Investigating the socioeconomic impacts of sewage spillages on businesses in the Umhlanga Rocks coastline area

Sewage spillage is fast becoming a significant concern in South Africa because of the deteriorating infrastructure and substandard service delivery. Thus, this study investigated the socioeconomic impacts of sewage spillages on businesses in the Umhlanga Rocks coastline area. A questionnaire with open and closed-ended questions was used to collect data from business owners in the affected area. One hundred business owners were handed questionnaires to complete, and 95 completed questionnaires were collected. The qualitative data from the questionnaires were analysed using thematic analysis, whereby line-by-line coding was manually completed using Excel. The quantitative data were analysed in R studio using numerous statistical tests, including the Shapiro–Wilk test, the Chi–square test, the Kruskal–Wallis test, Dunn’s test, and Cohen’s d test. The thematic analysis and statistical testing results showed that sewage spillages disrupted businesses significantly. Results indicated that businesses of different sizes experienced socioeconomic losses differently. Consequently, the results of this study have implications for business owners and communities living in the affected area. Moreover, findings have revealed practical strategies and interventions that may be used by micro- to medium-scale businesses to mitigate the socioeconomic impact of sewage spillages. Contribution: The practical strategies revealed in this study contribute to reducing the vulnerability of communities and businesses to sewage spillages. Findings of the study have also been disseminated to the business owners and other relevant stakeholders to provide them with alternative solutions in ‘softening the blow’ caused by the spillages

Myocardial Injury after Noncardiac Surgery : a Large, International, Prospective Cohort Study Establishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes

Background: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery. The study’s four Objetives: were to determine the diagnostic criteria, characteristics, predictors, and 30-day outcomes of MINS. Methods: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days. Patients with a troponin T level of 0.04 ng/ml or greater (elevated “abnormal” laboratory threshold) were assessed for ischemic features (i.e., ischemic symptoms and electrocardiography findings). Patients adjudicated as having a nonischemic troponin elevation (e.g., sepsis) were excluded. To establish diagnostic criteria for MINS, the authors used Cox regression analyses in which the dependent variable was 30-day mortality (260 deaths) and independent variables included preoperative variables, perioperative complications, and potential MINS diagnostic criteria. Results: An elevated troponin after noncardiac surgery, irrespective of the presence of an ischemic feature, independently predicted 30-day mortality. Therefore, the authors’ diagnostic criterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judged due to myocardial ischemia. MINS was an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87; 95% CI, 2.96–5.08) and had the highest population-attributable risk (34.0%, 95% CI, 26.6–41.5) of the perioperative complications. Twelve hundred patients (8.0%) suffered MINS, and 58.2% of these patients would not have fulfilled the universal definition of myocardial infarction. Only 15.8% of patients with MINS experienced an ischemic symptom. Conclusion: Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality