The assessment of the external costs of dust fallout in Blyvooruitzicht Gold Mining Village

Abstract: Mining is important for the South African economy, as it is for many developing African nations. In 2017, mining was reported to contribute 6.8 % to the South African GDP and provided more than 460, 000 jobs. Though mining adds an enormous amount of value to the country, it has significant impacts on the environment and the socio-economic factors of a society. The well-documented environmental impact of mining operations on surface and groundwater systems, known as Acid Mine Drainage (AMD), is just one of these environmental impacts. There are also other impacts such as the pollution of agricultural soils, the creation of sinkholes and air pollution. For example, airborne dust remains a persistent problem in South African urban areas due to the climatic conditions, extensive surface mining, unrehabilitated tailings dumps and mineral processing. However, very little is reported on the socio-economic costs that are due to poor environmental management. Some scholars assert that despite the Mine Health and Safety Act, deposition monitoring guidelines and national dust regulations, South Africa still experiences persistent dust problems, especially in coal and gold mining districts. This paper investigates the effect of gold mining dust pollution in and around Blyvooruitzicht Gold Mining Village, in South Africa. A quantitative and qualitative approach was used, where the community of Blyvooruitzicht was interviewed to examine their perceptions on dust pollution and their socio-economic environment. This paper examines how poor and premature mine closure by liquidation results in unrehabilitated mine tailings and how this has significant impacts on the socio-economic status of individuals and surrounding businesses. The community of Blyvoor being investigated in the paper, perceives the dust fallout impact to be a socio-economic threat. The paper finds that the community believes it incurs financial expenditures due to treating respiratory related diseases triggered by dust fallout

Medical tourism by Indian-South Africans to India: An exploratory investigation

Medical tourism is a well-established sector in developing countries, and attracts a significant number of tourists from developed countries. Medical tourism is a strong driver of economic growth, but some argue that this kind of tourism promotes inequality in terms of access to healthcare facilities in both developing and developed countries. Whilst research has been conducted on medical tourists travelling to South Africa, no research has focused on the geography of South Africans travelling abroad for medical tourist activities. This study therefore sought to obtain first-hand information from Indian-South African citizens who have partaken in medical tourism in India. Data was gathered through personal, semi-structured interviews conducted with 54 individuals. It was ascertained that the majority of the individuals interviewed in this study travelled to India primarily for medical treatment, while tourist activities were a secondary objective. A smaller proportion of interviewees travelled to India for vacation, with medical care being a secondary motivation, or an impulse due to the low cost of treatment and convenience. Medical tourism by Indian-South Africans travelling to India highlights various shortfalls in South African medical care, including a lack of treatment availability, a poorer quality of service, medical expertise abroad, and the higher cost incurred locally.SP201

L-Arginine promotes gut hormone release and reduces food intake in rodents

Aims: To investigate the anorectic effect of L‐arginine (L‐Arg) in rodents. Methods: We investigated the effects of L‐Arg on food intake, and the role of the anorectic gut hormones glucagon‐like peptide‐1 (GLP‐1) and peptide YY (PYY), the G‐protein‐coupled receptor family C group 6 member A (GPRC6A) and the vagus nerve in mediating these effects in rodents. Results: Oral gavage of L‐Arg reduced food intake in rodents, and chronically reduced cumulative food intake in diet‐induced obese mice. Lack of the GPRC6A in mice and subdiaphragmatic vagal deafferentation in rats did not influence these anorectic effects. L‐Arg stimulated GLP‐1 and PYY release in vitro and in vivo. Pharmacological blockade of GLP‐1 and PYY receptors did not influence the anorectic effect of L‐Arg. L‐Arg‐mediated PYY release modulated net ion transport across the gut mucosa. Intracerebroventricular (i.c.v.) and intraperitoneal (i.p.) administration of L‐Arg suppressed food intake in rats. Conclusions: L‐Arg reduced food intake and stimulated gut hormone release in rodents. The anorectic effect of L‐Arg is unlikely to be mediated by GLP‐1 and PYY, does not require GPRC6A signalling and is not mediated via the vagus. I.c.v. and i.p. administration of L‐Arg suppressed food intake in rats, suggesting that L‐Arg may act on the brain to influence food intake. Further work is required to determine the mechanisms by which L‐Arg suppresses food intake and its utility in the treatment of obesity

High HIV prevalence in an early cohort of hospital admissions with COVID-19 in Cape Town, South Africa

Background. South Africa (SA) has a high prevalence of HIV and tuberculosis. Cape Town was the SA metropole most affected in the early stages of the COVID-19 pandemic. Early observational data from Africa may provide valuable insight into what can be expected as the pandemic expands across the continent.Objectives. To describe the prevalence, clinical features, comorbidities and outcome of an early cohort of HIV-positive and HIV-negative patients admitted with COVID-19.Methods. This was a descriptive observational study of an early cohort of adults with COVID-19 pneumonia admitted from 25 March to 11 May 2020.Results. Of 116 patients (mean age 48 years, 61% female) admitted, 24 were HIV-positive (21%). The most common symptoms reported were cough (n=88; 73%), shortness of breath (n=78; 69%), fever (n=67; 59%), myalgia (n=29; 25%) and chest pain (n=22; 20%). The most common comorbidities were hypertension (n=46; 41%), diabetes mellitus (n=43; 38%), obesity (n=32; 28%) and HIV (n=24; 21%). Mortality was associated with older age (mean (standard deviation) 55 (12) years v. 46 (14) years; p<0.01); the presence of hypertension or hypertension along with diabetes and/or obesity; lower partial pressure of arterial oxygen to fraction of inspired oxygen ratio; and higher urea level, white cell count, neutrophil count, and C-reactive protein, lactate dehydrogenase and ferritin levels, and high neutrophil to lymphocyte ratio. The overall survival rate for all hospital admissions was 86/116 (73%). In this early cohort, survival was similar in patients with HIV (n=18; 75%) compared with those without HIV (n=67; 75%) (p=1). Of the 74 patients admitted to the wards, 63 (85%) survived, whereas 22 of 42 (52%) admitted to the intensive care unit survived.Conclusions. Patients with HIV infection represented a large proportion of all COVID-19 admissions. The presentation and outcome of patients with HIV did not differ significantly from those of patients without HIV

Tropospheric Ozone Assessment Report : Present-day ozone distribution and trends relevant to human health

This study quantifies the present-day global and regional distributions (2010–2014) and trends (2000–2014) for five ozone metrics relevant for short-term and long-term human exposure. These metrics, calculated by the Tropospheric Ozone Assessment Report, are: 4th highest daily maximum 8-hour ozone (4MDA8); number of days with MDA8 > 70 ppb (NDGT70), SOMO35 (annual Sum of Ozone Means Over 35 ppb) and two seasonally averaged metrics (3MMDA1; AVGMDA8). These metrics were explored at ozone monitoring sites worldwide, which were classified as urban or non-urban based on population and nighttime lights data.Present-day distributions of 4MDA8 and NDGT70, determined predominantly by peak values, are similar with highest levels in western North America, southern Europe and East Asia. For the other three metrics, distributions are similar with North–South gradients more prominent across Europe and Japan. Between 2000 and 2014, significant negative trends in 4MDA8 and NDGT70 occur at most US and some European sites. In contrast, significant positive trends are found at many sites in South Korea and Hong Kong, with mixed trends across Japan. The other three metrics have similar, negative trends for many non-urban North American and some European and Japanese sites, and positive trends across much of East Asia. Globally, metrics at many sites exhibit non-significant trends. At 59% of all sites there is a common direction and significance in the trend across all five metrics, whilst 4MDA8 and NDGT70 have a common trend at ~80% of all sites. Sensitivity analysis shows AVGMDA8 trends differ with averaging period (warm season or annual). Trends are unchanged at many sites when a 1995–2014 period is used; although fewer sites exhibit non-significant trends. Over the longer period 1970–2014, most Japanese sites exhibit positive 4MDA8/SOMO35 trends. Insufficient data exist to characterize ozone trends for the rest of Asia and other world regions

Bleeding and thrombosis outcomes in hospitalised COVID-19 patients on low-molecular-weight heparin and antiplatelet therapy

Background. An increased incidence of thromboembolic events in hospitalised COVID‐19 patients has been demonstrated despite the use of low‐molecular‐weight heparin (LMWH). Antiplatelet therapy prior to admission and early in the disease course has been hypothesised to be protective against thrombosis. Objectives. To describe the bleeding and thrombosis outcomes in hospitalised patients with confirmed COVID‐19 receiving LMWH, with and without concomitant antiplatelet therapy. Secondary objectives were to explore predictors of bleeding and thrombosis outcomes, and dosing practices of antiplatelet therapy and LMWH. Methods. We conducted a descriptive, cross‐sectional study of bleeding and thrombosis outcomes at Tygerberg Academic Hospital, Cape Town, South Africa, during the first COVID‐19 wave, in 808 hospitalised patients with confirmed COVID‐19 receiving LMWH with and without concomitant antiplatelet therapy. Multivariate logistic regression analysis was performed if predictors were deemed statistically and clinically significant. Results. Patients receiving both LMWH and antiplatelet therapy had similar bleeding outcomes compared with patients only receiving LMWH (odds ratio (OR) 1.5; 95% confidence interval (CI) 0.6 ‐ 4.0). Patients receiving both LMWH and antiplatelet therapy had increased odds of developing thrombosis compared with patients only receiving LMWH (OR 4.8; 95% CI 2.1 ‐ 10.7). Conclusion. The bleeding risk in COVID‐19 patients receiving both LMWH and antiplatelet therapy was not significantly increased. A potentially higher risk of thrombosis in patients receiving LMWH and antiplatelet therapy was observed. However, this could reflect confounding by indication. Randomised studies are required to further evaluate the use of antiplatelet therapy to treat hospitalised patients with COVID‐19

A point-prevalence study of body mass indices in HIV-positive and HIV-negative patients admitted to hospital with COVID-19 in South Africa

Background. Obesity is now well recognised as a risk factor for severe COVID‐19, but the true prevalence of obesity in hospitalised adults with COVID‐19 remains unclear because formal body mass indices (BMIs) are not routinely measured on admission. Objectives. To describe the true prevalence of obesity measured by the BMI, and associated comorbidities, in patients hospitalised with severe COVID‐19, including people with HIV (PWH). Methods. We conducted a point‐prevalence study of measured BMI in consecutive patients with severe COVID‐19 admitted to the medical COVID‐19 wards in a tertiary academic hospital in Cape Town, South Africa (SA). Patients were enrolled over a 2‐week period during the peak of the first COVID‐19 wave in SA. Results. We were able to measure the BMI in 122 of the 146 patients admitted during the study period. The prevalence of HIV was 20% (n=24/122). Most of the participants were overweight or obese (n=104; 85%), and 84 (68.9%) met criteria for obesity. The mean (standard deviation) BMI was 33 (7.5), and 34.5 (9.1) in PWH. Of PWH, 83% (n=20/24) were overweight or obese and 75% (n=18) met criteria for obesity. Multimorbidity was present in 22 (92%) of PWH. Conclusion. We found that most patients, including PWH, met criteria for being overweight or obese. The high prevalence of obesity in PWH and severe COVID‐19 reinforces the need for targeted management of non‐communicable diseases, including obesity, in PWH