A Coalition for Change? Role Orientations in the 12th Parliament of Botswana

Botswana’s parliamentary democracy features a weak parliament that is ineffective in law making and executive oversight. Conventional explanations emphasise a dominant party system that emerged following independence, lack of operational independence from the executive, and the poor capacity of parliament as factors that undermine its effectiveness. Using a novel dataset that is based on interviews with Members of Parliament (MPs) on a wide range of issues, including their role orientations, this article tests several interrelated hypotheses to investigate whether there is an emerging coalition for change. The article finds that there is a group of opposition MPs that constitutes a coalition for change because they are reform oriented, discuss parliamentary affairs and exercise executive oversight. We argue that this coalition for change is marked by a connected communication structure. The study furthers our understanding of the functioning of parliament as a core institution of Botswana’s democracy

Tanzania under Magufuli: the personalization of a party-based regime

Contemporary research has shown that authoritarian regimes are not static. At the same time, gradual changes are often difficult to detect and the literature has not yet developed convincing tools to identify autocracy-to-autocracy transitions outside the visible ruptures of coups, power transfers, and opposition victories. Building on fieldwork in Tanzania, we show that patterns of rule shifted significantly under Magufuli. Once the model case of a party-based system in Africa, we argue that Tanzania should be reclassified as a party-personalist regime for the time of his presidency. The basis for his success lies in the increasing factional tensions within the CCM which gave him the power to act as the arbiter and to manipulate party institutions and nominations to his favour. Beyond providing a thick description of a single case, we address the theoretical and empirical challenges of correctly classifying authoritarian regimes

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Elites and democracy in Ghana : A social network approach

This article presents new theoretical and empirical insights into democratization in Africa, using the typology developed by John Higley and Michael Burton to understand elite interaction in Ghana. Social network analysis (SNA) is used to test the main proposition of the Higley/Burton theory, namely that a ‘liberal democracy is impossible without a consensually united elite’. Empirical evidence is provided from a unique data set that maps the interaction patterns between Members of Parliament elected to the Ghanaian legislature in 2012. The article shows that MPs in Ghana form a dense and strongly interconnected network bridging ethnic and party cleavages, and that MPs from different parties have developed a measure of trust in one another. These findings not only support Higley and Burton's claim that elite integration is conducive to stable democracy, but also point to new directions in African Studies by demonstrating the capacity of actor-centric approaches to explain processes of democratization in countries that lack the classic structural preconditions for consolidation.publishe

Political Parties in Ghana : Agents of Democracy?

Political parties are generally thought of as agents of democracy that fulfil a range of functions, such as policy formulation, interest aggregation and articulation, social integration, and elite recruitment. However, given the weakness of many African parties, are they able to contribute positively to democracy? This article seeks to answer this question by using Ghana – one of Africa's most successful democracies – as a case study. It is found that parties in Ghana are comparatively strong and do indeed mobilise large numbers of voters. They even expose a degree of ideological competition and have successfully adapted their strategies to the local context. On the other hand, they expose serious weaknesses in the field of social integration and interest representation. Against this background it is argued that even in procedurally well-functioning democracies like Ghana, political parties can be instruments of elite competition that contribute to the exclusion of the poor from decision-making