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Electrocardiographic predictors of poor outcome in acute myocardial infarction
Get PDFIntroduction: Myocardial infarction (MI) is a major cause of death worldwide. An ECG is indicated in all patients with suspected MI. The aim of this study was to evaluate electrocardiographic predictors of outcome in acute coronary syndrome (ACS). Methods: We analyzed 12-lead ECGs of 301 consecutive patients admitted to the coronary care unit (CCU) at a tertiary centre during 2016 with a diagnosis of ACS. ECGs were done on admission, and after that daily throughout the hospitalisation. Poor outcome was defined as all-cause mortality within a three-year period after the index MI. Results: This cohort of 301 patients (42.2% female) with a mean age of 57.4±11.9 years, presented with either ST-elevation myocardial infarction (STEMI, 57.5%) or non-ST elevation myocardial infarction (NSTEMI, 42.5%). Fifty-one (16.9%) patients died within three years after their index presentation. Multivariable regression analyses revealed that left atrial enlargement (LAE, odds ratio [OR] 3.91 [95% confidence interval [CI] 1.39-11.02], p=0.010) and ST depression (OR 3.64 [95% CI 1.33-9.93], p=0.012) were predictive of poor outcome, wheras sinus rhythm with normal rate was associated with a better prognosis (OR 0.33 [95% CI 0.12- 0.91] p=0.032). Patients with two or more risk factors (i.e., LAE, ST depression, sinus tachycardia) experienced higher mortality rates (p<0.001).Conclusion: Our study showed that the ECG has prognostic value in patients presenting with acute MI. ECG features that were independently associated with increased mortality within the first three years of MI (LAE, ST depression and/or sinus tachycardia) could assist with risk stratification of patients presenting with ACS
Developing an Ubuntu-infused e-commerce business model for South African small businesses based on a holacratic organisational structure
Get PDFSouth Africa's e-commerce industry is one of the better performing industries in the African continent. As with other technologies, e-commerce has the potential to help the country leapfrog ahead and help address the challenge of unemployment, simultaneously contributing towards improving the country's overall economic performance. This can be realised by bolstering e commerce and entrepreneurship through innovation among small and medium size businesses. This study focuses on e-commerce as one of the technologies that South Africa can invest in to contribute positively towards sustainable job creation, with the benefit of improved gross domestic productivity (GDP). A mixed methods approach was undertaken to understand the enablers and inhibitors of e-commerce in South Africa, with the intention of using this understanding to develop a business model that is suitable for South Africa's e-commerce industry and to help unlock its full potential. To this effect, eight participants who are entrepreneurs were interviewed. The entrepreneurs consisted of two groups that either utilise e-commerce as part of their business operations, and those that do not. Their contributions in the findings of the qualitative study were subjected to quantitative research through a survey study that was based on 65 respondents. These respondents were selected based on a convenience sampling method, and as a final exercise, the insights gleaned from both studies were analysed and incorporated into the business model. The e-commerce business model presented herein incorporates the communitarian values of Ubuntu, which is the prevalent axiological system in South Africa. In the business model Ubuntu is blended with the self-governance organisational structure of holacracy. This complements the collaborative and self-organisation trait of South African communities, which allows for the economic pursuits of an e-commerce initiative to reflect the nature of the societies in which it co-exists
Vision-Based automatic translation for South African Sign Language (SASL)
Get PDFThere are more than four million South Africans who are deaf and hard of hearing (DHH). However, most people with hearing abilities neither understand sign language nor know how to sign. This creates a communication barrier between the deaf and hard of hearing and people with hearing, to the disadvantage of the DHH. In 2018, South African Sign Language (SASL) became an official subject in South African schools and in 2023 it became South Africa's 12th official language. However, these implementations do not impose it on institutions and service providers. Although some provisions are made to cater to the needs of DHH people in the form of sign language interpreters, such interpreters are not always readily available. Sign language interpreters are also costly, charging in excess of R500.00 per hour. In this research, we developed the first vision-based Neural Sign Language Translation model for SASL as a first step towards bridging the communication gap. To this end, we recorded a sizeable parallel SASL and English corpus with the help of six sign language interpreters, three of which are native signers and constitute around 90% of the dataset. The dataset comprises 5047 sentences in the domain of government and politics recorded in a studio setting with a uniform green background. At an average of 3.83 seconds per segment, this equates to around five hours of sign language data. We conducted comprehensive experiments using various visual feature extraction architectures as well as translation architectures. We found that recurrent translation models outperform transformer models. We also investigated the impact of pretraining our feature extractor on a Continuous Sign Language Recognition task and fine-tuning on the SASL dataset and found that this is effective for improving feature extraction. Our best models achieved a BLEU-4 score of 1.35 on the SASL test set, a comparable performance to the How2Sign dataset with a best BLEU-4 score of 1.73 but much lower than on the RWTH-PHOENIX-Weather 2014T dataset which produced a BLEU-4 score of 13.23 without gloss supervision. Our experiments also showed that annotating fingerspelled words as individual letters improves the performance of the model. Our model might benefit from the collection of more data and the addition of gloss annotation. Our results on the SASL dataset are very poor and still very far from practical, indicating that more resources and experiments are required before we can remove the language barrier between the hearing and the Deaf. This would be most effectively achieved by working in collaboration with the Deaf Community to produce high quality datasets, annotations, and models
Lefebvrean analyses of the South Africa-Botswana international border and borderlands
Get PDFInternational borders and borderlands are geographically organized political spaces which are primary objects of geographical research. This cluster of geographic border spaces embody the territorial dimensions of Lefebvre's scholarship which are critically under advanced and not readily appropriated in political geography. To address this gap, I advanced Lefebvre's spatiology and rhythmological science territorially for the critical analyses of South Africa's international border with Botswana, and its Batswana inhabited borderlands along the NorthWest Province, Southern District and South Eastern District respectively. Through a qualitative methodological design of spatial rhythmology underpinned by ethnographic as well as archival techniques, I made the following discoveries pertaining the political geography of Tswana populations straddling the international border of South Africa and Botswana at A1 and A2 border gates. I found that (a) the A1-A2 border-gated region of South Africa and Botswana is a territorial polyrhythmia in which the African society of Batswana are the dominant culture. (b) The A1 cross-border gates and borderlands of South Africa and Botswana are dominated by the Tshidi Barolong of Kgosi Montshiwa I, whose prehistoric dynasty is divided between the North-West Province and Botswana's Southern District, while the minority Batloung of Kgosi Shole are ensconced by the transnational Tshidi Barolong. (c) Political relations between the Barolong of Botswana and the Batloung of South Africa are eurhythmic however, the territorial specter of Apartheid and Bophuthatswana interstate histories threatens eurhythmic relations between South African Barolong and the Batloung of Greater Mahikeng, with arrhythmia. (d) There are no tangible cross-border governance structures and interstate relations between South Africa and Botswana despite a high degree of spatial integration and cross-border social interaction. (e) South Africa's international border with Botswana is an asymmetrical fracture line and monumental state space comprising superimposed spaces of accessibility, non-synchronized temporal rhythms, relatively fixed junction points and permanently established places of abode inhabited by a variety of Batswana. (f) The geopolitical spatial practices and asymmetric spatial rhythms of the international border of South Africa and Botswana produce binary border regimes which are directly influenced by interstate variations in their respective international border management practices and migration policies. These findings have significant implications for the Lefebvrean understandings of the contemporary political geography of the Batswana inhabited cross-border region of Southern Africa. Furthermore, the findings enhance the critical need for international border policymakers in the African sub-region to make empirically informed decisions pertaining interstate governance of territorial fracture lines, and the co-management of crossborderlands with territorial societies that inhabit them
Policy implementation and coordination capacity: a case study of the state s capacity to implement the National Integrated Early Childhood Development policy in a district in the Eastern Cape, South Africa
Get PDFEarly childhood Development (ECD) refers to the suite of interventions – provided to a child from conception until the transition into school, which nurtures and enables the child to thrive and reach their full potential. Of the policy responses directed at addressing inequality, ECD is identified as pivotal in increasing equality in a society and disrupting cycles of poverty across generations (Paananen et al., 2018; Irwin et al., 2007). In the South African context, where inequality and poverty persisted even with the transition to democracy, the prominence of ECD has evolved, culminating in the establishment of a National Integrated ECD Policy (2015). Despite the policy, the provision of integrated, quality ECD services for all children is yet to be realised. Across the country, varying degrees of implementation failures prevail, with devastating consequences for those residing within the poorest areas of the country. The coronavirus 2019 (COVID-19) crisis compounded the urgency to address the ECD policy implementation challenges, with research illustrating how the failure of government to coordinate the implementation of ECD has brought the sector to the brink of collapse (Wills et al., 2020). The emphasis on coordination structures, that are envisaged to oversee streamlined technical solutions, continues to dominate, shaping and re-shaping the implementation landscape. This research study set out to understand the state's capacity to coordinate the implementation of the NIECD policy. Through the use of case study methodology, the research delves into the implementation of ECD in a district in the Eastern Cape province. Howlett's (2018) multiple streams/critical junctures policy framework was applied to make sense of the implementation realities that plague the ECD sector. To deepen the understanding of coordination capacity – aspirational and existing - Wu et al's (2015) policy capacity matrix provided a complementary analytical framework. Based on the findings from this research study, there is a need to reconsider the focus on coordination structures for the ECD sector to challenge the perception that coordination constitutes structures as a way of dealing with the challenges of ECD policy implementation. Instead, a shift towards far more inclusive local level engagement may contribute to a renewed consideration of coordination as that of working within the complexities of diverse contexts. The focus of this research study is opportune, as it can contribute to the current debates on coordination capacity for the implementation of ECD services in South Africa
A retrospective review (audit) of gynaecological emergency surgery at Groote Schuur Hospital for the period of January to December 2019
Get PDFBackground. Gynaecological emergencies are a common cause of morbidity and mortality among women of reproductive age worldwide. There is less audit done on the burden of emergency surgery in developing countries. Objectives. The planned study analysed the clinical processes and outcomes of gynaecological emergency surgeries performed at a tertiary level hospital in the Western Cape (Groote Schuur) in the year 2019. Methods. The study was a retrospective descriptive record review of patients who underwent emergency surgery at Groote Schuur Hospital. Data was captured manually and electronically using theatre data base. Statistical analysis was performed using SPSS Statistics for Windows 2021. Results. We analysed 290 completed women records. The mean age was 30.16, with 230 (79.3%) women of reproductive age. There were 234 (79.1%) pregnancy related surgical procedures done. The most common occurrence among pregnancy related surgeries was ectopic pregnancy, accounting for 112 (47.9%) cases. A total of 130 (44.8%) women had anaemia and 125 (43.1%) had a tachycardia prior to surgery. Twenty-seven (9.3%) women were in hypovolaemic shock before surgery. A total of 179 (61.7%) women had the surgery 4 hours after being booked in theatre. Only 46 (15.9%) women accessed surgery within 2 hours. Twenty (6.9%) women had to wait for more than 24 hours for their operation to be done. The most common reason for the 24-hour delay, accounting for 85% (N=17), was the lack of emergency theatre time, as other cases from different disciplines were given priority. There were 42 (14.5%) women with complications post operatively and no mortality recorded. Conclusion. The study indicates good outcomes for emergency gynaecological surgeries performed at Groote Schuur Hospital in 2019. However, significant delays between the decision for surgical intervention and the actual performance of the surgeries were highlighted. The delays in hypovolaemic women were attributed to the need to compete with other surgical disciplines for emergency theatre time
The impact of mobile money on macroeconomic development: insights from Côte d'Ivoire
Get PDFMobile money has contributed to financial inclusion across African countries. Indeed, mobile money has proven immense economic benefits to developing countries and is a driving force behind numerous economic activities. However, there are concerns that mobile money may perhaps weaken financial stability. The consequences of mobile money on these macroeconomic indicators such as: inflation, interest spread rates, money stock, private-sector credit, and economic aggregate activity are intriguing. Côte d'Ivoire is viewed as the most robust financial state within the African continent and mobile money has evolved rapidly across the country. As such, this gives room to prospect the consequences of mobile money on macroeconomic development in Côte d'Ivoire. Indeed, the core idea of this analysis is to evaluate the repercussion of mobile money on macroeconomic development in Côte d'Ivoire. The study adopted a time series approach, making use of monthly data from January 2013 till December 2021. The economic investigation adopts the structural vector autoregressive (SVAR) to analyse the data. The results showed moderate effect on the macroeconomic development variables in Côte d'Ivoire. Specifically, the shocks involving mobile money may take time to impact productivity but nonetheless support economic aggregate activity in the country. Mobile money seems to not cause inflationary pressures. In the case of money stock, mobile money leads to a shift from non-financial assets to financial assets thus influencing money supply. Furthermore, mobile money may take time to influence supply of private credit but remains an essential tool for the supply private credit. As for interest spread rates, a positive impact is noticed, and remain relatively stable. Regarding the conduct of monetary policy, mobile money has moderate impact on monetary policy transmission mechanisms, monetary effects take longer to gain full potential in Côte d'Ivoire
ETD: The effect of career guidance in secondary schools on skills development and sustained economic participation: meaningful employment
No full textThis study addresses the persistent gap between education and workforce needs in South Africa, contributing to structural unemployment. Focusing on the role of career guidance in secondary schools, the research examines its impact on skills development and its potential to bridge workforce skills gaps. The study aligns with Meyer's (2017) definition of structural unemployment and emphasises the need for targeted interventions during the secondary school-to-employment transition. The research explores the subject of “The Effect of Career Guidance in Secondary Schools on Skills Development and Sustained Economic Participation: Meaningful Employment." By analysing students' perceptions against labour market realities, the study aims to shed light on the multifaceted relationship between career guidance, skills development, and sustained economic participation. Using an exploratory sequential research design, the study employs interviews, some statistical analysis, and surveys. Qualitative data explores skills development and career guidance phenomena, while quantitative data provides insights into identified relationships. The integrated data analysis, following Sandelowski's (2000) approach, seeks to contribute new knowledge on the impact of career guidance on skills development and its alignment with labour market requirements. The study's findings confirm the crucial role of early and comprehensive career guidance in shaping students' future prospects. It reveals that students from lower quintile schools often lack exposure to various career options, limiting their ability to align their skills and interests with labour market demands. The absence of adequate career guidance contributes significantly to structural unemployment. The study advocates for proactive career guidance starting from grade 9 and underscores the importance of equipping schools with the necessary resources to provide effective career guidance. Ethical considerations included obtaining written consent and securing ethical clearance. This study not only advances theoretical frameworks but also provides practical insights for policymakers, educators, and practitioners to enhance career guidance programs and address the complex challenges of youth unemployment
Typical and Atypical Antipsychotic induced weight gain (AIWG) and its metabolic correlates among male forensic inpatients in Cape Town, South Africa
Get PDFAntipsychotic induced weight gain (AIWG) is a well described phenomenon in psychiatric literature. However, there is a dearth of information on its prevalence in patients admitted to forensic units. Forensic inpatients are at heightened risk for weight gain and Metabolic Syndrome (MetS) due to long term exposure to antipsychotic (AP) medications. Aim: We aimed to describe and compare the weight changes and metabolic profile of male forensic state patients exposed to typical and atypical AP and identify modifiable risk factors, enabling us to determine if there is a significant difference between typical and atypical AP in the development of weight gain and MetS. Method: The study design was a retrospective folder review. The populations consisted of 75 male forensic state patients, stratified into those prescribed only atypical antipscyhotics (AAP) and those prescribed only typical antipsychotics (AP). The metabolic parameters on admission (From 2017) and at follow up (Up to 2022) were documented. Ethics approval was granted by the University's Human Research Ethics Committee (HREC). Results: An average increase of 17.7 kg weight from admission to follow-up across both groups, with a 35.1% and 25.1% increase in the atypical and typical groups respectively. There was a 46.2% increase in the incidence of MetS in the AAP group, compared to 40.1% in the typical AP group. Patients on AAP had a significantly larger absolute and % change in weight than those on typical AP (p= 0.01/0.025 respectively). Conclusion: This study is the first in a forensic unit in South Africa to show that all AP are associated with weight gain and MetS, with AAP having a significantly larger change in weight (p=0.01) . Further studies with larger sample sizes in other forensic state patient populations can be done to confirm associations found in our study
A review-aware multi-modal neural collaborative filtering recommender system
Get PDFOnline shopping has become a ubiquitous aspect of modern life and recommender systems have become a crucial tool for e-commerce giants to efficiently sift through vast amounts of data to locate the infor mation that users are seeking. Within e-commerce, recommender systems aim to provide users with personalised product recommendations based on their preferences and behaviours. They analyse user data, for example their browsing history, purchase history, and ratings to understand their preferences and make recommendations that align with these preferences. They have become fundamental for information retrieval and provide a particularly lucrative landscape for e-commerce platforms, providing suggestions that effectively prune large information spaces so that users are directed toward those items that best meet their needs and preferences. This thesis looks at developing a neural collaborative filtering (NCF) recommender system model which incorporates data from multi-modalities, textual data and explicit ratings data (and review sentiment). The primary objectives of this study are twofold. Firstly, the aim is to create and assess the efficacy of the, relatively new, deep learning-based collaborative filtering approach - NCF - in comparison to other more traditional collaborative filtering models, commonly used. Secondly, the study seeks to investigate the potential impact of incorporating product review text and review text sentiment in improving the accuracy of recommendations. Our model shall be trained and evaluated on the Amazon Product Reviews dataset, which contains millions of user reviews and feedback on thousands of different products across different categories. The metrics used to evaluate the model include predictive accuracy metrics such as mean absolute error, amongst others, as well as top-n evaluation metrics such as recall@n and precision@n. Our methodology is based on a literature analysis and aims to clearly extrapolate on the recent works which have established a framework for NCF. The results of our study show that the NCF model outperforms all the benchmark models in terms of predictive accuracy and top-n evaluation. The results also show that the inclusion of review text in the NCF model improves the predictive accuracy of the model significantly. The results of this study are significant as they demonstrate the potential benefits of incorporating review text into deep learning-based approaches for collaborative filtering for improved rating prediction