Strategies to Promote the Safety of Vulnerable Road Users in Developing and Emerging Countries: South African Experience

2003 ◽  
Vol 1846 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Hubrecht Ribbens
Keyword(s):  
South Africa ◽  
Middle East ◽  
The United States ◽  
Emerging Countries ◽  
Sub Saharan Africa ◽  
Successful Implementation ◽  
Road Traffic Safety ◽  
Road Users ◽  
Vulnerable Road Users ◽  
The Caribbean

Road casualties are discussed from a worldwide perspective. More than 80% of annual traffic casualties occur in developing and emerging countries in Asia, Latin America, the Caribbean, sub-Saharan Africa, and the Middle East. Vulnerable road users such as pedestrians and bicyclists are a major road safety problem in these countries. In Asia, Africa, the Caribbean, and the Middle East, more than 40% of annual road fatalities involve pedestrians compared with less than 20% in Europe and the United States. The focus of this study is South Africa’s strategy to promote the safety of vulnerable road users. The extent of casualties among vulnerable road users and contributing factors are highlighted. Over the last decade, pedestrian fatalities have gradually and steadily declined in South Africa. This study describes the various policies, strategies, and action plans developed and implemented by different government levels in South Africa to promote road traffic safety, particularly the safety of vulnerable road users such as pedestrians and bicyclists. Barriers to successful implementation are also pointed out. Apart from applying a holistic approach by involving all relevant disciplines, a coordinated and sustained effort of all government levels was encouraged. Joint-venture funding projects among different government levels was emphasized to improve hazardous pedestrian locations. The role of the private sector in South Africa to promote pedestrian safety is also discussed. Practical guidelines are presented for developing and emerging countries to promote the safety of vulnerable road users.

scholarly journals Integrated management: chronic kidney disease, diabetes mellitus, hypertension

2013 ◽  
Vol 16 (1) ◽  
Author(s):  
Sarala Naicker
Keyword(s):  
Diabetes Mellitus ◽  
South Africa ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Integrated Management ◽  
The United States ◽  
Emerging Countries ◽  
Sub Saharan Africa ◽  
Glomerular Diseases ◽  
End Stage

The increasing burden of chronic kidney disease and end stage kidney failure presents a challenge for both developed and emerging countries. While dialysis and transplantation consumes an ever-increasing proportion of the health budget in countries such as the United States, Japan and Taiwan, there is limited availability of these expensive therapies in the majority of emerging countries and more so in African nations. Aims: To review the prevalence, causes and integrated strategies for treatment and prevention of end stage renal disease (ESRD) in Sub-Saharan Africa (SSA).Materials and Methods: Review of literature and information received from colleagues in Africa. Results: Approximately 70% of the least developed countries of the world are in SSA. Rapid urbanisation is occurring in many parts of the continent, contributing to overcrowding and poverty. While infections and parasitic diseases are still the leading cause of death in Africa, non-communicable diseases are coming to the forefront. There is a continuing brain drain of healthcare workers (physicians and nurses) from Africa to more affluent regions, resulting in large rural areas of Africa having no health professionals to serve these populations. There are no nephrologists in many parts of SSA; the numbers vary from 0.5 per million population (pmp) in Kenya to 0.6 pmp in Nigeria, 0.7 pmp in Sudan and 1.1 pmp in South Africa. Chronic kidney disease (CKD) affects mainly young adults aged 20-50 years in SSA and is primarily due to hypertension and glomerular diseases. HIV-related chronic kidney disease is assuming increasing prominence and often presentslate, with patients requiring dialysis. Diabetes mellitus affects 9.4-million people in Africa. The prevalence of diabetic nephropathy is estimated to be 6-16% in SSA. The current dialysis treatment rate is <20pmp (and nil in many countries of SSA), with in-centre haemodialysis the modality of renal replacement therapy (RRT) for the majority. Transplantation is carried out in a few SSA countries: South Africa, Sudan, Nigeria, Mauritius, Kenya, Ghana and Rwanda, with most of the transplants being living donor transplants, except in South Africa where the majority are from deceased donors.Prevention programmes are in their infancy in most of SSA, due to lack of personnel and resources. Conclusion: Chronic kidney disease care is especially challenging in SSA, with large numbers of ESRD patients, inadequate facilities and funding, and lack of national or regional registries. Integrated management of CKD and its risk factors is necessary to impact on the burden of ESRD.

Britain and decolonization in an Era of Global Change

2017 ◽  
pp. 64-84
Author(s):  
Sarah Elizabeth Stockwell
Keyword(s):  
United States ◽  
South Africa ◽  
New Zealand ◽  
The United States ◽  
Great Power ◽  
Political Forces ◽  
Informal Empire ◽  
Colonial Empire ◽  
The Caribbean ◽  
Liberal Imperialism

This chapter considers processes of decolonization in Britain’s ‘empires’, incorporating discussion not just of the key dynamics and manifestations of decolonization in the colonial empire in India, Africa, the Caribbean and elsewhere, but also in Britain’s residual ‘informal’ empire in the Middle East, and in the ‘old’ Commonwealth countries of Australia, Canada, New Zealand and South Africa. The chapter argues that decolonization across these different contexts was driven by geo-political forces operating across the European empires, as the international order was reconfigured by two world wars, tilting power away from Britain and other European imperial powers. Stockwell nevertheless identifies elements of British imperial exceptionalism. She suggests that these were not to be found, as contemporaries liked to claim, in the form of a British liberal imperialism. Rather, Britain, which was at the centre of an empire larger than any other, retained a semblance of great power status, shaping British relations with the United States and Britain’s ambitions to exercise influence after empire.

African Englishes From a Sociolinguistic Perspective

2019 ◽  
Author(s):  
Rajend Mesthrie
Keyword(s):  
South Africa ◽  
First Language ◽  
The United States ◽  
West African ◽  
The Other ◽  
Language Varieties ◽  
15Th Century ◽  
British Colonization ◽  
The Caribbean ◽  
The 19Th Century

Four types of English exist in Africa, identifiable in terms of history, functions, and linguistic characteristics. West African Pidgin English has a history going back to the 15th century, 400 years before formal colonization. Creole varieties of English have a history going back to repatriation of slaves from the Caribbean and the United States in the 19th century. Second language varieties, which are the most widespread on the continent, are prototypically associated with British colonization and its education systems. L1 (First language) English occurred mostly in Southern and East Africa, and is best represented in South Africa. The latter shows significant similarities with the other major Southern Hemisphere varieties of English in Australia and New Zealand. All four subgroups of English are growing in numbers.

scholarly journals Novel Genetic Loci That Influence Fetal Hemoglobin Expression in Children with Sickle Cell Anemia

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 33-34
Author(s):  
Anu Marahatta ◽  
Thad A. Howard ◽  
Susan E. Stuber ◽  
Kathryn L McElhinney ◽  
Leon Tshilolo ◽  
...  
Keyword(s):  
United States ◽  
Allele Frequency ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Fetal Hemoglobin ◽  
The United States ◽  
Sub Saharan Africa ◽  
Cell Surface Receptor ◽  
Genome Wide ◽  
The Caribbean

Introduction: Elevated levels of fetal hemoglobin (HbF) are known to ameliorate both the morbidity and mortality of sickle cell anemia (SCA). Sustained post-natal HbF expression is heritable and regulated by multiple quantitative trait loci. Previous genomic studies have identified three major gene loci (BCL11A, HBS1L-MYB, and HBG2) that account for ~40% of HbF variation in SCA, but additional genetic modifiers remain to be discovered. We performed a genome wide association study (GWAS) using DNA collected from multiple cohorts of children with SCA, to identify novel genes and variants involved in HbF expression. Methods: We analyzed genomic DNA from 1009 children with SCA and pre-treatment steady-state HbF levels who enrolled in prospective research trials from the United States (HUSTLE, SWiTCH, TWiTCH), the Caribbean (SACRED) or sub-Saharan Africa (REACH, NOHARM). Whole blood DNA was first genotyped using the H3Africa SNP array (Illumina) that identifies over 2.2 million single nucleotide variants (SNVs) across the genome. Most samples also underwent whole exome sequencing (WES) using NimbleGen VCRome 2.1 capture reagents and the Illumina HiSeq2500 platform analysis, which identifies coding variants in all known exons. Square root transformed HbF values were the continuous variable for association testing using single-locus mixed model (EMMAX) adjusted for population stratification, with both age and sex as co-variates. The GWAS approach included 3 distinct steps. First, we performed two independent GWAS discovery steps using distinct African populations; these were designated Discovery I (N=211) and Discovery II (223). Second, only SNVs that were significant (p&lt;0.05) in both datasets were then selected for two independent replication steps; these were designated either African-American (N=157) or African (N=269). Third, the SNVs that were significant in both dual discovery and at least one of the replication cohorts were then verified using an additional Caribbean cohort (N=149) with TaqMan techniques for genotyping specific variants. Through this multistep process, we searched for genomic loci with consistent HbF associations across multiple cohorts. Results: From the combined SNP and WES dataset, 8 BCL11A variants passed genome wide significance (p&lt;10-8) in the discovery analysis, and 1,048 additional variants were identified with nominal HbF association (p&lt;0.001). We found that 173 of these novel variants had sustained association in at least one of the replication cohorts (p&lt;0.05). We selected 20 variants with the strongest and most consistent associations with HbF from the discovery and replication analyses for further verification (Table 1). Expected HbF associations with BCL11A (rs1427407) and HBS1L-MYB (rs4895441) were identified. Among other 18 novel candidate variants, the rs77737207 variant (allele frequency ~0.10) near the RUNX1T1 locus was strongly associated with lower HbF levels, while coding variant rs2279587 (allele frequency ~0.03) in the ITGA1 gene approached statistical significance (p&lt;0.08) in the final verification cohort and was associated with higher levels of HbF. Conclusions: Our large GWAS of HbF with diverse global cohorts of children with SCA from Africa, the United States, and the Caribbean validated the strong associations of HbF with common genetic variants near the BCL11A and HBS1L-MYB gene loci. We also identified two novel gene loci, ITGA1 and RUNX1T1, that have statistical associations with HbF expression. The RUNX1T1 gene is a broad transcriptional corepressor known to impact myeloid differentiation in hematopoiesis, while ITGA1 encodes the integrin alpha subunit of a cell-surface receptor involved in cell-cell adhesion and inflammation. Both of these genes represent novel loci that may be involved in the regulation of HbF expression in children with SCA and should be investigated further using cellular and animal models. Disclosures No relevant conflicts of interest to declare.

scholarly journals A SARS-CoV-2 Surveillance System in Sub-Saharan Africa: Modeling Study for Persistence and Transmission to Inform Policy (Preprint)

2020 ◽  
Author(s):  
Lori Ann Post ◽  
Salem T Argaw ◽  
Cameron Jones ◽  
Charles B Moss ◽  
Danielle Resnick ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Food Insecurity ◽  
Generalized Method Of Moments ◽  
The United States ◽  
Sub Saharan Africa ◽  
Reporting Practices ◽  
Data Limitations ◽  
The World ◽  
Sub Saharan

BACKGROUND Since the novel coronavirus emerged in late 2019, the scientific and public health community around the world have sought to better understand, surveil, treat, and prevent the disease, COVID-19. In sub-Saharan Africa (SSA), many countries responded aggressively and decisively with lockdown measures and border closures. Such actions may have helped prevent large outbreaks throughout much of the region, though there is substantial variation in caseloads and mortality between nations. Additionally, the health system infrastructure remains a concern throughout much of SSA, and the lockdown measures threaten to increase poverty and food insecurity for the subcontinent’s poorest residents. The lack of sufficient testing, asymptomatic infections, and poor reporting practices in many countries limit our understanding of the virus’s impact, creating a need for better and more accurate surveillance metrics that account for underreporting and data contamination. OBJECTIVE The goal of this study is to improve infectious disease surveillance by complementing standardized metrics with new and decomposable surveillance metrics of COVID-19 that overcome data limitations and contamination inherent in public health surveillance systems. In addition to prevalence of observed daily and cumulative testing, testing positivity rates, morbidity, and mortality, we derived COVID-19 transmission in terms of speed, acceleration or deceleration, change in acceleration or deceleration (jerk), and 7-day transmission rate persistence, which explains where and how rapidly COVID-19 is transmitting and quantifies shifts in the rate of acceleration or deceleration to inform policies to mitigate and prevent COVID-19 and food insecurity in SSA. METHODS We extracted 60 days of COVID-19 data from public health registries and employed an empirical difference equation to measure daily case numbers in 47 sub-Saharan countries as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS Kenya, Ghana, Nigeria, Ethiopia, and South Africa have the most observed cases of COVID-19, and the Seychelles, Eritrea, Mauritius, Comoros, and Burundi have the fewest. In contrast, the <i>speed</i>, <i>acceleration</i>, <i>jerk</i>, <i>and 7-day persistence</i> indicate rates of COVID-19 transmissions differ from observed cases. In September 2020, Cape Verde, Namibia, Eswatini, and South Africa had the highest speed of COVID-19 transmissions at 13.1, 7.1, 3.6, and 3 infections per 100,0000, respectively; Zimbabwe had an acceleration rate of transmission, while Zambia had the largest rate of deceleration this week compared to last week, referred to as a <i>jerk</i>. Finally, the 7-day persistence rate indicates the number of cases on September 15, 2020, which are a function of new infections from September 8, 2020, decreased in South Africa from 216.7 to 173.2 and Ethiopia from 136.7 to 106.3 per 100,000. The statistical approach was validated based on the regression results; they determined recent changes in the pattern of infection, and during the weeks of September 1-8 and September 9-15, there were substantial country differences in the evolution of the SSA pandemic. This change represents a decrease in the transmission model R value for that week and is consistent with a de-escalation in the pandemic for the sub-Saharan African continent in general. CONCLUSIONS Standard surveillance metrics such as daily observed new COVID-19 cases or deaths are necessary but insufficient to mitigate and prevent COVID-19 transmission. Public health leaders also need to know where COVID-19 transmission rates are accelerating or decelerating, whether those rates increase or decrease over short time frames because the pandemic can quickly escalate, and how many cases today are a function of new infections 7 days ago. Even though SSA is home to some of the poorest countries in the world, development and population size are not necessarily predictive of COVID-19 transmission, meaning higher income countries like the United States can learn from African countries on how best to implement mitigation and prevention efforts. INTERNATIONAL REGISTERED REPORT RR2-10.2196/21955

Irish Nationalists and the Making of the Irish Race

2012 ◽  
Author(s):  
Bruce Nelson
Keyword(s):  
United States ◽  
South Africa ◽  
Nineteenth Century ◽  
The United States ◽  
Close Attention ◽  
Irish Nationalism ◽  
Men And Women ◽  
Irish Immigrants ◽  
Full Independence ◽  
The Caribbean

This is a book about Irish nationalism and how Irish nationalists developed their own conception of the Irish race. The book begins with an exploration of the discourse of race—from the nineteenth-century belief that “race is everything” to the more recent argument that there are no races. It focuses on how English observers constructed the “native” and Catholic Irish as uncivilized and savage, and on the racialization of the Irish in the nineteenth century, especially in Britain and the United States, where Irish immigrants were often portrayed in terms that had been applied mainly to enslaved Africans and their descendants. Most of the book focuses on how the Irish created their own identity—in the context of slavery and abolition, empire, and revolution. Since the Irish were a dispersed people, this process unfolded not only in Ireland, but in the United States, Britain, Australia, South Africa, and other countries. Many nationalists were determined to repudiate anything that could interfere with the goal of building a united movement aimed at achieving full independence for Ireland. But others, including men and women who are at the heart of this study, believed that the Irish struggle must create a more inclusive sense of Irish nationhood and stand for freedom everywhere. The book pays close attention to this argument within Irish nationalism, and to the ways it resonated with nationalists worldwide, from India to the Caribbean.

scholarly journals A SARS-CoV-2 Surveillance System in Sub-Saharan Africa: Modeling Study for Persistence and Transmission to Inform Policy

10.2196/24248 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e24248
Author(s):  
Lori Ann Post ◽  
Salem T Argaw ◽  
Cameron Jones ◽  
Charles B Moss ◽  
Danielle Resnick ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Food Insecurity ◽  
Generalized Method Of Moments ◽  
The United States ◽  
Sub Saharan Africa ◽  
Reporting Practices ◽  
Data Limitations ◽  
The World ◽  
Sub Saharan

Background Since the novel coronavirus emerged in late 2019, the scientific and public health community around the world have sought to better understand, surveil, treat, and prevent the disease, COVID-19. In sub-Saharan Africa (SSA), many countries responded aggressively and decisively with lockdown measures and border closures. Such actions may have helped prevent large outbreaks throughout much of the region, though there is substantial variation in caseloads and mortality between nations. Additionally, the health system infrastructure remains a concern throughout much of SSA, and the lockdown measures threaten to increase poverty and food insecurity for the subcontinent’s poorest residents. The lack of sufficient testing, asymptomatic infections, and poor reporting practices in many countries limit our understanding of the virus’s impact, creating a need for better and more accurate surveillance metrics that account for underreporting and data contamination. Objective The goal of this study is to improve infectious disease surveillance by complementing standardized metrics with new and decomposable surveillance metrics of COVID-19 that overcome data limitations and contamination inherent in public health surveillance systems. In addition to prevalence of observed daily and cumulative testing, testing positivity rates, morbidity, and mortality, we derived COVID-19 transmission in terms of speed, acceleration or deceleration, change in acceleration or deceleration (jerk), and 7-day transmission rate persistence, which explains where and how rapidly COVID-19 is transmitting and quantifies shifts in the rate of acceleration or deceleration to inform policies to mitigate and prevent COVID-19 and food insecurity in SSA. Methods We extracted 60 days of COVID-19 data from public health registries and employed an empirical difference equation to measure daily case numbers in 47 sub-Saharan countries as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. Results Kenya, Ghana, Nigeria, Ethiopia, and South Africa have the most observed cases of COVID-19, and the Seychelles, Eritrea, Mauritius, Comoros, and Burundi have the fewest. In contrast, the speed, acceleration, jerk, and 7-day persistence indicate rates of COVID-19 transmissions differ from observed cases. In September 2020, Cape Verde, Namibia, Eswatini, and South Africa had the highest speed of COVID-19 transmissions at 13.1, 7.1, 3.6, and 3 infections per 100,0000, respectively; Zimbabwe had an acceleration rate of transmission, while Zambia had the largest rate of deceleration this week compared to last week, referred to as a jerk. Finally, the 7-day persistence rate indicates the number of cases on September 15, 2020, which are a function of new infections from September 8, 2020, decreased in South Africa from 216.7 to 173.2 and Ethiopia from 136.7 to 106.3 per 100,000. The statistical approach was validated based on the regression results; they determined recent changes in the pattern of infection, and during the weeks of September 1-8 and September 9-15, there were substantial country differences in the evolution of the SSA pandemic. This change represents a decrease in the transmission model R value for that week and is consistent with a de-escalation in the pandemic for the sub-Saharan African continent in general. Conclusions Standard surveillance metrics such as daily observed new COVID-19 cases or deaths are necessary but insufficient to mitigate and prevent COVID-19 transmission. Public health leaders also need to know where COVID-19 transmission rates are accelerating or decelerating, whether those rates increase or decrease over short time frames because the pandemic can quickly escalate, and how many cases today are a function of new infections 7 days ago. Even though SSA is home to some of the poorest countries in the world, development and population size are not necessarily predictive of COVID-19 transmission, meaning higher income countries like the United States can learn from African countries on how best to implement mitigation and prevention efforts. International Registered Report Identifier (IRRID) RR2-10.2196/21955

scholarly journals Musical Leadership and Societal Transformation: Inspiration and Courage in Action

2018 ◽  
Vol 50 (4) ◽  
pp. 41-65
Author(s):  
Nancy J. Adler ◽  
Linda M. Ippolito
Keyword(s):  
United States ◽  
South Africa ◽  
Middle East ◽  
Northern Ireland ◽  
The United States ◽  
Societal Transformation ◽  
The World ◽  
Traditional Approaches

Music is a form of leadership. Music-based interventions in organizations and society are being used throughout the world, including in situations of extreme conflict and consequence. Artists are going beyond the dehydrated language of economics, politics, and war to achieve goals that have eluded those using more traditional approaches. This article presents musical interventions in Bosnia-Herzegovina, Cyprus, Estonia, Northern Ireland, the Middle East, South Africa, the United States, and Venezuela, in which musicians have had the inspiration and courage to make a difference.

scholarly journals African and Not Religious: The State of Research on Sub-Saharan Religious Nones and New Scholarly Horizons

2021 ◽  
pp. 000203972110525
Author(s):  
Yonatan N. Gez ◽  
Nadia Beider ◽  
Helga Dickow
Keyword(s):  
United States ◽  
South Africa ◽  
Quantitative Data ◽  
Western Europe ◽  
Religious Tradition ◽  
The United States ◽  
Research Interest ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
State Of Research

Sub-Saharan African societies are widely seen as highly religious. However, at least 30 million Sub-Saharan Africans identify themselves as “religious nones” and are supposedly not affiliated with any religious tradition. While research interest in religious nones has been growing in the United States, Canada, and Western Europe, there is a dearth of literature on nones in Sub-Saharan Africa. In this paper, we offer an overview of this understudied subject and dwell on key challenges for studying African nones, including preconceived notions and structural oppositions. We further muse on the identity of African nones and consider differences from the characteristics established concerning Western nones. The article draws on quantitative data from across the region (primarily from Afrobarometer and Pew Research Center) and supplements them with interview data collected in Chad, Kenya, and South Africa.

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