So viel Buendnis war noch nie The institutional architecture of an alliance for jobs in Germany

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A survey of propofol injection practices reveals poor knowledge of and unsatisfactory adherence to the SASA Guidelines for Infection Control

CITATION: Breedt, A., et al. 2017. A survey of propofol injection practices reveals poor knowledge of and unsatisfactory adherence to the SASA Guidelines for Infection Control. Southern African Journal of Anaesthesia and Analgesia, 23(4):102-113, doi:10.1080/22201181.2017.1336370.The original publication is available at http://www.sajaa.co.za/index.php/sajaaBackground: Propofol lipid emulsion supports bacterial growth and various outbreaks of postoperative infection are attributed to extrinsic contamination. This study’s objectives were to ascertain propofol administration practices among South African anaesthesiologists and to determine the influence of the 2014 South African Society of Anaesthesiologists (SASA) Guidelines for Infection Control in Anaesthesia. Methods: A total of 1 598 SASA members were invited to participate anonymously and 634 replies were received. Using a riskscoring system developed from 13 questionnaire items, 542 respondents who administer propofol infusions were stratified into Low-, Moderate-, High- and Very High-Risk groups. Results: The majority (65%) of the 542 participants who administer propofol infusions were classified as Moderate Risk, 29% as Low Risk and 6% as High and Very High Risk. Some 61% were aware of the SASA Guidelines, of whom 47.3% had studied them. The median risk-score of the Studied Guidelines group was significantly smaller (p < 0.001). They included a greater proportion who were categorised as low risk (58% vs. 45%) and a lower proportion who were moderate risk (38% vs. 51%). Proportions of high-risk individuals did not differ. Of the total 634 respondents, 247 used rubber-stoppered vials of whom 28% had studied the SASA Guidelines; 20% of the Studied Guidelines group often/always shared vial contents between patients versus 12% of those who had not studied them (p = 0.13). Conversely, 40% (studied group) versus 13.6% (not-studied group) often/always wiped the diaphragm and seldom/never shared vial contents between patients (p < 0.0001). In all, 25% of the total 634 respondents often/ always pre-prepared multiple propofol syringes; 5.0% diluted propofol and often/always pre-prepared syringes. Conclusion: Penetration of the SASA Guidelines was low. Differences in unsafe practices among anaesthesiologists who had read the guidelines were statistically significant but clinically inconsequential. This highlights a need for greater publicity, emphasising their practical importance.http://www.sajaa.co.za/index.php/sajaa/article/view/2032Publisher's versio

The prevalence and risk factors for diabetes mellitus in healthcare workers at Tygerberg hospital, Cape Town, South Africa : a retrospective study

CITATION: Coetzeea, A., et al. 2019. The prevalence and risk factors for diabetes mellitus in healthcare workers at Tygerberg hospital, Cape Town, South Africa : a retrospective study. Journal of Endocrinology, Metabolism and Diabetes of South Africa, 24(3):77-82, doi:10.1080/16089677.2019.1620009.The original publication is available at http://www.jemdsa.co.za/index.php/JEMDSAObjectives: To assess the contribution of traditional and modifiable risk factors to the overall risk and prevalence of type 2 diabetes mellitus (T2DM) amongst health workers (HWs) in the public sector. Design: A retrospective analysis was performed on data obtained from 260 participants. Setting and subjects: HWs at Tygerberg Hospital, Western Cape attending the World Diabetes Day (WDD) metabolic screening and educational event. Outcome measures: The 10-year risk stratification for T2DM was calculated in all HWs attending the WDD event. This was based on the Finnish ‘Test2prevent’ diabetes risk calculator endorsed by the International Diabetes Federation assessing a set of wellestablished metabolic risk factors. Self-reported consumption of sugar-sweetened beverages (SSBs) was added to the questionnaire but did not add to the risk calculation. Results: The prevalence of known hyperglycaemia in this cohort is concerning (11%, n = 62). An additional 29 health workers were identified as at high risk to develop T2DM within 10 years. Consumption of SSBs and minimal physical activity were identified as modifiable targets for intervention. Conclusions: Education and lifestyle interventions are of paramount importance to ensure the metabolic health of HWs and their communities. Policies and guidelines focused on limiting unhealthy/obesogenic work environments are urgently needed.http://www.jemdsa.co.za/index.php/JEMDSA/article/view/707Publisher's versio

Teleaudiology hearing aid fitting follow-up consultations for adults : single blinded crossover randomised control trial and cohort studies

OBJECTIVE: To evaluate and compare the effectiveness and quality of standard face-to-face and teleaudiology hearing aid fitting follow-up consultations and blended services for adult hearing aid users. DESIGN AND STUDY SAMPLE: Fifty-six participants were randomly allocated to two equal groups, with equal numbers of new and experienced users. One standard and one teleaudiology follow-up consultation were delivered by an audiologist, the latter assisted by a facilitator. The order was reversed for the second group. Outcome measurement tools were applied to assess aspects of participants’ communication, fitting (physical, sensorial), quality of life, and service. Cross-sectional and longitudinal outcomes were analysed. RESULTS: Most participants presented with moderate, sloping, and symmetrical sensorineural hearing loss. The duration of teleaudiology (42.96 ± 2.73 min) was equivalent to face-to-face consultations (41.25 ± 2.61 min). All modes of service delivery significantly improved outcomes for communication, fitting, and quality of life (p>0.05). Satisfaction for both consultation modes was high, although significantly greater with standard consultations. The mode and order of delivery of the consultations did not influence the outcomes. CONCLUSION: Teleaudiology hearing aid follow-up consultations can deliver significant improvements, and do not differ from standard consultations. Blended services also deliver significant improvements. Satisfaction can be negatively impacted by technical or human-related issues.CAPES foundation, Science without borders program, Brazil, Ear Science Institute Australia, Perth, Australia and Telethon Kids Institute (Ear Health), Perth, Australia.https://www.tandfonline.com/loi/iija20Speech-Language Pathology and Audiolog