SOUTH African Health Minister Aaron Motsoaledi has distanced himself from a controversial proposal in the White Paper on National Health Insurance (NHI) to slash the benefits offered by medical schemes, saying the state should not limit patients’ choices. He has also dismissed the paper’s cost projections, saying NHI is a long term-project that should be financed on a programme-by-programme basis….more

With global infection rates of the Zika virus increasing rapidly, physicians should be prepared to handle possible cases of the virus and answer patients’ questions. No locally transmitted Zika virus cases have been reported in the continental United States, but cases have been confirmed in returning travelers. The AMA intends to update this resource center regularly to provide information to the public, physicians and other health care workers as they seek to learn more…more

‘Internationally, over the past decade in particular, an industry seems to have developed around CPG development, reporting, adoption, contextualization or adaptation, evaluation and implementation. The growing volume of evidence and the acronyms used in this field can be overwhelming, even for those involved.’

The paper below aims to ‘provide a guide describing common standards, methods and systems used in current international CPG activities and the various activities to produce and communicate them’. I have invited the authors to join us so that we can learn from their experience and expertise.

CITATION: Int J Qual Health Care. 2016 Jan 20. pii: mzv115

Guide to Clinical Practice Guidelines: The Current State of Play.

Kredo T, Bernhardsson S, Machingaidze S, Young T, Louw Q, Ochodo E, Grimmer K.

Full text: http://intqhc.oxfordjournals.org/content/early/2016/01/20/intqhc.mzv115.long

Author contact: tamara.kredo@mrc.ac.za

ABSTRACT

INTRODUCTION: Extensive research has been undertaken over the last 30 years on the methods underpinning clinical practice guidelines (CPGs), including their development, updating, reporting, tailoring for specific purposes, implementation and evaluation. This has resulted in an increasing number of terms, tools and acronyms. Over time, CPGs have shifted from opinion-based to evidence-informed, including increasingly sophisticated methodologies and implementation strategies, and thus keeping abreast of evolution in this field of research can be challenging.

METHODS: This article collates findings from an extensive document search, to provide a guide describing standards, methods and systems reported in the current CPG methodology and implementation literature. This guide is targeted at those working in health care quality and safety and responsible for either commissioning, researching or delivering health care. It is presented in a way that can be updated as the field expands.

CONCLUSION: CPG development and implementation have attracted the most international interest and activity, whilst CPG updating, adopting (with or without contextualization), adapting and impact evaluation are less well addressed.

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Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org

Previous research has suggested high rates of healthcare associated infections in Africa. This study from Ethiopia is a rare example that looks at knowledge and practice.

CITATION: Surg Res Pract. 2015;2015:736175. doi: 10.1155/2015/736175. Epub 2015 Dec 15.

Knowledge, Practice, and Associated Factors towards Prevention of Surgical Site Infection among Nurses Working in Amhara Regional State Referral Hospitals, Northwest Ethiopia.

Teshager FA, Engeda EH, Worku WZ.

Full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693022/

Contact: Eshetu Haileselassie Engeda: Email: moc.liamg@341tehse

ABSTRACT

Knowledge and practice of nurses about surgical site infections (SSIs) are not well studied in Ethiopia. This paper contains findings about Northwest Ethiopian nurses’ knowledge and practice regarding the prevention of SSIs. The main objective of the study was to assess knowledge, practice, and associated factors of nurses towards the prevention of SSIs. The study was done using a questionnaire survey on randomly selected 423 nurses who were working in referral hospitals during the study period. The study showed that more than half of the nurses who participated in the survey had inadequate knowledge about the prevention of SSIs. Moreover, more than half of them were practicing inappropriately. The most important associated factors include lack of training on evidence based guidelines and sociodemographic variables (age, year of service, educational status, etc.). Training of nurses with the up-to-date SSIs guidelines is recommended.

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Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org

CITATION: J Med Internet Res. 2016 Jan 19;18(1):e15. doi: 10.2196/jmir.5234.

Providing Doctors With High-Quality Information: An Updated Evaluation of Web-Based Point-of-Care Information Summaries.

Kwag KH, González-Lorenzo M, Banzi R, Bonovas S, Moja L.

Abstract

BACKGROUND: The complexity of modern practice requires health professionals to be active information-seekers.

OBJECTIVE: Our aim was to review the quality and progress of point-of-care information summaries-Web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. We aimed to evaluate product claims of being evidence-based.

METHODS: We updated our previous evaluations by searching Medline, Google, librarian association websites, and conference proceedings from August 2012 to December 2014. We included Web-based, regularly updated point-of-care information summaries with claims of being evidence-based. We extracted data on the general characteristics and content presentation of products, and we quantitatively assessed their breadth of disease coverage, editorial quality, and evidence-based methodology. We assessed potential relationships between these dimensions and compared them with our 2008 assessment.

RESULTS: We screened 58 products; 26 met our inclusion criteria. Nearly a quarter (6/26, 23%) were newly identified in 2014. We accessed and analyzed 23 products for content presentation and quantitative dimensions. Most summaries were developed by major publishers in the United States and the United Kingdom; no products derived from low- and middle-income countries. The main target audience remained physicians, although nurses and physiotherapists were increasingly represented. Best Practice, Dynamed, and UptoDate scored the highest across all dimensions. The majority of products did not excel across all dimensions: we found only a moderate positive correlation between editorial quality and evidence-based methodology (r=.41, P=.0496). However, all dimensions improved from 2008: editorial quality (P=.01), evidence-based methodology (P=.015), and volume of diseases and medical conditions (P<.001).

CONCLUSIONS: Medical and scientific publishers are investing substantial resources towards the development and maintenance of point-of-care summaries. The number of these products has increased since 2008 along with their quality. Best Practice, Dynamed, and UptoDate scored the highest across all dimensions, while others that were marketed as evidence-based were less reliable. Individuals and institutions should regularly assess the value of point-of-care summaries as their quality changes rapidly over time.

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Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org

Depression among the elderly is largely overlooked, but exercise can help to counter it.  Left! Clap! Right! Clap!” shouts a young woman dressed in an orange tracksuit. She stands in front of about 30 women, who follow her movements obediently to a regular beat, stepping from side to side with a chorus of echoing claps. “Now go down low!” calls the instructor over the noise in the cramped room. Giggling erupts as some women playfully protest. The instructor, a physiotherapy student at the University of the Witwatersrand, smiles broadly and says: “You’re old but you’re not dead! Come on!” ….more

THE government’s release on December 11 of the long-awaited white paper on National Health Insurance (NHI) was eagerly anticipated, but the event was largely overshadowed by the condemnation of President Jacob Zuma’s axing of Nhlanhla Nene as finance minister in the same week. Subsequent to the hasty reappointment of Pravin Gordhan as finance minister in a bid to stem the rand’s horrifying free fall, the rand has remained weaker than it was before, share values are also still lower and international ratings agencies have been moved to put out negative ratings watches on SA….more

Diabetes, the most common disorder of the endocrine (hormone) system, occurs when blood sugar levels in the body consistently stay above normal. It affects more than 25 million people in the U.S. alone. Diabetes is a disease brought on by either the body’s inability to makeinsulin (type 1 diabetes) or by the body not responding to the effects ofinsulin (type 2 diabetes). It can also appear during pregnancy. Insulin is one of the main hormones that regulates blood sugar levels and allows the body to use sugar (called glucose) for energy. Talk with your doctor about the different types of diabetes and your risk for this disease…..more and wider search

The National Health Insurance (NHI) will never come into being unless South Africa’s economy grows by 3.5% on average each year‚ AfriBusiness says…..more

Hundreds of Gauteng community health workers recently protested outside Gauteng Department of Health offices to demand stipend increases, annual leave and permanent employment……more

Released in December, this 56-page policy outlines the management of patient safety incidents, including the provision of feedback to patients, families and clinicians, as well as the sharing of lessons learned….more

Issued on 7 January, the Department of Health circular offers guidance to clinicians regarding the use of two-in-one combination antiretrovirals (ARV) following a change in ARV tendering….more

A QUARTER of a century after SA’s readmission to international cricket, a black African has scored a century for his country for the first time. Temba Bavuma’s sparkling unbeaten 102 against England at Newlands on Tuesday, the fourth day of the second test, was not expected. In his seven previous test innings he had scored just 145 runs, and in the first test in Durban he had thrown his wicket away. In the match situation on Tuesday, a sudden rash of wickets — Hashim Amla, Faf du Plessis and Quinton de Kock as the score went from 439 for three to 449 for six — could easily (and understandably) have been fatally infectious to Bavuma….more

THE African National Congress (ANC) anniversary statement ticked all the boxes but was lacklustre in inspiration, proceeding a economic crisis at the tail-end of 2015 and ahead of a crucial election mere months away. President Jacob Zuma delivered the ANC national executive committee’s anniversary statement in sweltering heat blazing down on some 60,000 supporters at the Royal Bafokeng Stadium in Rustenburg in the North West on Saturday….more

FOR future historians, I’m pretty sure the most memorable thing this year happened on Monday last week, December 21, when South African-born Elon Musk’s dream of a reusable rocket came true…..more

The 57-page strategy document focuses on six broad goals including preventing childhood obesity, enabling access to healthy food and promoting physical activity. At the centre of the strategy is a broad emphasis on communication, education and mobilization around growing obesity rates in the country. The document also notes a particular focus on preventing childhood obesity due to the profound impact obesity can have on childhood development……more

Can machines outperform doctors? Not yet. But in some areas of medicine, they can make the care doctors deliver better. Humans repeatedly fail where computers — or humans behaving a little bit more like computers — can help. Even doctors, some of the smartest and best-trained professionals, can be forgetful, fallible and prone to distraction. These statistics might be disquieting for anyone scheduled for surgery: One in about 100,000 operations is on the wrong body part. In one in 10,000, a foreign object — like a surgical tool — is accidentally left inside the body….more

She is black and trendy, and young South African girls are learning to love her. Meet Momppy Mpoppy, who is a step ahead of other black dolls across Africa who are often dressed in traditional ethnic clothes. Decked out in the latest fashions and sporting an impressive Afro, complete with a tiara, Momppy could play her own small part in changing the way that black children look at themselves. Maite Makgoba, founder of Childish Trading and Manufacturing, said she started her small business after realising that black dolls available on the market “did not appeal to children”…..more

In early 2015, clinical trials of a 1000 year-old Anglo-Saxon eye remedy established that it was almost 100% effective at wiping out the MRSA bacteria. The main ingredients of the remedy? Onion, garlic and wine. “We were blown away by just how effective the combination of ingredients was,” said Dr Freya Harrison of the University of Nottingham’s faculty of medicine and health sciences……more

We’ve finally been given government’s blue-print for how it plans to marry the private and public health sectors – the NHI White Paper. But many areas are fuzzy, particularly how it will persuade private doctors to work in a system that is likely to mean more work and less pay…..more