Abstract

9^TH ANNUAL PAIN SYMPOSIUM: Saturday, 3 June 2017 hosted by the Department of Family Medicine  at the University of Pretoria (Accredited for 6 + 2 Ethics CPD points)

Dear All,

Just a reminder to register for the 9^th Annual Pain Symposium on Saturday, 3^rd June 2017 (see attached programme). We have had an excellent response to our first invitation and we currently have more than 100 confirmed registrations. We have ± 2 months to go to the Symposium and we again expect a “full-house”.

Please book early to avoid disappointment. We have an excellent list of speakers and all have confirmed their participation. Please note that Velocity Vision has been appointed as Symposium organizers and all registration and other related communication can be done with them as follows:

Please fax the registration form to Janice Candlish (Administrator / Conference Organiser). Contact details: Tel: 011 894 1278 | Fax: 086 724 9360 | unipta@velocityvision.co.za For on-line registration please: CLICK HERE Enquiries: Prof Helgard Meyer: 012 373 1096 (Doris). Please note that the “early bird” registration fee of R950.00 closing date will be 30 April 2017.

Best regards and we hope to see you at our 2017 Annual Pain Symposium on Saturday 3 June 2017.

Prof Helgard Meyer, Department of Family Medicine, University of Pretoria

Abstract

Stumbling blocks remain to effective testing of how the National Health Insurance will work at pilot sites.  Teething problems at provincial health departments, including a lack of co-ordination, poor planning and uncertainty in districts, remain stumbling blocks to the effective testing of how the National Health Insurance (NHI) will work at pilot sites.

The dire state of affairs was detailed in a Financial and Fiscal Commission presentation to Parliament’s portfolio committee on health and the standing committee on appropriations.

In 2015, Health Minister Aaron Motsoaledi introduced the NHI white paper. In February, the government announced that it would set up an NHI fund even though the white paper is considered a work in progress…..more

Preamble

This award is in the spirit of Atai’s leadership in family medicine in Africa, inspired by her dedication to the advancement of women physicians and women’s health in family medicine, and in tribute to Atai’s exceptional courage, selflessness, and commitment to her patients with Ebola both in Uganda and Liberia. She pioneered the establishment of family medicine program at Makerere University, Uganda and   was head of the family medicine department, Makerere University from 2004 to 2011. Atai was an executive member of the Wonca Working Party on Women and Family Medicine and was the recipient of Wonca 2016 Global Five Star Doctor Award in recognition of her extraordinary service as a family medicine leader over many years, her service to the people of Uganda, and her recent extraordinary leadership tackling the Ebola crisis in West Africa. Atai passed away in May, 2016.

Focus: The aim of the award is to support opportunities for African women doctors whose economic circumstances limit their ability to attend WONCA biennial conferences, particularly those women in their early career. The candidate for the Atai Omoruto Award should be an African woman family physician or family medicine resident in Africa, who demonstrates significant contributions in Africa, in any the following areas:

• Leadership in Family Medicine at the institutional, local, or national level
• Commitment to the advancement of women in family medicine
• Clinical courage and selflessness in providing care to the most vulnerable populations

Process: A Potential candidate should submit:

• a two-page essay stating how her attendance at the relevant conference (in the first instance, the WONCA Africa regional meeting in August 2017, including the WONCA Working Party on Women and Family Medicine preconference immediately before the regional meeting) will contribute to her ability to advance her work in some or all of the above three areas of achievement demonstrated by Atai

.      Evidence of need for funding in order to attend

• a letter of support from a family physician familiar with her work
• a curriculum vitae

Desirable: Evidence of high level achievement for those applicants in early career stages; evidence of work with disadvantaged peoples; breadth of activity within family medicine (e.g. teaching / research); prior involvement with WONCA activities.

Submission of Application: Application package should be submitted to Kerry Pert: rcs.executiveassistant@anu.edu.au

Application closing date: June 1, 2017

Clinical effects of cardiovascular risk scores in people without cardiovascular disease

Review question

What is the evidence about the potential clinical benefits and harms of providing cardiovascular disease (CVD) risk scores in people without a history of heart disease or stroke?

Background

Cardiovascular disease (CVD) is a group of conditions that includes heart disease and stroke. CVD prevention guidelines emphasise the use of risk scores, equations that use clinical variables to estimate the chance of a first heart attack or stroke, to guide treatment decisions in the general population. While there has been much attention to developing different types of CVD risk scores, there is uncertainty about the effects of providing a CVD risk score in clinical practice.

The aim of this systematic review was to assess the effects of evaluating CVD risk scores in adults without a history of heart disease or stroke on cardiovascular outcomes, risk factor levels, preventive medication prescribing, and health behaviours.

Study characteristics

We searched scientific databases for randomised trials (clinical studies that randomly put people into different treatment groups) that systematically provided CVD risk scores or usual care to adults without a history of heart disease or stroke. The evidence is current to March 2016. Funding for the majority of trials came from government sources or pharmaceutical companies.

Key results

We identified 41 trials that included 194,035 participants. Many of the studies had limitations. Low-quality evidence suggests that providing CVD risk scores had little or no effect on the number of people who develop heart disease or stroke. Providing CVD risk scores may reduce CVD risk factor levels (like cholesterol, blood pressure, and multivariable CVD risk) by a small amount and may increase cholesterol-lowering and blood pressure-lowering medication prescribing in higher risk people. Providing CVD risk scores may reduce harms, but the results were imprecise.

Quality of the evidence

There is low-quality evidence to guide the use of CVD risk scores in clinical practice. Studies had multiple limitations and used different methods to provide CVD risk scores. It is likely that further research will influence these results.

More

Manhattan is packed with towers, but the city still has height restrictions in various neighborhoods.

As a way to get around these mandates, New York firm Clouds Architecture Office has proposed an outlandish skyscraper that would hang from cables attached to an asteroid. Since the tower wouldn’t touch the ground, the designers say it would bypass maximum height restrictions. (Regardless, it’s doubtful the city has considered zoning laws for a floating building.)

Called the Analemma Tower, it would be the world’s tallest building — though, of course, there are no plans to construct it. Ostap Rudakevych tells Business Insider that the firm created the design to imagine what could be possible in the future…..more

Medical concepts and language can be complex. People need easily understandable health information regardless of age, background or reading level. MedlinePlus offers guidelines and resources to help you create easy-to-read health materials.

What are easy-to-read (ETR) materials?

ETR materials are written for audiences who have difficulty reading or understanding information. These materials can also benefit people who prefer reading easy-to-read information.

How do you create easy-to-read materials?

Writing ETR materials involves several important steps:

• Plan and Research
• Organize and Write
• Evaluate and Improve
• Inform Us and Stay Informed

Step 1: Plan and Research….more

CITATION: Ferri CP, Jacob KS (2017) Dementia in low-income and middle-income countries: Different realities mandate tailored solutions. PLoS Med 14(3): e1002271. doi:10.1371/journal.pmed.1002271

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002271

‘The ageing of populations is the most significant social transformation of the 21st century [1] and has highlighted the importance of age-related conditions such as dementia, which has been recognised across regions, countries, and cultures. The number of people living with dementia has been increasing and is estimated to reach 75 million worldwide by 2030, with the majority of these individuals living in low-income and middle-income countries (LMICs) [2]. The assessment, recognition, and care of people living with dementia in LMICs are complex issues. Dementia is often seen as part of the ageing process, and even when recognized, there still remain problems related to stigma, lack of resources for the adequate care of people with dementia (PWD), variations in the way the condition is assessed and perceived, and how it is addressed in noncommunicable disease (NCD) policies and prevention strategies…

‘Dementia is under-recognised, underdisclosed, undertreated, and undermanaged, particularly in LMICs…

‘A strategy of employing community health workers to identify mental illnesses in general and dementia in particular in resource-poor settings has been recommended [9]; however, it has been found that this strategy leads to a very high false positive rate. The reasons for this rate include the fact that disorders with low prevalence at the community level cannot be diagnosed accurately unless a referral system is in place…’

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare information – Join HIFA: www.hifa.org  

Warts are benign (not cancerous) skin growths that appear when a virus infects the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). You are more likely to get one of these viruses if you cut or damage your skin in some way.

Wart viruses are contagious. Warts can spread by contact with the wart or something that touched the wart.

Warts are often skin-colored and feel rough, but they can be dark (brown or gray-black), flat, and smooth. ….more

The College of Medicine, a constituent College of the University of Malawi, has academic staff vacancies in the departments under the School of Public Health and Family Medicine; and the faculty of Medicine. Applications are invited from suitably qualified candidates to fill the positions indicated below: See attached here advert University of Malawi

‘There is insufficient knowledge regarding dengue and chikungunya fever among community members and healthcare workers.’ This is the conclusion of a new paper from tanzania. Unfortunately, the paper is restricted-access, so many of us will never learn more than the abstract below.

Knowledge and Practice Regarding Dengue and Chikungunya: a cross sectional study among Healthcare Workers and Community in Northern Tanzania

Debora C. Kajeguka, Rachelle E. Desrochers, Rose Mwangi, Maseke R. Mgabo, Michael Alifrangis, Reginald A. Kavishe, Franklin W. Mosha and Manisha A. Kulkarni

DOI: 10.1111/tmi.12863

http://onlinelibrary.wiley.com/doi/10.1111/tmi.12863/full

ABSTRACT

Objective: To investigate knowledge and prevention practices regarding dengue and chikungunya amongst community members, as well as knowledge, treatment and diagnostic practices among healthcare workers.

Method: We conducted a cross-sectional survey with 125 community members and 125 healthcare workers from 13 health facilities in six villages in the Hai district of Tanzania. A knowledge score was generated based on participant responses to a structured questionnaire, with a score of 40 or higher (out of 80 and 50 total scores for community members and healthcare workers, respectively) indicating good knowledge. We conducted qualitative survey (n=40) to further assess knowledge and practice regarding dengue and chikungunya fever.

Results: 15.2% (n=19) of community members had good knowledge regarding dengue, whereas 53.6%, (n=67) of healthcare workers did. 20.3% (n=16) of participants from lowland areas and 6.5% (n=3) from highland areas had good knowledge of dengue (?2 = 4.25, p=0.03). Only 2.4% (n=3) of all participants had a good knowledge score for chikungunya. In the qualitative study, community members expressed uncertainty about dengue and chikungunya. Some healthcare workers thought that they were new diseases.

Conclusion: There is insufficient knowledge regarding dengue and chikungunya fever among community members and healthcare workers. Health promotion activities on these diseases based on Ecological Health Mode components to increase knowledge and improve preventive practices should be developed.

—

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare information – Join HIFA: www.hifa.org  

‘The 56-year-old inpatient is scared and worried. His physician has told him the swelling in his right calf that brought him to the hospital may be caused by an “agent” or “pathogen,” but he is confused. An “agent” sounds like a person, and a “pathogen” sounds like “psychopath.” When the physician returns with the diagnosis, cellulitis, and says it is an “inflammation of the skin and subcutaneous tissues,” the patient is further confused and flummoxed about deciding whether to stay in the hospital for antibiotic treatment or receive a prescription and rest at home…’

‘Only 12 percent of U.S. adults are highly proficient when it comes to health literacy, which is the capacity to understand and act on medical information…

‘Killian and Coletti [http://journalofethics.ama-assn.org/2017/03/pfor1-1703.html] argue that physicians should make use of the Health Literacy Universal Precautions Toolkit, published by the Agency for Healthcare Research and Quality (AHRQ), to protect patients’ dignity and autonomy, manage the legal risks of misunderstandings, comply with accrediting bodies’ regulations, and improve patient safety and health care outcomes…

‘AHRQ also advises that to communicate clearly, physicians should:

• Greet patients warmly. Receive everyone with a welcoming smile, and maintain a friendly attitude throughout the visit.
• Make eye contact. Make appropriate eye contact throughout the interaction.
• Listen carefully. Try not to interrupt patients when they are talking. Pay attention, and be responsive to the issues they raise and questions they ask.
• Use plain, nonmedical language. Don’t use medical words. Use common words that you would use to explain medical information to your friends or family, such as stomach or belly instead of abdomen
• Use the patient’s words. Take note of what words the patient uses to describe his or her illness and use them in your conversation.
• Slow down. Speak clearly and at a moderate pace.
• Limit and repeat content. Prioritize what needs to be discussed, and limit information to three to five key points and repeat them
• Be specific and concrete. Don’t use vague and subjective terms that can be interpreted in different ways.
• Show graphics. Draw pictures, use illustrations, or demonstrate with 3-D models. All pictures and models should be simple, designed to demonstrate only the important concepts, without detailed anatomy.
• Demonstrate how it’s done. Whether doing exercises or taking medicine, a demonstration of how to do something may be clearer than a verbal explanation.
• Invite patient participation. Encourage patients to ask questions and be involved in the conversation during visits and to be proactive in their health care…’

The full article is freely available here: https://wire.ama-assn.org/delivering-care/medspeak-can-shut-down-effective-communication-patients

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare information – Join HIFA: www.hifa.org  

This WHO resource on Monitoring and Evaluating Digital Health Interventions provides step-wise guidance to improve the quality and value of monitoring and evaluation (M&E) efforts in the context of digital health interventions, also commonly referred to as mHealth or eHealth interventions. This Guide is intended for implementers and researchers of digital health activities, as well as policy-makers seeking to understand the various stages and opportunities for systematically monitoring implementation fidelity and for evaluating the impact of digital health interventions. …more

‘Gauteng as a village of 100 people’, GCRO’s latest Urban Data Gallery application, is an interactive animation that presents Gauteng as if it only had 100 residents. Who are these people? What are their life circumstances? What are their beliefs and opinions on key issues?

The urban setting in our animation is reminiscent of Gauteng. The square is surrounded by buildings and scenes from around the Gauteng City-Region. The figures in the square suggest the gender and racial diversity of Gauteng in a non-‘representative’ manner. In this interactive realm, the 100 animated ‘villagers’ roam around and each represent 1% of the 30 000 respondents in GCRO’s Quality of Life IV (2015/16) survey. In this fun and informative visualisation, users can explore the answers to a series of questions from the 2015/16 survey through five interactive scenarios. Each scenario has five variables that a user can select. You can discover where people in Gauteng would prefer to live; how worried or happy they are; or even whether they think South Africa is a failed state or not. Click these or a host of other questions and your selection changes the way in which the 100 villagers cluster and interact with one another, reflecting the results from the Quality of Life survey. In other words, the villagers are proxies for the survey data, where you, the user, can choose what results are shown from a set of themes and questions….here

While more than 10.3-million households in South Africa, or 60.6%, have access to a flush toilet, more than 4.3 million households still rely on pit latrines. And at least 409,881 households have no sanitation whatsoever, according to Stats SA .

But a KwaZulu-Natal company, Sanitation Solutions, with branches in other provinces, has come up with a water-saving ceramic flushing toilet that could be the answer to sanitation problems in rural and peri-urban areas.

The Lali Loo derives its name from the Xhosa word ilali ,which means a village. The loo can be used where there is no sewerage infrastructure. ….more