South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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South Africa (SA) has one of the highest rates of intimate partner violence (IPV) in the world. It is also in the midst of a demographic transition in which the number of people aged >60 years is expected to double by mid-century. Despite the confluence of these two public health issues, there are no published studies on the epidemiology and risk factors for IPV in older SA women. ⋯ This study is the first of its kind in the SA context, and shows that IPV is a persistent threat for women across the lifespan. It suggests that IPV may manifest differently in older women compared with women of reproductive age, necessitating future qualitative and quantitative studies that examine the correlates, causes and points of intervention unique to this growing population.
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Observational Study
A prospective clinical audit to evaluate postoperative quality of recovery in adults at New Somerset Hospital, Cape Town, South Africa.
Recent developments in perioperative medicine increasingly emphasise patient-centred approaches to quality of care metrics. To this end, the 15-item Quality of Recovery (QoR-15) scale is a well-validated and widely applied patient-centred measure of perioperative service quality. ⋯ We found the QoR-15 to be a valid, feasible and acceptable tool for clinical auditing of perioperative service quality in SA. The median QoR-15 score was 123, with the majority of patients reflecting a moderate QoR. We have highlighted areas with potential for improvement and provided recommendations to address these aspects.
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While inflammatory bowel disease (IBD) has been well characterised in the West and other parts of the world, there are little data from sub-Saharan Africa (SSA). To throw light on the current status of IBD in SSA, we performed a systematic review of the literature, extracting relevant publications. We found only 210 documented IBD cases in SSA (excluding South Africa (SA)), which were reported in 34 publications until August 2019. ⋯ The rest were mostly case reports or small case series; the largest from Nigeria comprised 32 patients. The paucity of documented cases possibly reflects under-diagnosis and under-reporting. Major deficiencies in diagnostic and clinical capacity were noted, which need to be addressed going forward.
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Observational Study
A prospective study of paediatric preoperative fasting times at Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Fasting for liquids and solids is recommended prior to procedures requiring anaesthesia, to reduce the risk of pulmonary aspiration. Children often experience excessive fasting, which is associated with negative physiological and behavioural consequences, and patient discomfort. The duration of preoperative fasting in children in South Africa (SA) is unknown. ⋯ This study demonstrates that children in an SA hospital experience excessive fasting times prior to elective procedures. To reduce fasting durations and improve the quality of perioperative care, quality improvement interventions are required to create an adaptable fasting system that allows individualised fasting. Improving preoperative fasting times in children is the responsibility of all healthcare professionals in the multidisciplinary management team.
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All children with burn injuries experience pain at some time during their management and recovery. Burn pain is challenging to manage, owing to a combination of factors. The process of achieving adequate analgesia involves the correct scripting of medication based on the doctor's knowledge, the correct fulfilling of that script, and patient compliance. ⋯ Burn-injured children commonly receive inadequate analgesia in our setting. The reasons for this are multifactorial. The correct dose and the correct drugs for burn-related background pain are deficits in the knowledge of doctors who deal with this common problem. Furthermore, even if the correct drug and dose are prescribed, the correct volume of medication is often not issued by the pharmacy. This study highlights barriers to achieving adequate analgesia in children with burns being managed as outpatients. Potential strategies to overcome barriers include improving education with regard to pain management and burns at an undergraduate and postgraduate level, and improved supply chain management.