Chronic pain in the community: A survey in a township in Mthatha, Eastern Cape, South Africa

Background: Comprehensive information is needed on the epidemiology and burden of chronic pain in the population for the development of appropriate health interventions. This study aimed to determine the prevalence, severity, risk indicators and responses of chronic pain among adults in Ngangelizwe, Mthatha, South Africa. Method: A cross-sectional survey utilising structured interviews of a sample of adult residents was used. Interviews elicited information on socio-demographic characteristics, general health status, and the prevalence, duration, frequency, severity, activity limitation and impact of chronic pain. Results: More than 95% (n = 473) of the sampled adults participated in the study. Of these, 182 [38.5%, 95% confidence interval (CI): 36.3-42.5%] reported chronic pain in at least one anatomical site. The most common pain sites were the back and head. The median pain score was 5 on a scale of 0 to 10 [interquartile range (IQR) = 4-7] and the median number of sites of pain was 1 (IQR = 1-2). Female gender [odds ratio (OR) = 2.6, 95% CI: 1.7-3.9] and being older than 50 years of age (OR = 3.5, 95% CI: 2.6-4.1) were identified as risk indicators for chronic pain in the sample. Over 65% of respondents reported that they self-treated; 92.1% had consulted with a doctor or nurse, 13.6% consulted a traditional healer, and 34.5% consulted a pharmacist because of their pain. Despite this, over 50% reported that relief of their pain was transient. Conclusion: Chronic pain is a common general complaint in this community, but there is a need for focused attention on women and the elderly.Department of HE and Training approved lis

Pain as a reason for primary care visits: cross-sectional survey in a rural and periurban health clinic in the Eastern Cape, South Africa

Background: The burden of pain in primary care has not been described for South Africa. This study aimed to determine the prevalence of pain in primary care and to characterise pain among adult patients attending a rural and a periurban clinic in the Eastern Cape (EC) Province. Method: cross-sectional descriptive survey was conducted among adult patients attending a rural and periurban clinic over four days. Consecutive patients were asked whether they were in the clinic because of pain and whether the pain was the major reason for their visit. Pain was characterised using an adaptation of the Brief Pain Inventory and the Pain Disability Index. The prevalence percentage and the 95% confidence interval (CI) of pain were estimated, and the relationship with demographic variables was determined at a significance level of P < 0.05. Results: Seven hundred and ninety-six adult patients were interviewed, representing a response rate of 97.4%. Almost three-quarters (74.6%; 95% CI: 63.2-81.4%) reported visiting the clinic because of pain. Pain was the primary reason for 393 (49.4%; 95% CI: 32.1-61.0%) visits and was secondary in 201 (25.3%; 95% CI: 12.8-33.7%) visits. The common sites of pain were the head, back and chest. The median pain score was eight on a scale of 0-10 (interquartile range: 6-8). Respondents experienced limitations in a number of activities of daily living as a result of pain. Conclusion: Pain is a central problem in public primary care settings in the EC Province and must therefore be a priority area for primary care research. Strategies are needed to develop to improve pain management at primary care level in the province.Department of HE and Training approved lis

Prevalence and risk indicators of chronic pain in a rural community in South Africa

Background: Despite the acknowledgement that chronic pain may be a problem for adults in rural settings, there is a lack of epidemiological investigations on its occurrence in rural South Africa. Objectives: To estimate the prevalence of chronic pain among adults in a rural community in South Africa and characterize the localization, severity, risk indicators and responses of pain sufferers. Methods: Cross-sectional analytical study using face-to-face interviews. Interviews elicited information on socio-demographic characteristics, general health status and presence of pain. Among those reporting pain, the duration, frequency, severity, activity limitation and impact was determined. Univariate statistics were used to describe the prevalence of chronic pain while bivariable χ2 tests and multivariable logistic regression models were used to assess the relationship of socio-demographic characteristics and reported health status with chronic pain. Results: A total of 394 adults were interviewed representing a response rate of 92.8%. Of these, 169 (42.9%; 95% CI: 37.4%-47.1%) reported suffering from chronic pain. The common sites were the back, knee, ankles, head and shoulders. The median pain score was 6 on a scale of 0-10 (IQR= 5-8) and the median number of sites of pain was 1 (IQR= 1-2). The type of pain slightly varied with age with younger adults reporting more back pain and headaches while older people reported more joint pain. Female gender (adjusted odds-ratio AOR= 2.2, 95% CI: 1.9-2.8) and being older than 50 years (AOR= 3.1, 95% CI:2.7-3.9) were identified as risk indicators for chronic pain in the sample. Respondents reported that they self-treated (88.3%); consulted with a doctor or nurse (74.3%); traditional-healer (24.5%) and spiritual-healer (4%). Most respondents (63.4%) reported only transient relief of their pain. Conclusions: Chronic pain is an important health problem in the surveyed community. Further comparative studies on the relationship with risk factors are needed meanwhile interventions targeting females and the elderly are recommended

FEATURES OF TEACHING THERAPEUTIC DISCIPLINES TO STUDENTS OF THE TRAINING DIRECTION “LABORATORY DIAGNOSTICS” OF THE EDUCATIONAL LEVEL “BACHELOR”

The article highlights the experience of teaching the disciplines of the therapeutic profile at the department of care of patients and the higher nursing education to future laboratory assistants for the credit transfer system

The Darrieus-Landau instability in fast deflagration and laser ablation

The problem of the Darrieus-Landau instability at a discontinuous deflagration front in a compressible flow is solved. Numerous previous attempts to solve this problem suffered from the deficit of boundary conditions. Here, the required additional boundary condition is derived rigorously taking into account the internal structure of the front. The derived condition implies a constant mass flux at the front; it reduces to the classical Darrieus-Landau condition in the limit of an incompressible flow. It is demonstrated that in general the solution to the problem depends on the type of energy source present in the system. In the common case of a strongly localized source, compression effects make the Darrieus-Landau instability considerably weaker. In particular, the Darrieus-Landau instability growth rate is reduced for laser ablation in comparison with the classical incompressible case. The instability disappears completely in the Chapman-Jouguet regime of ultimately fast deflagration.Comment: 24 pages, 3 figures, version to appear in Physics of Plasma

Towards an optimal therapy strategy for myogenous TMD, physiotherapy compared with occlusal splint therapy in an RCT with therapy-and-patient-specific treatment durations

Appendix. Threshold of signs and symptoms. Post-hoc power analysis on measures of effectiveness. Two-way ANOVA statistical analysis for pain intensity. Rules for progressing and ending splint therapy. Rules for progressing and ending physiotherapy. A stepped-care model including two possible therapies. (PDF 86 kb

ВЗАЄМОЗВ’ЯЗОК МАСИ ТІЛА, ПОРОГУ СМАКОВОЇ ЧУТЛИВОСТІ ДО КУХОННОЇ СОЛІ, ЦЕНТРАЛЬНОГО ВЕНОЗНОГО ТИСКУ У ХВОРИХ НА ЕСЕНЦІАЛЬНУ ГІПЕРТЕНЗІЮ II СТ. ЗА РІЗНИХ ВАРІАНТІВ ЦИРКАДІАННОГО РИТМУ АРТЕРІАЛЬНОГО ТИСКУ

For the purpose of diagnostics and substantiationthe new risk factors of the disease progression the body weightindex (WI), the central venous pressure level (CVP) and thethreshold of a gustatory sensitivity to a salt (TGSS) were evaluated by means of the appropriate methods in 70 patients with2nd stage of essential hypertension at different variants of thedaily rhythm of arterial pressure (D - “Dipper”, ND - “NonDipper”, NP - “Night Picker”). It has been established that ingeneral survey sample 82 % of the patients have the abundant(WI 25-30 kg/m2) and the excessive (WI&gt;30kg/m2) weight. Direct relation between CVP and WI was revealed mainly in theND and NP groups combined by the high TGSS. The tetrad ofthe interrelated diagnostic criteria: 1) daily index AP: ND andNP; 2) WI&gt;25 kg/m2; 3) CVP&gt;140 mm of water; 4) TGSS &gt;0,36 % NaCl solution characterizing the salt-sensitive “volumerelated” variant of the disease in the most of patients has beenfound outУ 70 больных эссенциальной гипертензией (ЭГ) II стадии разной структуры циркадианного ритма АД (D - “Dipper”, ND - “Non-Dipper”, NP - “Night Picker”) оценива­ли индекс массы тела (ИМТ), уровень центрального веноз­ного давления (ЦВД), порог вкусовой чувствительности к поваренной соли (ПВЧПС) соответствующими методиками с целью диагностики и обоснования новых факторов риска прогрессирования болезни. Установлено, что в общей груп­пе больных ЭГ II ст. 82 % обследованных имели избыточную (ИМТ 25-30 кг/м2) и чрезмерную (ИМТ &gt; 30 кг/м2) массу тела. Обнаружена прямая зависимость ЦВД от ИМТ пре­имущественно в группах ND и NP, сочетающаяся с высоким ПВЧПС. Обнаружена тетрада взаимозависимых диагности­ческих критериев: 1) суточный индекс АД: ND и NP; 2) ИМТ &gt; 25 кг/ м2; 3) ЦВД&gt;140 мм H2O; 4) ПВЧПС &gt; 0,36 % раствора NaCl, характеризующих у значительной части больных ЭГ II ст. солечувствительный - «объемзависимый» вариант болезни.У 70 хворих на есенціальну гіпертензію (ЕГ) II стадії за різної структури циркадіанного ритму АТ (D - “Dipper”, ND - “Non-Dipper”, NP - “Night Picker”) оцінювали індекс маси тіла (ІМТ), рівень центрального венозного тиску (ЦВТ), поріг смако­вої чутливості до кухонної солі (ПСЧКС) за відповідними методиками з метою діагностики та обгрунтування нових факторів ризику прогресування хвороби. Встановлено, що у загальній групі хворих на ЕГII ст. 82 % обстежених мали надлишкову (ІМТ 25-30 кг/м2) та надмірну (ІМТ &gt; 30 кг/м2) масу тіла. Виявлено пряму залежність ЦВТ від ІМТ переважно у групах ND та NP, що поєднується з високим ПСЧКС. Виявлена тетрада взаємозалежних діагностичних критеріїв: 1) добовий індекс АТ: ND та NP; 2) ІМТ &gt; 25 кг/м2; 3) ЦВТ&gt;140 мм H2O; 4) ПСЧКС &gt; 0,36 % розчину NaCl, які характеризують у значної частини хворих на ЕГII ст. солечутливий - «об’ємозалежний» варіант захворювання

Організація навчального процесу в умовах кредитно-модульної системи навчання

The article analyses the experience of teaching therapeutic subjects to Nursing students under credit-module system at the Department of Patients Care and Higher Nursing Education.В статье проанализирован опыт преподавания дисциплин терапевтического профиля для студентов специальности “Сестринское дело” по кредитно-модульной системе на кафедре ухода за больными и высшего медсестринского образования.У статті проаналізовано досвід викладання дисциплін терапевтичного профілю для студентів спеціальності “Сестринська справа” за кредитно-модульною системою на кафедрі догляду за хворими та вищої медсестринської освіти