Burnout and associated factors in undergraduate medical students at a South African university

Background. Medical students are at risk of burnout owing to various challenges.Objectives. To investigate burnout and associated factors among undergraduate students at a South African medical school.Methods. In this cross-sectional study, findings of the Copenhagen Burnout Inventory (CBI), demographic data and information related to resilience were collected by means of an anonymous self-administered questionnaire. Associations between burnout subscales and various factors were determined.Results. Five-hundred students (preclinical, n=270; clinical, n=230) completed the questionnaire. CBI mean scores for preclinical and clinical students were 17.9 and 17.4 (personal), 22.3 and 21.9 (work related) and 24.8 (patient related; clinical students only), respectively. High scores on the subscale reflect low levels of burnout in related areas. Male students and students with high self-reported resilience and low stress had significantly lower burnout levels. White preclinical students had lower levels of personal and work-related burnout, and black clinical students had less patient-related burnout.High mean scores in all three burnout subscales indicated low burnout levels among students. Academic and personal stress, as well as perceived poor support from institutional structures, were associated with significantly higher personal and work-related burnout, but not patient-related burnout in clinical students

Secondary school teachers' experiences related to learner teenage pregnancies and unexpected deliveries at school

Background: The incidence of learner teenage pregnancies can be reduced, provided that the major stakeholders, which include the Department of Education and the Department of Health, combine to address this issue. Despite the implementation of Life Orientation as a school subject, which focuses on sexual behaviour, health, decision-making, pregnancy risk, sexually transmitted infections and HIV and AIDS, the prevalence of learner teenage pregnancies at secondary schools remains alarmingly high.Aim: The purpose of this study was to explore and describe teachers' experiences of learner teenage pregnancies in secondary schools in a province in South Africa.Setting: Secondary schools in KwaZulu-Natal.Method: A qualitative approach with exploratory, descriptive and contextual strategies was used in this research. Semi-structured interviews were conducted with teachers who had been selected through purposive sampling. Tesch's steps of systematic open coding were used to analyse all of the interviews.Results: The results that emerged during the data analysis indicate that firstly, teachers' experiences of having pregnant learners in their classrooms are negative as these learners are frequently absent from school, perform badly and drop out of school. Secondly, teachers' experiences related to unexpected deliveries are coloured by their lack of the necessary skills and competencies to deal and their resultant insecurity. Thirdly, the teachers feel that they do not receive the assistance they need to deal with teenage pregnancies as well as unexpected deliveries.Conclusions: Collaboration between and continuous support from the Department of Health and the Department of Education are crucial if teenage pregnancies at secondary schools are to be handled with greater success. Support from health care personnel should include guidance on contraception and health campaigns should target both the teachers and secondary school learners. Furthermore, coping strategies for the teachers should form part of the preservice curriculum of teachers

Secondary school teachers' experiences related to learner teenage pregnancies and unexpected deliveries at school

Background: The incidence of learner teenage pregnancies can be reduced, provided that the major stakeholders, which include the Department of Education and the Department of Health, combine to address this issue. Despite the implementation of Life Orientation as a school subject, which focuses on sexual behaviour, health, decision-making, pregnancy risk,sexually transmitted infections and HIV and AIDS, the prevalence of learner teenage pregnancies at secondary schools remains alarmingly high. Aim: The purpose of this study was to explore and describe teachers' experiences of learner teenage pregnancies in secondary schools in a province in South Africa. Setting: Secondary schools in KwaZulu-Natal. Method: A qualitative approach with exploratory, descriptive and contextual strategies was used in this research. Semi-structured interviews were conducted with teachers who had been selected through purposive sampling. Tesch's steps of systematic open coding were used to analyse all of the interviews. Results: The results that emerged during the data analysis indicate that firstly, teachers' experiences of having pregnant learners in their classrooms are negative as these learners are frequently absent from school, perform badly and drop out of school. Secondly, teachers' experiences related to unexpected deliveries are coloured by their lack of the necessary skills and competencies to deal and their resultant insecurity. Thirdly, the teachers feel that they do not receive the assistance they need to deal with teenage pregnancies as well as unexpected deliveries. Conclusions: Collaboration between and continuous support from the Department of Health and the Department of Education are crucial if teenage pregnancies at secondary schools are to be handled with greater success. Support from health care personnel should include guidance on contraception and health campaigns should target both the teachers and secondary school learners. Furthermore, coping strategies for the teachers should form part of the preservice curriculum of teachers

Health Promotion Needs of Hammanskraal Families with Adolescents Orphaned by HIV/AIDS

Health promotion is regarded as the cornerstone of good health. It is the action expected from individuals and families in order to better their own health situation. Health promotion is an art and science (Edelman et Mandle; 2002:16) that is integrated into the primary health care to reduce existing health problems. The purpose of the research on which this article is reporting; was to explore and describe the health promotion needs of families with adolescents orphaned by human immunodeficiency virus or acquired immune deficiency syndrome (HIV/AIDS). The research was located within a qualitative paradigm that is both exploratory and descriptive. Eight families who were purposely selected participated in the research process. Qualitative methods; such as group interviews and field notes were utilised to collect data. The health promotion needs of the families with adolescents orphaned by HIV/AIDS were explored and described. Tesch's analysis process; which entails a series of steps; was followed (Creswell; 2003:192). Themes; categories and subcategories that form the central focus of health promotion needs emerged during the data analysis. These themes;categories and subcategories are used to develop guidelines for health promotion

Antegrade scrotal sclerotherapy versus inguinal microsurgical varicocelectomy in the treatment of varicocele ­ a prospective, randomized, parallel group study

Objective To evaluate the efficacy; safety and cost-effectiveness of antegrade scrotal sclerotherapy (ASS) compared to inguinal microsurgical varicocelectomy (IMV) for the treatment of varicocele of the testis. Patients and Methods Male patients above 13 years of age with grade 2 to 3 varicocele; who were either symptomatic or presented with an abnormal semen analysis; were included in the study. The patients were randomized in a ratio of 1:1 between ASS or IMV. ASS was performed using sodium tetradecyl sulphate (Fibro-veinr) as sclerosing agent in a 1and 3mixture. IMV was performed using an inguinal approach and microsurgery loupes during spermatic cord dissection to identify and preserve the testicular artery and lymphatics. Color doppler ultrasound was used to measure testicular volume and pampiniform vein diameter before treatment and at 6 and 12 month follow-up visits. Semen analysis was obtained at the same time intervals. The efficacy parameters included serum follicle stimulating hormone (FSH); luteinizing hormone (LH); semen analysis; pregnancy rate of partners and estimation of costs involved. Results Between April 2000 and December 2003; 25 patients were included in the study. ASS was performed on 12 patients (6 bilateral procedures) and IMV on 13 patients (2 bilateral). Obliteration of the clinically detectable varicocele was achieved in 10/12 patients in the ASS and in 11/13 in the IMV group (89and 87success rate; respectively). ASS was superior to IMV with regard to costs; average theatre time; hospitalization and postoperative recovery. Both procedures had a one year pregnancy rate of 50. The mean sperm count and mean sperm morphology improved significantly from baseline to 12 months in both groups. However; there were no statistically significant differences between the two methods with regard to semen analysis improvement; testicular volume or biochemical data (LH; FSH; testosterone). Serum FSH decreased in those who had successful treatment of their varicocele; but not in those with recurrence; although the difference was not statistically significant (p=0.09); probably due to the small patient numbers. Conclusion ASS is a minimally invasive treatment for varicocele; which is feasible as an out-patient procedure in adolescents and adults. It can save costs; theatre time; hospitalization and time lost from work. ASS and IMV appear to be equally successful in terms of varicocele recurrence; pregnancy rate and semen analysis improvement