South African Paediatric Surgical Outcomes Study : a 14-day prospective, observational cohort study of paediatric surgical patients

BACKGROUND : Children comprise a large proportion of the population in sub-Saharan Africa. The burden of paediatric surgical disease exceeds available resources in Africa, potentially increasing morbidity and mortality. There are few prospective paediatric perioperative outcomes studies, especially in low- and middle-income countries (LMICs). METHODS : We conducted a 14-day multicentre, prospective, observational cohort study of paediatric patients (aged <16 yrs) undergoing surgery in 43 government-funded hospitals in South Africa. The primary outcome was the incidence of in-hospital postoperative complications. RESULTS : We recruited 2024 patients at 43 hospitals. The overall incidence of postoperative complications was 9.7% [95% confidence interval (CI): 8.4–11.0]. The most common postoperative complications were infective (7.3%; 95% CI: 6.2–8.4%). In-hospital mortality rate was 1.1% (95% CI: 0.6–1.5), of which nine of the deaths (41%) were in ASA physical status 1 and 2 patients. The preoperative risk factors independently associated with postoperative complications were ASA physcial status, urgency of surgery, severity of surgery, and an infective indication for surgery. CONCLUSIONS : The risk factors, frequency, and type of complications after paediatric surgery differ between LMICs and high-income countries. The in-hospital mortality is 10 times greater than in high-income countries. These findings should be used to develop strategies to improve paediatric surgical outcomes in LMICs, and support the need for larger prospective, observational paediatric surgical outcomes research in LMICs. CLINICAL TRIAL REGISTRATION : NCT03367832.Jan Pretorius Research Fund; Discipline of Anaesthesiology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal; Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital and University of Cape Town; Department of Anaesthesia, University of the Witwatersrand; and the Paediatric Anaesthesia Community of South Africa (PACSA).https://bjanaesthesia.org2020-02-01gl2019Anaesthesiolog

A factor analytical study of the dimensions of sportscapes in selected soccer stadia in Gauteng, South Africa

Central to the game of soccer are the spectators who are key constituents of the sport. The environment within which the game is staged also plays a vital role with regard to spectator attendance. Once a spectator enters a sport stadium, the physical environment and the experience of the game may lead to a relationship with the environment, resulting in revisiting the sport facility or avoiding the environment. The purpose of the study was to establish the salient sportscapes components that spectators take cognisance of when attending professional soccer matches. The target population consisted of spectators attending games at Soccer City Stadium (formerly FNB Stadium) and Orlando Stadium in Soweto in the Gauteng province. The survey comprised 170 male and female respondents, eighteen years and above. To ensure randomisation every fourth spectator entering the stadiums was interviewed. Factor analysis was used to ascertain the various sportscape dimensions. This procedure resulted in the extraction of seven meaningful factors which were labelled as scoreboard quality, refreshment provisioning, facility aesthetics, space allocation, stadium accessibility, seating comfort and stadium cleanliness. The results indicate that in order for developers and stadium managers to maintain sustained patronage, all sportscape attributes need to be enhanced in order to create a total sport experience for spectators as opposed to focusing on a single dimension. By fulfilling spectators’ expectations, sport marketers can ensure that spectators are satisfied with their game experiences and the physical environment which in turn would assist in spectator attendance.Keywords: Atmospherics, servicescapes, sportscapes, factor analysis, approach behaviour,avoidance behaviour

The relationship between stadium sportscapes dimensions, desire to stay and future attendance

Leisure and sport services require spectators to spend extended periods of time in the physical surroundings of the service provider. Servicescapes play an important role in determining whether or not spectators are satisfied, which in turn may influence how long they desire to stay in the facility and whether they intend to re-patronise the leisure facility. Research on servicescapes and to a limited extent on sportscapes has sought to establish the importance of cues in service environments. This study is part of a wider study that examined various dimensions of sportscapes using a quantitative approach in establishing the reliability and validity of a sportscapes scale. Seven sportscapes dimensions were established, namely, scoreboard quality, refreshments, facility aesthetics, space allocation, stadium accessibility, seating comfort and stadium cleanliness. The purpose of the study was to examine the relationship of the identified seven sportscapes dimensions on desire to stay in a sport facility and future attendance. Significant positive correlations were found between the seven sportscape dimensions; desire to stay within a facility and future attendance. The regression analysis reported significant predictive relationships between the stadium sportscapes and desire to stay within the stadia and future attendance. With increasing competition among various sport industries, managers and owners of stadiums need to take cognisance of sportscapes which shape spectators’ experience in service provider’s environments.Key words: Servicescapes, sportscapes, desire to stay, future attendance

Mathematics 1: MATM 1/0; EMAT1/0; MAT11E0; EATH 1/0

Examination on Mathematics 1: MATM 1/0; EMAT1/0; MAT11E0; EATH1/0, Nov/Dec 201

Mathematics 111: MATH 3/0

Examination on Mathematics 111: MATH 3/0, Nov/Dec 201

The association between preoperative anemia and postoperative morbidity in pediatric surgical patients: A secondary analysis of a prospective observational cohort study

BACKGROUND : The prevalence of anemia in the South African pediatric surgical population is unknown. Anemia may be associated with increased postoperative complications. We are unaware of studies documenting these findings in patients in low- and middle-income countries (LMICs). AIM : The primary aim of this study was to describe the association between preoperative anemia and 26 defined postoperative complications, in noncardiac pediatric surgical patients. Secondary aims included describing the prevalence of anemia and risk factors for intraoperative blood transfusion. METHOD : This was a secondary analysis of the South African Paediatric Surgical Outcomes Study, a prospective, observational surgical outcomes study. Inclusion criteria were all consecutive patients aged between 6 months and <16 years, presenting to participating centers during the study period who underwent elective and nonelective noncardiac surgery and had a preoperative hemoglobin recorded. Exclusion criteria were patients aged <6 months, undergoing cardiac surgery, or without a preoperative Hb recorded. To determine whether an independent association existed between preoperative anemia and postoperative complications, a hierarchical stepwise logistic regression was conducted. RESULTS : There were 1094 eligible patients. In children in whom a preoperative Hb was recorded 46.2% had preoperative anemia. Preoperative anemia was independently associated with an increased risk of any postoperative complication (odds ratio 2.0, 95% confidence interval: 1.3-3.1, P = .002). Preoperative anemia (odds ratio 3.6, 95% confidence interval: 1.8-7.1, P < .001) was an independent predictor of intraoperative blood transfusion. CONCLUSION : Preoperative anemia had a high prevalence in a LMIC and was associated with increased postoperative complications. The main limitation of our study is the ability to generalize the results to the wider pediatric surgical population, as these findings only relate to children in whom a preoperative Hb was recorded. Prospective studies are required to determine whether correction of preoperative anemia reduces morbidity and mortality in children undergoing noncardiac surgery.http://wileyonlinelibrary.com/journal/panhj2021Anaesthesiolog