A review of Morgagni and Bochdalek hernias in adults

The incidence of Bochdalek and Morgagni hernias among adults is very rare. The purpose of this study was to determine retrospectively the prevalence and characteristics of adult Bochdalek and Morgagni hernias in a decade. Consequently, we demonstrated 12 patients with Bochdalek and 8 patients with Morgagni hernias. We presented plain radiography, operation images, and computed tomography findings of an adult patient with symptoms due to Bochdalek and Morgagni hernias. In surgical repair, the Morgagni hernia is best approached via laparotomy, and the Bochdalek hernia can be treated through thoracotomy or laparotomy. (Folia Morphol 2011; 70, 1: 5-12

Surgical procedures as a major risk factor for chronic hepatitis C virus infection in Italy: Evidence from a case-control study

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“Making a difference” – Medical students’ opportunities for transformational change in health care and learning through quality improvement projects

Background Quality improvement is increasingly becoming an essential aspect of the medical curriculum, with the intention of improving the health care system to provide better health care. The aim of this study was to explore undergraduate medical students’ experiences of their involvement in quality improvement projects during a district health rotation. Methods Student group reports from rotations in learning centres of the University of Pretoria in Mpumalanga Province, South Africa were analysed for the period 2012 to 2015. Interviews were conducted with health care providers at four learning centres in 2013. Results Three main themes were identified: (1) ‘Situated learning’, describing students’ exposure to the discrepancies between ideal and reality in a real-life situation and how they learned to deal with complex situations, individually and as student group; (2) ‘Facing dilemmas’, describing how students were challenged about the non-ideal reality; (3) ‘Making a difference’, describing the impact of the students’ projects, with greater understanding of themselves and others through working in teams but also making a change in the health care system. Conclusion Quality improvement projects can provide an opportunity for both the transformation of health care and for transformative learning, with individual and ‘collective’ self-authorship

A new health care profession in rural district hospitals : a case study of the introduction of clinical associates in Shongwe hospital

BACKGROUND : One of the reasons to develop training courses for medical mid-level workers in South Africa is a shortage of doctors. The introduction of this new profession has led to task sharing and redefining of professional boundaries. The primary aim of this study is to evaluate the introduction of new healthcare professionals in a rural hospital district. METHODS : This multi-method qualitative research study used a semi-structured questionnaire to assess the effectiveness of Clinical Associates. A review of documents from 2012 to 2015 was done including a longitudinal study of the development of the Bachelor in Clinical Medical Practice (BCMP) programme at Shongwe hospital. RESULTS : Three Clinical Associates in 2011 and six Clinical Associates in 2014 completed questionnaires. Student satisfaction increased as measured with the Med IQ tool. At the end of 2013 Shongwe Clinical Learning Centre (CLC) had improved from last position out of 17 CLCs in 2011 to position number eight in 2014. Casualty was run by Clinical Associates and during observations it became clear that Clinical Associates were able to take responsibility for outpatient departments (OPDs), the emergency unit and some wards with supervision by a doctor. CONCLUSION : The introduction of the BCMP programme and the establishment of a Clinical Learning Centre in Shongwe hospital have led to improved patient care and a more conducive environment for teaching and learning. With the availability of more Clinical Associates vacant medical officer posts can be converted to employ Clinical Associates to serve patients without an increase in the cost of total human resources.The University of Pretoriahttp://www.tandfonline.com/loi/ojfp20http://www.safpj.co.za/index.php/safpjam2018Family Medicin

'Everyday memory' impairments in autism spectrum disorders

‘Everyday memory’ is conceptualised as memory within the context of day-to-day life and, despite its functional relevance, has been little studied in individuals with autism spectrum disorders (ASDs). In the first study of its kind, 94 adolescents with an ASD and 55 without an ASD completed measures of everyday memory from the Rivermead Behavioural Memory Test (RBMT) and a standard word recall task (Children’s Auditory Verbal Learning Test-2: CAVLT-2). The ASD group showed significant impairments on the RBMT, including in prospective memory, alongside impaired performance on the CAVLT-2. Social and communication ability was significantly associated with prospective remembering in an everyday memory context but not with the CAVLT-2. The complex nature of everyday memory and its relevance to ASD is discussed

Prevalence of overweight and obesity in children aged 6–13 years—alarming increase in obesity in Cracow, Poland

This study in children aged 6–13 years (n = 1,499) was performed between October 2008 and March 2009. Height and weight measurements were taken to calculate BMI. The prevalence of overweight and obesity was determined by means of IOTF cut-offs with respect to age. Alarming is the fact that the percentage of obese children in Cracow increased dramatically from 1.04% in boys and 0.20% in girls in 1971 to 7% in boys and 3.6% in girls in 2009. In this report, a higher percentage of overweight boys was observed in rural boys (28.14%) than in urban ones (27.31%). Obesity was identified in an almost twice as high percentage of urban boys (7.78%) as in rural ones (3.52%). A higher percentage of overweight girls was registered in rural areas (16.49%) than in urban ones (16.09%). Obesity was prevailing in rural girls (4.12%) relative to their urban counterparts (3.44%). The highest number of overweight urban boys was diagnosed in the group of 12-year-olds (n = 48) and rural boys in the group of 10-year-olds (n = 39), as well as in urban girls aged 11 (n = 17) and rural girls aged 9 (n = 9). The highest number of obesity was observed in rural boys aged 12 (n = 3) and in urban boys aged 9 and 10 (n = 9 in both groups). In the group of girls, obesity prevailed in urban 9-year-olds (n = 5) and in rural 7-year-olds (n = 5). Conclusions: Overweight and obesity affect boys almost twice as frequently as girls. Obesity is twice as frequent in urban boys as in their rural peers