scholarly journals A Systematised Review of the Health Impact of Urban Informal Settlements and Implications for Upgrading Interventions in South Africa, a Rapidly Urbanising Middle-Income Country

2019 ◽  
Vol 16 (19) ◽  
pp. 3608 ◽  
Author(s):  
Amy Weimann ◽  
Tolu Oni
Keyword(s):  
South Africa ◽  
Systems Approach ◽  
Longitudinal Research ◽  
Informal Settlement ◽  
Informal Settlements ◽  
The Elderly ◽  
Health Impact ◽  
Middle Income ◽  
Increased Risk ◽  
The Impact

Informal settlements are becoming more entrenched within African cities as the urban population continues to grow. Characterised by poor housing conditions and inadequate services, informal settlements are associated with an increased risk of disease and ill-health. However, little is known about how informal settlement upgrading impacts health over time. A systematised literature review was conducted to explore existing evidence and knowledge gaps on the association between informal settlement characteristics and health and the impact of informal settlement upgrading on health, within South Africa, an upper-middle income African country. Using two databases, Web of Science and PubMed, we identified 46 relevant peer-reviewed articles published since 1998. Findings highlight a growing body of research investigating the ways in which complete physical, mental and social health are influenced by the physical housing structure, the psychosocial home environment and the features of the neighbourhood and community in the context of informal settlements. However, there is a paucity of longitudinal research investigating the temporal impact of informal settlement upgrading or housing improvements on health outcomes of these urban residents. Informal settlements pose health risks particularly to vulnerable populations such as children, the elderly, and people with suppressed immune systems, and are likely to aggravate gender-related inequalities. Due to the complex interaction between health and factors of the built environment, there is a need for further research utilising a systems approach to generate evidence that investigates the interlinked factors that longitudinally influence health in the context of informal settlement upgrading in rapidly growing cities worldwide.

scholarly journals INVESTIGATING THE USE OF 3D GEOVISUALIZATIONS FOR URBAN DESIGN IN INFORMAL SETTLEMENT UPGRADING IN SOUTH AFRICA

2016 ◽  
Vol XLI-B2 ◽  
pp. 425-431
Author(s):  
V. Rautenbach ◽  
S. Coetzee ◽  
A. Çöltekin
Keyword(s):  
South Africa ◽  
Urban Design ◽  
Spatial Data ◽  
Informal Settlement ◽  
Informal Settlements ◽  
3D Models ◽  
Design Activities ◽  
Feasible Alternative ◽  
Visualization Design ◽  
The Impact

Informal settlements are a common occurrence in South Africa, and to improve in-situ circumstances of communities living in informal settlements, upgrades and urban design processes are necessary. Spatial data and maps are essential throughout these processes to understand the current environment, plan new developments, and communicate the planned developments. All stakeholders need to understand maps to actively participate in the process. However, previous research demonstrated that map literacy was relatively low for many planning professionals in South Africa, which might hinder effective planning. Because 3D visualizations resemble the real environment more than traditional maps, many researchers posited that they would be easier to interpret. Thus, our goal is to investigate the effectiveness of 3D geovisualizations for urban design in informal settlement upgrading in South Africa. We consider all involved processes: 3D modelling, visualization design, and cognitive processes during map reading. We found that procedural modelling is a feasible alternative to time-consuming manual modelling, and can produce high quality models. When investigating the visualization design, the visual characteristics of 3D models and relevance of a subset of visual variables for urban design activities of informal settlement upgrades were qualitatively assessed. The results of three qualitative user experiments contributed to understanding the impact of various levels of complexity in 3D city models and map literacy of future geoinformatics and planning professionals when using 2D maps and 3D models. The research results can assist planners in designing suitable 3D models that can be used throughout all phases of the process.

scholarly journals INVESTIGATING THE USE OF 3D GEOVISUALIZATIONS FOR URBAN DESIGN IN INFORMAL SETTLEMENT UPGRADING IN SOUTH AFRICA

2016 ◽  
Vol XLI-B2 ◽  
pp. 425-431 ◽  
Author(s):  
V. Rautenbach ◽  
S. Coetzee ◽  
A. Çöltekin
Keyword(s):  
South Africa ◽  
Urban Design ◽  
Spatial Data ◽  
Informal Settlement ◽  
Informal Settlements ◽  
3D Models ◽  
Design Activities ◽  
Feasible Alternative ◽  
Visualization Design ◽  
The Impact

Informal settlements are a common occurrence in South Africa, and to improve in-situ circumstances of communities living in informal settlements, upgrades and urban design processes are necessary. Spatial data and maps are essential throughout these processes to understand the current environment, plan new developments, and communicate the planned developments. All stakeholders need to understand maps to actively participate in the process. However, previous research demonstrated that map literacy was relatively low for many planning professionals in South Africa, which might hinder effective planning. Because 3D visualizations resemble the real environment more than traditional maps, many researchers posited that they would be easier to interpret. Thus, our goal is to investigate the effectiveness of 3D geovisualizations for urban design in informal settlement upgrading in South Africa. We consider all involved processes: 3D modelling, visualization design, and cognitive processes during map reading. We found that procedural modelling is a feasible alternative to time-consuming manual modelling, and can produce high quality models. When investigating the visualization design, the visual characteristics of 3D models and relevance of a subset of visual variables for urban design activities of informal settlement upgrades were qualitatively assessed. The results of three qualitative user experiments contributed to understanding the impact of various levels of complexity in 3D city models and map literacy of future geoinformatics and planning professionals when using 2D maps and 3D models. The research results can assist planners in designing suitable 3D models that can be used throughout all phases of the process.

Abstract T P136: Potential Contributors to the Declining Impact of Stroke Risk Factors with Age: Implications for Stroke Epidemiology in the Elderly

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
George Howard ◽  
Mary Cushman ◽  
Maciej Banach ◽  
Brett M Kissela ◽  
David C Goff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Stroke Risk Factors ◽  
Age Related ◽  
Increased Risk ◽  
The Impact ◽  
Age Related Changes

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.

scholarly journals Tuberculosis Mortality by Occupation in South Africa, 2011–2015

2018 ◽  
Vol 15 (12) ◽  
pp. 2756 ◽  
Author(s):  
Tahira Kootbodien ◽  
Kerry Wilson ◽  
Nonhlanhla Tlotleng ◽  
Vusi Ntlebi ◽  
Felix Made ◽  
...  
Keyword(s):  
South Africa ◽  
Smoking Status ◽  
Direct Method ◽  
Multivariate Logistic Regression Analysis ◽  
World Health ◽  
Health Concern ◽  
Mortality Data ◽  
Middle Income ◽  
Risk Of Death ◽  
Increased Risk

Work-related tuberculosis (TB) remains a public health concern in low- and middle-income countries. The use of vital registration data for monitoring TB deaths by occupation has been unexplored in South Africa. Using underlying cause of death and occupation data for 2011 to 2015 from Statistics South Africa, age-standardised mortality rates (ASMRs) were calculated for all persons of working age (15 to 64 years) by the direct method using the World Health Organization (WHO) standard population. Multivariate logistic regression analysis was performed to calculate mortality odds ratios (MORs) for occupation groups, adjusting for age, sex, year of death, province of death, and smoking status. Of the 221,058 deaths recorded with occupation data, 13% were due to TB. ASMR for TB mortality decreased from 165.9 to 88.8 per 100,000 population from 2011 to 2015. An increased risk of death by TB was observed among elementary occupations: agricultural labourers (MORadj = 3.58, 95% Confidence Interval (CI) 2.96–4.32), cleaners (MORadj = 3.44, 95% CI 2.91–4.09), and refuse workers (MORadj = 3.41, 95% CI 2.88–4.03); among workers exposed to silica dust (MORadj = 3.37, 95% CI 2.83–4.02); and among skilled agricultural workers (MORadj = 3.31, 95% CI 2.65–4.19). High-risk TB occupations can be identified from mortality data. Therefore, TB prevention and treatment policies should be prioritised in these occupations.

scholarly journals Doctors’ Extended Shifts as Risk to Practitioner and Patient: South Africa as a Case Study

2020 ◽  
Vol 17 (16) ◽  
pp. 5853
Author(s):  
Koot Kotze ◽  
Helene-Mari van der Westhuizen ◽  
Eldi van Loggerenberg ◽  
Farah Jawitz ◽  
Rodney Ehrlich
Keyword(s):  
South Africa ◽  
South African ◽  
Medical Practice ◽  
Health And Safety ◽  
Working Hours ◽  
Middle Income ◽  
The Impact ◽  
Safe Working ◽  
Working Hour

Extended shifts are common in medical practice. This is when doctors are required to work continuously for more than 16 h, with little or no rest, often without a maximum limit. These shifts have been a part of medical practice for more than a century. Research on the impact of fatigue presents compelling evidence that extended shifts increase the risk of harm to patients and practitioners. However, where the number of doctors is limited and their workloads are not easily reduced, there are numerous barriers to reform. Some of these include a perceived lack of safer alternatives, concerns about continuity of care, trainee education, and doctors’ preferences. As such, working hour reorganisation has been contentious globally. South Africa, a middle-income country where extended shifts are unregulated for most doctors, offers a useful case study of reform efforts. The South African Safe Working Hours campaign has promoted working hour reorganization through multi-level advocacy efforts, although extended shifts remain common. We propose that extended shifts should be regarded as an occupational hazard under health and safety legislation. We suggest options for managing the risks of extended shifts by adapting the hierarchy of controls for occupational hazards. Despite the challenges reform pose, the practice of unregulated extended shifts should not continue.

Appraisal of fire safety interventions and strategies for informal settlements in South Africa

2019 ◽  
Vol 28 (3) ◽  
pp. 343-358 ◽  
Author(s):  
Richard Shaun Walls ◽  
Rodney Eksteen ◽  
Charles Kahanji ◽  
Antonio Cicione
Keyword(s):  
South Africa ◽  
Fire Protection ◽  
Fire Safety ◽  
Informal Settlements ◽  
Content Type ◽  
Active Fire ◽  
Passive Fire Protection ◽  
Safety Interventions ◽  
The Impact ◽  
Broad Understanding

Purpose Informal settlements are inherently unstructured in nature, lack adequate services, regularly have high population densities and can experience social problems. Thus, fires can easily propagate rapidly through such areas, leaving thousands homeless in a single fire. The purpose of this paper is to present an appraisal of various interventions and strategies to improve fire safety in informal settlements in South Africa (globally, similar settlements are known as slums, ghettos, favelas, shantytowns, etc.), considering aspects of both technical suitability and social suitability. Design/methodology/approach This paper focusses on three specific aspects: ignition risk management, active fire protection interventions and passive fire protection interventions. These are presented within a framework to outline how they may mitigate the impact of fires. Findings Often “solutions” proposed to improve fire safety either lack a sound engineering basis, thus becoming technically inefficient, or do not consider social circumstances and community responses in settlements, thereby becoming practically, socially or economically unsuitable. It must be understood that there is no “quick fix” to this significant problem, but rather a combination of interventions can improve fire safety in general. A broad understanding of the various options available is essential when addressing this problem, which this paper seeks to provide. Practical implications This paper seeks to provide an overview to guide policymakers and organisations by illustrating both the advantages/benefits and disadvantages/challenges of the interventions and strategies currently being rolled out, as well as potential alternatives. Originality/value A broad but succinct appraisal is provided that gives insight and direction for improving fire safety in informal settlements. It is hoped that the challenges associated with the fire safety interventions discussed can be addressed and improved over time.

scholarly journals Intersectoral (in)activity: towards an understanding of public sector department links between water, sanitation and hygiene (WASH) and childhood undernutrition in South Africa

2020 ◽  
Vol 35 (7) ◽  
pp. 829-841 ◽  
Author(s):  
D J Momberg ◽  
P Mahlangu ◽  
B C Ngandu ◽  
J May ◽  
S A Norris ◽  
...  
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Nutritional Status ◽  
Physical Growth ◽  
Human Right ◽  
Poor Child ◽  
Middle Income ◽  
Sanitation And Hygiene ◽  
Nutritional Status Of Children ◽  
The Impact

Abstract Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), contribute to poor child health, nutritional status and physical growth. The primary responsibility for the provision of water and sanitation, as a basic service and human right, lies with the State, as such, a number of stakeholders are involved. Despite relatively high levels of WASH infrastructure coverage in South Africa, enteric infections and stunting remain high for a middle-income country. The aim of this study is to elucidate the landscape of WASH in South Africa in relation to nutritional status of children under the age of 5 years in the South African, Gauteng and City of Johannesburg contexts. The authors detailed the national and provincial public sector departments and through purposive sampling proceeded to map the various departments and associated policies that are responsible for the provision of WASH facilities, as well the nutritional status of children. Of the six policies identified for review, three mentioned WASH, nutrition and children; however, none explicitly linked WASH to nutritional status in children. An in-depth review and analysis of these three crucial policy documents was conducted. Finally, a set of expert interviews were conducted and a consensus development conference convened, with experts at the intersection between WASH and nutritional status. The authors found that the public sector would benefit from better integration of the concept of WASH into their policy, planning and implementation frameworks. The WASH sector should emphasize the role in which WASH plans consider the impact of WASH on the nutritional status of children. The various public sector departments involved in WASH service provision, and other WASH stakeholders, including community-based organizations, non-governmental organizations and intergovernmental organizations, should be involved in the decision-making of the nutrition sector.

Robotic-assisted Ivor-Lewis esophagectomy in the elderly patient.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 93-93
Author(s):  
Andrea M. Abbott ◽  
Tobin Joel Crill Strom ◽  
Nadia Saeed ◽  
Ravi Shridhar ◽  
Sarah E. Hoffe ◽  
...  
Keyword(s):  
Blood Loss ◽  
The Elderly ◽  
Separate Analysis ◽  
Ivor Lewis ◽  
Robotic Assisted ◽  
Ivor Lewis Esophagectomy ◽  
Estimated Blood Loss ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact

93 Background: Esophageal cancer continues to increase in incidence worldwide with the age of diagnosis continuing to move towards an older onset. Robotic assisted approaches to esophagectomy have demonstrated decreased complications and length of hospitalization (LOH). We sought to examine the impact of age on outcomes in patients undergoing robotic assisted esophagectomy (RAIL). Methods: From 2009-2013, we identified patients undergoing robotic assisted Ivor Lewis esophagectomy. Patients were then stratified according to 3 age groups. Cohort 1, age less then 50, cohort 2, age 50-70, and cohort 3 >70. Statistical comparisons between LOH, operative time (OT), estimated blood loss (EBL), adverse events (AE) and mortality were made with Kruskal-Wallis and Chi-square tests. Results: We identified 134 patients who underwent RAIL and found no statistically significant difference between the three cohorts for OT, LOH, days spent in intensive care, AE or mortality. There was a difference in EBL with higher median blood loss (150 cc) seen in cohort 1 (50-600cc) and 3 (50-400cc) compared to cohort 2 (100 cc, (25-400cc)), p < 0.01. The most common AE were arrhythmia and pneumonia but this was not significantly different between the cohorts. The overall AE rate was 10% (cohort 1), 21% (cohort 2), 34% (cohort 3), p=0.14. There were 4 leaks (p =0.38) and 2 deaths (p=0.90) in the entire cohort. A separate analysis was done to compare elderly (>70) to the non-elderly (<70). Median EBL was higher in the elderly cohort (100cc (25-600) vs 150cc (50-400), p <0.01). There was a trend towards longer LOH in the elderly (9 (4-35) vs 11 (6-38) days, p =0.06). AE and mortality were not significantly different, although there was a trend toward increased AE (19.8% vs 34%, p=0.07) in the elderly, with arrhythmia being the most common AE. Conclusions: RAIL is a safe surgical technique for use in an aging patient population. We demonstrated there was no increased risk of LOH, AE or death in the elderly patients compared to their younger cohort.

The impact of the introduction of treated water on aspects of community health in a rural community in Kwazulu-Natal, South Africa

2004 ◽  
Vol 50 (1) ◽  
pp. 105-110 ◽  
Author(s):  
I.W. Bailey ◽  
L. Archer
Keyword(s):  
South Africa ◽  
Water Supply ◽  
Rural Community ◽  
Health Indicators ◽  
Diarrhoeal Disease ◽  
Health Impact ◽  
Environmental Health Perspective ◽  
Innovative Methodology ◽  
Kwazulu Natal ◽  
The Impact

A project was designed by Umgeni Water (funded by the Water Research Commission of South Africa) to monitor the implementation of water reticulation in Vulindlela and evaluate the Water Supply Scheme from a community and environmental health perspective. The findings would hopefully contribute toward the development of criteria for Health Impact Assessment on Water Reticulation Projects. One objective of this study was to evaluate the usefulness of diarrhoeal disease as opposed to other health indicators for water-associated diseases. The innovative methodology followed in the study, a “stepped wedge design”, compared four discrete areas of water reticulation implementation in Vulindlela over a 15-month period. Five surveys, including a baseline and four follow-ups at each household, were carried out. Analysis (microbiological, chemical) was carried out of samples from the household drinking water and from the source of the water. Each survey included health questionnaires, the respondent being the head of the household in each case. Overall, there was no direct correlation proved between water quality and diarrhoea per se. However, there was a marked decrease in diarrhoea with the introduction of the new water supply. There was definite correlation between hygiene behaviours and diarrhoea. Diarrhoea would seem to be the health impact associated with water, of choice.

scholarly journals The impact of age on approach-related complications with navigated lateral lumbar interbody fusion

2020 ◽  
Vol 49 (3) ◽  
pp. E8
Author(s):  
Yamaan S. Saadeh ◽  
Clay M. Elswick ◽  
Eleanor Smith ◽  
Timothy J. Yee ◽  
Michael J. Strong ◽  
...  
Keyword(s):  
Risk Factor ◽  
Elderly Patients ◽  
Interbody Fusion ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Lumbar Interbody Fusion ◽  
Related Complication ◽  
Lateral Lumbar Interbody Fusion ◽  
Increased Risk ◽  
The Impact

OBJECTIVEAge is known to be a risk factor for increased complications due to surgery. However, elderly patients can gain significant quality-of-life benefits from surgery. Lateral lumbar interbody fusion (LLIF) is a minimally invasive procedure that is commonly used to treat degenerative spine disease. Recently, 3D navigation has been applied to LLIF. The purpose of this study was to determine whether there is an increased complication risk in the elderly with navigated LLIF.METHODSPatients who underwent 3D-navigated LLIF for degenerative disease from 2014 to 2019 were included in the analysis. Patients were divided into elderly and nonelderly groups, with those 65 years and older categorized as elderly. Ninety-day medical and surgical complications were recorded. Patient and surgical characteristics were compared between groups, and multivariate regression analysis was used to determine independent risk factors for complication.RESULTSOf the 115 patients included, 56 were elderly and 59 were nonelderly. There were 15 complications (25.4%) in the nonelderly group and 10 (17.9%) in the elderly group, which was not significantly different (p = 0.44). On multivariable analysis, age was not a risk factor for complication (p = 0.52). However, multiple-level LLIF was associated with an increased risk of approach-related complication (OR 3.58, p = 0.02).CONCLUSIONSElderly patients do not appear to experience higher rates of approach-related complications compared with nonelderly patients undergoing 3D navigated LLIF. Rather, multilevel surgery is a predictor for approach-related complication.

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