Comorbidity of respiratory and cardiovascular diseases among the elderly residing close to mine dumps in South Africa: A cross-sectional study

Background. Pollution arising from mine dumps in South Africa (SA) has been a source of concern to nearby communities.Objective. To investigate whether comorbidity of respiratory and cardiovascular diseases among elderly persons (≥55 years) was associated with proximity to mine dumps.Methods. Elderly persons in communities 1 - 2 km (exposed) and ≥5 km (unexposed) from five preselected mine dumps in Gauteng and North West provinces in SA were included in a cross-sectional study.Results. Exposed elderly persons had a significantly higher prevalence of cardiovascular and respiratory diseases than those who were unexposed. Multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma + hypertension (odds ratio (OR) 1.67; 95% confidence interval (CI) 1.22 - 2.28), asthma + pneumonia (OR 1.86; 95% CI 1.14 - 3.04), emphysema + arrhythmia (OR 1.38; 95% CI 1.07 - 1.77), emphysema + myocardial infarction (OR 2.01; 95% CI 1.73 - 2.54), emphysema + pneumonia (OR 3.36; 95% CI 1.41 - 7.98), hypertension + myocardial infarction (OR 1.60; 95% CI 1.04 - 2.44) and hypertension + pneumonia (OR 1.34; 95% CI 1.05 - 1.93).Conclusion. Detrimental associations between comorbidity of the health outcomes and proximity to mine dumps were observed among the elderly in SA

Comorbidity of respiratory and cardiovascular diseases among the elderly residing close to mine dumps in South Africa: A cross-sectional study.

Background. Pollution arising from mine dumps in South Africa (SA) has been a source of concern to nearby communities.Objectives. To investigate whether comorbidity of respiratory and cardiovascular diseases among elderly persons (≥55 years) was associated with proximity to mine dumps.Methods. Elderly persons in communities 1 - 2 km (exposed) and ≥5 km (unexposed) from five preselected mine dumps in Gauteng and North West provinces in SA were included in a cross-sectional study.Results. Exposed elderly persons had a significantly higher prevalence of cardiovascular and respiratory diseases than those who were unexposed. Multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma + hyper- tension (odds ratio (OR) 1.67; 95% confidence interval (CI) 1.22 - 2.28), asthma + pneumonia (OR 1.86; 95% CI 1.14 - 3.04), emphysema + arrhythmia (OR 1.38; 95% CI 1.07 - 1.77), emphysema + myocardial infarction (OR 2.01; 95% CI 1.73 - 2.54), emphysema + pneumonia (OR 3.36; 95% CI 1.41 - 7.98), hypertension + myocardial infarction (OR 1.60; 95% CI 1.04 - 2.44) and hypertension + pneumonia (OR 1.34; 95% CI 1.05 - 1.93).Conclusion. Detrimental associations between comorbidity of the health outcomes and proximity to mine dumps were observed among the elderly in SA.

Gathering the evidence and identifying opportunities for future research in climate, heat and health in South Africa : the role of the South African Medical Research Council

Abstract: Background. A changing climate is likely to have widespread and varying impacts on ecosystems and human health. South Africa (SA) is particularly vulnerable to the impacts of climate change, given the projected increases in temperature, and changes in the amount and patterns of rainfall. Moreover, SA’s vulnerability is exacerbated by extreme inequality and poverty. To prepare for the impacts of climate change and to ensure timeous adaptation, a perspective is given on essential heat and health research in the country. Objectives. To gather studies conducted by the South African Medical Research Council (SAMRC)’s Environment and Health Research Unit (EHRU) to illustrate the range of possible research key areas in the climate, heat and health domain and to present future research priorities. Methods. Studies conducted by the SAMRC’s EHRU were gathered and used to illustrate the range of possible research key areas in the climate, heat and health domain. Using national and international published and grey literature, and tapping into institutional research experiences, an overview of research findings to date and future research priorities were developed. Results. Heat and health-related research has focussed on key settings, for example, schools, homes and outdoor work places, and vulnerable groups such as infants and children, the elderly and people with pre-existing diseases. The need to address basic needs and services provision was emphasised as an important priority. Conclusions. High and low temperatures in SA are already associated with mortality annually; these impacts are likely to increase with a changing climate. Critical cross-sectoral research will aid in understanding and preparing for temperature extremes in SA

Acceptable care? Illness constructions, healthworlds, and accessible chronic treatment in South Africa

Achieving equitable access to health care is an important policy goal, with access influenced by affordability, availability, and acceptability of specific services. We explore patient narratives from a 5-year program of research on health care access to examine relationships between social constructions of illness and the acceptability of health services in the context of tuberculosis treatment and antiretroviral therapy in South Africa. Acceptability of services seems particularly important to the meanings patients attach to illness and care, whereas—conversely—these constructions appear to influence what constitutes acceptability and hence affect access to care. We highlight the underestimated role of individually, socially, and politically constructed healthworlds; traditional and biomedical beliefs; and social support networks. Suggested policy implications for improving acceptability and hence overall health care access include abandoning patronizing approaches to care and refocusing from treating “disease” to responding to “illness” by acknowledging and incorporating patients’ healthworlds in patient–provider interactions

End of life care in sub-Saharan Africa: a systematic review of the qualitative literature

<p>Abstract</p> <p>Background</p> <p>End of life (EoL) care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research. It seeks to identify areas of existing research; describe findings specifically relevant to the African context; and, identify areas lacking evidence.</p> <p>Methods</p> <p>Relevant literature was identified through eight electronic databases: AMED, British Nursing Index & Archive, CINAHL, EMBASE, IBSS, MEDLINE, PsycINFO, and the Social Sciences Citation Index; and hand searches. Inclusion criteria were: published qualitative or mixed-method studies in sub-Saharan Africa, about EoL care. Study quality was assessed using a standard grading scale. Relevant data including findings and practice recommendations were extracted and compared in tabular format.</p> <p>Results</p> <p>Of the 407 articles initially identified, 51 were included in the qualitative synthesis. Nineteen came from South Africa and the majority (38) focused on HIV/AIDS. Nine dealt with multiple or unspecified conditions and four were about cancer. Study respondents included health professionals, informal carers, patients, community members and bereaved relatives. Informal carers were typically women, the elderly and children, providing total care in the home, and lacking support from professionals or the extended family. Twenty studies focused on home-based care, describing how programmes function in practice and what is needed to make them effective. Patients and carers were reported to prefer institutional care but this needs to be understood in context. Studies focusing on culture discussed good and bad death, culture-specific approaches to symptoms and illness, and the bereavement process.</p> <p>Conclusions</p> <p>The data support or complement the findings from quantitative research. The review prompts a reconsideration of the assumption that in Africa the extended family care for the sick, and that people prefer home-based care. The review identifies areas relevant for a research agenda on socio-cultural issues at the EoL in sub-Saharan Africa.</p

The Power Board of the KM3NeT Digital Optical Module: design, upgrade, and production

The KM3NeT Collaboration is building an underwater neutrino observatory at the bottom of the Mediterranean Sea consisting of two neutrino telescopes, both composed of a three-dimensional array of light detectors, known as digital optical modules. Each digital optical module contains a set of 31 three inch photomultiplier tubes distributed over the surface of a 0.44 m diameter pressure-resistant glass sphere. The module includes also calibration instruments and electronics for power, readout and data acquisition. The power board was developed to supply power to all the elements of the digital optical module. The design of the power board began in 2013, and several prototypes were produced and tested. After an exhaustive validation process in various laboratories within the KM3NeT Collaboration, a mass production batch began, resulting in the construction of over 1200 power boards so far. These boards were integrated in the digital optical modules that have already been produced and deployed, 828 until October 2023. In 2017, an upgrade of the power board, to increase reliability and efficiency, was initiated. After the validation of a pre-production series, a production batch of 800 upgraded boards is currently underway. This paper describes the design, architecture, upgrade, validation, and production of the power board, including the reliability studies and tests conducted to ensure the safe operation at the bottom of the Mediterranean Sea throughout the observatory's lifespa

Embedded Software of the KM3NeT Central Logic Board

The KM3NeT Collaboration is building and operating two deep sea neutrino telescopes at the bottom of the Mediterranean Sea. The telescopes consist of latices of photomultiplier tubes housed in pressure-resistant glass spheres, called digital optical modules and arranged in vertical detection units. The two main scientific goals are the determination of the neutrino mass ordering and the discovery and observation of high-energy neutrino sources in the Universe. Neutrinos are detected via the Cherenkov light, which is induced by charged particles originated in neutrino interactions. The photomultiplier tubes convert the Cherenkov light into electrical signals that are acquired and timestamped by the acquisition electronics. Each optical module houses the acquisition electronics for collecting and timestamping the photomultiplier signals with one nanosecond accuracy. Once finished, the two telescopes will have installed more than six thousand optical acquisition nodes, completing one of the more complex networks in the world in terms of operation and synchronization. The embedded software running in the acquisition nodes has been designed to provide a framework that will operate with different hardware versions and functionalities. The hardware will not be accessible once in operation, which complicates the embedded software architecture. The embedded software provides a set of tools to facilitate remote manageability of the deployed hardware, including safe reconfiguration of the firmware. This paper presents the architecture and the techniques, methods and implementation of the embedded software running in the acquisition nodes of the KM3NeT neutrino telescopes

Probing invisible neutrino decay with KM3NeT-ORCA

In the era of precision measurements of the neutrino oscillation parameters, upcoming neutrino experiments will also be sensitive to physics beyond the Standard Model. KM3NeT/ORCA is a neutrino detector optimised for measuring atmospheric neutrinos from a few GeV to around 100 GeV. In this paper, the sensitivity of the KM3NeT/ORCA detector to neutrino decay has been explored. A three-flavour neutrino oscillation scenario, where the third neutrino mass state $\nu_3$ decays into an invisible state, e.g. a sterile neutrino, is considered. We find that KM3NeT/ORCA would be sensitive to invisible neutrino decays with $1/\alpha_3=\tau_3/m_3 < 180$~$\mathrm{ps/eV}$ at $90\%$ confidence level, assuming true normal ordering. Finally, the impact of neutrino decay on the precision of KM3NeT/ORCA measurements for $\theta_{23}$, $\Delta m^2_{31}$ and mass ordering have been studied. No significant effect of neutrino decay on the sensitivity to these measurements has been found.Comment: 27 pages, 14 figures, bibliography updated, typos correcte