Primary care drug therapy training: the solution for PHC nurses?

The priority of the National Health System in South Africa is primary health care (PHC). The approach involves a health system led by PHC services and includes personal and curative services for acute minor ailments delivered by PHC nurses. The nurses are also responsible for the treatment of these ailments with essential drugs according to protocols as proposed in the Essential Drugs List. A before-after experimental research design was used to evaluate the effect of a competency-based primary care drug therapy (PCDT) training programme for PHC nurses in the treatment of acute minor ailments. An experimental group (n = 35) and control group (n = 31) consisting of registered nurses undergoing training in PHC at Gold Fields Nursing College were randomly selected. The results showed a significant increase in prescribing outcomes and medicine utilisation.

Air movement and heat loss from sheep. I. Boundary layer insulation of a model sheep, with and without fleece.

A model sheep, made from metal cylinders and hemispheres, was heated electrically. Heat loss by forced convection in a wind tunnel was analysed in terms of the dependence of the Nusselt number (Nu) on Reynolds number (Re). For a bare trunk Nu = 0.095 Re0.684, but with fleece covering the trunk to a depth of 3.5 cm, Nu = 0.0112 Re0.875 when the mean radiative temperature of the the coat was taken as the surface temperature. Heat transfer by convection from the whole body, including legs, was described by Nu = 0.029 Re0.80. However, a bulk Nesselt number should not be used to estimate heat loss from a live sheep in a hot environment if the windspeed is below about 4 m s-1 because the relation between mean surface temperature, Nusselt number and convective heat flux is not unique.

Air movement and heat loss from sheep. II. Thermal insulation of fleece in wind.

Penetration of an animal's coat by wind reduces its thermal insulation and increases heat loss to the environment. From studies of the sensible heat loss from a life-sized model sheep covered with fleece, the average fleece resistance -rf(s cm-1) was related to windspeed u (m s-1) by 1/-rf(u) = 1/-rf(0)+cu, where c is a dimensionless constant. As c is expected to be inversely proportional to coat depth l, the more general relation -k(u) = -k(0)+c'u was evaluated, where -k = l/-rf is the thermal diffusivity (cm2 s-1) of the fleece and c' = cl is another constant (cm). The orientation of the model to the wind had little effect on the bulk resistance of the fleece, but the resistance on the windward side was substantially lower than on the leeward side.