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Search Results: 1 - 10 of 189904 matches for " G Joubert "
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Profile of Research Methodology and Statistics Training of Undergraduate Medical Students at South African Universities
J Dommisse, G Joubert
South African Family Practice , 2009,
Abstract: Background: Medical practitioners need to have knowledge of statistics and research principles, especially with the increasing emphasis on evidence-based medicine. The aim of this study was to determine the profile of research methodology and statistics training of undergraduate medical students at South African universities in terms of which topics are taught, by whom teaching is done, when these topics are taught and how they are taught. Method: Respondents for this descriptive study were persons responsible for the teaching of statistics and research methodology at the eight medical schools in South Africa. They were identified by the head of each school who also gave permission for the school to participate. The respondents completed a questionnaire and checklist after giving informed consent. No response was obtained from one university. Responses were compared to international guidelines. Results: At five universities the material is taught in the first year, at one in the second year and one in the third or fourth year, depending on when it is selected as an elective. The material is reinforced in other modules in the medical programme at three universities. The persons responsible for teaching are mainly statisticians (six universities). Class sizes vary from 40 to 320 students with four universities having 200 or more students per class. At two universities the current course has been in place since 2003, at two since 2000, and at two since the 1970/80s. The following topics are taught at the majority of universities: study designs in medical research, exploring and presenting data, summarising data, probability, sampling, statistical inference, analysis of cross tabulation and critical reading. At four universities there are practical classes, three of these mainly for computer work. At three universities tutors are used, at two of these the tutors are postgraduate students in statistics whereas at one university registrars, doctors and researchers are used as tutors. Students at three of the universities complete a research project, at two of these the students complete the full research process from planning up to reporting, whereas the project at the other university focuses mainly on the analysis of data. Conclusion: Recommendations have been made regarding topics which should be covered and teaching methods which should be used at all universities. Doctors should be involved in the training to ensure clinically appropriate material and examples.
A survey of nurses’ basic life support knowledge and training at a tertiary hospital
M Keenan, G Lamacraft, G Joubert
African Journal of Health Professions Education , 2009,
Abstract: Objective: Survival after cardiac arrest is related to time taken for resuscitation, and defibrillation, to commence. At many hospitals, the healthcare worker most likely to be present when a patient suffers a cardiac arrest is a nurse. This study was performed to assess BLS knowledge and training of nurses, and thus to determine whether further action is required to improve their BLS competency. Method: The study was a cross-sectional survey. A questionnaire was distributed, on one day, to nurses in the wards, out-patient-departments and theatres. Completion of the form was voluntary and confidential. The forms were all returned that day. Results: Questionnaires were completed by 338 of the 405 nursing personnel on duty that day (83.4% response rate). Administrators and student nurses were excluded as well as incomplete questionnaires , leaving a final sample size of 286 nurses. A pass mark of 80% was achieved by 11% of responders. Training in BLS had been available for 77.5% of nurses and of these 93.1% had attended a course, 60.9% within the last year. Training in the use of a defibrillator had not been received by 32% of nurses and there was generally a poor understanding of the significance of defibrillation in resuscitation. Conclusion: Despite a relatively good rate of attendance at recent BLS courses, over a fifth of nurses remain without any BLS training. In addition few nurses have retained the BLS knowledge required for competency. Action is needed to ensure all nurses receive BLS training and practice this skill regularly.
Antimicrobial resistance patterns in outpatient urinary tract infections – the constant need to revise prescribing habits
FJ Bosch, C van Vuuren, G Joubert
South African Medical Journal , 2011,
Abstract: Background. There is a global emergence of resistance against commonly prescribed antibiotics. Empirical antibiotic prescribing should be guided by local antimicrobial susceptibility patterns. Aim. To identify organisms and determine antibiotic susceptibility in urinary tract infections (UTIs) at 3 Military Hospital, Bloemfontein. Methods. All urine samples collected during 2008 were analysed. The first positive urine culture per patient collected from the casualty, gynaecology, internal medicine and surgical outpatient departments were included. Only adult patients (>12 years old) were included. Prior use of antibiotics and underlying conditions were determined from electronic and paper-based patient and pharmacy records. Results. Positive cultures (N=65) were divided into uncomplicated (N=28) and complicated (N=37) UTIs. Escherichia coli (E. coli) was the most common uropathogen in uncomplicated (75%) and complicated (59%) UTIs. In uncomplicated UTIs, trimethoprimsulfamethoxazole (TMP-SMX) (54%) and amoxicillin (46%) had the highest rates of resistance. Nitrofurantoin and ciprofloxacin had sensitivity rates of 89%. Co-amoxiclav was most commonly prescribed (36%). In complicated UTIs, TMP-SMX (68%) and amoxicillin (65%) had the highest resistance rates, followed by ciprofloxacin (41%). Nitrofurantoin had a sensitivity rate of 73%. Ciprofloxacin was prescribed most often (35%). All E. coli UTI isolates were sensitive to nitrofurantoin. Conclusion. E. coli remains the most common uropathogen. TMPSMX and amoxicillin are of no value in this population with UTIs. Uncomplicated UTIs can be treated effectively with nitrofurantoin; this will lead to cost savings and sparing quinolones as a class of antibiotics known to induce resistance. In this setting, ciprofloxacin should not be used empirically for complicated UTIs.
Use of traditional medicine versus use of the community-based primary health care clinic by the San community at Platfontein
GF De Jager, EAM Prinsloo, G Joubert
South African Family Practice , 2010,
Abstract: Introduction: Working amongst a San community led to the observation that, despite the availability of modern healthcare, high mortality and morbidity associated with disease, such as dehydration, malnutrition and tuberculosis, still prevailed. This study aimed to determine how traditional beliefs and customs influenced the utilisation of Western medicine. Methods: An observational-descriptive study was conducted. Consenting patients, facilitated by interpreters, completed questionnaires during consultations conducted by nurses and the principal investigator at the Platfontein primary health care (PHC) clinic. Results: Of the 113 participants, two-thirds were female. The median age was 40 years; 56.7% lacked formal education; 42.5% conversed only in their native tongue. The initial use of the PHC facility was high (71.4%), even though 37% of the participants visited a traditional healer in the preceding year. Circumcision was the condition for which traditional healers were consulted most commonly (28.8%). Conditions preferably requiring clinic visitation were coughing (51.4%), pain (35.1%) and diarrhoea (34.2%). Of the participants leading mostly a traditional lifestyle (n = 48), 30.6 % indicated that they did not use traditional medicine or healers; 72.9% indicated that illness could be caused by a spell. Of the participants not leading a traditional lifestyle (n = 41), 85.4% indicated that they did not use traditional medicine; 41.4% indicated that illness could be caused by a spell. Conclusion: The assumption that the mortality and morbidity observed for certain conditions were due to the preference for traditional medicine in this community could not be confirmed. Doctors working amongst isolated communities or in multicultural environments, however, should recognise that traditional medicine still plays a role in the health care of their patients.
University of the Free State medical students’ view of at-risk drinking behaviour and psychoactive substance use
P Smit, PJ Pretorius, G Joubert
South African Journal of Psychiatry , 2009,
Abstract: Objectives. To investigate undergraduate medical students’ knowledge of at-risk drinking behaviour and their own patterns of alcohol intake. The use of non-alcoholic psychoactive substances was also investigated. Design. A cross-sectional study design was used. Participants completed a self-administered anonymous questionnaire designed using the US Department of Health and Human Services guidelines for identifying at-risk drinking. Setting. The School of Medicine, University of the Free State, Bloemfontein. Subjects. Participants included first-, fourth- and fifth-year medical students enrolled in 2006. Results. Of 408 questionnaires, 371 (90.9%) were returned. Of students who repeated an academic year, 10% ascribed it to substance use. The majority of students conservatively estimated the maximum daily and weekly safe levels of alcohol consumption for both men and women as notably lower than set by the guidelines. Nevertheless, 32% of students admitted to alcohol intake exceeding these limits, and 55.3% were identified as at-risk drinkers. Marijuana was the most common non-alcoholic substance used by medical students (14.6%) in the preceding 3 years. Alcohol and other substances were most frequently used during social activities with friends. Conclusions. Both medical students’ knowledge of levels of alcohol intake associated with increased risks and their own drinking patterns could potentially influence their approach to patients with alcohol-related problems. Education regarding at-risk drinking behaviour therefore needs to be addressed.
Multidisciplinary Training to Undergraduate Students in the Faculty of Health Sciences: Hypertension as a Case Study
H Dippenaar, L Grobler, G Joubert
South African Family Practice , 2008,
Abstract: Background: Healthcare students should be aware of the specific skills, knowledge and management options of other disciplines in order to achieve an effective and cohesive working relationship. Aim: The aim of this study was to expose healthcare students at the University of the Free State to one another\'s domains, as related to hypertension management, during a formal didactic lecture attended by medical, physiotherapy and dietetic students, and to determine whether they could apply in practice the theoretical knowledge regarding blood pressure measurement and exercise, obtained during a multidisciplinary session. The perceptions of students regarding multidisciplinary sessions were also to be obtained. Method: Students received a formal lecture on hypertension from a medical doctor, a dietitian, a physiotherapist and an occupational therapist and they then worked in multidisciplinary groups to demonstrate the physiological effect of exercise on blood pressure and pulse rate. Students had to report their findings and perceptions of the session by completing data forms. Results: A total of 125 medical, physiotherapy and human nutrition students participated in the session. The students were able to demonstrate the influence of exercise on blood pressure and pulse measurements. They reported that they enjoyed the multidisciplinary session and gained information on the scope of practice of the domains of the other disciplines. Negative feedback was received on the size of the groups and lack of equipment. Conclusion: The students could apply theoretical knowledge in practice and all gave positive feedback. The sessions will continue in the current format but attention will be given to smaller groups and the availability of more equipment. South African Journal of Family Practice Vol. 50 (4) 2008: pp. 70a-70b
Cerebral aneurysms – an audit
DJ Louw, C de Vries, G Joubert
South African Journal of Radiology , 2004,
Abstract: We performed an audit to determine the profile of cerebral aneurysms at the Universitas Hospital Bloemfontein, the only government hospital with a vascular suite in the Free State and Northern Cape area. Two hundred and twenty-three government patients, diagnosed with cerebral aneurysms during the period 1 January 2000 to 31 December 2003, were included in the study. Of the 223 patients, 37.2% were male and 62.8% female. The patients’ average age was 45.5 years (range 11 - 78 years).Most patients (61.4%) were older than 40 years. The average age for males and females was 41.4 and 46.3 years, respectively, with the females being significantly older (95% CI: 1.7 - 8.2). Most patients had single aneurysms (65.5%). More females (42.9%) had multiple aneurysms compared with the males (20.5%) (95% CI females - males: 9.9 - 33.7%). Of the patients 40 years and younger, 22.1% had multiple aneurysms compared with 42.3% of the patients older than 40 years (95% CI: 7.8 - 31.7%). In our audit the females (when compared with the males) had a clear preponderance for cerebral aneurysms, were significantly older, and had a significant increase in multiplicity with an increase in age.
House-dust mite species in Bloemfontein, South Africa
W Sinclair, L Coetzee, G Joubert
South African Medical Journal , 2010,
Abstract: House-dust mites (HDMs) are an important source of allergens that are reputed to act as a trigger for atopic disease. Climatic conditions in parts of South Africa are not suitable for their proliferation, and there is doubt whether they occur on the Highveld. We studied whether HDMs occur in homes in Bloemfontein, Free State. Methods. Ten houses were sampled over a 1-year period. Dust was collected monthly or quarterly from a mattress, a bedroom floor and the living room floor of each house and examined for the presence of HDMs. Climate data were collected during the same period and a questionnaire was completed by home-owners to gather data on indoor factors that could influence mite proliferation. Results. HDMs were regularly found in 3 houses (30%). Dermatophagoides farinae was the dominant species (97.5%). The highest numbers were found in winter, when climatic conditions were the least favourable. Climatic conditions never met the requirements for active proliferation of the mites. Indoor factors that may have promoted mite proliferation in some houses were artificial heating (especially under-floor heating), en-suite bathrooms and lack of adequate ventilation during the winter months. Conclusion. HDMs do occur in central South Africa, owing to a microclimate created indoors. Adequate ventilation, to reduce indoor humidity, should suffice to reduce mite numbers and prevent atopic symptoms induced by them.
Practices of Primary Caretaker of children aged 1-5 years before attending Peri-Urban and Urban clinics in Thaba Nchu
SIN Yiga, G Joubert, LA Hiemstra
South African Family Practice , 2002,
Abstract: Background: The basic philosophy of Primary Health Care (PHC) is self-reliance and community participation. In South Africa PHC is free, and there is a perception that the service is misused. Before embarking on health promotion and health education campaigns to foster self-reliance, it is necessary to determine the current self-care practices of community members. Methods: This descriptive study was conducted among caretakers of sick or injured children aged between 1 and 5 years, attending peri-urban and urban clinics in Thaba Nchu, Free State Province, South Africa. Clinics were grouped according to their service hours, and a random sample of clinics was chosen. For these clinics a random sample of days were selected. On these days one researcher (SINY) interviewed caretakers using a structured questionnaire. Nursing staff at the clinics served as translators where necessary. Results: Of the 151 respondents, the majority was female (90.1%) and the child's mother (74.2%). Approximately half (51%) had completed standard 8 or higher. The majority (79.5%) had sought advice from a relative or neighbour for the illness in question. In 80.8%, the respondents were advised to go to the clinic. The median duration of illness before taking the child to the clinic was 3 days. Cough was the major presenting complaint in 66.9% of the children. At the clinic the majority of the children (78.8%) received treatment with no follow-up. Conclusion: In most cases advice was sought before going to the clinic. There are ample opportunities for patient education, which should be extended to include other family members. Self-care needs to be encouraged and facilitated. SA Fam Prac Vol.25(1) 2002: 9-13
Obstetrical ultrasound training of and practise by general practitioners in the private sector, Free State
S Foulkes, G Joubert, LA Hiemstra
South African Family Practice , 2004,
Abstract: Background: The aim of the study was to determine the level of obstetrical ultrasound training and practice of general practitioners in the Free State private sector. Methods: In this descriptive study, questionnaires were mailed to all general practitioners in the Free State private sector. The questionnaire included demographic information about the practitioner, the ultrasound profile of the practice, and the type of machine used. Results: Four hundred and eighty-one questionnaires were sent to general practitioners and 229 (47.6%) were returned. Of the 176 practising respondents, 47 (26.8%) used ultrasound. The majority of ultrasound examinations done per month were obstetrical. Eight practitioners had relevant qualifications for using ultrasound and more than a third (18, 38.3%) had no training in ultrasound use. Less than half (19, 40.4%) of the practitioners that use ultrasound were aware of the South African Association of Ultrasound in Obstetrics and Gynaecology (SASUOG). Conclusions: The response to the questionnaire was low and may have influenced the results. The study indicates that there are general practitioners who perform ultrasound examinations without training. As general practitioners mainly do obstetrical ultrasound, it is recommended that the SASUOG play a bigger role in their training. A diploma course in ultrasound and support from medical aid organisations to only pay full fees to doctors who can prove that they have sufficient ultrasound training and competence will be ideal. For full text, click here:SA Family Pract 2004,46(6): 25-27
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