Exploring the association of the National Benchmark Test results with the academic performance of medical students who completed the degree in minimum time

The National Benchmark Tests (NBT) have been used for selection and placement of students in South Africa since 2005. The NBT assess students’ cognitive knowledge in three domains: academic literacy; quantitative literacy; and mathematics. In this study we aimed to explore the NBT entry-level abilities in relation to school quintiles of the 2011 class of medical students at the University of the Witwatersrand who graduated in minimum time and to explore the link between the NBT domains and academic performance in the first, third, and sixth year of study. The results of students who attended Quintile 5 schools (n = 93) show that 31% obtained proficiency in NBT mathematics, 65% in NBT academic literacy, and 79% in NBT quantitative literacy. The academic literacy domain was a consistently significant predictor in all three years of study. The results show that proficiency and intermediate upper levels of all NBT domains are associated with minimum time completion

A critical evaluation of the anaesthetic services in the province of Gauteng outside the greater Johannesburg area

M.Med. (Anaesthesia), Faculty of Health Sciences, University of the Witwatersrand, 2011The purpose of this study was to evaluate the anaesthetic services in the province of Gauteng outside of the greater Johannesburg area in two parts: Part 1: assessing the level of training in anaesthesia of those doctors who deliver the anaesthetic service in the area described and Part 2: reviewing the records of anaesthetics delivered in a two week period. Part 1 of the study was conducted using a questionnaire at three academic and five non academic hospitals. The questionnaire was administered to all doctors delivering anaesthesia at these hospitals and achieved a response rate of 50% and 69,2% at the academic and non academic hospitals respectively. Part 2 of the study reviewed the records of anaesthetic procedures performed over a two week period using the theatre registers as a primary data source and then a formal record retrieval for additional data. The findings of part one showed that the majority (n=15, 83.33%) of practitioners at the non academic hospitals did not have a postgraduate qualification in anaesthesia while this applied to a smaller (n=22, 39.29%) proportion at the academic hospitals. There are significantly fewer doctors with postgraduate qualifications in anaesthesia at the non academic hospitals studied. Similarly 45% of the doctors at the non academic hospitals felt that their training was inadequate for the anaesthetics they were expected to perform. The findings of part two showed that a wide range of procedures were performed for patients of all ages. There were significant differences in the distribution of major and minor cases between the regional and district hospitals. While the selection of anaesthetic was appropriate in all cases, there was a higher than accepted rate of general anaesthesia for caesarean sections. However, there was no significant difference in the length of hospital stay following either a spinal or a general anaesthetic for Caesarean Sections. Most of the cases reviewed took shorter than an hour to be completed and most patients were discharged within a week of surgery. In only 27 (5%) of the procedures reviewed could a complete anaesthetic record be retrieved

The nature of social accountability in South African medical practice and education: a qualitative reflection

Social accountability describes the extent to which a medical education institution’s research, service and education make a difference to the health status of the community in which they work. An individual practitioner is expected to attain a range of graduate attributes and competencies many of which enable a responsive approach to practice in society

A genome-wide scan for common alleles affecting risk for autism

Although autism spectrum disorders (ASDs) have a substantial genetic basis, most of the known genetic risk has been traced to rare variants, principally copy number variants (CNVs). To identify common risk variation, the Autism Genome Project (AGP) Consortium genotyped 1558 rigorously defined ASD families for 1 million single-nucleotide polymorphisms (SNPs) and analyzed these SNP genotypes for association with ASD. In one of four primary association analyses, the association signal for marker rs4141463, located within MACROD2, crossed the genome-wide association significance threshold of P < 5 × 10−8. When a smaller replication sample was analyzed, the risk allele at rs4141463 was again over-transmitted; yet, consistent with the winner's curse, its effect size in the replication sample was much smaller; and, for the combined samples, the association signal barely fell below the P < 5 × 10−8 threshold. Exploratory analyses of phenotypic subtypes yielded no significant associations after correction for multiple testing. They did, however, yield strong signals within several genes, KIAA0564, PLD5, POU6F2, ST8SIA2 and TAF1C

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Survey and interviews from A responsive e-learning system for the challenges facing health sciences education

Data Description The data presented is from a survey that investigated the usage of information and communication technologies (ICT) for eLearning amongst the 2017 medical student population at Wits. Methods The methodology was a descriptive, cross-sectional, online and paper-based survey. It was distributed to a convenience sample of medical students at Wits. The survey was generated using REDCap (Research Electronic Data Capture) software. The target population was stratified by points in the curriculum in which there is a change due to the teaching and learning methodology being used or the addition of new students into the class. 1 First year (entry year; n=255) 2 Third year (when graduate entrants join the school leavers in the Graduate Entry Medical Programme (GEMP); n=350) 3 Sixth year (final year; n=319) medical students. Process A pilot study with 19 student volunteers was conducted starting in May 2017. Volunteers were recruited by students from MBBCh 5. Following the pilot study, the questionnaire was edited to reduce the length, enhance clarity and to ensure readability across a range of devices. The final survey consisted of seven sections: 1. information and consent (1 question), 2. demographic data (4 questions), 3. year of study (2 questions), 4. device ownership and 5. usage to support learning (12 questions), 6. access to and reliability of the internet connection (5 questions), 7. usage of the learning management system (2 questions), 8. BYOD (6 questions). In Section 4, students were also asked to place themselves on a 100-point scale bound by opposite terms designed to measure their attitude and disposition and attitude to technology as developed and validated in the ECAR study. Lower numbers indicate certain characteristics about disposition to use technology (reluctant user, late adopter, critic, technophobe) and attitudes towards technology usage (useless, burdensome, distraction), while higher numbers indicate more positive dispositions (enthusiast, supporter, early adopter, technophile) and attitudes (useful, beneficial, enhancement) towards ICT.NL201

The social accountability of doctors: a relationship based framework for understanding emergent community concepts of caring

Background: Social accountability is defined as the responsibility of institutions to respond to the health priorities of a community. There is an international movement towards the education of health professionals who are accountable to communities. There is little evidence of how communities experience or articulate this accountability. Methods In this grounded theory study eight community based focus group discussions were conducted in rural and urban South Africa to explore community members’ perceptions of the social accountability of doctors. The discussions were conducted across one urban and two rural provinces. Group discussions were recorded and transcribed verbatim. Results Initial coding was done and three main themes emerged following data analysis: the consultation as a place of love and respect (participants have an expectation of care yet are often engaged with disregard); relationships of people and systems (participants reflect on their health priorities and the links with the social determinants of health) and Ubuntu as engagement of the community (reflected in their expectation of Ubuntu based relationships as well as part of the education system). These themes were related through a framework which integrates three levels of relationship: a central community of reciprocal relationships with the doctor-patient relationship as core; a level in which the systems of health and education interact and together with social determinants of health mediate the insertion of communities into a broader discourse. An ubuntu framing in which the tensions between vulnerability and power interact and reflect rights and responsibility. The space between these concepts is important for social accountability. Conclusion Social accountability has been a concept better articulated by academics and centralized agencies. Communities bring a richer dimension to social accountability through their understanding of being human and caring. This study also creates the connection between ubuntu and social accountability and their mutual transformative capacity as agents for social justiceMedicine, Faculty ofNon UBCFamily Practice, Department ofReviewedFacult

Knowledge gaps among South African healthcare providers regarding the prevention of neonatal group B streptococcal disease.

OBJECTIVE:To evaluate obstetric healthcare provider knowledge regarding the prevention of group B streptococcal disease in South African infants. METHODS:Questionnaires exploring knowledge, attitudes and beliefs around group B streptococcal prevention were administered to consenting doctors and maternity nurses in a tertiary academic hospital. Qualitative assessments (focus groups) were undertaken with junior doctors and nurses. RESULTS:238 participants completed the questionnaire: 150 (63.0%) doctors and 88 (37.0%) nurses. Overall, 22.7% of participants correctly identified the risk-based prevention protocol recommended at this hospital. Most doctors (68.0%) and nurses (94.3%) could not correctly list a single risk factor. A third of doctors did not know the correct antibiotic protocols, and most (80.0%) did not know the recommended timing of antibiotics in relation to delivery. Focus group discussions highlighted the lack of knowledge, awareness and effective implementation of protocols regarding disease prevention. CONCLUSIONS:Our study highlighted knowledge gaps on the risk-based prevention strategy in a setting which has consistently reported among the highest incidence of invasive group B streptococcal disease globally. In these settings, education and prioritization of the risk-based intrapartum antibiotic strategy is warranted, but an alternative vaccine-based strategy may prove more effective in preventing invasive group B streptococcal disease in the long-term