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Finally, most respondents did not identify to whom the accountable party should answer. CONCLUSION Whilst the development of professional identity is seen as a process of 'becoming', the ability to define and understand what it means to be socially accountable is not a linear process. Assessment of this progress may start with comprehending how social accountability is understood by students when they begin their education and when they are graduating, as well as in knowing how their educators, both clinical and community, define it.BACKGROUND Health literacy is a relatively new concept in the South African primary healthcare (PHC) sector as well as globally, and limited new literature is available on the topic. In this study, we focused on investigating, describing and comparing health literacy scores calculated using three different tools to assess a patient's level of English comprehension. Health literacy is defined as the degree to which patients have the capacity to obtain, process and understand basic health information and services to make appropriate health decisions. South Africa is a linguistically and culturally diverse country, yet English is often used as the main language for imparting health education in PHC facilities. Patients often do not comprehend the health education received. Primary healthcare workers need to determine the health literacy levels of their patients before imparting health education. The REALM-R (SA 1, 2 and 3) tools are adapted from the original REALM-R to test health literacy levels of South Africa the LAB. CONCLUSION The results of the study indicated that although patients are able to read and pronounce medical words as such used in the REALM-R (SA) tools, it does not necessarily mean that they are able to comprehend the meaning of the words as indicated by the results of the LAB. Currently, the REALM-R (SA) tools only test health literacy levels based on word recognition and pronunciation. It is recommended that a word comprehension section be added to determine patients' understanding of the words.BACKGROUND Extra-pulmonary tuberculosis (EPTB) accounts for about 20% of TB cases worldwide. Its diagnosis is challenging. Antineoplastic and Immunosuppressive Antibiotics inhibitor AIM This study meant to assess the prevalence of EPTB types, procedures to diagnose EPTB and medical officers' (MOs) views on procedures performed in the diagnosis of EPTB over a 2-year period in Botswana. SETTING The study was conducted in 13 urban and rural facilities of 29 health districts in Botswana. METHODS This was a cross-sectional study that reviewed patients' TB data and administered a questionnaire to MOs. RESULTS About 2 in 10 TB (n = 2996, 22.7%) cases were classified as EPTB. The most common site of EPTB was pleural (n = 1066, 36.7%) followed by lymph node (LN) (n = 546, 18.8%). A pleural tap was performed in 182 (17.0%) cases of pleural TB and a fine needle aspiration (FNA) in one-third (n = 160, 29.6%) of LN TB cases. There were statistical differences in work experience amongst MOs' responses regarding their self-reported confidence to undertake basic procedures to diagnose EPTB such as pleural tap (p = 0.032) or FNA (p 0.0001). CONCLUSION This study reviewed and evaluated the proportion of EPTB and inquired about MO's experience in managing EPTB. Despite MOs' attendance at Botswana National Tuberculosis Programme (BNTP) TB case management (TBCM) training, the emphasis by the BNTP guidelines and availability of logistics, the execution rate of procedures to diagnose EPTB was still low in Botswana.BACKGROUND Facilitation and collaboration differentiates person-centred practice (PcP) from biomedical practice. In PcP, a person-centred consultation requires clinicians to juggle three processes facilitation, clinical reasoning and collaboration. How best to measure PcP in these processes remains a challenge. AIM To assess the measurement of facilitation and collaboration in selected reviews of PcP instruments. METHODS Ovid Medline and Google Scholar were searched for review articles evaluating measurement instruments of patient-centredness or person-centredness in the medical consultation. RESULTS Six of the nine review articles were selected for analysis. Those articles considered the psychometric properties and rigour of evaluation of reviewed instruments. Mostly, the articles did not find instruments with good evidence of reliability and validity. Evaluations in South Africa rendered poor psychometric properties. Tools were often not transferable to other socio-cultural-linguistic contexts, both with and without adaptation. CONCLUSION The multiplicity of measurement tools is a product of many dimensions of person-centredness, which can be approached from many perspectives and in many service scenarios inside and outside the medical consultation. Extensive research into the myriad instruments found no single valid and reliable measurement tool that can be recommended for general use. The best hope for developing one is to focus on a specific scenario, conduct a systematic literature review, combine the best items from existing tools, involve multiple disciplines and test the tool in real-life situations.BACKGROUND South Africa started to lead the cross-culturally validation and use of the Primary Care Assessment Tool (PCAT) in Africa, when Professor Bresick filled a gap, as this continent was until then the only one that had never used it in evaluation of primary health care facilities until 2015. AIM The authors aim to demonstrate that after the consolidation of Bresick's team to an African version of PCAT, it had been adapted to household survey in Brazil. METHODS In this letter, authors reflect on how Brazil had adapted PCAT to a national random household survey with Brazilian National Institute of Geography and Statistics (IBGE) - the Brazilian Census Bureau. RESULTS In the the beginning of 2019, Brazilian Ministry of Health brought back the PCAT as the official national primary health care assessment tool. Brazilian National Institute of Geography and Statistics (IBGE) included a new module (set of questions) in its National Health Survey (PNS-2019) and collected more than 100 000 households interviews in about 40% of the country's municipalities.

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