South African Family Practice - Volume 46, Issue 8, 2004
Volume 46, Issue 8, 2004
Author Don O'MahonySource: South African Family Practice 46 (2004)More Less
Extracted from text ... Editorial Post-graduate training will be mandatory for doctors wanting to work as independent family physicians from 2009, 1 yet my impression is that most general/family practitioners in private practice (GPs) seem unaware of the training proposals and the fact that they can still influence their formulation. The process for family medicine specialty training was initiated by FaMEC (South Africa's Family Medicine Education Consortium), assisted by ICHO (the interuniversitary consortium for Family Medicine training, Flanders, Belgium).1 When Family Medicine was recognized as a Specialty in October 2003 by the Health Professions Council, the Medical and Dental Board tasked the General Practice ..
Author Sam FehrsenSource: South African Family Practice 46 (2004)More Less
Extracted from text ... SA Fam Pract 2004;46(8) 4 Training for Family Medicine To the Editor: In response to the editorial of De Villiers I wish to make some comments1. Being in agreement with most of his sentiments I wish to congratulate him and all those who worked so tenaciously to achieve the establishment of Family Medicine as a speciality. Two issues induce me to comment. He says we need to tackle, "what would be relevant training for Family Medicine (content, context, scope and duration).....". In my view the process and context of training are greater determinants of outcome than content, scope and duration. ..
Source: South African Family Practice 46, pp 5 –8 (2004)More Less
A key principle of family medicine is the management of resources. Human Resource Management (HRM) underpins other principles of family medicine. It is not only the doctor but also the staff around him or her who enables and responds to the patient experience. <br>South African private general practitioners struggle with staff management within an increasingly complex and regulated environment. Simple approaches, documents such as employment contracts and codes of conduct, and checklists highlighting statutory and best practise requirements can ensure good HRM. <br>People-centred HRM contributes to a patient-centred practice. It can also address skills and incapacity in a fair manner, keeping the practice within the law and partnering in social transformation and primary health care delivery.
Author A.T.O. Abdool-CarrimSource: South African Family Practice 46, pp 9 –12 (2004)More Less
Peripheral arterial disease (PAD) is a common disease. One in five of the middle-aged population of the United Kingdom has evidence of peripheral vascular disease on clinical examination, although only a quarter of these people have symptoms. PAD is a distinct atherothrombotic syndrome that is associated with an elevated risk of cardiovascular and cerebrovascular events, including death, myocardial infarction (MI) and stroke. In essence, PAD is an important manifestation of systemic atherosclerosis.
Four common infectious skin conditions : tinea corporis, pityriasis versicolor, scabies, larva migrans : review articleAuthor W.K. JacykSource: South African Family Practice 46, pp 13 –16 (2004)More Less
Four dermatological conditions, all with well-established pathogens, will be discussed in this article: tinea corporis (dermatophytic infection), pityriasis versicolor (an asymptomatic infection) caused by the yeast <i>(Pityrosporon orbiculare)</i> and two parasitic infestations, scabies and larva migrans.
Physical activity knowledge, attitudes and practices of the elderly in Bloemfontein old age homes : original researchSource: South African Family Practice 46, pp 17 –19 (2004)More Less
<i>Background:</i> The aim of this study was to describe physical activity knowledge, attitudes and practices of the elderly in Bloemfontein old age homes. <br><i>Methods:</i> Three hundred and ninety residents (65 years and older) from 11 Bloemfontein old age homes participated in the study. All participants gave informed oral consent before answering a structured questionnaire. <br><i>Results:</i> The participants had a good general knowledge of the influence of physical activity on life quality, but had less knowledge of the influence of exercise on cholesterol, diabetes and hypertension. Most of the participants (80.5%) enjoyed exercising and 60% had a positive attitude towards exercise. Most participants (62.8%) felt that they had not received enough information about physical activity from their doctor. Few participants (3.8%) took part in prescribed exercise programmes. <br><i>Conclusions:</i> The participants had a positive attitude towards physical activity, but lacked sufficient knowledge of the practice of physical fitness to be able to understand adequate physical fitness programmes. Elderly people who do not exercise because of a specific health problem may be motivated to exercise in a way that improves quality of life.
An unsuccessful resuscitation : the families' and doctors' experiences of the unexpected death of a patient : original researchSource: South African Family Practice 46, pp 20 –25 (2004)More Less
<i>Background:</i> The objective was to elicit families' experience of the death of a family member at the Elsies River Community Health Centre, their feelings towards the staff involved in the resuscitation and their opinions about how things could be improved. The study also elicited the doctors' experiences of communicating with the families of patients who had died in the emergency unit. <br><i>Methods:</i> This was a qualitative study, using free attitude interviews for family members and focus group discussions for doctors. Twelve family members whose loved ones had died in the emergency room and 15 doctors who worked in the emergency room were included. <br><i>Results:</i> Key themes were identified, relating to issues in the pre-resuscitation period, the resuscitation, breaking the bad news, after breaking the bad news and post-event sequelae. In the pre-resuscitation period, there were problems in admitting, identifying and responding to acutely ill patients. During the resuscitation, the families and staff disagreed about witnessing the resuscitation. Breaking the bad news was often difficult for the doctors and hindered by the physical environment. Afterwards, there were mixed feelings about the quality of emotional support, the use of medication and bereavement counselling. All agreed that viewing the body was helpful and funeral arrangements were not a problem. There was no effective follow-up of the families and the doctors also experienced increased stress following unsuccessful resuscitations. <br><i>Conclusion:</i> The study found that the role of security staff should be clarified and a better triage system established to enable critically ill patients to be seen promptly. Families should be given the option of viewing the resuscitation and always be kept informed of progress. Doctors need better training in communication skills and breaking bad news, which should be done in a private area. Families should also be given the opportunity to view the body. Families should be assisted with contacting the undertaker and a follow-up visit should be organised after the initial shock, when further questions can be asked and abnormal grief reactions identified. Bereavement counselling should be available and community-based resources should be identified in this regard. Debriefing should also be available for staff involved in unsuccessful resuscitations.
Source: South African Family Practice 46, pp 26 –27 (2004)More Less
<i>Background:</i> The purpose of the study was to determine the proportion of patients with bronchogenic carcinoma amenable to curative surgery at diagnosis. <br><i>Methods:</i> A retrospective approach was used in the setting of an academic hospital. The patients used for the study were all those presenting at the hospital over a two-year period (1999-2000) who were confirmed to have primary bronchogenic carcinoma. No interventions were undertaken. <br><i>Results:</i> Eighty-six (86) patients were confirmed with bronchogenic carcinoma during the study period. The mean age of the patients was 57.9 <u>+</u> 10.8 years. Eighty-five percent (85%) were current tobacco users. Ninety percent (90%) of the cancers were of the non-small cell variety. Only 15% of the patients were deemed suitable for curative surgery. The tumour histology, the sex of the patients and the duration of symptoms prior to presentation had no bearing on the probability of being suitable for curative surgery. Almost 40% of the patients had metastatic disease at presentation. <br><i>Conclusions:</i> The prognosis of bronchogenic carcinoma remains extremely grave. Tobacco use remains an important risk factor.
Bapong - an interactive experience about the meaning of child health and illness : rural health issuesAuthor Claire Van DeventerSource: South African Family Practice 46, pp 28 –29 (2004)More Less
Extracted from text ... SA Fam Pract 2004;46(8) 28 RHI RURAL HEALTH Initaitive The South African Academy of Family Practice's Rural Health Initiative (RHI) is proud to be able to bring you the following section of the journal, that will concentrate on issues pertaining to rural health in South Africa. We hope to provoke discussion on these issues and would encourage anyone interested in rural health to offer contributions to future issues. BAPONG - An interactive experience about the meaning of child health and illness Rural Health Issues Introduction "But mothers must continue breastfeeding for at least 3 years. If they are working they ..
Report on the 2nd International Executive Diploma Conference on HIV / AIDS Prevention : world congress reportAuthor I. GovenderSource: South African Family Practice 46 (2004)More Less
Extracted from text ... SA Fam Pract 2004;46(8) 30 World Congress Report I recently attended the International Diploma Conference on HIV and AIDS Prevention, held by the College of Venereal Disease Prevention of London. The course took place at the Falmer Campus Conference Centre of the Brighton University from the 23 to 27 August 2004. The course structure and content were very appropriate to a universal approach to HIV and AIDS prevention. I found the experiences of other delegates and what is happening in their respective countries very enlightening and educational. Delegates came from all parts of the world with most representatives from Africa ..
Author G.A. OgunbanjoSource: South African Family Practice 46 (2004)More Less
Extracted from text ... SA Fam Pract 2004;46(8) 31 Making Sense of Statistics Introduction A case-control study is an epidemiologic study that compares those with the disease (cases) with those without the disease (controls) in order to determine their frequency of past exposure to possible risk factors. In other words, this study design initially identifies the cases and controls and then collects information on exposure later. In case-control studies, the researcher can only investigate one disease at a time although many exposures to risk factors are simultaneously possible. When to use case-control studies? Ideally case-control studies are useful for studying rare diseases due to ..
Source: South African Family Practice 46 (2004)More Less
Extracted from text ... HYPERTENSION Measure BP in sitting position CDL - guidelines at a glance Chronic disease list algorithms The new Medical Schemes Act requires that chronic diseases be diagnosed and managed according to the prescribed therapeutic algorithms for the condition, published by the Minister of Health. Algorithms for the 25 conditions on the chronic disease list are available at http://www.medicalschemes.com . This algorithm is reproduced with the kind permission of the Council for Medical Schemes. Glossary: ? ?-blocker - Alpha-receptor blocker ? ACE inhibitor - Angiotensin converting enzyme inhibitor ? ARB - Angiotensin receptor blocker ? BP - Blood pressure ? ?-blocker ..
Author U. MennenSource: South African Family Practice 46 (2004)More Less
Extracted from text ... SA Fam Pract 2004;46(8) 36 CPD-Clinical skills Mennen U, MBChB, FRCS (Glasg), FRCS (Edin), FCS (SA) Orth., MMed (Orth), MD (Ort) Pret Emeritus Professor: Department of Hand and Microsurgery Medical University of Southern Africa, RSA (SA Fam Pract 2004;46(8): 36) Dear Colleague RE: Your patient with a painful elbow on the lateral side: lateral epicondelytis Thank you, for your referral of your patient Mr. R N a forty-five year old right handed researcher, whom for the last seven months complains of pain over the lateral epicondyle. He also experiences pain in the elbow joint. This pain radiates proximally and distally. ..
Author E. WassermanSource: South African Family Practice 46, pp 40 –42 (2004)More Less
Biological warfare has been a threat to society for many decades. This article summarises some of the most likely organisms suitable for a bio-terrorist attack, including Bacillus anthracis, Francisella tularensis, Yersinia pestis, the agents of viral haemorrhagic fevers, Variola virus and botulism toxin.