South African Family Practice最新文献

No abstract available.

Background: Allergic rhinitis (AR) has a significant impact on the community as a whole with regard to quality of life and its relationship to allergic multi-morbidities. Appropriate diagnosis, treatment and review of the efficacy of interventions can ameliorate these effects. Yet, the importance of AR is often overlooked, and appropriate therapy is neglected. The availability of effective medications and knowledge as to management are often lacking in both public and private health systems.

Methods: This review is based on a comprehensive literature search and detailed discussions by the South African Allergic Rhinitis Working Group (SAARWG).

Results: The working group provided up-to-date recommendations on the epidemiology, pathology, diagnosis and management of AR, appropriate to the South African setting.

Conclusion: Allergic rhinitis causes significant, often unappreciated, morbidity. It is a complex disease related to an inflammatory response to environmental allergens. Therapy involves education, evaluation of allergen sensitisation, pharmacological treatment, allergen immunotherapy (AIT) and evaluation of the success of interventions. Regular use of saline; the important role of intranasal corticosteroids, including those combined with topical antihistamines and reduction in the use of systemic steroids are key. Practitioners should have a thorough knowledge of associated morbidities and the need for specialist referral.Contribution: This review summarises the latest developments in the diagnosis and management of AR such that it is a resource that allows easy access for family practitioners and specialists alike.

Background: COVID-19 is an acute respiratory disease. Its morbidity and mortality in patients with comorbidities have been established. This study evaluated the knowledge, attitude and practices regarding COVID-19 of patients with comorbidities attending primary health care services.

Methods: An analytical cross-sectional study was conducted, with data collected from patients using a self-administered questionnaire. Knowledge, attitude and practice scores were calculated. Descriptive and inferential statistical analyses were used, and the level of significance was set at 5%.

Results: This study enrolled 469 participants aged 18-84 years, and the majority were women. The mean knowledge score was 7.09 ± 1.73 out of 9, the mean attitude score was 2.33 ± 0.86 out of 3, and the mean practices score was 3.79 ± 0.56 out of 4. There was a positive linear relationship between knowledge and attitude scores and between attitude and practices scores; as one score increased, the other also increased significantly.

Conclusion: The level of knowledge was good in general, with optimistic attitudes and good practices by the patients. Those aged 70 years and above need special attention because older persons have poorer knowledge of and practices towards COVID-19, which could lead to higher hospitalisation and mortality rates.Contribution: This study found that patients with chronic diseases had good COVID-19 knowledge, attitudes and practices, while interventions targeting patients aged 70 years and above are needed to improve their COVID-19 awareness and practices.

Background: Peer review frequently improves a manuscript, but authors may consider some reviewer feedback negative, inappropriate or unclear. This study aims to summarise and analyse review comments received by authors.

Methods: This longitudinal study included all submissions of which the researcher was an author, reviewed by any journal during 2020-2022. First-round reviews were retrieved from emails and documents received by the authors or the faculty's medical editors or the journal platforms. A confidential datasheet with review items compiled from literature and the researcher's experience as author and reviewer was completed for each submission. Review comments were noted verbatim for subjective items such as rude or vague statements.

Results: The 65 submissions received 118 reviews from 36 journals, mainly in the form of unstructured narrative reports (59%). The majority of first-round reviews (58%), including those for rejected submissions, contained some positive comments. Reviewers frequently (75% of reviews, 88% of submissions) required some expansion of information. Vague and incorrect statements occurred in 15% and 18% of reviews, respectively. Only two reviews contained statements that could be considered rude. The types of comments made were associated with the review format.

Conclusion: The majority of reviews contained some positive comments and rude comments were extremely rare. Reviewers frequently requested the expansion of information provided.Contribution: This study gives insight to authors, reviewers and editors regarding the type and tone of review comments. This could guide authors during manuscript preparation and authors, reviewers and editors during the review process.

Vitamin D is a fat-soluble molecule referring to the different isoforms, ergocalciferol (D2) and cholecalciferol (D3). Its physiological functions include increasing calcium serum concentrations. 25-hydroxyvitamin D3 (25(OH)D) (Calcifediol), a non-active, circulating instant precursor is seen as a pre-hormone. Studies have shown that a deficiency in calcifediol is related to chronic conditions such as cardiovascular, musculoskeletal, immune system, neurological, and anti-neoplastic functions. Vitamin D supplementation has shown its benefit as prophylaxis and treatment during the coronavirus disease 2019 (COVID-19) pandemic and an increase in the prescribing of vitamin D supplementation has been observed. The intention of this review article is to provide guidance on the recommended dosage regimen as a prophylactic measure during COVID-19 and its use as a supplement in general. From this review article, it is clear that vitamin D has an important role to play not only in COVID-19 but also in various other health aspects of the human body.Contribution: This review article highlighted the role of vitamin D in managing vitamin D deficiency and its role as a supplement in the management of respiratory tract infections, especially COVID-19. This overview can assist physicians in optimising healthcare by optimised dosing recommendations and indications.

Background: The purpose of this study was to assess the presence of occupational burnout among full-time employed doctors of all ranks at the Mankweng and Pietersburg tertiary academic hospitals in South Africa's Limpopo province.

Methods: A quantitative, observational study was conducted firstly to determine whether burnout was present among medical doctors at these institutions and, secondly, to quantify the amount of burnout in those affected. Data collection was done using structured questionnaires. All ranks of medical doctors from various departments participated in the study, resulting in a total sample size of 150.

Results: The study revealed that occupational burnout was present at these institutions, with an overall prevalence of 36%. When compared to other studies conducted at public sector hospitals in South Africa, this figure appears to fall within the middle range. However, different studies have used different criteria to measure burnout.

Conclusion: Currently, there is too much variation in the criteria of burnout among different studies, making comparisons difficult. More studies are needed to standardise the measurement of burnout.Contribution: The main contribution of the research is to understand the extent of burnout at the tertiary hospital in Limpopo province.

Background: Substance use is a major public health issue in South Africa. Cocktails, containing two or more low-quality substances, have been reported. Nyaope is one of the most popular and is widely available. It has a significant impact on users and communities. The aim of this study was to explore community members' perceptions of the potential contributors to Nyaope use and dependency.

Methods: This was an exploratory descriptive qualitative study that conducted three focus group interviews with 29 community members. A maximum variation sample was used. Data were analysed using the framework method, assisted by Atlas-ti.

Results: Seven main themes were identified, namely unfavourable home environments, distrust between community members and the local police, easy access to Nyaope at school, inadequate social services, lack of religious or spiritual drive, unfavourable community environments and the effects of Nyaope on users.

Conclusion: The factors identified, were used to construct an emerging model of how Nyaope use is driven in Tshwane. It is clear that a multisectoral response is required involving health and social services, basic education, policing and community leadership. Further research will explore the views of family members and users and quantify the importance of the factors identified.Contribution: This study showed that rather than a simple linear chain of events, Nyaope use is enabled by a complex system of interconnected elements. According to the respondents, variables in the community at large, the school, the home and the specific user all have a role in Nyaope usage and dependency.

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Climate change has been declared as the biggest threat to human health in the 21st century. Not all family doctors are aware of the threats and how to tackle them. There are three key aspects to consider: the health and social effects of climate change, the challenge of climate change to primary health care (PHC) facilities and services, and the contribution of health services to the problem of climate change. Climate change and global pollution are ecological drivers associated with significant health and social effects that are often seen in PHC services. These ecological drivers impact health and society via a number of proximate causes, such as air pollution and decreased food production. The health and social effects include malnutrition, infectious diseases, non-communicable diseases, displacement and migration, and mental health problems. Climate change-induced extreme weather events are associated with immediate loss of life and injuries, destruction of homes and livelihoods, and disruption of PHC facilities and services. For adapting to these challenges, the World Health Organization has developed an operational framework for a climate-resilient health system. The Global Green and Healthy Hospitals agenda provides practical guidance for mitigating the contribution of health services to climate change. This article uses these frameworks to suggest practical steps that family doctors can take in leading climate adaptation and mitigation within PHC.