Integrated sun protection advice for the South African population

Exposure to solar ultraviolet radiation (UVR) is associated with several cutaneous adverse effects. However, to the best of our knowledge, in South Africa there are no formal guidelines on sun protection. A group of South African dermatologists and researchers convened over the course of 1 year to deliberate on integrated advice for sun protection among the multi-ethnic South African population. For people with light skin and those with genetic skin disorders (e.g., oculocutaneous albinism), sun protection was identified as critical to prevent sunburn, skin cancer, and photoaging. The evidence is less clear for people with medium and darker skin types, especially the latter, in whom melanin may confer a degree of protection against some parts of the solar spectrum. Recent studies have demonstrated that visible light can cause pigmentary changes in individuals with darker skin types in particular. Sun protection for people of all skin colors is beneficial to protect against photoaging and ocular damage. Herein sun protection advice is suggested for South Africans of all skin colors to reduce morbidity and mortality from sun exposure, particularly relating to skin cancer. Several knowledge gaps are identified as future research priorities.https://onlinelibrary.wiley.com/journal/13654632hj2024Geography, Geoinformatics and MeteorologySDG-03:Good heatlh and well-bein

Mutation update and genotype-phenotype correlations of novel and previously described mutations in TPM2 and TPM3 causing congenital myopathies

Mutations affecting skeletal muscle isoforms of the tropomyosin genes may cause nemaline myopathy, cap myopathy, core-rod myopathy, congenital fiber-type disproportion, distal arthrogryposes, and Escobar syndrome. We correlate the clinical picture of these diseases with novel (19) and previously reported (31) mutations of the TPM2 and TPM3 genes. Included are altogether 93 families: 53 with TPM2 mutations and 40 with TPM3 mutations. Thirty distinct pathogenic variants of TPM2 and 20 of TPM3 have been published or listed in the Leiden Open Variant Database (http://www.dmd.nl/). Most are heterozygous changes associated with autosomal-dominant disease. Patients with TPM2 mutations tended to present with milder symptoms than those with TPM3 mutations, DA being present only in the TPM2 group. Previous studies have shown that five of the mutations in TPM2 and one in TPM3 cause increased Ca2+ sensitivity resulting in a hypercontractile molecular phenotype. Patients with hypercontractile phenotype more often had contractures of the limb joints (18/19) and jaw (6/19) than those with nonhypercontractile ones (2/22 and 1/22), whereas patients with the non-hypercontractile molecular phenotype more often (19/22) had axial contractures than the hypercontractile group (7/19). Our in silico predictions show that most mutations affect tropomyosin–actin association or tropomyosin head-to-tail binding

The development of a hassle-based diagnostic scale for predicting burnout in call centres

The aim of this study was to develop a brief daily hassle diagnostic questionnaire that could be used to identify daily hassles for customer service representatives within a call centre environment, and to investigate the relationship between daily hassles and burnout. A crosssectional survey was used with an accidental sample (N = 394) taken from a service and sales call centre. An exploratory factor analysis of the data resulted in a six-factor model of daily hassles consisting of daily demands, continuous change, co-worker hassles, demotivating work environment, transportation hassles and personal concerns. The internal consistency of one factor, namely personal concerns, was low. Exhaustion was best predicted by four categories of daily hassles, namely daily demands, continuous change, a demotivating work environment, and transportation hassles

Exploring antecedents and consequences of burnout in a call centre

The aim of this study was to investigate the relationship between six characteristics of call centre work environments, burnout, affective commitment and turnover intentions. These characteristics were competing management goals, work overload, electronic performance monitoring, lack of career opportunities, lack of skill variety and emotional labour. A convenient sample of employees (N = 146) was obtained from a call centre. Multiple regression analysis showed that work overload, lack of career opportunities, skill variety and emotional labour were the most important predictors of burnout. Burnout had a direct effect on turnover intentions. Affective commitment partially mediated the relationship between burnout and turnover intention

Modelling the healthcare costs of skin cancer in South Africa

CITATION: Gordon, L. G., et al. 2016. Modelling the healthcare costs of skin cancer in South Africa. BMC Health Services Research, 16:113, doi:10.1186/s12913-016-1364-z.The original publication is available at http://bmchealthservres.biomedcentral.comBackground: Skin cancer is a growing public health problem in South Africa due to its high ambient ultraviolet radiation environment. The purpose of this study was to estimate the annual health system costs of cutaneous melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in South Africa, incorporating both the public and private sectors. Methods: A cost-of-illness study was used to measure the economic burden of skin cancer and a ‘bottom-up’ micro-costing approach. Clinicians provided data on the patterns of care and treatments while national costing reports and clinician fees provided cost estimates. The mean costs per melanoma and per SCC/BCC were extrapolated to estimate national costs using published incidence data and official population statistics. One-way and probabilistic sensitivity analyses were undertaken to address the uncertainty of the parameters used in the model. Results: The estimated total annual cost of treating skin cancers in South Africa were ZAR 92.4 million (2015) (or US$15.7 million). Sensitivity analyses showed that the total costs could vary between ZAR 89.7 to 94.6 million (US$15.2 to $16.1 million) when melanoma-related variables were changed and between ZAR 78.4 to 113.5 million ($13.3 to $19.3 million) when non-melanoma-related variables were changed. The primary drivers of overall costs were the cost of excisions, follow-up care, radical lymph node dissection, cryotherapy and radiation therapy. Conclusion: The cost of managing skin cancer in South Africa is sizable. Since skin cancer is largely preventable through improvements to sun-protection awareness and skin cancer prevention programs, this study highlights these healthcare resources could be used for other pressing public health problems in South Africa.https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1364-zPublisher's versio