Medical interns' training in family medicine at a district hospital and primary health care clinics in Middelburg, Mpumalanga.

Training of medical interns at the Middelburg district hospital has been introduced as part of the mandatory 6 months' rotation in Family Medicine department since 2021. This report provides an overview of what has been attained in 2021 and 2022. It covers various aspects of the activities medical interns have been exposed to in the Middelburg hospital and the surrounding primary health care clinics.Contribution: Sharing experiences of family medicine training for medical interns in district hospitals is essential because the 6 months' rotation is new for most family physician trainers, especially those in small hospitals and primary health care clinics. Taking into account the paucity of evidence on the topic, the report brings current information that supports that training medical interns in district hospitals and primary health care clinics prepares them to be comfortable and competent clinicians for the generalist work during the community service year ahead.

Three-Stage Assessment as Reverse Innovation in Interprofessional Student Clinical Rotations.

Social determinants of health are increasingly recognized as important factors in individual and public health outcomes and are therefore of interest to both health care systems and medical schools. However, teaching holistic assessment strategies during clinical education remains a challenge. This article reports on the experiences of American physician assistant students who completed an elective clinical rotation in South Africa. In particular, the students' training and practice with 3-stage assessment is highlighted as an example of a reverse innovation practice that could be incorporated in interprofessional health care education models in the United States.

Hypertensive patients' knowledge and practices on lifestyle modification in Extension 6, Middelburg.

BACKGROUND: Hypertension (HTN) is one of the most common chronic diseases affecting the majority of patients worldwide, including in South Africa. The control of HTN and prevention of complications are major challenges for patients and healthcare workers. The proper control of the disease requires a multifactorial approach consisting of medical treatment, as well as lifestyle modification, with the assistance of healthcare workers. Addressing patients' beliefs, the practice of lifestyle and acceptance of change are some of the ways of aiding control. METHODS: The researchers used a cross-sectional and descriptive survey to establish the knowledge and practices of lifestyle modifications in patients with hypertension. A validated questionnaire was adopted. A total of 250 participants from the Extension 6 Clinic in Middelburg, Mpumalanga, constituted the study population. RESULTS: Most of the participants had borderline high blood pressure (37.2%) or uncontrolled high blood pressure (46%). The participants' knowledge of HTN and its complications was not adequate. The study established that increased age and long duration of HTN were associated with high numbers of uncontrolled HTN. Most of the participants (88.8%) had difficulty exercising. Also, most of the participants (90.8%) did not have a place or facility for exercises. Fifty per cent of the participants were unable to maintain a balanced healthy diet which included fruits and vegetables. CONCLUSION: The study explored the participants' knowledge and practice of lifestyle modification. The participants lacked knowledge regarding the definition of HTN and the meaning of controlled HTN. To assist the patients and improve on the identified pitfalls, each consultation session should include some methods of education, and motivation for healthy behaviours and lifestyle modification. This should be extended to all the people visiting the health facilities for them to adopt a healthier diet, greater intake of vegetables and availability of fitness facilities for the community.

Association between social support and viral load in adults on highly active antiretroviral therapy - Witbank, South Africa.

BACKGROUND: There are significant number of patients who are on highly active antiretroviral therapy (HAART) not virally suppressed, which is a huge clinical challenge. Social support as a non-pharmacological factor, which may influence the viral suppression, is less studied and has equivocal results. The aim of this study was to investigate the association between social support and viral load (VL) in adults on HAART. METHODS: This was an analytical cross-sectional study. Using a structured questionnaire, 380 adults (≥ 18 years) on HAART for ≥ 6 months were recruited between November 2018 and February 2019 from Witbank hospital and surrounding clinics. Multivariable logistic regression was carried out. RESULTS: The mean age of the participants was 40.5 years (s.d. = 10.3). The majority were females (73%), at least high school educated (84%), unemployed (57%), single (63%) and did not have comorbidity (80%). The vast majority had moderate to high adherence (84%) and moderate to good perceived social support (94%). The viral suppression rate was 87%. Both adherence (p 0.001) and social support (p = 0.017) were significantly associated with VL. However, only adherence was predictive of viral suppression in multivariable analysis. Compared to poorly adherent, moderately (OR = 2.8; 95% CI = 1.32-5.98) and highly (OR = 5.3; 95% CI = 2.41-11.81) adherent participants were more likely to have suppressed VL. CONCLUSION: Viral suppression rate was high. Self-reported adherence to HAART was highly predictive of viral suppression, which highlights the importance of assessing and addressing adherence issues at every contact with patients taking HAART. Good social support did not predict viral suppression.

Social media use by health professionals: To do or not to do?

No abstract available.

Mastering your fellowship.

The series, 'Mastering your Fellowship', provides examples of the Different question formats encountered in the written and clinical examinations, that is, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination. The series is aimed at helping family medicine registrars prepare for this examination.

A study of the knowledge and practice of lifestyle modification in patients with type 2 diabetes mellitus in Middelburg sub-district of Mpumalanga

Introduction: Diabetes mellitus is one of the most common clinical conditions seen by family physicians in their daily practice. They are constantly confronted with the burden of caring for poorly controlled and poorly adherent patients presenting with preventable debilitating, disabling and mutilating complications. Lifestyle modifications in combination with medications have been proven to contribute to the prevention and delay of complications.Aims: The study aimed to investigate the knowledge and practice of lifestyle modifications and also to determine challenges faced by patients in their practice of lifestyle changes in the management of type 2 diabetes mellitus in the Middelburg subdistrict of Mpumalanga.Study design: An observational, descriptive and cross-sectional study was done. Data were collected from 150 patients with type 2 diabetes mellitus (T2DM) using a self-administered questionnaire. Results: The results showed that DM was more prevalent among females and the age group 50­ 59 years was mostly affected. Nearly 50% of the respondents were obese and about 35% of them overweight. Lifestyle modification was understood as healthy dietary habits. Only 35% of the respondents participated in exercises. Brisk walking (59%) was the preferred form of exercise among these participants. A statistically significant finding was that 79.63% of participants who did not adhere to exercise recommendations had poor glycaemic control. Only 40.48% of participants who adhered to exercise recommendations had good glycaemic control. Obesity (47.52%) and overweight (32.67%) were associated with poor glycaemic control. Conclusion and recommendation: The majority of the participants thought that lifestyle modification was healthy eating; only a third of them regularly exercised. The author recommends a multidisciplinary and multilevel approach involving different stakeholders­ among others, patients and community, health professionals/providers and government services­in assisting diabetic patients with lifestyle modification