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African Health Sciences Mar 2024It may be necessary for healthcare professionals to refer patients to other professionals and institutions that are able to provide the care needed by patients,...
INTRODUCTION
It may be necessary for healthcare professionals to refer patients to other professionals and institutions that are able to provide the care needed by patients, depending on the severity each case presents, healthcare requirements, and resources available to offer care. In healthcare generally, patient referral is standard procedure; however, in South Africa, referral patterns between allopathic and traditional healthcare practitioners are unknown, and this is a problem yet to be addressed.
OBJECTIVES
The study objective was to explore patient referral practices from the perspectives of traditional healthcare practitioners of South Africa.
METHODS
A qualitative, exploratory and descriptive design was employed to collect data from 11 traditional healthcare practitioners who were sampled using snowball sampling. An individual semi structured interview schedule was used to collect data. Content analysis was used to analyze the data.
RESULTS
Patient referral was common practice in traditional health practices, however not reciprocal between the traditional and allopathic healthcare. Several indications for patient referral to allopathic healthcare practitioners included management of chronic conditions amongst others.
DISCUSSION
Patient referral being an important part of healthcare practices should be promoted and regulation and traditional health practices improved to promote safe referral practices and curb unsafe self-referrals by patients.
Topics: Humans; Referral and Consultation; South Africa; Medicine, African Traditional; Qualitative Research; Female; Male; Interviews as Topic; Adult; Health Personnel; Middle Aged
PubMed: 38962336
DOI: 10.4314/ahs.v24i1.31 -
African Health Sciences Mar 2024The School Feeding Programme if properly executed has the capacity to improve the nutritional status of the school children.
BACKGROUND
The School Feeding Programme if properly executed has the capacity to improve the nutritional status of the school children.
OBJECTIVE
To assess the nutritional status of school children in Ondo State Nigeria given that the National Home-Grown School Feeding Programme (NHGSFP) has been operational in the state for over five years.
METHODS
This was a descriptive cross-sectional study.
RESULTS
A total of 234 subjects from public schools and 227 subjects from private schools were enrolled in the study. Their mean age was 8.23 ± 1.92 years. Wasting, overweight, obesity, underweight, and stunting were noted in 19.4%, 11.4%, 0.4%, 5.0%, and 20.7% of the children, respectively. The prevalence of stunting (30.3%) and wasting (23.9%) was more among subjects from the public schools. A significant association was found between Weight-for-Age Z-score, Height-for-Age Z-score, and BMI-for-Age Z-score and the children's school type (p < 0.005).
CONCLUSION
Majority of the children showed normal growth, the rest were in both extremes of malnutrition, the subjects from private schools seem to present better nutritional status, although there is no baseline data to ratify this finding. A further study on this subject using the current finding as a baseline data is recommended.
Topics: Humans; Nutritional Status; Nigeria; Cross-Sectional Studies; Male; Female; Child; Schools; Prevalence; Thinness; Malnutrition; Growth Disorders; Child, Preschool; Food Services; Overweight; Body Mass Index
PubMed: 38962331
DOI: 10.4314/ahs.v24i1.29 -
African Health Sciences Mar 2024Women living with HIV/AIDS possess fertility desires similar to their uninfected counterparts, and with advances in health therapies, these women can realistically have...
BACKGROUND
Women living with HIV/AIDS possess fertility desires similar to their uninfected counterparts, and with advances in health therapies, these women can realistically have and raise uninfected children. Preconception care (PC) is a specialized form of intervention aimed at the prevention, identification, treatment, and management of biomedical, behavioural, and social conditions that militate against safe motherhood and the delivery of healthy offspring.
OBJECTIVE
The study aimed to assess preconception and contraceptive care among women living with HIV and attending Antiretroviral Therapy Clinics in Alimosho, Lagos State, Nigeria.
METHODS
This was a descriptive facility-based cross-sectional study of 383 women of reproductive age living with HIV/AIDS and attending ART clinics in the study area. Probability sampling methods were used in the selection procedures. Data were analyzed using descriptive statistics, Chi-square test, and univariate logistic regression at a 5% level of significance. Stratified and simple random sampling were used in the selection process.
RESULTS
Only 37.4% of respondents received optimal PC services. Being 20-29 years old [OR =1.716 (95% CI: 1.664, 1.769), = 0.020], being 30-39 years [OR =1.514 (95% CI: 0.598, 3.831), = 0.005], tertiary education [OR =8.43. (95% CI: 1.41, 18.5), = 0.020], and being single [OR =2.00 (95% CI: 1.928-2.072), = 0.002] were significantly related to the utilization of contraceptives.
CONCLUSION
There is a need to provide structure and guidelines for optimal streamlined PC and contraceptive services for women living with HIV/AIDS.
Topics: Humans; Female; Adult; Nigeria; Cross-Sectional Studies; HIV Infections; Young Adult; Preconception Care; Contraception; Adolescent; Family Planning Services; Contraception Behavior; Health Knowledge, Attitudes, Practice; Middle Aged
PubMed: 38962324
DOI: 10.4314/ahs.v24i1.5 -
Health SA = SA Gesondheid 2024The National Department of Health has different operational policies to monitor the performance of its employees and to reward them accordingly. These policies could...
BACKGROUND
The National Department of Health has different operational policies to monitor the performance of its employees and to reward them accordingly. These policies could have a direct bearing on job satisfaction and career advancement for radiographers employed by the public sector, as there are previous reports that show that these policies affect the job satisfaction of other healthcare professionals negatively.
AIM
The aim of the study was to explore the influence of government policies on the job satisfaction of radiographers employed by public tertiary hospitals in the Gauteng province.
SETTING
The study was conducted in two public tertiary hospitals in the Gauteng province.
METHODS
The study used a primary exploratory qualitative research design, with a purposive sampling technique. Data were collected through individual and focus group interviews. The researcher recorded and transcribed the interviews. Thematic analysis was used to analyse the data.
RESULTS
Three government policies had a negative impact on job satisfaction for radiographers. These were the Occupational Specific Dispensation (OSD), the Performance Management and Development System (PMDS) and the . The failure to effectively implement these policies also had a negative bearing on career pathing.
CONCLUSION
The implementation and structure of these three government policies have resulted in job dissatisfaction amongst radiographers employed by public tertiary hospitals and reduced the structure of career pathing.
CONTRIBUTION
The study highlighted three government policies that negatively affect job satisfaction in Gauteng.
PubMed: 38962294
DOI: 10.4102/hsag.v29i0.2502 -
Frontiers in Oncology 2024The management of soft tissue sarcomas presents considerable therapeutic challenges. This study was designed to assess the efficacy of neoadjuvant sequential...
Preoperative sequential chemotherapy and hypofractionated radiotherapy combined with comprehensive surgical resection for high-risk soft tissue sarcomas: a retrospective study.
INTRODUCTION
The management of soft tissue sarcomas presents considerable therapeutic challenges. This study was designed to assess the efficacy of neoadjuvant sequential chemotherapy and hypofractionated radiotherapy in conjunction with extensive surgical resection for the treatment of high-risk soft tissue sarcomas.
MATERIALS AND METHODS
We performed a retrospective review of 31 high-risk soft tissue sarcoma patients treated at our institution from June 2021 to June 2023. The cohort consisted of 21 males and 10 females with a mean age of 55.7 years and included both initial and recurrent disease presentations. Our treatment regimen comprised two to three cycles of neoadjuvant chemotherapy coupled with hypofractionated radiotherapy, delivered at 5 Gy per fraction to a total dose of 25-35 Gy across 5-7 days, prior to surgical resection aimed at achieving wide margins. Data collection was systematic, covering surgical outcomes, chemoradiotherapy-related complications, and prognostic factors.
RESULTS
All patients completed the prescribed course of neoadjuvant chemoradiotherapy. 29% patients experienced grade 3+ chemotherapy toxicity, necessitating a reduction or interruption in their chemotherapy regimen. Limb preservation was accomplished in 30 patients finally. Response evaluation using RECIST 1.1 criteria post-neoadjuvant therapy revealed 9.7% with PD, 58.1% with SD, 29% with a PR, and 3.2% with a CR, culminating in an ORR of 32.2%. Postoperative complications included superficial wound infections in four patients and deep incisional infections in another four. 6 patients had developed metastasis, and 3 patients were still alive. Two experienced local recurrence. One-year DFS was 79.3%, with a one-year OS rate of 89.6%.
CONCLUSION
Neoadjuvant sequential chemotherapy and hypofractionated radiotherapy followed by extensive surgical resection represents an effective treatment paradigm for high-risk soft tissue sarcomas. This multimodal approach not only facilitates tumor reduction but also significantly reduces the risks of local recurrence and distant metastasis.
PubMed: 38962275
DOI: 10.3389/fonc.2024.1423151 -
Data in Brief Jun 2024Monitoring ocean surface temperature is critical to infer the variability of the upper layers of the ocean, from short temporal scales to climatic change scales....
Monitoring ocean surface temperature is critical to infer the variability of the upper layers of the ocean, from short temporal scales to climatic change scales. Analysis of the climatological trends and anomalies is fundamental to comprehend the long-term effects of climate change on marine ecosystems and coastal regions. The original data for the dataset presented was collected by the Portuguese Hydrographic Institute () using seven Ondograph and Meteo-oceanography buoys anchored offshore along the Portuguese coast to acquire ocean surface temperatures. The original raw data was pre-processed to provide averages over 3-hour periods and daily averages, and this data constitutes the provided dataset. The 3-hour temperature averages were obtained mainly between 2011 and 2015, and the daily temperature averages were obtained in intervals that vary with the considered buoy, having an average interval of 14 years per buoy. The data gathered provides a considerable temporal window, enabling the creation of data series and the implementation of data mining algorithms to develop decision support systems. Collecting data makes it possible to validate simulated results obtained using approximation models. This allows for more accurate temperature readings and facilitates testing and correcting created models.
PubMed: 38962202
DOI: 10.1016/j.dib.2024.110287 -
Pulmonary Circulation Jul 2024Children with pulmonary hypertension (PH) often demonstrate limited exercise capacity. Data support exercise as an effective nonpharmacologic intervention among adults...
Children with pulmonary hypertension (PH) often demonstrate limited exercise capacity. Data support exercise as an effective nonpharmacologic intervention among adults with PH. However, data on exercise training in children and adolescents are limited, and characteristics of the optimal exercise program in pediatric PH have not been identified. Exercise programs may have multiple targets, including muscle deficits which are associated with exercise limitations in both adult and pediatric PH. Wearable accelerometer sensors measure physical activity volume and intensity in the naturalistic setting and can facilitate near continuous data transfer and bidirectional communication between patients and the study team when paired with informatics tools during exercise interventions. To address the knowledge gaps in exercise training in pediatric PH, we designed a prospective, single arm, nonrandomized pilot study to determine feasibility and preliminary estimates of efficacy of a 16-week home exercise intervention, targeting lower extremity muscle mass and enriched by wearable mobile health technology. The exercIse Training in pulmONary hypertEnsion (iTONE) trial includes (1) semistructured exercise prescriptions tailored to the participant's baseline level of activity and access to resources; (2) interval goal setting fostering self-efficacy; (3) real time monitoring of activity via wearable devices; (4) a digital platform enabling communication and feedback between participant and study team; (5) multiple avenues to assess participant safety. This pilot intervention will provide information on the digital infrastructure needed to conduct home-based exercise interventions in PH and will generate important preliminary data on the effect of exercise interventions in youth with chronic cardiorespiratory conditions to power larger studies in the future.
PubMed: 38962181
DOI: 10.1002/pul2.12402 -
Jamba (Potchefstroom, South Africa) 2024The eMalahleni Local Municipality (eLM) in Mpumalanga province, South Africa, has a number of informal settlements because of the influx of people seeking employment in...
UNLABELLED
The eMalahleni Local Municipality (eLM) in Mpumalanga province, South Africa, has a number of informal settlements because of the influx of people seeking employment in the municipal area. These informal settlements are exposed to a number of hazards, including underground fires, air and water pollution, sinkholes, abandoned mining areas and acid mining drainage. South Africa's National Development Plan (NDP) incorporates the United Nation's Sustainable Development Goals, which are intended to upgrade informal settlements on suitable land. The Department of Human Settlement recognised the gap in the policy because upgrading only included physical structures and did not include adaptive capacity for communities to create resilience to withstand disasters. The researcher used a case study research design for the inquiry intended to recommend adaptive capacity and reduce disaster risks in informal settlements in the eLM. Purposive sampling was used to select 25 participants from eLM, provincial government departments and informal settlements. The data were analysed using thematic analysis based on the study's conceptual framework. The research findings revealed that the government has not done much to involve vulnerable communities during the development of policies to reduce disaster risks within informal settlements. In particular, the failure of the government to promote and reinforce public participation in disaster risk reduction programmes leaves the vulnerable communities defenceless.
CONTRIBUTION
This study strengthens the intergovernmental structures and public participation to reduce disaster risks in communities. This study discourages a silos mentality and encourages coordination between government departments to identify root causes by applying the pressure and release model for effective disaster risk reduction.
PubMed: 38962164
DOI: 10.4102/jamba.v16i1.1488 -
Frontiers in Microbiology 2024Cytomegalovirus reactivation (CMVr) and bloodstream infections (BSI) are the most common infectious complications in patients after allogeneic haematopoietic stem cell...
Reactivation of cytomegalovirus and bloodstream infection and its impact on early survival after allogeneic haematopoietic stem cell transplantation: a multicentre retrospective study.
Cytomegalovirus reactivation (CMVr) and bloodstream infections (BSI) are the most common infectious complications in patients after allogeneic haematopoietic stem cell transplantation (allo-HSCT). Both are associated with great high morbidity whilst the BSI is the leading cause of mortality. This retrospective study evaluated the incidence of CMVr and BSI, identified associated risk factors, assessed their impact on survival in allo-HSCT recipients during the first 100 days after transplantation. The study comprised 500 allo-HSCT recipients who were CMV DNA-negative and CMV IgG-positive before allo-HSCT. Amongst them, 400 developed CMVr and 75 experienced BSI within 100 days after allo-HSCT. Multivariate regression revealed that graft failure and acute graft-versus-host disease were significant risk factors for poor prognosis, whereas CMVr or BSI alone were not. Amongst all 500 patients, 56 (14%) developed both CMVr and BSI in the 100 days after HSCT, showing significantly reduced 6-month overall survival ( = 0.003) and long-term survival ( = 0.002). Specifically, in the initial post-transplant phase (within 60 days), BSI significantly elevate mortality risk, However, patients who survive BSI during this critical period subsequently experience a lower mortality risk. Nevertheless, the presence of CMVr in patients with BSI considerably diminishes their long-term survival prospects. This study provides real-world data on the impact of CMVr and BSI following transplantation on survival, particularly in regions such as China, where the prevalence of CMV IgG-positivity is high. The findings underscore the necessity for devising and executing focused prevention and early management strategies for CMVr and BSI to enhance outcomes for allo-HSCT recipients.
PubMed: 38962143
DOI: 10.3389/fmicb.2024.1405652 -
Frontiers in Microbiology 2024The COVID-19 pandemic caused by SARS-CoV-2 has led to a wide range of clinical presentations, with respiratory symptoms being common. However, emerging evidence suggests...
The COVID-19 pandemic caused by SARS-CoV-2 has led to a wide range of clinical presentations, with respiratory symptoms being common. However, emerging evidence suggests that the gastrointestinal (GI) tract is also affected, with angiotensin-converting enzyme 2, a key receptor for SARS-CoV-2, abundantly expressed in the ileum and colon. The virus has been detected in GI tissues and fecal samples, even in cases with negative results of the reverse transcription polymerase chain reaction in the respiratory tract. GI symptoms have been associated with an increased risk of ICU admission and mortality. The gut microbiome, a complex ecosystem of around 40 trillion bacteria, plays a crucial role in immunological and metabolic pathways. Dysbiosis of the gut microbiota, characterized by a loss of beneficial microbes and decreased microbial diversity, has been observed in COVID-19 patients, potentially contributing to disease severity. We conducted a comprehensive gut microbiome study in 204 hospitalized COVID-19 patients using both shallow and deep shotgun sequencing methods. We aimed to track microbiota composition changes induced by hospitalization, link these alterations to clinical procedures (antibiotics administration) and outcomes (ICU referral, survival), and assess the predictive potential of the gut microbiome for COVID-19 prognosis. Shallow shotgun sequencing was evaluated as a cost-effective diagnostic alternative for clinical settings. Our study demonstrated the diverse effects of various combinations of clinical parameters, microbiome profiles, and patient metadata on the precision of outcome prognostication in patients. It indicates that microbiological data possesses greater reliability in forecasting patient outcomes when contrasted with clinical data or metadata. Furthermore, we established that shallow shotgun sequencing presents a viable and cost-effective diagnostic alternative to deep sequencing within clinical environments.
PubMed: 38962119
DOI: 10.3389/fmicb.2024.1342749