Epide·miology of non-fatal injuries due to external causes in Johannesburg-Soweto Part I. Methodology and materials

In this, the first of two articles examining the epidemiology of non-fatal trauma in Johannesburg-Soweto, we define case inclusion criteria, and discuss the methodology and materials used in this low-cost, hospital-based survey. The survey was conducted between 8 June 1989 and 24 August 1990. Sampling of both inpatient trauma cases and those seen in casualty departments took place in 6 state and 5 private hospitals located within or nearby the Johannesburg magisterial district. Demographic details about each patient, as well as information concerning spatial and temporal details of the incident, involvement of alcohol or drugs, diagnosis, severity of injury, and placement after casualty treatment, were collected by interviewing each patient. Data concerning the age, sex and racial composition of the background population were assembled from a number of sources. After discussing the internal limitations of this methodology, it is concluded that its findings may be of limited use for improving secondary interventions, but are of definite value for trauma prevention programmes

The Determination of the Level of Organisational Commitment among Police Officers in the Sebokeng Cluster

In general, organisational commitment is considered as the inclination of employees to identify with the goals of and retain membership of an organisation. The review of related literature on organisational commitment presupposes that organisational commitment constitutes of three dimensions, namely, affective commitment, continuance commitment and normative commitment. The purpose of this study was to determine the level of organisational commitment among police officers in the Sebokeng Cluster, in South Africa. The Sebokeng Cluster consists of eight police stations: Sebokeng, Vanderbijlpark, Evaton, Orange Farm, Ennderdale, Sharpeville, The Barrage and Boipatong. To achieve the research objective, the organisational commitment of police officers was assessed by means of a survey using a self-administered structured questionnaires distributed to 267 police officers in all the polices stations in the Sebokeng Cluster, with 199 police officers completing and returning the questionnaires. Frequency analysis and the computation of mean scores were performed to analyse data. The results from this study indicated that police officers identified with and were loyal to the safety and security cluster. The police officers felt that they were bound to remain with their safety and security cluster because the costs for leaving were great. Finally, police officers wished to maintain the membership of their safety and security cluster for moral or ethical reasons. DOI: 10.5901/mjss.2015.v6n1s1p10

Epidemiology of non-fatal injuries due to external causes in Johannesburg-Soweto Part 11. Incidence and determinants

A total of 3535 trauma cases were enumerated in Johannesburg- Soweto between 1989 and 1990 in the course of 271 hospital ward rounds and 43 casualty watches. The overall trauma incidence was 2886 new cases per annum per 100000 population, rising to 19872 for coloured males aged 20 - 24 years and to 8761 for black males aged 20 - 24 years. Overall the malelfemale ratio was 2,9 rising to 6 or more in adolescence (15 - 19) for blacks andcoloureds. There were some 156 new resident cases of trauma daily; half these were victims of interpersonal violence, and coloureds constituted 22% of this group, although forming only 8% of the denominator population. Witluegards to cause, most trauma among blacks and coloureds arose from interpersonal violence and significantly less from transport accidents. Among blacks injured in transport accidents (the majority of which involved motor vehicles) most were pedestrians, whereas most whites injured in such accidents were occupants of vehicles. For all groups trauma was most likely to be incurred 'in the street' although for white and coloured women the home was most dangerous. The implications of these and related findings for treatment and prevention and briefly reviewed

Five recommendations to accelerate sustainable solutions in cement and concrete through partnership

Though the technical knowledge to make cement and concrete more sustainable already exists, implementation of solutions lags behind the rate needed to mitigate climate change and meet the targets set by the Sustainable Development Goals. Whilst most of the focus around the built environment is on embodied carbon, we stress an important but neglected dimension: partnership (SDG17). Effective partnerships can be powerful enablers to accelerate sustainable solutions in cement and concrete, and let such solutions transfer from academia to the market. This can be achieved through knowledge generation, solution implementation, and policy development, among other routes. In this article, we share five recommendations for how partnerships can address neglected research questions and practical needs: 1) reform Science, Technology, Engineering and Mathematics (STEM) education to train “circular citizens”; 2) map out routes by which cementitious materials can contribute to a “localization” agenda; 3) generate open‐access maps for the geographical distribution of primary and secondary raw materials; 4) predict the long‐term environmental performance of different solutions for low‐CO2 cements in different geographical areas; 5) overhaul standards to be technically and regionally fit for purpose. These approaches have the potential to make a unique and substantial contribution towards achieving collective sustainability goals

Modern African nuclear detector laboratory: Development of state-of-the-art in-house detector facility at the University of the Western Cape

The upcoming detector facility aims at developing new state-of-the-art particle detectors as well as providing hands-on training to postgraduate students using both analog and digital signal processing from nuclear radiation detectors. The project is two-fold and aims at developing: 1) ancillary detectors to be coupled with the new GAMKA array at iThemba LABS. Of particular interest to our group is the determination of nuclear shapes, which depend on the hyperfine splitting of magnetic substates; 2) PET scanners for cancer imaging using a cheaper technology. Performance of NaI(Tl) inorganic scintillator detectors has been evaluated using PIXIE-16 modules from XIA digital electronics. Gamma-ray energy spectra were acquired from 60Co and 137Cs radioactive sources to calculate the detector resolution as well as to optimize the digital parameters. The present study focuses on improving and optimizing the slow and fast filter parameters for NaI(Tl) detectors which can eventually be used in the list mode of data aquisition

Predicted effects of the introduction of long-acting injectable cabotegravir pre-exposure prophylaxis in sub-Saharan Africa: a modelling study

BACKGROUND: Long-acting injectable cabotegravir pre-exposure prophylaxis (PrEP) is recommended by WHO as an additional option for HIV prevention in sub-Saharan Africa, but there is concern that its introduction could lead to an increase in integrase-inhibitor resistance undermining treatment programmes that rely on dolutegravir. We aimed to project the health benefits and risks of cabotegravir-PrEP introduction in settings in sub-Saharan Africa. METHODS: With HIV Synthesis, an individual-based HIV model, we simulated 1000 setting-scenarios reflecting both variability and uncertainty about HIV epidemics in sub-Saharan Africa and compared outcomes for each with and without cabotegravir-PrEP introduction. PrEP use is assumed to be risk-informed and to be used only in 3-month periods (the time step for the model) when having condomless sex. We consider three groups at risk of integrase-inhibitor resistance emergence: people who start cabotegravir-PrEP after (unknowingly) being infected with HIV, those who seroconvert while on PrEP, and those with HIV who have residual cabotegravir drugs concentrations during the early tail period after recently stopping PrEP. We projected the outcomes of policies of cabotegravir-PrEP introduction and of no introduction in 2022 across 50 years. In 50% of setting-scenarios we considered that more sensitive nucleic-acid-based HIV diagnostic testing (NAT), rather than regular antibody-based HIV rapid testing, might be used to reduce resistance risk. For cost-effectiveness analysis we assumed in our base case a cost of cabotegravir-PrEP drug to be similar to oral PrEP, resulting in a total annual cost of USD$144 per year ($114 per year and $264 per year considered in sensitivity analyses), a cost-effectiveness threshold of$500 per disability-adjusted life years averted, and a discount rate of 3% per year. FINDINGS: Reflecting our assumptions on the appeal of cabotegravir-PrEP, its introduction is predicted to lead to a substantial increase in PrEP use with approximately 2·6% of the adult population (and 46% of those with a current indication for PrEP) receiving PrEP compared with 1·5% (28%) without cabotegravir-PrEP introduction across 20 years. As a result, HIV incidence is expected to be lower by 29% (90% range across setting-scenarios 6-52%) across the same period compared with no introduction of cabotegravir-PrEP. In people initiating antiretroviral therapy, the proportion with integrase-inhibitor resistance after 20 years is projected to be 1·7% (0-6·4%) without cabotegravir-PrEP introduction but 13·1% (4·1-30·9%) with. Cabotegravir-PrEP introduction is predicted to lower the proportion of all people on antiretroviral therapy with viral loads less than 1000 copies per mL by 0·9% (-2·5% to 0·3%) at 20 years. For an adult population of 10 million an overall decrease in number of AIDS deaths of about 4540 per year (-13 000 to -300) across 50 years is predicted, with little discernible benefit with NAT when compared with standard antibody-based rapid testing. AIDS deaths are predicted to be averted with cabotegravir-PrEP introduction in 99% of setting-scenarios. Across the 50-year time horizon, overall HIV programme costs are predicted to be similar regardless of whether cabotegravir-PrEP is introduced (total mean discounted annual HIV programme costs per year across 50 years is $151·3 million vs$150·7 million), assuming the use of standard antibody testing. With antibody-based rapid HIV testing, the introduction of cabotegravir-PrEP is predicted to be cost-effective under an assumed threshold of $500 per disability-adjusted life year averted in 82$144 per year, in 52% at $264, and in 87$114. INTERPRETATION: Despite leading to increases in integrase-inhibitor drug resistance, cabotegravir-PrEP introduction is likely to reduce AIDS deaths in addition to HIV incidence. Long-acting cabotegravir-PrEP is predicted to be cost-effective if delivered at similar cost to oral PrEP with antibody-based rapid HIV testing. FUNDING: Bill & Melinda Gates Foundation, National Institute of Allergy and Infectious Diseases of the National Institutes of Health

Nef-mediated down-regulation of CD4 and HLA class I in HIV-1 subtype C infection: association with disease progression and influence of immune pressure.

CAPRISA, 2014.Abstract available in pdf

Governing multisectoral action for health in low- and middle-income countries

Kumanan Rasanathan and colleagues argue that the potential of multisectoral collaboration for improving health remains untapped in many low- and middle-income countries