Exploring the differences in psychological traits between surgical specialties at an academic hospital in Bloemfontein.

BACKGROUND: Studies have attempted to categorise undergraduate medical and postgraduate students and specialists into personality types, to determine what influences personality has on specialty choice and job satisfaction. This study explored the personality characteristics of doctors in four surgical and three consulting specialties at an academic hospital in Bloemfontein, South Africa. METHOD: This analytical cross-sectional study used the Zuckerman-Kuhlman Personality Questionnaire as a measuring tool which included five scales: impulsive sensation seeking (subscales impulsivity and sensation seeking), neuroticismanxiety, aggression-hostility, sociability (parties and friends and isolation intolerance), and activity ( work activity and general activity). Overall, 70 consultants and senior registrars from surgical specialties (anaesthesiology, obstetrics and gynaecology, orthopaedic surgery, surgery), (response rate 60.3%) and 58 consultants and senior registrars from three consulting specialties (internal medicine, paediatrics, family medicine) (response rate 71.6%) participated. RESULTS: Respondents from four surgical specialties had higher medians than the overall consulting group for the subscale sensation seeking. The subscale sensation seeking scored higher than impulsivity across surgical and consulting groups. The surgical group scored lower than the consulting group in neuroticism-anxiety, with anaesthesiology scoring the highest (42.1%) and orthopaedic surgery scoring the lowest (15.8%). Orthopaedic surgery scored the highest (50.0%) in aggressionhostility, sociability (52.9%), parties and friends (44.4%) and isolation intolerance (65.5%). The surgical group scored significantly higher than the consulting group for activity (p < 0.01). CONCLUSION: In exploring the personality types of specialists, the orthopaedic surgeons in specialist departments in Bloemfontein seem unique in their sociability and aggression-hostility traits, anaesthesiologists scored strongly on the sensation seeking and neuroticism-anxiety scales, while the obstetricians and gynaecologists did not manifest either of these traits strongly. This data contributes to a growing discussion on personality choice and job satisfaction.

The Profile of deliberate self-poisoning cases presenting at the emergency department of pelonomi regional hospital

Background Deliberate self-poisoning (DSP) remains a common method employed for suicide worldwide. Despite its frequent occurrence and the high cost required in its management, only few studies have been carried out on this subject in South Africa. Inadequate research into DSP in South Africa is a great concern as this may inadvertently result in an inadequate knowledge of health professionals on the general approach to victims presenting at emergency departments. This may consequently result in a poor clinical outcome of these cases. This study was aimed at determining the demographics of DSP cases presenting to the emergency department (ED) of Pelonomi hospital and also to enquire into the drugs/agents commonly used, reasons for DSP and the clinical outcome of these cases

Association between personality factors and consulting specialty of practice of doctors at an academic hospital in Bloemfontein, South Africa

Background. Studies found an association between personality types and field of specialty. The current study could assist aspiring specialists in deciding which specialty they are best suited for by comparing their own personalities with the results.. To explore the personality characteristics of doctors in three consulting and four surgical specialties at an academic hospital in Bloemfontein,South Africa.Methods. In this analytical cross-sectional study, questionnaires, including the Zuckerman-Kuhlman Personality Questionnaire, were handed out.Overall, 58 consultants and senior registrars from the departments of Family Medicine, Paediatrics and Internal Medicine (response rate 71.6%) and 70 consultants and senior registrars from surgical specialties (response rate 60.3%) participated.Results. Family medicine had the lowest median score for impulsive sensation seeking (21.1%) and aggression-hostility (11.8%), and highest for parties and friends (33.3%). Paediatrics scored highest for neuroticism-anxiety (44.7%) and aggression-hostility (23.5%). Internal medicine scored highest for sociability (25.0%) and isolation intolerance (37.8%), and lowest for neuroticism-anxiety (36.8%) and activity (47.1%). Overall, the consulting group scored lower than the surgical group for impulsive sensation seeking, aggression-hostility, sociability and activity, and higher for neuroticism-anxiety. Conclusion. The study identified personality types of some specialties, and revealed differences between characteristics of local specialists compared with findings from studies elsewhere

The bird's-eye perspective: how do district health managers experience the impact of family physicians within the South African district health system? A qualitative study

Background: Health policy-makers in Africa are looking for local solutions to strengthen primary care teams. A South African national position paper (2015) described six aspirational roles of family physicians (FPs) working within the district health system. However, the actual contributions of FPs are unclear at present, and evidence is required as to how this cadre may be able to strengthen health systems.Methods: Using semi-structured interviews, this study sought to obtain the views of South African district health managers regarding the impact made by FPs within their districts on health system performance, clinical processes and health outcomes.Results: A number of benefits of FPs to the health system in South Africa were confirmed, including: their ability to enhance the functionality of the local health system by increasing access to a more comprehensive and coordinated health service, and by improving clinical services delivered through clinical care, capacitating the local health team and facilitating clinical governance activities.Conclusions: District managers confirmed the importance of all six roles of the FP and expressed both direct and indirect ways in which FPs contribute to strengthening health systems' performance and clinical outcomes. FPs were seen as important clinical leaders within the district healthcare team. Managers recognised the need to support newly appointed FPs to clarify their roles within the healthcare team and to mature across all their roles. This study supports the employment of FPs at scale within the South African district health system according to the national position paper on family medicine

Staphylococcus aureus on Computer Mice and Keyboards in Intensive Care Units of the Universitas Academic Hospital; Bloemfontein; and ICU staff's Knowledge of its Hazards and Cleaning Practices

Nosocomial infections result in severe health and financial difficulties for patients and healthcare facilities. The objective of the study was to determine the presence of Staphylococcus aureus on computer mice and keyboards in the intensive care units (ICUs) of Universitas Academic Hospital; Bloemfontein; and ICU staff's knowledge regarding cleaning of computer mice and keyboards and their potential hazard as reservoirs for pathogens. Swab specimens from computer mice and keyboards (14 each) were investigated for S. aureus. Swabbing was repeated six months later. Standard microbiology laboratory methods were used to culture and identify organisms. An anonymous questionnaire completed by the ICU staff determined their awareness of computer mice and keyboards as potential sources of nosocomial infections. In addition to various environmental microorganisms and normal human flora; S. aureus was initially isolated from one computer mouse; and from two keyboards and five mice six months later. The questionnaire response rate was 85.6. Seventy-one percent of respondents stated that they regarded keyboards and mice as an important source of nosocomial infections. Nevertheless; 62of doctors and 40.3of nurses indicated that they never washed their hands before or after using the computer. Ninety-seven percent of respondents were not aware of an official cleaning policy for computer equipment. In order to prevent nosocomial infections resulting from microbial transmission between equipment; staff and patients; proper cleaning policies should be implemented

Knowledge of and Attitude towards Pain Relief during Labour of Women Attending

Objective: This study determined women's knowledge of and attitudes to pain relief during labour. Methods : This descriptive study included 151 women; 18 years or older; attending the antenatal clinic of Cecilia Makiwane Hospital. Women were interviewed using a questionnaire that determined their knowledge of and attitudes regarding pain relief. Results : The median age of the women was 29 years and most was pregnant for a second or third time. More than half the women (56.3) indicated that they knew about pain relief and most had received their information from a previous labour experience (56.5) or from friends and relatives (55.3). Of the women who had knowledge of pain relief (n=85); 65.9 had experienced severe pain during previous labour and 65.3 indicated injections. Half the women (51.7) believed that they should experience mild pain; however; while 55.7 of these had found the experience to be unacceptable. Most women (59.8) who had been pregnant were not told what to expect when in labour. Of those who had been told (n=41); 75.6) and good (31.2 found the information useful. The women who had previously delivered in a health facility rated the service received in relieving labour pain as fair (47.3)). Most of the women (99.3) believed that the staff had an important role to play in helping to relieve labour pain. Most of the women (78) expressed no concern about problems associated with pain relief methods; while a large number (83.4)expressed little or no confidence in labour pain relief.Conclusion : Most of the women gained knowledge regarding pain relief from past experiences or from friends and relatives. Even though the few women who received information about what to expect during labour found the information useful; most expressed little confidence in labour pain relief

Decline in the ischaemic heart disease mortality rates of South Africans, 1968-1985.

The age-adjusted ischaemic heart disease (IHD) mortality rates (MRs) of white, Asian and coloured South Africans aged 35-74 years were studied for the period 1968-1985. Asians have the highest IHD MR in the RSA, followed by whites, coloureds and then blacks. Asian female have much higher rates than females in the other groups, especially in the older age groups. Asian males have noticeably higher rates in the younger age groups. Coloured females aged 35-44 years have a surprisingly high rate. Declines of 36.5% (from 482 to 306/100,000) for whites between 1970 and 1985, 27.5% (from 583 to 422/100,000) for Asians between 1973 and 1985, and 19.5% (from 287 to 231/100,000) for coloureds between 1976 and 1985 were observed. Rates declined among both males and females as well as in all the age groups studied. Trends in IHD MRs for black South Africans were studied for 1978-1985. The MRs for IHD among blacks are very much lower than those for South African Asians, coloureds and whites. The age-adjusted IHD MR for all South Africans was 162/100,000 in 1978 and had dropped to 121/100,000 in 1985, a 25.3% decline.

Comparison of the decline in the ischaemic heart disease mortality rate in the RSA with that in other Western countries.

South African age-adjusted ischaemic heart disease (IHD) mortality rates (MRs) in the age group 35-74 years were compared with equivalent IHD MRs of five Western countries for the period 1968-1983. South African Asians had higher IHD MRs than all the other countries studied, and South African whites had among the highest despite the declines in rates over the period studied. Although the younger South African age groups had the greatest decline in IHD MRs, in the age group 35-44 years and 45-55 years South African rates still remain higher than those for the five other Western countries studied. Overall, the South African whites' ranking, compared with the other Western countries studied, had changed from the 2nd highest in 1970 to 4th position for males and 3rd for females in 1982.

Notification of five of the EPI target diseases in South Africa. An assessment of disease and vaccination reporting.

The incidence of 5 of the 6 EPI target diseases, diphtheria, tetanus, poliomyelitis, measles and tuberculosis, in South Africa is examined. Incidence is linked to vaccination coverage and an assessment of municipal vaccination coverage and programme monitoring is made. Diphtheria incidence has decreased sharply and this is probably due to vaccination. A change in the cyclical pattern of polio incidence may be due to improved vaccination. No influence of vaccination could be detected with respect to measles, tetanus and tuberculosis. Vaccination programmes report results as 'total doses given' and not as coverage rates. Improvements in three major areas, i.e. vaccination coverage, programme monitoring and evaluation and programme co-ordination are proposed.