A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in Emergency Medicine. Johannesburg, 2015 / Aim: To determine any association between the lunar synodic or anomalistic months and the nature and volume of emergency department patient consultations and hospital admissions from the emergency department (ED). Design: A retrospective, descriptive study. Setting: All South African EDs of a private hospital group. Patients: All patients consulted from 01 January 2005 to 31 December 2010. Methods: Data was extracted from monthly records and statistically evaluated, controlling for calendric variables. Lunar variables were modelled with volumes of differing priority of hospital admissions and consultation categories including; trauma, medical, paediatric, work injuries, obstetrics and gynaecology, intentional self harm, sexual assault, dog bites and total ED consultations. Main Results: No significant differences were found in all anomalistic and most synodic models with the consultation categories. Small but significant increases were found with a small number of synodic models around full moon with some categories, P2 medical, total paediatric consultations and total admissions. Significant decreases in admissions, particulary total admissions, were found around perigee. The effect sizes of all significant lunar associations were smaller than those of the calendric variables. Conclusions: Most comparisons demonstrated no lunar association. Small but significant associations were demonstrated around full moon with some synodic models. A number of anomalistic admission models demonstrated small but significant decreases in admissions at perigee.

Thesis (M.H.A.)--University of Michigan, 1979.

Thesis (M.H.A.)--University of Michigan, 1960.

Thesis (M.H.A.)--University of Michigan, 1979.

Thesis (M.H.A.)--University of Michigan, 1960.

Thesis (M.Sc.(Med.) Emergency Medicine--University of the Witwatersrand, Faculty of Health Sciences, 2014. / This study was designed to investigate how confident South African medical interns are to perform emergency medical procedures and to investigate how their experiences or demographic differences might influence these confidences. A transverse descriptive study using a cross sectional questionnaire was undertaken. A combination of the paper-based and electronic questionnaires were distributed to doctors currently performing their internship in South Africa. The data were analysed using a Fishers exact test and applying a Bonferroni correction where necessary. The study showed a high level of confidence in the majority of procedures studied and identified some points of influence on this confidence. The confidence of South African interns compares favourably with international colleagues at a similar qualification level.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Emergency Medicine, Johannesburg / Introduction Point-of-care ultrasound (PoCUS) is a widely utilized tool in Emergency Medicine (EM). The core PoCUS curriculum in South Africa (SA) does not currently include lung ultrasound or basic bedside echocardiography, although the burden of disease in a typical South African Emergency Department (ED) is skewed towards respiratory and cardiac pathologies. This study was undertaken to determine the profile of PoCUS examinations actually performed and potentially indicated in this ED, and whether current training in PoCUS is meeting the need in clinical practice. Methods This was a prospective observational audit of bedside PoCUS examinations actually performed, and potentially indicated, over a two-week period in the Helen Joseph Hospital ED in Johannesburg. Results The study included 372 patients. Ultrasound aided in the diagnosis and management of 107 (28,8%) of the patients. A total of 137 PoCUS investigations were performed. A total of 38,9% of the patients had positive ultrasound findings. The most frequently performed PoCUS applications were e-FAST (extended focused assessment by sonography in trauma) (32,8%), DVT assessment (13,9%) and procedural guidance (10,9%). A total of 758 PoCUS examinations were indicated in 307 (82,5%) of the patients. Overall, 18,1% of the potentially indicated PoCUS investigations were performed. The most frequently potentially indicated PoCUS applications were lung ultrasound (28,2%), basic cardiac (28%) and haemodynamic assessments (20,4%). Conclusions These findings reflect the high number of respiratory and cardiac cases seen in South African EDs. This highlights the consequent need for additional ultrasound skills to assist in the emergency management of such cases. Training of future South African EM specialist consultants should include both lung ultrasound and basic bedside echocardiography. It is time to update to the South African core PoCUS curriculum. / LM2019

Thesis (D.P.H.)--University of Michigan, 1994.

Thesis (D.P.H.)--University of Michigan, 1994.

research report submitted to the Faculty of Health Sciences, University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Public Health in the field of Hospital Management MAY 2014 / BACKGROUND: One of the key challenges facing the Limpopo Department of Health and Social Development in the area of Casualty Care is the lack of trained personnel and the inappropriate referral and utilisation of these services. There has been no known study conducted in this area in the South African context and therefore this study was undertaken to evaluate the services rendered within the Casualty Department at the Polokwane Mankweng Hospital Complex with specific reference to material and human resources as well as efficiency of the unit. AIM: To evaluate the Hospital Casualty Department in the Polokwane Mankweng Hospital Complex in terms of caseload, influencing factors and implications on resource utilisation during a one year study period. METHODOLOGY: A cross sectional study design was employed in this study. A retrospective record review was done and information was extracted from various sources of hospital information systems. No primary data was collected for this study. The setting of this study was the Casualty Departments at Polokwane Mankweng Hospital Complex. The two hospitals constituting this complex are situated 30 km apart in Polokwane and Turfloop respectively. Data was collected on various variables that are relevant to the functioning of, and resource utilisation in the Casualty Unit of this Complex. Variables including that of caseload, patient profiles, service costs and workload on human resources were measured. RESULTS: This study based on retrospective review of records of 250 patients’ records selected by a simple random sample from a cohort of 14,113 patients who attended the Casualty Department of the Polokwane Mankweng Hospital Complex during one year study period. One fifth of the patients were referred from other health facilities and more than 60% of the patients were discharged after receiving treatment which implied that these patients could be managed at a regional or district hospital. More patients with medical aid bypassed the referral system. Almost half of the patients arrived after-hours (from 18h00 to 6h00). This is the first study in the Limpopo Province which looked at the direct cost per patient at the Casualty Department. In 2008/09, overall expenditure was R 10,321,401.42 (including R 954,168.45 for pharmacy products, other consumables R 177,261.16 and Laboratory tests R 1,866,233.25). Overall the Department accounts for an estimated R 7,323,804 in personnel annual expenditure of the hospital. Unit personnel cost per patient was estimated at R518.94 (70.96% of total recurrent cost), while the unit costs for the Pharmaceuticals, Stores and Laboratory tests were; R67.23 (9.24%), R12.56 (1.72%) and R132.24 (18.08%) per patient respectively. Overall the combined unit cost was estimated at R731.34 per single emergency care patient excluding the capital costs. CONCLUSION: The results of the study will be used to guide the allocation of appropriate resources, and to highlight the need to implement an effective referral system, which will assist in reducing the workload.