Suchergebnisse

In the recent Mapungubwe Institute for Strategic Reflection (MISTRA) & Lilliesleaf Roundtable held on 4 March 2015, leading figures in the intellectual life of liberation movements in sub-Saharan Africa reflected on the past, present and future relationships of such political intellectuals within the new independent states of the region. ; http://www.sajs.co.za ; am2015

Sophiatown in Johannesburg, District Six in Cape Town, and Cato Manor in Durban have become political metaphors for urban dispossession and resistance. Cato Manor has the most complex and violently contested history of land ownership and occupation of any area in Durban. In the early 1960s, the Durban Corporation began to expropriate the land from Indian owners and cleared the area of African shack dwellers and of most Indian residents. Despite the development of some Indian housing during the mid‐1980s, the land still remains largely vacant. Africans are re‐establishing themselves in shack settlements in the area.
The future of Cato Manor is now a major political controversy. The entrenched segregation of South Africa cities makes it extremely difficult to redress the legacy of past policies: all require massive investment in urban infrastructural amenities and low‐income housing. Cato Manor and District Six are the only two large areas of urban land available for planned development of new housing within any South African city. Planning for the best use of Cato Manor is highly complex and has to take account of competing and contradictory claims to the land. The current state of negotiations over the future of the land is hardly a promising beginning. Cato Manor remains a highly contested urban space.

Durban originated as an imperial port, serving Natal and the Witwatersrand. Cato Manor Farm is a huge area of land located within five miles of the centre of Durban. Cato Manor has the most complex history of settlement in terms of its class and racial composition, patterns of legal and illegal ownership, residence and occupation of any area in Durban. The future of Cato Manor is now a major political controversy. The article looks at Cato Manor, contradictory claims to the land in this area and the issues connected with town planning. (DÜI-Sen)

IntroductionAgeing populations place considerable burden on healthcare systems. Innovative methods to implement and evaluate new care models to reduce unwarranted hospital presentations, are needed.
Objectives and ApproachTo use linked Electronic Medical Record (EMR) data to evaluate a pilot community-based model of care to reduce hospital presentations in a cohort of patients at-risk of hospital representations following an acute admission. Patients admitted to a metropolitan hospital with a non-surgical condition andidentified as being at-risk of readmission using a state-wide risk algorithm, were eligible to receive a 30-day care navigation model of care. The intervention group were matched to similar eligible patients, who received usual care using propensity score matching. Linked data were obtained from the EMR based Data Warehouse to provide information on subsequent readmissions and community-based health service contacts. Readmission rates were compared at 30, 60, and 90-days post-discharge using Cox Proportional Hazards Regression, adjusted for confounders and weighted by the propensity score. Descriptive analyses were used to compare demographics and healthcare utilisations.
ResultsData from 412,971 potentially eligible patients were extracted. Sixty-five received the intervention of which 63 were matched to 280 controls (aged 51-91 years, 54% female, 63% lived alone). At 30-days post-discharge (during intervention delivery) an 80% reduction in readmission rate in the intervention group was observed (Hazard Ratio [HR] 0.20; 95%Confidence Interval (CI) [0.01, 4.20]). At 60-days (HR 0.48; 95%CI [0.03, 8.05]) and 90-days (HR 0.83; 95%CI [0.06, 11.36]), readmission rate reductions decreased to 52% and 17% respectively. In the intervention group, 68.9% received an out-patient appointment compared to 40% of controls (P<0.001) and 7.7% received allied health compared to none of the controls (p=0.003) within 90-days post-discharge.
Conclusion/ImplicationsResults have informed hospital-wide service implementation thereby demonstrating the value of linked EMR data and advanced statistical methods in the evaluation of real-world healthcare.