIV status.Design. Cross-sectional population-based survey.Setting. North West province of South Africa.Subjects. A representative sample of 1854 apparently healthy volunteers aged ≥ 15 years, was recruited from 37 randomly selected sites throughout the province. Subjects were stratified into five urbanisation strata (S): Sl rural villages, S2 farms, S3 informal housing or 'squatter camps', S4 urban townships, and S5 surburban housing.Outcome measures. Demographic, physical activity and dietary intake information was collected using validated and culture-sensitive questionnaires. Anthropometric measurements and lipid analyses were determined using standardised methodology.Results. The results revealed significantly lower mean(95% confidence interval) total serum cholesterol (TC) levels in HIV-negative men in Sl -S4 compared with S5 (S1 3.91 (3.77- 4.05) v. S5 4.79 (4.54- 5.04) mmol/1). In HIV-negative women, TC levels were significantly lower in Sl - S3 than in S4 and S5 (S1 4.05 (3.94- 4.17) v. S5 4.79 (4.59- 5.00) mmol/1). The same trends were seen for serum low-density lipoprotein cholesterol (LDLC) and triglycerides and in HIV-positive subjects. Binary logistical analysis indicated that the main factor responsible for the increased TC levels seemed to be increased body mass index (BMI) due to decreased physical activity. Conclusions. Serum lipid levels increased with urbanisation although they remained within levels recommended for ther populations. This may, however, become an important health problem in future if preventive strategies are not implemented. Culturally sensitive physical activity programmes to decrease BMI, targeted at professional me and women, and women in urban townships, seem to constitute the most appropriate intervention

Changing prevalence of wheeze, rhinitis and allergic sensitisation in late childhood: findings from 2 Isle of Wight birth cohorts’ 12-years apart

Background: While the prevalence of asthma in children is decreasing or remaining the same, time-trends in the prevalence of rhinitis in children are not known. Understanding sensitisation trends may help inform about trends in asthma and rhinitis prevalence.Objective: To assess time -trends of wheeze, rhinitis and aero-allergen sensitisation prevalence at 10 years of age we compared two birth cohorts established 12 years apart. To gain insight into differences in disease prevalence we assessed association of family-history, early life exposures and sensitisation with wheeze and rhinitis in each cohort.Methods: The IoW (Isle-of-Wight) and FAIR (Food-Allergy-and-Intolerance-Research) unselected birth cohorts were established in 1989 and 2001 in IoW. Identical ISAAC questionnaire and Skin Prick test data were collected and compared at 10 years of age.Results: Over the 12 year period from 2001 to 2012, prevalence of lifetime-wheeze, current-wheeze, and those ever-treated-for-asthma decreased by 15.9% (45.5-vs-29.6,p<0.001), 3.9% (18.9-vs-15, p=0.020) and 8.2% (31.7-vs-23.5, p=0.001) respectively. Conversely, current-rhinitis and lifetime-rhinitis prevalence increased by 5.5% (22.6-vs-28.1, p=0.004) and 13% (18.6-vs-31.7, p<0.001) respectively. Atopic status remained stable, however house dust mite (HDM) sensitisation decreased by 5.6% (19.2-vs-13.6, p=0.004) and grass sensitisation increased by 3.5% (12.9-vs-16.4, p=0.054). Male-sex, parental history of asthma and HDM sensitisation were significantly associated with lifetime-wheeze in both cohorts while maternal smoking during pregnancy was a significant risk factor only in the earlier IoW-cohort. Parental history of rhinitis and grass sensitisation were significantly associated with lifetime-rhinitis in both cohorts while HDM sensitisation was significant only for the IoW-cohort.Conclusion: Contrasting changes were noted with falling wheeze and HDM sensitisation but rising rhinitis and grass sensitisation prevalence. Changing prevalence of aero-allergen sensitisations may explain the different time trends observed in these cohorts

Health-related quality of life in children with perceived and diagnosed food hypersensitivity

The few studies measuring health-related quality of life (HRQL) in food hypersensitivity (FHS) have found significantly reduced HRQL in patients and their families, particularly in the areas of family and social activities, emotional issues and family economy. One aspect that has not been studied is the effect of suspected FHS (food allergy/intolerance) vs. diagnosed FHS [based on a food challenge or a positive skin prick test (SPT) and good clinical history] on HRQL. Therefore, the aim of this study was to investigate the HRQL in children with a proven diagnosis of FHS vs. those with reported FHS.MethodsWe have utilized the 10-yr old follow-up cohort of the Food Allergy and Intolerance Research (FAIR) study from the Isle of Wight and assessed the child's HRQL with the Food Allergy Quality of Life Questionnaire – Parent form (FAQLQ-PF) which measures HRQL using four domains: food anxiety, emotional impact, social and dietary limitation.ResultsWhen comparing the two groups of children (proven FHS vs. perceived FHS), no difference in HRQL was found, although food anxiety showed a p-value of (p = 0.062). This was also the case when correcting for all confounding factors identified.ConclusionWe have found that having a clear diagnosis of FHS is not an independent predictor of HRQL. Future studies are required comparing two more similar groups. We also need to focus more on the effect of continuous input from the multidisciplinary team on HRQL and which particular factors of FHS management affect HRQL

Provision of acute and elective general surgical care at a tertiary facility in the era of subspecialisation

Background. The need for an acute care and general surgical unit (ACGSU) to provide care for patients previously managed on an ad hoc basis by subspecialist units was recognised by the provincial government of the Western Cape Province, South Africa, the management of Groote Schuur Hospital (GSH) and the Department of Surgery.Objective. To describe the resulting ACGSU and its functioning.Methods. Data available from administrative records, patient files and operating room forms were collected in spreadsheet form for the period July 2013 - November 2016 inclusive.Results. The ACGSU comprised a medical care team of four consultants and four to five trainees. A total of 7 571 patients were seen during the study period, the majority (66.1%) referred from the GSH Emergency Centre. Skin and soft-tissue infections formed the major disease complex. A total of 3 144 operative records were available. The most common procedures were wound debridement and inguinal hernia repairs. Trainees acted as primary surgeon in most cases. Complications (Clavien-Dindo grades I - V) were noted in 25.0% of patients.Conclusions. The ACGSU provides patient management that would otherwise complicate care in the subspecialist surgical units. It serves as a training ground for registrars and stands as a model for other institutions. Further research into the effect on patient care is planned.

Very low prevalence of IgE mediated wheat allergy and high levels of cross-sensitisation between grass and wheat in a UK birth cohort

BackgroundPatients often report adverse reactions to wheat. Interpretation of sensitization to wheat pollen and flour with/without sensitization to grass pollen is a clinical problem.AimWe set out to determine the prevalence of wheat allergy in a birth cohort (10/11 year olds) and investigate the usefulness of performing skin prick tests (SPT), specific IgE tests and component resolved diagnostics to wheat pollen and flour.MethodsThe Food Allergy and Intolerance Research (FAIR) birth cohort included babies born on the Isle of Wight (UK) between September 2001–August 2002 (n = 969). Children were followed up at 1, 2, 3 and 10/11 years. 588 children had SPTs to wheat pollen and grass during the 10 year follow-up. 294 children underwent further SPT to wheat flour and 246 had specific IgE testing to wheat and grass.ResultsEight children underwent oral food challenges (OFC). We diagnosed 0.48 % (4/827; 95 % CI 0–1 %) children with wheat allergy based on OFC. 16.3 % (96/588) were sensitized to grass pollen, 13.4 % (79/588) to wheat pollen; 78 % (75/96) sensitized to both. Only one child was sensitized to wheat flour and wheat pollen, but not grass pollen. For specific IgE, 15.0 % (37/246) and 36.2 % (89/246) were sensitized to wheat and grass pollen, with 40.5 % (36/89) sensitized to both. Of the 37 children sensitized to wheat, 3 (8.1 %) were sensitized to omega 5 gliadin, 1 (2.7 %) to wheat lipid transfer protein and 1 to wheat gliadin.ConclusionClinicians should be aware of the high level of cross-sensitization when performing tests to wheat and grass pollen i.e. sensitisation to wheat specific IgE and wheat pollen SPT should be assessed in the presence of grass pollen SPT and/or specific IgE