scholarly journals Treatment advantage in HBV/HIV coinfection compared to HBV monoinfection in a South African cohort

2019 ◽  
Author(s):  
Tongai G Maponga ◽  
Anna L McNaughton ◽  
Marije Van Schalkwyk ◽  
Susan Hugo ◽  
Chikezie Nwankwo ◽  
...  
Keyword(s):  
South Africa ◽  
Antiviral Therapy ◽  
Clinical Care ◽  
Antiviral Treatment ◽  
Laboratory Data ◽  
University Hospital ◽  
Cross Sectional ◽  
Hiv Coinfection ◽  
Liver Health ◽  
The Impact

ABSTRACTObjectivePrompted by international targets for elimination of hepatitis B virus (HBV) infection, we performed a cross-sectional observational study of adults with chronic HBV (CHB) infection in South Africa, characterising individuals with HBV monoinfection vs. those coinfected with HBV/HIV, to evaluate the impact of therapy and to guide improvements in clinical care as guidelines for antiviral therapy change over time.DesignWe prospectively recruited 115 adults with CHB, over a period of one year at a university hospital in Cape Town, South Africa. HIV coinfection was present in 39 (34%) subjects. We recorded cross-sectional demographic, clinical and laboratory data.ResultsAdults with HBV monoinfection were comparable to those with HBV/HIV coinfection in terms of age, sex and body mass. HBeAg-positive status was more common among those with HIV coinfection (p=0.01). However, compared to HBV/HIV coinfection, HBV monoinfected patients were less likely to have had assessment with elastography (p<0.0001) and less likely to be on antiviral treatment (p<0.0001). The HBV monoinfected group was more likely to have detectable HBV viraemia (p=0.04), and features suggesting underlying liver disease including moderate/severe thrombocytopaenia (p=0.007), elevated bilirubin (p=0.004), and APRI score >2 (p=0.02). Three cases of hepatocellular carcinoma were documented, all in patients with HBV monoinfection.ConclusionIn this setting, individuals with HBV monoinfection are disadvantaged in terms of clinical assessment and appropriate antiviral therapy compared to those with HIV coinfection, associated with relatively worse liver health. Enhanced advocacy, education, resources and infrastructure are required to optimise interventions for CHB.

scholarly journals In-hospital mortality in COVID-19 vs. pre-COVID-19 era in the Split-Dalmatia County, Croatia

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
I Marasovic Šušnjara
Keyword(s):  
Hospital Mortality ◽  
Respiratory Diseases ◽  
Score Test ◽  
Additional Research ◽  
University Hospital ◽  
Complete Picture ◽  
Cross Sectional ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
The Impact

Abstract Background The COVID-19 pandemic marked 2020 with numerous consequences for the health of the population. Therefore, this study aimed to explore whether the COVID-19 pandemic affected in-hospital mortality. Methods We employed a cross-sectional comparative study using two different time periods, pre-COVID-19 (2019 year) and COVID-19 era (2020 year) to explore possibilities of COVID-19 influences in-hospital mortality in Split-Dalmatia County, Croatia. The research used data from the national information system on hospitalizations from the Clinical Hospital Center Split, University Hospital Split. The indicators were statistically analyzed. The z-score test for two population proportions is used. Results In 2020, there was a significantly higher in-hospital mortality compared to 2019 (z = 9.0827; p &lt; 0.00001), which was supported by a significant increase in mortality from respiratory diseases according to the comparison of disease categories of International Statistical Classification of Diseases and Related Health Problems (ICD-10) (z = 9.0427; p &lt; 0.00001). Within hospital departments, significantly higher mortality was in the Intensive Care Unit (z = 5.2763; p &lt; 0.00001) and the Infectious Diseases Department (z = 9.6982; p &lt; 0.00001). Among deaths in 2020 with confirmed COVID-19, there were significantly more positive among deaths from respiratory diseases (z=-17.4462; p &lt; 0.00001). There was no difference in mortality rates between 2020 and 2019 by age. Conclusions The results of the study indicate that COVID-19 has a contribution to hospital mortality. Given that the pandemic has not yet completed additional research, it will be necessary to obtain a more complete picture of the impact of COVID-19 on hospital mortality in Split-Dalmatia County, as well as in other regions and countries. Key messages The results of the study indicate that COVID-19 has a contribution to hospital mortality. Given that the pandemic has not yet completed additional research, it will be necessary to obtain a more complete picture of the impact of COVID-19 on hospital mortality.

scholarly journals SASS: South African Simulation Survey – a review of simulation-based education

2019 ◽  
pp. 12-20
Author(s):  
R Swart ◽  
R Duys ◽  
ND Hauser
Keyword(s):  
South Africa ◽  
South African ◽  
Undergraduate Students ◽  
Online Survey ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool ◽  
South African Society ◽  
Simulation Based ◽  
The Impact

Background: Simulation-based education (SBE) has been shown to be an effective and reproducible learning tool. SBE is used widely internationally. The current state of SBE in South Africa is unknown. To the best of our knowledge this is the first survey that describes the use and attitudes towards SBE within South Africa. Methods: An online survey tool was distributed by email to: i) the South African Society of Anaesthesiologists (SASA) members; and ii) known simulation education providers in South Africa. The respondents were grouped into anaesthesia and non-anaesthesia participants. Descriptive statistics were used to analyse the data. Ethics approval was obtained: HREC REF 157/2017. Results: The majority of the respondents provide SBE and integrate it into formal teaching programmes. There is a will amongst respondents to grow SBE in South Africa, with it being recognised as a valuable educational tool. The user groups mainly targeted by SBE, were undergraduate students, medical interns, registrars and nurses. Learning objectives targeted include practical skills, medical knowledge, critical thinking and integrated management. Amongst anaesthesia respondents: the tool most commonly used to assess the quality of learner performance during SBE, for summative assessment, was ‘expert opinion’ (33%); the most frequent methods of evaluating SBE quality were participant feedback (42%) and peer evaluation (22%); the impact of SBE was most frequently assessed by informal discussion (42%) and learner feedback (39%). In anaesthesia SBE largely takes place within dedicated simulation facilities on site (47%). Most respondents report access to a range of SBE equipment. The main reported barriers to SBE were: finance, lack of trained educators, lack of equipment and lack of protected time. A limited number of respondents report engaging in SBE research. There is a willingness in both anaesthesia and non-anaesthesia groups (96% and 89% respectively) to collaborate with other centres. Conclusion: To the best of our knowledge this publication provides us with the first cross-sectional survey of SBE in anaesthesia and a selection of non-anaesthetic respondents within South Africa. The majority of respondents indicate that SBE is a valuable education tool. A number of barriers have been identified that limit the growth of SBE within South Africa. It is hoped that with a commitment to ongoing SBE research and evaluation, SBE can be grown in South Africa.

scholarly journals The impact of Temporal Artery Biopsy for the diagnosis of Giant Cell Arteritis in clinical practice in a tertiary University Hospital

2019 ◽  
Author(s):  
E Kaltsonoudis ◽  
E Pelechas ◽  
A Papoudou-Bai ◽  
E.T. Markatseli ◽  
M Elisaf ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Laboratory Data ◽  
Unknown Origin ◽  
Temporal Artery ◽  
University Hospital ◽  
Temporal Artery Biopsy ◽  
Acute Phase Reactants ◽  
Anemia Of Chronic Disease ◽  
The Impact

ABSTRACTBackgroundTemporal artery biopsy (TAB) is useful in assisting with giant cell arteritis (GCA) diagnosis but lacks sensitivity. The aim of our study was to assess the diagnostic impact of TAB histology in patients with suspected GCA on hospital admission.MethodsA prospectively maintained database was queried for all TABs performed between 1-1-2000 until 31-12-2017 at the University Hospital of Ioannina. Thus, inclusion criteria were made on the grounds of every patient that underwent a TAB during the above-mentioned period, regardless of demographic, clinical and laboratory data.ResultsTwo hundred forty-five TABs were included (149 females and 96 males), with a mean age of 64.5 (±3.5) years. The mean symptoms duration until admission to the hospital was 8.6 (±1.3) weeks and all had elevated acute phase reactants on admission. The reasons of admission were fever of unknown origin (FUO) in 114 (46.5%) patients, symptoms of polymyalgia rheumatica (PMR) in 84 (34.3%), new headache in 33 (13.5%), anemia of chronic disease (ACD) in 8 (3.32%) and eye disturbances in 6 (2.5%) patients. Positive results were found in 49 (20%) TABs. More specifically, in 14% of patients with FUO, 21% in those with PMR, while in patients with a new headache the percentage was 27%. Finally, 5 out of 6 (83.3%) of patients with ocular symptoms and only one (12.5%) of those suffering from ACD. Visual manifestations and FUO are correlated with a positive TAB.ConclusionIt seems that TAB is useful in assisting with GCA diagnosis, but lacks sensitivity.

scholarly journals Women's birth beliefs and associated factors in an obstetrics clinic in the Southeastern Anatolian Region of Turkey

2020 ◽  
Vol 34 (4) ◽  
pp. 345-351
Author(s):  
Figen Alp Yilmaz ◽  
Yeter Durgun Ozan
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Healthcare Personnel ◽  
Delivery Mode ◽  
Cross Sectional ◽  
Content Type ◽  
Pregnancy And Delivery ◽  
Consultation Services ◽  
The Impact

PurposeThe impact of birth beliefs on pregnancy and delivery are universally recognized, but the factors that affect birth beliefs vary across regions depending on individual and cultural characteristics. This study aimed to determine women's birth beliefs and examine their associated factors.Design/methodology/approachThis cross-sectional study was conducted with 548 primiparas in the obstetrics clinic of a university hospital located in the Southeastern Anatolian Region of Turkey from February to June 2019. Descriptive characteristics, form and the Birth Beliefs Scale were used in data collection. To analyze the data, descriptive statistics, T-tests and ANOVA analyses were used.FindingsIt was determined that factors such as age group, income level, any problems during pregnancy and preferred delivery mode statistically affected women's birth beliefs.Originality/valueBased on the findings from this study, healthcare personnel should provide training and consultation services to pregnant women starting from the prenatal period to help ensure a positive labor experience.

scholarly journals Quality of Life in Patients with Psoriasis Seen in the Department of Dermatology, Antananarivo, Madagascar

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fandresena Arilala Sendrasoa ◽  
Naina Harinjara Razanakoto ◽  
Volatantely Ratovonjanahary ◽  
Onivola Raharolahy ◽  
Irina Mamisoa Ranaivo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Young Patients ◽  
The Body ◽  
University Hospital ◽  
Medical Decision ◽  
Cross Sectional ◽  
The Difference ◽  
The Impact

Background. Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. Objective. To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. Methods. A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. Results. 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002). Conclusion. Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

scholarly journals Quality of life in swallowing of the elderly patients affected by stroke

2017 ◽  
Vol 54 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Émerson Soares PONTES ◽  
Ana Karênina de Freitas Jordão do AMARAL ◽  
Flávia Luiza Costa do RÊGO ◽  
Elma Heitmann Mares AZEVEDO ◽  
Priscila Oliveira Costa SILVA
Keyword(s):  
Quality Of Life ◽  
Life Quality ◽  
Public Health Problem ◽  
The Elderly ◽  
University Hospital ◽  
Feeding Time ◽  
Cross Sectional ◽  
Significance Level ◽  
The Impact

ABSTRACT BACKGROUND The elderly population faces many difficulties as a result of the aging process. Conceptualize and evaluate their life quality is a challenge, being hard to characterize the impact on daily activities and on functional capacity. The stroke is one of the most disabling neurological diseases, becoming a public health problem. As an aggravating result, there is dysphagia, a disorder that compromises the progression of the food from the mouth to the stomach, causing clinical complications to the individual. OBJECTIVE Characterize the life quality of the elderly swallowing affected by stroke. METHODS Cross-sectional study conducted at the University Hospital, attended by 35 elderly with stroke, being 19 women and 16 men, with age between 60 and 90 years old, that self-reported satisfactory overall clinical picture. It was applied the Quality of Life Swallowing protocol. The data were statistically analyzed, by means of ANOVA tests, Spearman correlation, t test, with significance level of 5%. RESULTS The mean age was 69.5 years; as for the scores obtained by the 35 participants in the 11 domains of the protocol, it was observed a change in score indicating severe to moderate impact in quality of life related to self-reported swallowing (31.8% to 59.5%); the domain that most interfered was the feeding time (31.8%). CONCLUSION Elderly affected by stroke that present dysphagia has low scores in quality of life related to swallowing.

Social enterprises and organizational learning in South Africa

2018 ◽  
Vol 10 (1) ◽  
pp. 117-133 ◽  
Author(s):  
Boris Urban ◽  
Elena Gaffurini
Keyword(s):  
South Africa ◽  
Organizational Learning ◽  
Social Innovation ◽  
Emerging Market ◽  
Cross Sectional Study ◽  
Social Enterprises ◽  
African Countries ◽  
Cross Sectional ◽  
Content Type ◽  
The Impact

Purpose The purpose of this study is to determine the relationship between different dimensions of organizational learning capabilities (OLC) and levels of social innovation in social enterprises. Design/methodology/approach The empirical strategy adopted is a cross-sectional study based on primary survey data. Following a survey of social enterprises in South Africa, statistically analysis is conducted using regression analyses to test the study hypotheses. Findings The findings show that the OLC dimensions of knowledge conversion, risk management, organizational dialogue and participative decision-making all have a significant and positive relationship with social innovation. Research limitations/implications In many emerging economies, the notion of organizational learning appears to have considerable potential relevance, particularly as African countries are moving toward knowledge-based economies. By focusing on OLC, it is anticipated that social enterprises can configure and leverage the different factors in ways that enable them to overcome the constraints of the complex and unpredictable environments and increase their levels of social innovation. Originality/value The paper provides a pioneering empirical investigation into the impact that OLC has on levels of social innovation, in an under-researched emerging market context.

How social stigma sustains the HIV treatment gap for MSM in Mpumalanga, South Africa

2017 ◽  
Vol 26 (4) ◽  
pp. 6-13 ◽  
Author(s):  
Kabelo Maleke ◽  
Joseph Daniels ◽  
Tim Lane ◽  
Helen Struthers ◽  
James McIntyre ◽  
...  
Keyword(s):  
South Africa ◽  
Social Stigma ◽  
Clinical Care ◽  
Traditional Healers ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Care Seeking ◽  
Mpumalanga Province ◽  
Sex With Men ◽  
The Impact

There are gaps in HIV care for men who have sex with men (MSM) in African settings, and HIV social stigma plays a significant role in sustaining these gaps. We conducted a three-year research project with 49 HIV-positive MSM in two districts in Mpumalanga Province, South Africa, to understand the factors that inform HIV care seeking behaviors. Semi-structured focus group discussions and interviews were conducted in IsiZulu, SiSwati, and some code-switching into English, and these were audio-recorded, transcribed, and translated into English. We used a constant comparison approach to analyze these data. HIV social stigma centered around gossip that sustained self-diagnosis and delayed clinical care with decisions to use traditional healers to mitigate the impact of gossip on their lives. More collaboration models are needed between traditional healers and health professionals to support the global goals for HIV testing and treatment.

scholarly journals Comorbidity and Healthcare Expenditure in Women with Osteoporosis Living in the Basque Country (Spain)

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Roberto Nuño-Solinis ◽  
Carolina Rodríguez-Pereira ◽  
Edurne Alonso-Morán ◽  
Juan F. Orueta
Keyword(s):  
Healthcare Cost ◽  
Healthcare Expenditure ◽  
Basque Country ◽  
Clinical Care ◽  
Population Group ◽  
Deprivation Level ◽  
Chronic Patients ◽  
Cross Sectional ◽  
One Year ◽  
The Impact

Objectives.This study aimed to establish the prevalence of multimorbidity in women diagnosed with osteoporosis and to report it by deprivation index. The characteristics of comorbidity in osteoporotic women are compared to the general female chronic population, and the impact on healthcare expenditure of this population group is estimated.Methods.A cross-sectional analysis that included all Basque Country women aged 45 years and over (N= 579,575) was performed. Sociodemographic, diagnostic, and healthcare cost data were extracted from electronic databases for a one-year period. Chronic conditions were identified from their diagnoses and prescriptions. The existence of two or more chronic diseases out of a list of 47 was defined as multimorbidity.Results.9.12% of women presented osteoporosis and 85.04% of them were multimorbid. Although multimorbidity in osteoporosis increased with age and deprivation level, prevalence was higher in the better-off groups. Women with osteoporosis had greater risk of having other musculoskeletal disorders but less risk of having diabetes (RR = 0.65) than chronic patients without osteoporosis. People with poorer socioeconomic status had higher healthcare cost.Conclusions.Most women with osteoporosis have multimorbidity. The variety of conditions emphasises the complexity of clinical management in this group and the importance of maintaining a generalist and multidisciplinary approach to their clinical care.

Nursing Perception of the Impact of Medication Carts on Patient Safety and Ergonomics in a Teaching Health Care Center

2012 ◽  
Vol 26 (2) ◽  
pp. 131-137 ◽  
Author(s):  
Élise Rochais ◽  
Suzanne Atkinson ◽  
Jean-François Bussières
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Focus Group ◽  
Point Of Care ◽  
Care Center ◽  
Drug Distribution ◽  
University Hospital ◽  
Cross Sectional ◽  
Health Care Center ◽  
The Impact

Objectives: In our Quebec (Canada) University Hospital Center, 68 medication carts have been implemented as part of a nationally funded project on drug distribution technologies. There are limited data published about the impact of medication carts in point-of-care units. Our main objective was to assess nursing staff’s perception and satisfaction of medication carts on patient safety and ergonomics. Method: Quantitative and qualitative cross-sectional study. Data were gathered from a printed questionnaire administered to nurses and an organized focus group composed of nurses and pharmacists. Results: A total of 195 nurses completed the questionnaire. Eighty percent of the nurses agreed that medication carts made health care staff’s work easier and 64% agreed that it helped to reduce medication incidents/accidents. Only 27% and 43% agreed that carts’ location reduces the risk of patients’ interruptions and colleagues’ interruptions, respectively. A total of 17 suggestions were extracted from the focus group (n = 7 nurses; n = 3 pharmacist) and will be implemented in the next year. Conclusions: This descriptive study confirms the positive perception and satisfaction of nurses exposed to medication carts. However, interruptions are a major concern and source of dissatisfaction. The focus group has revealed many issues which will be improved.

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