South African Guidelines on the Determination of Death

Death is a medical occurrence that has social, legal, religious and cultural consequences requiring common clinical standards for its diagnosis and legal regulation.The following document compiled by the Critical Care Society of Southern Africa outlines the core standards for determination of death in the hospital context. It aligns with the latest evidence-based research and international guidelines and is applicable to the South African context and legal system.The aim is to provide clear medical standards for health care providers to follow in the determination of death, thereby promoting safe practices and high-quality care through the use of uniform standards. Adherence to such guidelines will provide assurance to medical staff, patients, their families and the South African public that the determination of death is always undertaken with diligence, integrity, respect and compassion, and is in accordance with accepted medical standards and latest scientific evidence

South African guidelines on the determination of death

Death is a medical occurrence that has social, legal, religious and cultural consequences requiring common clinical standards for its diagnosis and legal regulation. This document compiled by the Critical Care Society of Southern Africa outlines the core standards for determination of death in the hospital context. It aligns with the latest evidence-based research and international guidelines and is applicable to the South African context and legal system. The aim is to provide clear medical standards for healthcare providers to follow in the determination of death, thereby promoting safe practices and high-quality care through the use of uniform standards. Adherence to such guidelines will provide assurance to medical staff, patients, their families and the South African public that the determination of death is always undertaken with diligence, integrity, respect and compassion, and is in accordance with accepted medical standards and latest scientific evidence. The consensus guidelines were compiled using the AGREE II checklist with an 18-member expert panel participating in a three-round modified Delphi process. Checklists and advice sheets were created to assist with application of these guidelines in the clinical environmenAlso published as: Thomson, D., Joubert, I., De Vasconcellos, K. et al. South African guidelines on the determination of death. Southern African Journal of Critical Care 2021, vol. 37, no. 1b, pp. 41-54. https://doi.org/10.7196/SAJCC.2021v37i1b.466.The Critical Care Society of Southern Africa (CCSSA)http://www.samj.org.zahttp://www.sajcc.org.zadm2022Critical CareNursing ScienceSurger

Critical Care Society of Southern Africa adult patient blood management guidelines: 2019 Round-table meeting, CCSSA Congress, Durban, 2018

The CCSSA PBM Guidelines have been developed to improve patient blood management in critically ill patients in southern Africa. These consensus recommendations are based on a rigorous process by experts in the field of critical care who are also practicing in South Africa (SA). The process comprised a Delphi process, a round-table meeting (at the CCSSA National Congress, Durban, 2018), and a review of the best available evidence and international guidelines. The guidelines focus on the broader principles of patient blood management and incorporate transfusion medicine (transfusion guidelines), management of anaemia, optimisation of coagulopathy, and administrative and ethical considerations. There are a mix of low-middle and high-income healthcare structures within southern Africa. Blood products are, however, provided by the same notfor- profit non-governmental organisations to both private and public sectors. There are several challenges related to patient blood management in SA due most notably to a high incidence of anaemia, a frequent shortage of blood products, a small donor population, and a healthcare system under financial strain. The rational and equitable use of blood products is important to ensure best care for as many critically ill patients as possible. The summary of the recommendations provides key practice points for the day-to-day management of critically ill patients. A more detailed description of the evidence used to make these recommendations follows in the full clinical guidelines section.http://www.sajcc.org.za/index.php/SAJCCam2021Critical Car

Ethiopian indigenous goats offer insights into past and recent demographic dynamics and localadaptation in sub-Saharan African goats

Abstract Knowledge on how adaptive evolution and human socio‐cultural and economic interests shaped livestock genomes particularly in sub‐Saharan Africa remains limited. Ethiopia is in a geographic region that has been critical in the history of African agriculture with ancient and diverse human ethnicity and bio‐climatic conditions. Using 52K genome‐wide data analysed in 646 individuals from 13 Ethiopian indigenous goat populations, we observed high levels of genetic variation. Although runs of homozygosity (ROH) were ubiquitous genome‐wide, there were clear differences in patterns of ROH length and abundance and in effective population sizes illustrating differences in genome homozygosity, evolutionary history, and management. Phylogenetic analysis incorporating patterns of genetic differentiation and gene flow with ancestry modelling highlighted past and recent intermixing and possible two deep ancient genetic ancestries that could have been brought by humans with the first introduction of goats in Africa. We observed four strong selection signatures that were specific to Arsi‐Bale and Nubian goats. These signatures overlapped genomic regions with genes associated with morphological, adaptation, reproduction and production traits due possibly to selection under environmental constraints and/or human preferences. The regions also overlapped uncharacterized genes, calling for a comprehensive annotation of the goat genome. Our results provide insights into mechanisms leading to genome variation and differentiation in sub‐Saharan Africa indigenous goats

Towards identifying the vulnerability of HIV/AIDS affected households to food insecurity: the RVAC-UNAIDS experience: challenges and opportunities

Paper presented to the United Nations Regional Inter-Agency Coordinating and Support Office, "Measuring the impact of HIV/AIDS on food insecurity", Johannesburg, 9-11 SeptemberThis paper provides an overview of attempts to focus an HIV/AIDS lens on the data generated during the Vulnerability Assessment Committee surveys in August 2002, December 2002 and April to June 2003. The objective was to further the understanding of the impacts of HIV/AIDS on household food insecurity in southern Africa. The final part of the paper includes suggestions for an improved approach and way forward

Data from: Landscape genomics and pathway analysis to understand genetic adaptation of South African indigenous goat populations

Extensively raised livestock populations in most smallholder farming communities are exposed to harsh and heterogeneous climates and disease pathogen that they adapt to in order to survive. Majority of these livestock species including goats are of non-descript breeds and their response to natural selection presented by heterogeneous environments is still unresolved. This study investigated genetic diversity and its association with environmental and geographic conditions in 194 South African indigenous goats from different geographic using Illumina goat SNP50K genotypes. The Tankwa goats formed a homogeneous genetic cluster restricted to the Northern Cape province. Overall, the Boer, Kalahari Red, and Savanna showed a wide geographic spread of shared genetic components whereas the village ecotypes revealed a longitudinal distribution. The relative importance of environmental factors on genetic variation of goat populations was assessed using Redundancy Analysis (RDA). Variance partitioning using Model I with both climatic and geographic variables explained 22% of the total variation while model II with climatic variables accounted for 17%. Model III, which accounted for geographic variables, explained 1% of the total variation. The first axis (Model I) of the RDA analysis, revealed 329 outlier SNPs. Landscape genomic approaches of Spatial Analysis Method identified a total of 843 (1.75%) SNPs, while Latent Factor Mixed Models identified 714 (1.48%) SNPs significantly associated with environmental variables. Significant markers were within genes involved in biological functions potentially important for environmental adaptation. Overall, the study suggested environmental factors to have some effect in shaping the genetic variation of South African indigenous goat populations