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Retrospective and prospective case review of chronic inflammatory demyelinating polyradiculoneuropathy at the Johannesburg HospitalAnderson, David Graham 04 May 2009 (has links)
Background: Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) is an immune mediated neuropathy with variable presentation ranging from symmetrical paralysis to a variety of focal manifestations progressing slowly or in a fluctuating pattern. There is no information about the condition in Africa.
Method: A Prospective case series of CIDP patients defined according to the criteria of Saperstein. Patients were recruited from the Johannesburg Hospital, South Africa, over a 2-year period.
Results: 26 patients were identified. The male to female ratio was 1: 2 with an average age of 41 years. 10 patients were HIV positive. All were black females. There were no differences clinically between the HIV positive and HIV negative groups. The CSF proteins level was raised in only 42% of patients.
Conclusion: The patients seen by us at the Johannesburg hospital have a younger age of onset and a female predominance. HIV was identified in 40% of our patients.
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Knowledge and practices of doctors and nurses about management of health care waste at Johannesburg Hospital in the Gauteng Province, South AfricaRamokate, Tuduetso 29 August 2008 (has links)
ABSTRACT
Introduction: The Gauteng Province in South Africa is home to four large
hospitals which generate enormous amounts of waste. However, no formal study
has been done to asses the magnitude of this problem. Health care waste falls
under a cluster of waste which is regarded as hazardous due to its composition
and therefore ability to transmit disease. It has become an important type of waste
mainly because of its ability to transmit HIV/AIDS, Hepatitis B and C among other
infectious diseases. This study attempted to address the knowledge and practices
of doctors and nurses, which are just some of the factors which influence health
care waste management.
Aims: The main aim of this study was to evaluate the current knowledge and
practices of doctors and nurses regarding the management of health care waste.
Methods: This was a descriptive cross sectional study. A self administered
questionnaire was used to collect the data. A total sample of 128 doctors and
nurses was drawn from the Johannesburg Hospital, an academic hospital in the
Gauteng Province.
Results: Although there was overall lack of awareness about the existence of the
international, national, provincial and local documents (Act, Regulation, Manual,
Code of Practice and Policies) regulating heath care waste management, the
majority of the respondents (84%) knew about the existence of the Johannesburg
Hospital’s policy on waste management. Generally, knowledge of nursing staff
was significantly higher than that of doctors. Although some good practices such
as use of gloves were reported, there is generally a lack of knowledge about key
documents regulating health care waste, particularly among the doctors.
Conclusion: This study was the first of its kind to be done at the Hospital. As the
Hospital policy is more accepted and accessible to the health professionals than
the other documents investigated in this study, it should be updated regularly to
incorporate new changes. The Hospital should not only make that policy document
more easily accessible and visible but also strive to reach doctors with training in health care waste management. Continuous monitoring and evaluation is also
necessary to ensure that policies and procedures are followed.
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Knowledge, attitudes and practices of health care workers regarding disaster preparedness at Johannesburg hospital in Gauteng Province, South AfricaMoabi, Rosemary Maud 03 November 2009 (has links)
M.P.H., Faculty of Health Sciences, University of the Witwatersrand, 2008. / The purpose of the study is to ascertain the knowledge, attitudes and practices
of hospital management at the Johannesburg Hospital regarding disaster
preparedness.
Objectives: The study is to assess the current status of awareness of the
management regarding disaster preparedness; to determine whether there are
hospital specific plans; knowledge of whether the plans are regularly updated
or not; to determine attitudes towards disaster management plans and drills
and to determine current practices with regards to disaster preparedness .
Study design: The study design was a cross sectional survey. The study
population included the hospital administrators, head of clinical units, head of
casualties, the chief porter, the chief clerk, the theatre matron, senior sisters
and doctors in the casualty department, head of security, head of transport
and the chief pharmacist
The study was conducted utilizing a self administered questionnaire with
structured and open ended questions. In case where management were not
available, the person acting in that capacity was requested to complete the
questionnaire. Twenty five out of the thirty five managers selected completed
a self administered questionnaire. The response rate was 71,4%.
Findings: The management at the Johannesburg Hospital was aware of the
disaster preparedness of the hospital and its plans, and disaster management
preparedness. Their attitudes to the plans and drill were largely positive.
However, the practices were deficient and work still needs to be done in
regard to ongoing training, performance of drills and the frequency of regular
updating of the plans.
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An analysis of reasons for exclusion of potential live kidney donorsLevy, Cecil Steven 23 March 2009 (has links)
No description available.
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An assessment of the Remunerative Work Outside Public Sector Policy at the Johannesburg HospitalKhan, Farzana 13 October 2008 (has links)
Good infrastructure and equitable distribution of resources are critical factors in
securing equal health care access to all. Poverty, food production and distribution,
water, sanitation, housing, environmental protection and education all impact on
health (Lee and Mills, 1983). Despite the multi-dimensional determinants of health
and healthcare, one of the most noticeable challenges facing the health care
system is that of human resources. Health care systems cannot function optimally
without sufficient levels and adequate distribution of health care personnel. Brain
drain in South Africa is one of the critical areas of concern according to the Health
Minister (Poggenpoel, 2004). Recruitment and retention of health care workers
within public health institutions is still one of the most critical challenges facing
South Africa. Poor working conditions; limited consumable resources and
mismanagement of facilities aggravate the problem of shortage of skilled health
care personnel.
Limited private practice (LPP) is seen as one of the many mechanisms to retain
health care personnel. Limited Private Practice or moonlighting allows for
government or state employees to perform private duties within certain time
parameters. LPP is common in many developing countries, including South Africa.
This study focuses on the health professionals engaging in limited private practice
in South Africa. Remunerative Work Outside Public Sector (RWOPS) is potentially
an alternative term used for LPP in South Africa. The study focuses on the evolutionary process of the RWOPS policy and explores
the attitudes and perceptions of the health professionals and management at the
Johannesburg Hospital with regards to the RWOPS policy. Policy documents,
press releases, international studies and official documents collected through
searches on the world-wide-web have provided the bases for the evolutionary
process of the study. The perception and attitudes were determined through a selfadministered
structured questionnaire. Participants were randomly selected from a
list obtained from the Johannesburg Hospital Human Resource personnel. Some
participants were selected using snowball sampling. A total of forty two
questionnaires were handed out to the respective participants with feedback from
thirty five participants. The questionnaire compromised of closed and open ended
questions. The sample population consisted of the following participants:
· Nursing personnel (these included nurses at all levels, professional nurses,
senior nurses, chief nurses as well as representatives from DENOSA)
· Doctors (all levels registrars, senior registrars, Head Of Department’s, consultants and reps from SAMA)
· Management (the CEO and some human resource personnel responsible
for processing the RWOPS applications)
· Allied Health Professionals (all levels of physiotherapists, occupational
therapists, pharmacists and the speech and hearing therapists) The results are presented graphically. The data was thematically analyzed
allowing the researcher to identify the role of the key actors in the implementation
process. The Walt and Gilson (1994) model was used to analyze and assess the
RWOPS policy.
A pilot study was conducted to determine if the validity and reliability of the
questionnaire in determining the role, attitudes and perceptions of these key actors
with regards to the RWOPS policy. The pilot study was included in the actual
sample population. Management n=2; doctors n=11; nurses n=15 and allied health
n=7 were the total number of respondents.
Most individuals felt that a shortage of human resource was the most critical
challenge. Most participants are not familiar with the RWOPS policy even though
seventy seven percent of the participants answered yes to being familiar with the
policy. The expectation from many participants was for them to receive substantial
financial incentives through the policy. This relates the lack of knowledge on the
policy terms. Participants also felt that certain professions and individuals
benefited the most from the RWOPS resulting in animosity amongst health care
workers at the Johannesburg Hospital. The questionnaires indicated that there
was minimal input from all the relevant key actors. This lack of consultation with all
relevant actors or perhaps a miscommunication amongst the relevant players may
have contributed to the abuse of this policy.
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Epidemiology of primary paediatric brain tumours at Johannesburg and Chris Hani Baragwanath hospitals from April 1995 to April 2005Nkusi, Agabe Emmy 15 May 2009 (has links)
Epidemiology of primary paediatric brain tumours has been studied extensively in
developed countries of the west. Such studies are lacking in developing
countries especially sub-Saharan Africa.
This study seeks to establish the epidemiology of primary brain tumours seen
among children that were treated at Chris Hani Baragwanath and Johannesburg
Hospitals from April 1995 to April 2005.
The records of 252 patients who presented with this condition during the study
period were reviewed, for the following details:
● Demographic details such as age, gender and race
● Diagnosis and the date when it was made
● The follow-up period at the hospital(s)/clinic(s)
● The anatomical location of the tumours; supratentorial or infratentorial
● The treatment that was given which included mainly surgery for tumour
removal or biopsy, radiotherapy, chemotherapy and others which included
ventriculoperitoneal shunt, external ventricular drain insertion.
● The outcome of treatment included:
- alive
- dead
- presumed alive
- lost to follow-up
It was found:
● That 225 patients had full demographic details of race, gender and age.
● That there was a slight male predominance among children with primary
brain tumour.
● That the majority of children with brain tumours were black, followed by
whites which is in keeping with the country’s demographics.
● The three most common tumours were astrocytomas, medulloblastomas
and brainstem gliomas in the descending order of frequency.
● Medulloblastomas were the commonest tumours in the infratentorial
region while craniopharyngiomas were commonest tumours in the
supratentorial region.
● More children had infratentorial tumours
● Younger children were more likely to have infratentorial tumours.
● Majority of patients had surgery either for diagnosis or for diagnosis and
treatment.
● Few patients were presumptively diagnosed clinically and by imaging
modalities
● Combination therapy of surgery, chemotherapy and radiotherapy had the
best survival outcome while chemotherapy as the only form of treatment
had the worst outcome.
● The overall 5 year survival rate for all the study participants was much
lower than that of their counterparts in the literature.
● Children who had craniopharyngiomas and astrocytomas had better
survival.
● Mortality incidence was slightly higher for whites than blacks but that could
have been skewed by a high number of blacks that was lost to follow-up.
● A higher infratentorial tumour prevalence than in the literature was noted.
It was noted that racial prevalence of primary paediatric brain tumours follows
population demographics.
From the results of this study, there is a need for a better record keeping and
improved patients follow-up.
There is also a need for a larger epidemiological study in the two hospitals.
There is need to establish a specialized paediatric unit which will help start a
paediatric team comprising of a paediatric neurosurgeon, paediatric oncologist,
paediatric intensivist and neuroradiologist with dedicated neuropaediatric ICU.
Such a team given resources will improve survival outcome of children with brain tumours.
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