South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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The use of analgesics is prevalent in runners, with an associated potential for serious harm. More information is needed regarding runners' practices and the factors that may influence their use of analgesics, to identify potential sources of misuse or abuse. ⋯ A large percentage of runners in our study displayed unsafe practices regarding analgesic use during training and competition, predominantly for perceived injury management. Importantly, the lack of education and recommendations regarding analgesics from health professionals is very concerning, as there is a risk of potentially life-threatening analgesic-induced adverse effects, especially as a high percentage were using two NSAIDs concomitantly. Knowledge of these practices, gained through this study, could allow for the development and implementation of corrective strategies to promote education and safe practice of analgesic use in runners.
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The quality of international normalised ratio (INR) control determines the effectiveness and safety of warfarin therapy. Data on INR control in non-metropolitan settings of South Africa (SA) are sparse. ⋯ INR control, as determined by TTR and proportion of TTR ≥65%, in these non-metropolitan clinics was poor. Age and hospitalisation as a marker of illness predicted poor control. There was a difference in control between groups, depending on the indication for warfarin. Evidence-based measures to improve the quality of INR control in patients on warfarin therapy need to be instituted as a matter of urgency.
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Workplace bullying and other negative workplace behaviours are problems that need to be addressed across many work settings, including at universities. ⋯ A combination of strategies is needed, including clear FHS policies to prevent bullying, training in bullying prevention and critical diversity, and positive practice environments.
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Identification of patients on antiretroviral therapy (ART) with virological failure (VF) and the response in the public health sector remain significant challenges. We previously reported improvement in routine viral load (VL) monitoring after ART commencement through a health system-strengthening, nurse-led 'VL champion' programme as part of a multidisciplinary team in three public sector clinics in Durban, South Africa. ⋯ This enhanced intervention to improve VF in the public sector using a paper-based data management system failed to achieve significant improvements in first-line VF management over the standard of care. In addition to interventions that better address patient-centred factors that contribute to VF, we believe that there are substantial limitations to and staffing requirements involved in the ongoing utilisation of a paper-based tool. A prioritisation is needed to further expand and upgrade the electronic medical record system with capabilities for prompting staff regarding patients with missed visits and critical laboratory results demonstrating VF.