Hinesreed9379

Purpose This qualitative study examined experiences and attitudes related to cancer-peer interactions among adolescent and young adult (AYA) cancer survivors. Methods Twenty-six survivors, aged 16-24 years who were diagnosed with cancer between the ages of 14 and 18, completed one-on-one semistructured interviews as part of a larger study. Interviews were coded and analyzed using an iterative consensus and data-driven approach. Results The data for this study revealed three main themes related to cancer peers, including the unique aspects of shared illness experience (i.e., personalizing of support from lived experience, inspiration from upward comparisons, space to be scared and to joke about cancer), benefits of providing support to other patients/survivors (i.e., giving back, healing after cancer, and incorporating cancer into life as a survivor), and considerations and concerns when connecting with cancer peers (i.e., exposure to adverse outcomes, "ignorance is bliss" blocking cancer out, guilt and cancer imposter syndrome). Conclusion Study findings demonstrate the importance of cancer-peer connection and support in AYA cancer care, both during treatment and in survivorship. Future research should explore the ways in which peer-to-peer support programs could be tailored to best serve the AYA population in the context of cancer care.

Climate change presents an unprecedented and urgent threat to human health and survival. South Africa's health response will require a strong and effective intersectoral organisational effort.

Exploratory interview outcomes are used to advance practice and policy recommendations, as well as for broad input in the development of a draft national framework for a health risk and vulnerability assessment (RVA) for national departments.

Nationally in South Africa.

Twenty key expert interviews were conducted with South African experts in the field of climate change and health. Interview data was analysed by means of thematic content analysis.

Findings suggest that previously poor communities are most at risk to the impacts of climate change on health, as well as those with underlying medical conditions. Climate change may also serve as a catalyst for improving the healthcare system overall and should serve as the conduit to do so. A draft climate change and health RVA should take into account existing frameworks and should be implemented by local government. It is also critical that the health and health system impacts from climate change are well understood, especially in light of the plans to implement the (South African) National Health Insurance (NHI) scheme.

Practice and policy initiatives should be holistic in nature. Consideration should be given to forming a South African National Department of Climate Change, or a similar coordinating body between the various national departments in South Africa, as health intercepts with all other domains within the climate change field.

Practice and policy initiatives should be holistic in nature. Consideration should be given to forming a South African National Department of Climate Change, or a similar coordinating body between the various national departments in South Africa, as health intercepts with all other domains within the climate change field.

Clinical associates (ClinAs) were introduced into South Africa as part of the remedy for the severe shortage of healthcare workers in rural areas. Walter Sisulu University (WSU) graduated 100 ClinAs between 2011 and 2014. These ClinAs were expected to be based at district hospitals where they would work under the supervision of doctors, reduce the workload of doctors and increase access to healthcare in the Eastern Cape.

This study aimed to examine the role played by ClinAs in healthcare delivery in Eastern Cape district hospitals, and to determine whether the training of ClinAs adequately prepared them for this role.

The study was conducted in the Eastern Cape province of South Africa amongst ClinAs who graduated from WSU between 2011 and 2014, and healthcare workers from Madzikane KaZulu Memorial Hospital.

This was an exploratory cross-sectional mixed methods study with a convergent design. Surveys and in-depth interviews were conducted amongst ClinAs, nurses, doctors and one pharmacist. Both qualitative and quantitative data were analysed and reported.

Clinical associates are seen to improve the workload of doctors, and to increase access to healthcare. Thirty-four percent of ClinAs were no longer contributing to healthcare in the Eastern Cape.

Clinical associates are making a significant contribution to access to healthcare in the Eastern Cape. Their supervision regimen needs to be revisited and factors that contribute to the attrition of ClinAs in the Eastern Cape need to be addressed.

Clinical associates are making a significant contribution to access to healthcare in the Eastern Cape. Their supervision regimen needs to be revisited and factors that contribute to the attrition of ClinAs in the Eastern Cape need to be addressed.

The demand for long-term care facilities (LTCFs) amongst older people in South Africa (SA) is growing and there is insufficient information on the profile and healthcare needs of this population.

This study was conducted to describe the demographic and clinical characteristics of residents in LTFCs in SA.

Three LTCFs in eThekwini district.

A cross-sectional design was used to collect data from a purposive sample of 102 (N= 204) residents. A structured questionnaire was used to collect demographic and clinical data. The data were entered into Microsoft Excel and analysed descriptively and inferentially using R version 3.5.1 software.

The majority of the residents (59.8%) were between 65 and 80 years (78.9 ± 8.1 years) and 74.5% were women. The residents were white people (91.1%), SA born (82.4%) and widowed (54.9%). English was the primary language (91.1%), with the majority being christian (52.0%). Some residents had a university education, were previously employed and are financially independent. Nical conditions, each suffering from at least three clinical conditions. Hypertension (63.7%), high cholesterol (53.9%), arthritis (38.2%), depression (37.3%) were the most prevalent clinical conditions recorded amongst the residents. Most residents were assessed to be intermediately frail, at risk of malnutrition and had mild depression as based on the respective mean frailty-, nutrition-, and geriatric depression scores.Conc lusion Residents in LTCFs in the eThekwini district are more likely to be white people; women, christian, widowed, intermediately frail and at risk of malnutrition.

Specialist training in family medicine (FM) is growing rapidly in sub-Saharan Africa. The strong emphasis on workplace-based learning for speciality training makes it vital to gain in-depth insights into registrar supervision. Previous studies have explored aspects of supervision at decentralised sites in high-income countries, however, little is known about the benefits and constraints of decentralised postgraduate supervision in low- to middle-income countries, especially in Africa.

This study aimed to explore family physicians' and registrars' perceptions of the strengths and challenges of clinical and educational supervision across decentralised training sites.

The study was conducted across two provinces at five decentralised training sites affiliated with the University of the Witwatersrand, Johannesburg.

This qualitative study involved semi-structured interviews with a purposive sample of 11 FPs and 11 registrars. The data were thematically analysed.

Two of the four themes identified, 'supervages and a lack of standardisation across training sites, need to be addressed. Regular faculty development is essential for supervisors to be aware of relevant aspects of, and current trends in, postgraduate training.Aflatoxins are potent hepatotoxic and carcinogenic secondary metabolites produced by toxigenic fungi. The present study investigated the protective effect of methanolic leaf extracts of Monanthotaxis caffra (MLEMC) against aflatoxin B1-induced toxicity in male Sprague-Dawley rats. The rats were randomly divided into 6 groups of 8 animals each. Five groups were administered orally for seven days with three different concentrations of MLEMC (100 mg/kg, 200 mg/kg and 300 mg/kg), curcumin (10 mg/kg) or vehicle (25% propylene glycol). The following day, these groups were administered 1 mg/kg b.w. of aflatoxin B1 (AFB1). The experiment was terminated three days after administration of AFB1. Group 6 represented untreated healthy control. Serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, creatinine and liver histopathology were evaluated. Methanolic leaf extracts of M. caffra decreased the levels of aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase and creatinine in the sera of rats as compared with the AFB1 intoxicated group. Co-administration of MLEMC improved the histological characteristics of the hepatocytes in contrast to the AFB1 treated group, which had mild to severe hepatocellular injuries including bile duct proliferation, bile duct hyperplasia, lymphoplasmacytic infiltrate and fibrosis. Extracts of M. caffra were beneficial in mitigating the hepatotoxic effects of AFB1 in rats by reducing the levels of liver enzymes and preventing hepatic injury.The purpose of this position paper by the South African Academy of Family Physicians (SAAFPs) is to inform decision making on human resources for health policy in South Africa and the placement of family physicians (FPs) in the district health system. National policies have been marred by misunderstanding of the roles and contribution of FPs; and there is unhelpful variability in how FPs are positioned in the health services between provinces. In the private sector, medical aid schemes have discriminated against FPs by failing to remunerate them as specialists and to recognise their scope of practice.

A simple hysterectomy is considered the definitive treatment modality for cervical intraepithelial neoplasia (CIN). However, it is associated with recurrence of vaginal intraepithelial neoplasia (VAIN) of up to 7.4%. We sought to determine recurrence rates of VAIN, in women living with HIV (WLWH) and non-infected women.

This was a descriptive retrospective review of patients who received a simple hysterectomy for CIN between January 2015 and December 2017 in Pietermaritzburg.

Fifty-eight files were reviewed. Forty-two (72.4%) WLWH were seen; amongst those, 76.2% were virally suppressed. Abnormal vault cytology was only seen in patients with CIN grades 2 and 3. The recurrence rates for high-grade squamous intraepithelial lesion (HSIL) were 6.1% and 5.0% at 6 and 12 months, respectively. Human immunodeficiency virus co-infection was associated with 26.2% versus 13.3% of abnormal vault cytology compared to the HIV-negative counterparts (p= 0.164). Virologically suppressed patients had more abnormal cytolog.

Many health systems were poorly prepared for the coronavirus disease 2019 (COVID-19) pandemic and found it difficult to protect maternity and reproductive health services. The aim of the study was to explore the influence of the COVID-19 pandemic on the ability of maternity healthcare providers to maintain the positive practices introduced by the CLEVER Maternity Care programme and to elicit information on their support needs.

This multimethod study was conducted in midwife-led obstetric units (MOUs) and district hospitals in Tshwane District, South Africa and included a survey questionnaire and qualitative reports and reflections by the CLEVER implementation team. Two five-point Likert-scale items were supplemented by open-ended questions to provide suggestions on improving health systems and supporting healthcare workers.

Most of the 114 respondents were advanced midwives or registered nurses (86%). read more Participants from MOUs rated the maintenance of quality care practices significantly higher than those from district hospitals (p= 0.