South African Family Practice - Volume 46, Issue 3, 2004
Volume 46, Issue 3, 2004
Author S.W.P. MhlongoSource: South African Family Practice 46 (2004)More Less
Extracted from text ... Editorial Towards the close of last year (2003), there was an intensive and healthy debate amongst FAMEC members on the issue of the place of the district hospital in the lives and training of family physicians. The debate continues albeit with reduced intensity. Two strands appear to have emerged from this debate: i) Uncritical and over-whelming enthusiasm for the district hospital ii) A critical minority welcoming the district hospital but to proceed with caution in defense of the nascent independent status of primary health care physicians. Both strands appear to be agreed on one fundamental issue, i.e. the training of ..
Source: South African Family Practice 46 (2004)More Less
Extracted from text ... Scientific Letter SA Fam Pract 2004;46(3) 4 To the editor: Sore throat is a common problem encountered in the Family Medicine clinic at Kalafong hospital. Such patients are usually treated with penicillin as stipulated by the standard treatment guidelines of the National Department of Health for tonsillitis. 1 It is possible that patients are treated with antibiotics unnecessarily but it is well known that it may be difficult to accurately discriminate between bacterial and viral tonsillitis/ pharyngitis by only observing the throat and possible rash (as the above guidelines seem to suggest.) The tendency to prescribe antibiotics to most patients ..
Source: South African Family Practice 46, pp 5 –7 (2004)More Less
Despite Alma Ata in 1978, the developing countries continue to divert scarce resources to multiple-story tertiary hospitals at the expense of primary health care services. No country in the world has unlimited resources with regard to budget allocation for health care. Paradoxically, a number of advanced western countries are in the forefront with regard to budget allocations to primary care. <br>The continuing dominance of the biomedical/engineering model of health care which views the human body as a machine requiring regular servicing and fixing is the major stumbling block - hence the current suspicions and disequilibrium between the non-selective bio-psycho-social primary health care approach and biomedicine. Biomedicine, with the hospital as a bureaucratic organisation, remains the latent albatross over communities and legislators alike. Behavioural sciences, underpinned by the bio-psycho-social consultation model need to be introduced urgently in all medical school curriculums.
Source: South African Family Practice 46, pp 10 –20 (2004)More Less
<ul> <li>The diagnosis and treatment of common opportunistic infections influencing quality of life in HIV disease.</li> <li>The diagnosis and treatment of some life-threatening opportunistic infections in HIV disease.</li> <li>The management of the side effects of some of the drugs used.</li> </ul>
Source: South African Family Practice 46, pp 21 –26 (2004)More Less
There has been a lively debate in the media about working conditions in rural South African hospitals, with a particular focus on staffing and quality of care. From a medical perspective, it has been stated that poorly equipped and managed hospitals, inappropriate training and an excessive workload are significant contributors to the problem. This study was conducted to investigate the experiences of medical practitioners in performing their professional duties in rural district hospitals in the Western Cape. Twenty in-depth, free-attitude interviews were conducted. <br>Three major themes became apparent from the data, namely the importance of situational factors, knowledge and skills, and support structures. Two conceptual frameworks emerged from the themes that describe the impact of working conditions on the quality of care, and captured positive and negative factors influencing performance. This study provides evidence that substantial after-hour duties, an excessive workload and a perceived lack of management support impact negatively on doctors' views of working in district hospitals. Unless these are addressed, the problem of retaining medical staff in rural hospitals will continue, and equity of access to health services for rural communities will remain an unfulfilled obligation. Recommendations are made on how these issues can be addressed.
Source: South African Family Practice 46, pp 27 –32 (2004)More Less
<i>Background:</i> Recruitment and retention of medical staff are important issues in rural health. The aim of this study was to describe and understand the perceptions of women doctors working in rural hospitals in South Africa about their work. <br><i>Methods:</i> This was a descriptive study, using a qualitative methodology. Free attitude interviews were conducted with 14 women doctors. Themes were identified and tested against the data and comments from the research diary. <br><i>Results:</i> The main theme was balance. A rural woman doctor has to juggle different issues, including running the household and responsibilities at work. Other themes that were identified included the reason for working at a rural hospital, attitudes to rural life, opportunities for personal and professional growth, the feeling of being needed in a rural hospital, advantages and disadvantages for children and family, the impact of relationships on the rural woman doctor, issues regarding the environment and security, and that the proximity of home and work gives a rural woman doctor far more connection with her family. <br><i>Conclusions:</i> Some of the themes identified in this study agreed with international research, e.g. the importance of a job for the spouse, family considerations influencing the choice to specialise, and balancing responsibilities at home and work. The advantage of accommodation close to the hospital is a theme that has not been documented before. Based on the findings, recommendations are made to attract women doctors to rural areas.
Author Colin PfaffSource: South African Family Practice 46, pp 33 –34 (2004)More Less
Extracted from text ... Introduction Nepal is a fascinating country, famous for its mighty Himalayan peaks and ancient untouched cultures. In spite of its great beauty and attraction, Nepal remains one of the poorest countries in the world. As in many developing countries, most of the population lives in rural areas while most of the medical facilities and health professionals are found in the capital city. Although there are many rural hospitals scattered throughout the hills of Nepal, many function very poorly, suffering from shortage of staff, medicines and low quality of care. Some however have gained a reputation for offering good and appropriate ..
Ethical issues in family practice : informed consent - disclosure of information in clinical practice : review articleSource: South African Family Practice 46, pp 35 –37 (2004)More Less
Extracted from text ... SA Fam Pract 2004;46(3) 35 CPD Ethics Ogunbanjo GA, MBBS, MFGP (SA), M Fam Med, FACRRM, FACTM, FAFP (SA) Dept. of Family Medicine & Primary Health Care, Medical University of Southern Africa (Medunsa), Pretoria Knapp van Bogaert D, MBA (Kobe), Ph.D. (Kobe), M. Phil (Stell), D. Phil (Stell) Part-time senior lecturer , Biomedical Ethics - Dept. of Family Medicine & Primary Health Care, Medunsa and SARETI* Keywords: informed consent, clinical practice, ethical, disclosure (SA Fam Pract 2004;46(3): 35-37) Ethical Issues in Family Practice: Informed Consent - Disclosure of Information in Clinical Practice Introduction In this article we overview the concept ..
Author U. MennenSource: South African Family Practice 46 (2004)More Less
Extracted from text ... SA Fam Pract 2004;46(3) 38 Clinical skills "Bossing" of the second and third Carpo-Meta-Carpal joint Mennen U, MBChB, FRCS (Glasg), FRCS (Edin), FCS (SA) Orth., MMed (Orth), MD (Ort) Pret Head: Department Hand- and Microsurgery Medical University of Southern Africa, RSA (SA Fam Pract 2004;46(3): 38) Dear Colleague, Re: Your patient with a hard tender swelling on the dorsal aspect of his right hand Thank you for your referral of Mr. R G, a twenty-eight year old right-handed policemen who is a keen sportsman. He complains of pain in his right hand, which has been present for quite some time. ..
Author E.L. KokSource: South African Family Practice 46, pp 39 –42 (2004)More Less
Human sexuality can be defined as the ways in which people experience and express themselves as sexual beings. This would include their perception of themselves as male or female and their capacity for erotic experiences and responses. The lack of genital sensation through injury for instance or the fact that somebody does not engage in sexual intercourse or fantasy does not preclude him or her from being sexual. <br>Sexuality and the feelings associated with it do not start in adolescence and disappear at the age of retirement. It begins long before birth and continues up to the day a person dies. <br>The study of human sexuality draws on many disciplines. Biologists are interested in the physiological mechanisms of sexual arousal and response. Medical science informs us about sexually transmitted infections like HIV/AIDS and the organic bases of sexual dysfunctions. Psychologists study the effect of perception, learning, thought, motivation, emotion and personality on sexual behaviour and attitudes. Sociologists focus on the contexts of sexual behaviour pertaining to the relationships between sexual behaviour and religion, race and social class. Anthropologists concentrate on cross-cultural similarities and differences in sexual behaviour, while scientist from many disciplines look into possible parallels between the sexual behaviour of humans and other animals.