Urban and rural differences in child injury deaths in South Africa: A one-year review

Injury, a major cause of morbidity and mortality for children worldwide, is concentrated in low- to middle-income countries (LMICs). Despite the growing rate of childhood injury in LMICs, effective prevention and control remain inadequate owing to the lack of comprehensive epidemiological information on the external causes and magnitude of this problem. This population based study examined whether the incidence and the pattern of fatal injuries among children differ in rural and urban areas of South Africa. The National Injury Mortality Surveillance System (NIMSS) was used to select cases for the period of 2007. Age and gender-specific incidence rates for rural and urban children were computed for specific injury types. Following a cross-sectional method, we analysed all deaths among children below 15 years of age in Gauteng (urban) and Mpumalanga (rural) who died in 2007. For the year 2007, NIMSS recorded a total of 612 injury deaths among children in Mpumalanga (rural) and another 1 400 injury deaths among children in Gauteng (urban). Equally high overall injury death rates were found among children from Gauteng (31.7/100 000) and Mpumalanga (29.2/100 000). The study also revealed several differences with respect to the primary external causes of child injury-related deaths across the two provinces. In particular, passenger related motor vehicle deaths were more evident among children in rural areas than in urban areas, while other unintentional (non-transport-related) deaths – specifically those associated with burns – were more common among urban children than among rural children.Such differences may arise because of the many environmental and infrastructure-related differences that exist between rural and urban areas. Therefore, prevention and intervention efforts in South Africa should focus on the risk factors that are unique to urban and rural children respectively.Keywords: childhood, urban, rural, death

Emerging role of G protein-coupled receptors in microvascular myogenic tone

Blood flow autoregulation results from the ability of resistance arteries to reduce or increase their diameters in response to changes in intravascular pressure. The mechanism by which arteries maintain a constant blood flow to organs over a range of pressures relies on this myogenic response, which defines the intrinsic property of the smooth muscle to contract in response to stretch. The resistance to flow created by myogenic tone (MT) prevents tissue damage and allows the maintenance of a constant perfusion, despite fluctuations in arterial pressure. Interventions targeting MT may provide a more rational therapeutic approach in vascular disorders, such as hypertension, vasospasm, chronic heart failure, or diabetes. Despite its early description by Bayliss in 1902, the cellular and molecular mechanisms underlying MT remain poorly understood. We now appreciate that MT requires a complex mechanotransduction converting a physical stimulus (pressure) into a biological response (change in vessel diameter). Although smooth muscle cell depolarization and a rise in intracellular calcium concentration are recognized as cornerstones of the myogenic response, the role of wall strain-induced formation of vasoactive mediators is less well established. The vascular system expresses a large variety of Class 1 G protein-coupled receptors (GPCR) activated by an eclectic range of chemical entities, including peptides, lipids, nucleotides, and amines. These messengers can function in blood vessels as vasoconstrictors. This review focuses on locally generated GPCR agonists and their proposed contributions to MT. Their interplay with pivotal G(q-11) and G(12-13) protein signalling is also discussed

THE INTERNMENT OF JAPANESE AMERICANS DURING WORLD WAR II: A CASE STUDY OF NATIONAL TRAUMA AND INSTITUTIONAL VIOLENCE

The events set in motion by the Japanese bombing of Pearl Harbour wereamong the more consequential events in the history of the world (Toland, 1982).The subsequent development of the atomic bomb and its use at Hiroshima andNagasaki permanently changed the conditions under which men and women live(Selden and Selden, 1989) and provided a dramatic illustration of what humanbeings are capable of doing to each other (Lifton and Markusen, 1988). Theimmediate effects of the surprise attack on the United States (US) were traumatic asthe nation entered a war for which it was not prepared. The long range-effectsinclude the imprinting of the surprise attack in collective memories and a nationaldetermination by the US to never again be caught unprepared militarily (Neal,2005). Both political leaders and journalists drew upon the memories of PearlHarbour as they attempted to make sense out of the surprise terrorist attack ofSeptember 11, 2001 (9/11), and to mobilize the nation for an effective response

Science data quality assessment for the Large Synoptic Survey Telescope

LSST will have a Science Data Quality Assessment (SDQA) subsystem for the assessment of the data products that will be produced during the course of a 10 yr survey. The LSST will produce unprecedented volumes of astronomical data as it surveys the accessible sky every few nights. The SDQA subsystem will enable comparisons of the science data with expectations from prior experience and models, and with established requirements for the survey. While analogous systems have been built for previous large astronomical surveys, SDQA for LSST must meet a unique combination of challenges. Chief among them will be the extraordinary data rate and volume, which restricts the bulk of the quality computations to the automated processing stages, as revisiting the pixels for a post-facto evaluation is prohibitively expensive. The identification of appropriate scientific metrics is driven by the breadth of the expected science, the scope of the time-domain survey, the need to tap the widest possible pool of scientific expertise, and the historical tendency of new quality metrics to be crafted and refined as experience grows. Prior experience suggests that contemplative, off-line quality analyses are essential to distilling new automated quality metrics, so the SDQA architecture must support integrability with a variety of custom and community-based tools, and be flexible to embrace evolving QA demands. Finally, the time-domain nature of LSST means every exposure may be useful for some scientific purpose, so the model of quality thresholds must be sufficiently rich to reflect the quality demands of diverse science aims

Compliance with hygiene practices among healthcare workers in the intensive care unit

Background. Intensive care unit (ICU)-related healthcare-associated infections (HCAIs) are two to three times higher in lower-income countries than in higher-income ones. Hand cleansing and other hygiene measures have been documented as one of the most effective measures in combating the transmission of HCAIs. There is a paucity of data pertaining to hygiene practices in the ICU in developing countries.Objectives. To determine compliance with hygiene practices among healthcare workers in a tertiary hospital ICU.Methods. Hygiene practices of healthcare workers in a tertiary academic hospital ICU in Johannesburg, South Africa, were discreetly observed over an 8-week period. Compliance with hand cleansing and other hygiene practices was documented and analysed. Retrospective consent was obtained, and subject confidentiality was maintained. Results. A total of 745 hygiene opportunities were observed. Of the 156 opportunities where handwashing with soap and water was indicated (20.9%), compliance was noted in 89 cases (57.1%), while an alcohol-based hand rub was inappropriately used in 34 cases (21.8%) and no hand hygiene was performed in the remaining 33 cases (21.1%). Of the 589 opportunities where an alcohol-based hand-rub was indicated, it was used in 312 cases (53.0%). Compliance with the donning of disposable surgical gloves, disposable plastic aprons and being ‘bare below the elbows’ was noted in 114 (90.6%), 108 (71.1%) and 355 (47.7%) opportunities, respectively, where these were indicated.Conclusions. Overall compliance with hygiene measures among healthcare workers in the ICU was suboptimal in this study, but in keeping with general international trends. Regular retraining of staff, frequent reminders, peer oversight and regular audits may improve compliance

Held to ransom - CMV treatment in South Africa

Cytomegalovirus is a multi-systemic infection reactivated in the immunocompromised. Diagnosis and treatment are prohibitively costly in sub-Saharan Africa, and efforts need to be made for their price reduction to support the expanding highly active antiretroviral treatment programme in the region

Two Distant Halo Velocity Groups Discovered by the Palomar Transient Factory

We report the discovery of two new halo velocity groups (Cancer groups A and B) traced by 8 distant RR Lyrae stars and observed by the Palomar Transient Factory (PTF) survey at R.A.~129°, Dec~20° (l~205°, b~32°). Located at 92 kpc from the Galactic center (86 kpc from the Sun), these are some of the most distant substructures in the Galactic halo known to date. Follow-up spectroscopic observations with the Palomar Observatory 5.1-m Hale telescope and W. M. Keck Observatory 10-m Keck I telescope indicate that the two groups are moving away from the Galaxy at v_(gsr) = 78.0+-5.6 km s^(-1) (Cancer group A) and v_(gsr) = 16.3+-7.1 km s^(-1) (Cancer group B). The groups have velocity dispersions of σ_(v_)gsr))=12.4+-5.0 km s^(-1) and σ _(v_(gsr))=14.9+-6.2 km s^(-1), and are spatially extended (about several kpc) making it very unlikely that they are bound systems, and are more likely to be debris of tidally disrupted dwarf galaxies or globular clusters. Both groups are metal-poor (median metallicities of [Fe/H]^A = -1.6 dex and [Fe/H]^B =-2.1 dex), and have a somewhat uncertain (due to small sample size) metallicity dispersion of ~0.4 dex, suggesting dwarf galaxies as progenitors. Two additional RR Lyrae stars with velocities consistent with those of the Cancer groups have been observed ~25 ° east, suggesting possible extension of the groups in that direction

A hot and fast ultra-stripped supernova that likely formed a compact neutron star binary

Compact neutron star binary systems are produced from binary massive stars through stellar evolution involving up to two supernova explosions. The final stages in the formation of these systems have not been directly observed. We report the discovery of iPTF 14gqr (SN 2014ft), a type Ic supernova with a fast-evolving light curve indicating an extremely low ejecta mass (≈0.2 solar masses) and low kinetic energy (≈2 × 10^(50) ergs). Early photometry and spectroscopy reveal evidence of shock cooling of an extended helium-rich envelope, likely ejected in an intense pre-explosion mass-loss episode of the progenitor. Taken together, we interpret iPTF 14gqr as evidence for ultra-stripped supernovae that form neutron stars in compact binary systems

Design of the Spitzer Space Telescope Heritage Archive

It is predicted that Spitzer Space Telescope’s cryogen will run out in April 2009, and the final reprocessing for the cryogenic mission is scheduled to end in April 2011, at which time the Spitzer archive will be transferred to the NASA/IPAC Infrared Science Archive (IRSA) for long-term curation. The Spitzer Science Center (SSC) and IRSA are collaborating to design and deploy the Spitzer Heritage Archive (SHA), which will supersede the current Spitzer archive. It will initially contain the raw and final reprocessed cryogenic science products, and will eventually incorporate the final products from the Warm mission. The SHA will be accompanied by tools deemed necessary to extract the full science content of the archive and by comprehensive documentation