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In the year ending 30 June 1989, 26,8% of 5345 deaths in the Port Elizabeth area were classified as ill-defined. A study was undertaken in an attempt to identify the reasons for the high proportion of such deaths. Copies of all death notifications and death register forms of black people in the area served by the Port Elizabeth City Health Department were collected for a 6-week period. Of the 316 deaths, 154 (48,7%) were certified by medical practitioners at a hospital, 158 (50%) by the police and 4 (1,3%) by private medical practitioners. Of the police-certified deaths 116 (73,4%) were recorded as due to 'natural causes', with the remainder being submitted to autopsy. Of the hospital deaths, 26% were not adequately described in the section for the cause of death on the death certificate. Review of national mortality data for 1985 showed that only 29,9% of ill-defined deaths (in all population groups) were certified by a medical practitioner. The prime source of deaths classifed as ill-defined, both in Port Elizabeth and nationally, were those not certified by a medical practitioner. Strategies aimed' at minimising the number of deaths certified by the police need to be developed.

Introduction: Hepatitis C (HCV) remains one of the main causes of chronic liver disease worldwide. The impact of chronic HCV on the long-term ranges widely, from minimal histologic changes to decompensated cirrhosis or hepatocellular carcinoma. These last years, the development of direct acting antivirals have revolutionized HCV care. We present the experience in the KU Leuven affiliated hospitals with the latest generation of direct acting antivirals. These are therapies without concomitant use of interferon, such as simeprevir, sofosbuvir, daclatasvir, and ombitasvir/paritaprevir ritonavir – dasabuvir. Aim Goal of this abstract is to demonstrate the safety and efficacy of the newest generation of direct acting antivirals in the general population in Belgium (the KU Leuven affiliated hospitals). Methods A national retrospective, interventional cohort study conducted between December 2013 and November 2015 in 6 Belgian centers during which patients infected with HCV were treated with the new regimes of DAA. All centers were experienced in treating HCV. In case antiviral treatment was started data were collected in a central database, with main focus on treatment outcome and side effects. Results and discussion In total, 134 patients (age 58 ± 12 years) were treated with one of the newest generation DAAs. All patients had multiple comorbidities, with an average rate of 1.55 ± 1.6. These were highest in the simeprevir/sofosbuvir group. HCV genotype 1b was most prevalent. 45.9% of the patients were treatment naïve, and 38.7% % was once treated before. 59 patients were treated with daclatasvir/sofosbuvir ± ribavirin, 48 with simeprevir/sofosbuvir ± ribavirin, and 27 with ombitasvir/ paritaprevir, ritonavir – dasabuvir ± ribavirin. Treatment is completed in only 60.4% of all patients. Moreover, only 42.5% were treated long enough so they could achieve SVR. From this group, almost everyone obtained SVR (96.5%). Subanalysis showed an SVR-rate of 100% (10/10) in the daclatasvir/sofosbuvir ± ribavirin group, 92.6% (25/27) in the simeprevir/sofosbuvir ± ribavirin group, and 100% (20/20) in the ombitasvir/ paritaprevir, ritonavir – dasabuvir ± ribavirin group. Side effects were present in 49.3 % of the total population, most frequent were an increase in fatigue and skin eruptions. Only in 9.7 %, this required a change in therapy. Ribavirin was lowered in dose or stopped in these cases. These are preliminary results, we will present larger data at the time of the congress. Conclusion Real-life experience with DAAs in Belgium shows comparable excellent results in achieving SVR for the treatment of HCV. Side effects were frequent, but rarely cause a need for therapy change. This study is part of the Limburg Clinical Research Program (LCRP) UHasselt-ZOL-Jessa, supported by the foundation Limburg SterkMerk, Hasselt University, Ziekenhuis Oost-Limburg and Jessa Hospital.

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With the first round of renewable energy projects in South Africa’s Renewable Energy Independent Power Producer Programme (REIPPPP) reaching commercial operation, this paper aims to provide insight into what was learnt from the commissioning processes and what can be improved for the next REIPPPP rounds. We outline and compare the commissioning processes for a solar PV plant in South Africa to existing solar PV plants in the UK with regards to weather instrumentation, thermal imagery testing, performance ratio testing, contracted capacity vs. achieved capacity, and grid interface. Suggestions are made to improve the current commissioning procedures in South Africa looking towards the commissioning of future projects under the REIPPPP rounds., 1st Africa Photovoltaic Solar Energy Conference and Exhibition Proceedings, AfricaPVSEC 2014

Summary Background Previous trials of antiplatelet therapy for the prevention of venous thromboembolism have individually been inconclusive, but a meta-analysis of their results indicated reductions in the risks of deep-vein thrombosis and of pulmonary embolism in various high-risk groups. The aim of this large randomised placebo-controlled trial was to confirm or refute these apparent benefits. Methods During 1992–1998, 148 hospitals in Australia, New Zealand, South Africa, Sweden and the UK randomised 13 356 patients undergoing surgery for hip fracture, and 22 hospitals in New Zealand randomised a further 4088 patients undergoing elective arthroplasty. Study treatment was 160 mg daily aspirin or placebo, started preoperatively and continued for 35 days. Patients received any other thromboprophylaxis thought necessary. Follow-up was of mortality and of in-hospital morbidity up to day 35. Findings Among the patients with hip fracture, allocation to aspirin produced proportional reductions in pulmonary embolism of 43% (95% CI 18–60; p=0·002) and in symptomatic deep-vein thrombosis of 29% (3–48; p=0·03). Pulmonary embolism or deep-vein thrombosis was confirmed in 105 (1·6%) of 6679 patients assigned aspirin compared with 165 (2·5%) of 6677 assigned placebo, which represents an absolute reduction of 9 (SE 2) per 1000 and a proportional reduction of 36% (19–50; p=0·0003). Similar proportional effects were seen in all major subgroups, including patients receiving subcutaneous heparin. Aspirin prevented 4 (1) fatal pulmonary emboli per 1000 patients (18 aspirin-group vs 43 placebo-group deaths), representing a proportional reduction of 58% (27–76; p=0·002), with no apparent effect on deaths from any other vascular cause (hazard ratio 1·04 [95% CI 0·86–1·26]) or non-vascular cause (1·01 [0·84–1·23]). Deaths due to bleeding were few (13 aspirin vs 15 placebo), but there was an excess of 6 (3) postoperative transfused bleeding episodes per 1000 patients assigned aspirin (p=0·04). Among electivearthroplasty patients, rates of venous thromboembolism were lower, but the proportional effects of aspirin were compatible with those among patients with hip fracture.

The growth, survival and success of a family business are often influenced by issues relating to family relationships and family harmony. Not only do the actions of family members influence the success or failure of the family business, but so does the behaviour of non-family stakeholders. The success or failure of the family business may also have important emotional and financial ramifications for the different stakeholders involved in the business, whether that involvement is physical or emotional. Yet, very little is known about the impact that the various stakeholder groups have on the success of the family business, its continuity or the family harmony that prevails. Consequently, the primary objective of this study is to evaluate the impact of selected stakeholders, namely non-family members, inactive family members, the senior generation and the incumbent generation on the success of family businesses. Success, for the purposes of this study, was measured using two variables, family harmony and perceived future continuity. Respondents were identified by means of convenience sampling,and a total of 468 usable questionnaires were returned. The data collected were subjected to various statistical analyses. The validity of the measuring instrument was assessed by means of an exploratory factor analysis and reliability by calculating Cronbach’s alpha coefficients. The relationships proposed in the hypothesised model were assessed by means of structural equation modelling (SEM).The empirical results of this study reveal that family harmony influences the perceived future continuity of family businesses. In turn, inactive family members and the incumbent generation have a significant impact on the family harmony that exists in the family business.Key words: family business, inactive stakeholders, active stakeholders, continuity, family harmony

OBJECTIVES: To determine the current prevalence of retinopathy of prematurity (ROP) in premature babies treated with non-invasive ventilation at Tygerberg Children's Hospital, Parow, Cape Town, South Africa, and to identify risk factors associated with the development of ROP. METHODS: A retrospective medical records review of infants screened for ROP during a 2-year period (January 2009 - December 2010). Infants who did not receive invasive ventilation during the first week of life were included. Twenty-four previously reported risk factors for the development of ROP were identified for use in a multivariate logistic regression (MLR) analysis. RESULTS: A total of 356 patients were included. The overall prevalence of ROP was 21.8% and that of clinically significant ROP (CSROP) 4.4%. The risk factors with a statistically significant association with the development of ROP on MLR analysis were severe apnoea (p=0.0005) and decreasing birth weight (p=0.0382). CONCLUSIONS: There is a low prevalence of ROP in the cohort of preterm infants treated exclusively with non-invasive ventilation in the first week of life. The risk factors of importance in our population were severe apnoea and lower birth weight. Birth weight is a practical and reproducible variable that can be used to aid development of ROP screening criteria.

When modern humans left Africa ca. 60,000 years ago (60 kya), they were already infected with Helicobacter pylori, and these bacteria have subsequently diversified in parallel with their human hosts. But how long were humans infected by H. pylori prior to the out-of-Africa event? Did this co-evolution predate the emergence of modern humans, spanning the species divide? To answer these questions, we investigated the diversity of H. pylori in Africa, where both humans and H. pylori originated. Three distinct H. pylori populations are native to Africa: hpNEAfrica in Afro-Asiatic and Nilo-Saharan speakers, hpAfrica1 in Niger-Congo speakers and hpAfrica2 in South Africa. Rather than representing a sustained co-evolution over millions of years, we find that the coalescent for all H. pylori plus its closest relative H. acinonychis dates to 88-116 kya. At that time the phylogeny split into two primary super-lineages, one of which is associated with the former hunter-gatherers in southern Africa known as the San. H. acinonychis, which infects large felines, resulted from a later host jump from the San, 43-56 kya. These dating estimates, together with striking phylogenetic and quantitative human-bacterial similarities show that H. pylori is approximately as old as are anatomically modern humans. They also suggest that H. pylori may have been acquired via a single host jump from an unknown, non-human host. We also find evidence for a second Out of Africa migration in the last 52,000 years, because hpEurope is a hybrid population between hpAsia2 and hpNEAfrica, the latter of which arose in northeast Africa 36-52 kya, after the Out of Africa migrations around 60 kya.