'N vergelykende studie van vismeel, sonneblomoliekoekmeel en formaldehiedbehandelde sonneblomoliekoekmeel as proteïen supplemente vir skape

No Abstrac

Prevalence of hearing loss at primary health care clinics in South Africa

Background: Hearing loss prevalence data in South Africa is scarce, especially within primary health care settings. Objectives: To determine; (i) the prevalence of hearing disorders in patients ≥3 years of age attending two primary health care clinics, and (ii) the nature and characteristics of hearing disorders at these primary health care clinics. Method: A cross-sectional design was used at two primary health care clinics. Non-probability purposive sampling was used to screen participants at clinics for hearing loss with pure tone audiometry. A total of 1236 participants were screened (mean age 37.8 ±17.9 years). Diagnostic testing was available for confirmation of hearing loss on participants who failed the screening. Results: Hearing loss prevalence was 17.5% across both clinics. Most hearing losses were bilateral (70.0%) and were of a sensorineural nature (84.2%). Conclusion: Hearing loss prevalence was comparable at both primary health care clinics. Participants 40 years and older were at significantly higher risk for hearing loss. The current study is the first attempt to establish hearing loss prevalence for primary health care clinics in South Africa.Keywords: Hearing loss, primary health care clinics, South Africa

International survey of audiologists' attitudes toward telehealth

PURPOSE : A better understanding of the attitudes of audiologists toward teleaudiology and their willingness to use teleaudiology is required to progress the application of teleaudiology technologies and services into clinical practice. Audiologists around the world were surveyed on their attitudes toward teleaudiology and their willingness to use it. METHOD : An online survey was sent to audiologists through professional associations' mailing lists. The survey included questions on the use of computer and video-conferencing technologies, awareness and previous use of teleaudiology, and willingness to use teleaudiology. RESULTS : Responses were provided by 269 people from 28 different countries, representing a wide cross-section of experience, qualification, and work settings; 77.8% of respondents were women. Almost all respondents had used PC-based video-conferencing; most had used related technologies and reported positive attitudes toward using these. However, less than 25% had used teleaudiology. CONCLUSIONS : Despite positive attitudes toward telehealth and associated technology, the low number of audiologists who have used teleaudiology for services indicates limited clinical adoption.Portions of this work were presented at the Second International Meeting on Internet & Audiology, Snekkersten, Denmark (September 2015).http://aja.pubs.asha.org/Speech-Language Pathology and Audiolog

Applying the trigger review method after a brief educational intervention: potential for teaching and improving safety in GP specialty training?

<p>Background: The Trigger Review Method (TRM) is a structured approach to screening clinical records for undetected patient safety incidents (PSIs) and identifying learning and improvement opportunities. In Scotland, TRM participation can inform GP appraisal and has been included as a core component of the national primary care patient safety programme that was launched in March 2013. However, the clinical workforce needs up-skilled and the potential of TRM in GP training has yet to be tested. Current TRM training utilizes a workplace face-to-face session by a GP expert, which is not feasible. A less costly, more sustainable educational intervention is necessary to build capability at scale. We aimed to determine the feasibility and impact of TRM and a related training intervention in GP training.</p> Methods We recruited 25 west of Scotland GP trainees to attend a 2-hour TRM workshop. Trainees then applied TRM to 25 clinical records and returned findings within 4-weeks. A follow-up feedback workshop was held. <p>Results: 21/25 trainees (84%) completed the task. 520 records yielded 80 undetected PSIs (15.4%). 36/80 were judged potentially preventable (45%) with 35/80 classified as causing moderate to severe harm (44%). Trainees described a range of potential learning and improvement plans. Training was positively received and appeared to be successful given these findings. TRM was valued as a safety improvement tool by most participants.</p> <p>Conclusion: This small study provides further evidence of TRM utility and how to teach it pragmatically. TRM is of potential value in GP patient safety curriculum delivery and preparing trainees for future safety improvement expectations.</p&gt

Paediatric trauma care

Paediatric trauma care varies in different countries. In South Africa injury is the leading cause of death in the 5 - 14-yearold age group - 1,5 - 3,8 times higher than in the USA. In 1978 the Child Safety Centre was established and prospectively collected data on paediatric injuries. The various types of injuries are discussed. Trauma is responsible for the highest percentage of years of life lost but the least amount of money is being spent on research and prevention of injuries. The Child Accident Prevention Foundation of Southern Africa has been constituted to research, prevent and reduce the risk factors of the injuries and to improve facilities for the injured child

Self-reported hearing loss and pure tone audiometry for screening in primary health care clinics

OBJECTIVE : To evaluate the performance of self-reported hearing loss alone and in combination with pure tone audiometry screening in primary health care clinics in South Africa. DESIGN : Nonprobability purposive sampling was used at 2 primary health care clinics. A total of 1084 participants (mean age 41.2 years; SD 15.5 years; range 16-97 years, 74.0% female) were screened using self-report and audiometry screening. Those failing audiometric screening and a sample of those who passed audiometric screening were also assessed by diagnostic pure time audiometry, to confirm or negate the finding of a hearing loss. RESULTS : Four hundred and thirty-six participants (40.2%) self-reported a hearing loss with no significant association with gender or race. One hundred and thirty-six participant (12.5%) self-reported hearing loss and failed audiometry screening (35 dB HL at 1, 2, and 4 kHz). Combining self-report with a second stage audiometry screening revealed a high test accuracy (81.0%) for hearing loss, being most accurate (86.1%) to identify high-frequency hearing loss. CONCLUSION : While self-report of hearing loss is an easy and time-efficient screening method to use at primary health care clinics, its accuracy may be limited when used in isolation and it may not be sufficiently sensitive to detect hearing loss. Combining a simple audiometry screening as a second-stage screen can significantly improve overall performance and efficiency of the screening protocol.The financial assistance of the National Research Foundation (NRF) toward this research is hereby acknowledged (Grant No. 87757).https://journals.sagepub.com/home/jpcam2019Speech-Language Pathology and Audiolog

Accuracy of remote hearing assessment in a rural community

BACKGROUND : This study determined the accuracy of pure tone air conduction (AC) thresholds obtained using a synchronous telemedicine approach without a sound booth in a rural South African community. The global need for increased hearing healthcare currently far exceeds the capacity for delivering these services, especially in developing countries. A tele-audiology approach using a portable diagnostic audiometer could provide the solution, enabling hearing assessments to be conducted remotely and without a sound booth. MATERIALS AND METHODS : Hearing thresholds in a sound booth and natural environment were obtained froman initial sample of 20 adults (age range, 19– 63 years; mean age, 50 – 13 years; 55%female), recruited from a rural agricultural community. A subgroup of 10 adults (20 ears) volunteered for the telemedicine threshold testing. AC thresholds (250–8,000 Hz) were determined and subsequently compared in these environments. Typical threshold variability was determined using test–retest correspondence as a reference for the threshold correspondence using a telemedicine mode. RESULTS : Test–retest threshold correspondence in the booth and natural environmentswas within – 5 dB in 96.7%and 97.5%of comparisons, respectively. No significant differences were obtained in AC hearing thresholds determined in the telemedicine configuration comparedwith those recorded in the gold standard booth environment. Threshold correspondence between the telemedicine compared with booth and natural environments were within – 5 dB in 82% and 85% of comparisons, respectively. CONCLUSIONS : The current study demonstrates the validity of using synchronous telemedicine for conducting hearing assessments in a remote rural agricultural community without a sound booth.http://online.liebertpub.com/TMJhb201

Identification of depression in a rural general practice

Major depression is underdiagnosed by general practitioners, but the reasons for this are not clear. This study aimed to establish the prevalence of major depression and coexisting generalised anxiety disorder in a rural general practice in the Orange Free State. It also assessed the predictive value of a screening questionnaire for use by general practitioners. The two practitioners evaluated 858 patients over a 4-week period. Those who met the screening criteria, together with a random sample of 60 patients who did not, were re-evaluated by a registrar in psychiatry who was unaware of the findings of his colleagues. Of the patients studied, 134 (15,6%) had major depression; 59 of these (44,0%) also had coexisting generalised anxiety disorder. The general practitioners had . correctly diagnosed major depression in 32 patients (3,7%) before the study started. The screening questionnaire had a 42% chance of correctly identifying a patient with depression and a 97% chance of correctly identifying a patient who did not have major depression. Both practitioners were equally capable at identifying major depression. The study confirmed both the high prevalence of depression in a rural general practice and its low identification rate. It also showed the advantage of using a screening questionnaire to alert practitioners to the possibility of depression in their patients