Student review of doctor-patient communication skills training in a South African undergraduate medical programme

Background. Barriers to the training of doctor-patient communication in the South African (SA) context have been well explored through qualitative research at several SA medical schools. However, this aspect of training has not been reviewed in a systematic way by a large number of students. A student review of doctor-patient communication skills training in the undergraduate medical programme of a medical school in SA was obtained to improve training and identify further research needs. Objective. To investigate doctor-patient communication skills training in the undergraduate programme of a medical school in SA to identify shortcomings and further research needs. Methods. A descriptive, cross-sectional design was used. Data were collected through an anonymous questionnaire based on Harden’s extended vision of the curriculum. Printed anonymous questionnaires, distributed to all the fourth- and fifth-year undergraduate medical students, were analysed quantitatively. Open-ended questions were analysed qualitatively using grounded theory. Results. The sample comprised 106/132 fifth-year students (response rate 80.3%) and 65/120 fourth-year students (response rate 54.2%). Frequent training in history-taking was reported by >75% of students, while >60% reported infrequent training in breaking bad news. More than 50% of participants indicated that senior doctors seldom or never modelled patient-centred communication in the clinical teaching milieu. Students preferred experiential learning to didactic methods. Conclusion. Medical students want to see patient-centred communication unequivocally modelled in the clinical setting. A greater emphasis on practical training in context-specific communication skills is required. Positive role-modelling is needed in the clinical environment

Simulation as an educational strategy to deliver interprofessional education

Background. Various educational methods are available to deliver interprofessional education (IPE) to prepare healthcare students for collaborative practice. One such method is simulation-based health education.Objectives. To identify current IPE methods used in undergraduate programmes in the Faculty of Health Sciences at the University of the Free State, Bloemfontein, South Africa, and to determine the opinions of module leaders on using simulation as a particular IPE teaching strategy.Methods. A quantitative, cross-sectional descriptive study design was employed. Structured interviews were conducted with 47 module leaders of the undergraduate programmes in the Faculty of Health Sciences. These programmes cover 66 modules in the Schools for Allied Health Professions (nutrition and dietetics, occupational therapy, physiotherapy and optometry), nursing and medicine.Results. At the time of the study, IPE activities were used in 29 (43.9%) of the modules, of which 17 (58.6%) were coincidental.  Respondents’ opinions on the potential use of simulation to address formalised IPE activities included the challenge of ‘scheduling’ (73.9%) and ‘logistical and high cost issues’ (19.6%). The most prominent advantage that was foreseen (41.3%) was better clarification of roles among the different professions.Conclusions. The module leaders had a positive attitude towards simulation and its potential use for IPE, with their major concern being logistical challenges. To improve role clarification, a scenario should be developed to engage students from all the relevant professions. The proposed type of simulation was to use standardised patients in a role-play scenario. The outcomes of these activities should be aligned with the principles of IPE

The Effects of Strategic Nitrogen Fertiliser Application During the Cool Season on the Composition of a Perennial Ryegrass-White Clover Pasture in the Western Cape Province of South Africa

Application of fertiliser N to stimulate DM production of perennial ryegrass-white clover pastures during the cool season can be an important management tool. Application of fertiliser N should however maintain clover contents between 30 and 50 percent (Martin, 1960; Harris, 1994). The aim of the study was to develop a better understanding of the effect of a strategic N fertiliser application during the cool season on the grass-clover balance and to identify possible management guidelines that would maximise dry matter production without suppressing clover content to values lower than required to maintain the benefit of clover in the pasture

Quantification of Mineral Composition and Total Protein Content in Sorghum [ (L.) Moench] Genotypes

Sorghum is a drought tolerant cereal and staple food which is a dietary source of protein and more than 20 minerals. The concentration of the mineral elements and protein content in sorghum varies due to genotypic and environmental influences and genotype by environment interactions. The objective of this study was to determine the contents of eight mineral elements (Ca, Fe, K, Mn, Na, P, Zn and Mg) and protein in sorghum genotypes. The analysis of variance showed significant differences in mineral and protein contents. There was a significant relationship between Zn and Fe and between protein and P and Zn. The principal component (PC) analysis showed that Fe, Mn, P, Zn and protein contributed largely to clustering of the genotypes in PC1; Ca, P and Mg to PC2 and Ca, K and Na to PC3. The presence of a considerable amount of compositional variability of mineral and protein contents among tested genotypes suggests that they can be a valuable source of genes for nutritional quality improvement of sorghum

Assessment of genetic diversity in sorghum accessions using amplified fragment length polymorphism (AFLP) analysis

Amplified fragment length polymorphism (AFLP) analysis was used to assess the genetic relationships among 46 accessions of sorghum (Sorghum bicolor (L.) Moench) collected from the north-western, western and central parts of Ethiopia as well as South Africa. Six AFLP primer combinations were used for the analysis of DNA fragment amplification. Dice similarity coefficients were calculated and a dendrogram was constructed following the UPGMA method of cluster analysis. A total of 186 fragments were amplified of which 78 (43.10%) were polymorphic. The number of polymorphic fragments amplified per primer combination varied from 9 to 21. Genetic polymorphism present among sorghum accessions was low, as evidenced by the high level of similarity in the AFLP marker profiles of different sorghum accessions. Pair-wise genetic similarity coefficients ranged from 0.87 to 0.99, with an average of 0.92. This indicates low levels of genetic diversity among tested sorghum accessions. The landraces were genetically very similar, while the differences between landraces, the Ethiopian cultivars and the South African cultivars were relatively higher. Genetic similarity within the South African and the Ethiopian cultivars was very high. Almost all accessions clustered according to the geographical origin. Results of this study indicate that the landraces were related, and this most likely results from the exchange of seeds between farmers in the collection regions, although no duplications were found in the material.Key words: Amplified fragment length polymorphism (AFLP), accessions, genetic diversity, sorghum

Gaseous elemental mercury depletion events observed at Cape Point during 2007–2008

Gaseous mercury in the marine boundary layer has been measured with a 15 min temporal resolution at the Global Atmosphere Watch station Cape Point since March 2007. The most prominent features of the data until July 2008 are the frequent occurrences of pollution (PEs) and depletion events (DEs). Both types of events originate mostly within a short transport distance (up to about 100 km), which are embedded in air masses ranging from marine background to continental. The Hg/CO emission ratios observed during the PEs are within the range reported for biomass burning and industrial/urban emissions. The depletion of gaseous mercury during the DEs is in many cases almost complete and suggests an atmospheric residence time of elemental mercury as short as a few dozens of hours, which is in contrast to the commonly used estimate of approximately 1 year. The DEs observed at Cape Point are not accompanied by simultaneous depletion of ozone which distinguishes them from the halogen driven atmospheric mercury depletion events (AMDEs) observed in Polar Regions. Nonetheless, DEs similar to those observed at Cape Point have also been observed at other places in the marine boundary layer. Additional measurements of mercury speciation and of possible mercury oxidants are hence called for to reveal the chemical mechanism of the newly observed DEs and to assess its importance on larger scales

Unspoken victims: A national study of male rape incidents and police investigations in South Africa

Background. The burden of sexual violence has been well described in children of both sexes and in women, but there is minimal literature on adult male rape victims. Studies of adult male rape victims have mainly been conducted among incarcerated males or military personnel, and in high-income countries.Objectives. To describe the epidemiology, occurrence and reporting of rape cases involving male victims, both child (<18 years old) and adult, in South Africa (SA).Methods. The study consisted of a nationally representative sample of case dockets maintained by the SA Police Service of rape incidents reported in 2012. A retrospective review of the dockets provided sociodemographic information on the victim and suspect, the circumstances of the rape and the medicolegal services provided to the victim. Data on male victims were analysed using Stata 13 to test for significant differences between child and adult male victims.Results. The study comprised 209 male victims, including 120 (57.4%) children and 89 (42.6%) adults. The findings showed that there were significant differences in the occurrence and reporting of rape of male victims by age. Adult males experienced more violent rapes, perpetrators were more likely to be armed and often humiliated the victim, and rapes were more likely to occur in institutional settings. Adult males reported incidents of rape earlier and therefore had visible non-genital injuries during the medical examination. In contrast, more child rapes involved known perpetrators, occurred in a home and perpetrators were more likely to act kindly to the victim after the incident. This parallels the patterns in rape circumstances seen in female adult and child victims.Conclusions. While there is political commitment to understanding sexual violence against women as a societal problem, work on such violence against men lags behind and is little understood. Rape of males needs to be acknowledged, and their vulnerabilities to sexual abuse and rape need to be addressed. Prevention efforts to end violence against women and girls, especially in relation to children, can be used to address violence against men and boys

Student review of doctor-patient communication skills training in a South African undergraduate medical programme

Background. Barriers to the training of doctor-patient communication in the South African (SA) context have been well explored through qualitative research at several SA medical schools. However, this aspect of training has not been reviewed in a systematic way by a large number of students. A student review of doctor-patient communication skills training in the undergraduate medical programme of a medical school in SA was obtained to improve training and identify further research needs. Objective. To investigate doctor-patient communication skills training in the undergraduate programme of a medical school in SA to identify shortcomings and further research needs. Methods. A descriptive, cross-sectional design was used. Data were collected through an anonymous questionnaire based on Harden’s extended vision of the curriculum. Printed anonymous questionnaires, distributed to all the fourth- and fifth-year undergraduate medical students, were analysed quantitatively. Open-ended questions were analysed qualitatively using grounded theory. Results. The sample comprised 106/132 fifth-year students (response rate 80.3%) and 65/120 fourth-year students (response rate 54.2%). Frequent training in history-taking was reported by >75% of students, while >60% reported infrequent training in breaking bad news. More than 50% of participants indicated that senior doctors seldom or never modelled patient-centred communication in the clinical teaching milieu. Students preferred experiential learning to didactic methods. Conclusion. Medical students want to see patient-centred communication unequivocally modelled in the clinical setting. A greater emphasis on practical training in context-specific communication skills is required. Positive role-modelling is needed in the clinical environment

Errors in drug administration by anaesthetists in public hospitals in the Free State

Objective. To investigate errors in administering drugs by anaesthetists working in public hospitals in the Free State province. Methods. Anonymous questionnaires were distributed to doctors performing anaesthesia in public hospitals in the Free State, i.e. 188 doctors at 22 public sector hospitals. Outcomes included demographic information on respondents, information regarding the administration of anaesthetics, reporting of errors, and the occurrence of errors during anaesthesia. Results. The response rate was 46.3%; 48.8% were medical officers, and 39.3% of participants were involved in at least one event of erroneous drug administration. Registrars and specialists reported the most errors. Most events were of no clinical significance, caused no permanent harm to patients, and most commonly involved fentanyl and suxamethonium. Of the respondents, 23.8% indicated that they were aware of a South African standard for colour-coding syringe labels, and 92.9% indicated that they would report anaesthetic errors if a single reporting agency for such events existed. Conclusions. More than a third of participating anaesthetists were involved in a drug error at some stage in their practice. Preventive systems and precautionary measures should be put in place to reduce drug administration errors