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How the latest reforms affect Healthcare in South Africa

Changes to Healthcare reform such as the NHI are hot topics of debate at the upcoming Healthcare summit taking place later this month in Johannesburg. The cost of private Healthcare, the Consumer Protection Act and pricing structure of medical schemes will be addressed by leading experts in the industry.

Editor's comment: Last word

...Day for the Elimination of Violence Against Women � November 25; Children�s Day - November 20; AIDS Awareness day � December 1; Human Rights day � December 10; 16 Days of Activism of No Violence against Women and Children � November 25 to December 10....

Dermatology: Sunbeds and skin cancer

Catherine ML Roberts: MB ChB, MRCP, Dermatology SpR, Nottingham University Hospitals, Nottingham.
Dafydd L Roberts: MB BS, FRCP, Consultant Dermatologist, Singleton Hospital, Swansea

Abstract

Ultraviolet (UV) radiation from sunlight is well recognised to be the main environmental cause of skin cancer. Sunbeds provide a source of artificial UV light exposure, and their widespread use for cosmetic tanning purposes raises concern about further increases in the already rising levels of skin cancer. There is evidence that those who have used sunbeds are at increased risk of developing malignant melanoma and squamous cell carcinoma. However, no increased risk of basal cell carcinoma or dose�response relationship between sunbed use and skin cancer has as yet been identified. As the common usage of sunbeds has only been in place since the 1980s, there may be a significant lag time before we see the true damage being done by these devices.

Paediatric nutrition: Hungry baby

Rowena Bennett: RN, RM, RPN, CHN, Grad Dip Health Promotion

Common reasons for increased hunger
Insufficient milk

If a baby is not gaining enough weight, it may be because of insufficient milk intake (breast or formula). Where there is concern about weight, the first step is to increase the amount of milk and if this fails to bring about weight gain, a doctor should make sure there�s no physical reason.

Paediatric nutrition: Choosing an infant or paediatric formula

Juanita Dale: PhD, RN, CPNP Children�s Medical Center of Dallas Dallas, Texas.
Allison L. Morrow: RD/LD, Clinical Editor and Dietitian, Children�s Medical Center of Dallas, Dallas, Texas.

Introduction

Choosing an appropriate formula can be a daunting task with the wide array of choices out on the market today. Not only do formulas exist for different purposes and nutrient needs, but one must choose amongst forms (powder vs. concentrate), calorie levels, flavours, and manufactu-rers. Knowing the basic categories of formulas can help to eliminate some of the confusion.

Diabetes � questions and answers

What is diabetes?

Diabetes is a chronic disease that develops when the pancreas does not produce enough insulin or when the body becomes unable to use the insulin it produces effectively.

Infectious diseases: Tuberculosis and HIV co-infection

Stephen D Lawn MBBS MRCP MD DTM&H Dip HIV Med is a Reader in the Department of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, London, UK. Competing interests: none declared.

Abstract�

HIV infection is the strongest risk factor for development of tuberculosis (TB) and conversely TB is the commonest HIV-associated opportunistic disease worldwide. HIV modifies the clinical presentation of TB, with an increased frequency of radiographically atypical pulmonary TB as well as extrapulmonary and disseminated disease. A high index of suspicion of TB should always be maintained during investigation of febrile HIV-infected patients and mycobacterial culture of multiple specimens is important. While it has been thought that the bacteriological response to antituberculosis treatment is not significantly affected by HIV status, some data indicate that relapse rates following standard rifampicin-containing TB treatment are higher in HIV-positive patients and may be reduced by extending therapy and by use of antiretroviral therapy (ART). Nosocomial outbreaks of multi-drug resistant TB are a risk in HIV treatment and care settings. ART reduces the incidence of TB by 80�90%, but rates nevertheless remain significantly higher than background. Concurrent administration of ART and anti-tuberculosis drugs is complicated by pharmacokinetic interactions of rifamycins with non-nucleoside reverse transcriptase inhibitors and protease inhibitors, but good responses to ART are nevertheless achievable. The early stages of ART may be complicated by the immune reconstitution inflammatory syndrome. Here, rapid restoration of host inflammatory responses to mycobacteria may lead to clinical deterioration of existing TB or �unmasking� of previously subclinical TB.

Injuries and wounds: Bedsores or pressure ulcers

S. Joan Lewis, BSc MBChB

'Pressure ulcer' is a more correct term for bedsores, which are also known as decubitus ulcers. Pressure ulcers can appear anywhere on the body where there is unrelieved pressure, particularly over bony or cartilaginous areas. If diagnosed early they may be easily treatable, but if neglected they can become life-threatening.

Physical abuse: 16 Days of Activism against abuse �Don�t look away � act against

Imagine if, for 16 days, there was no rape, no child abuse. The 16 Days of Activism for No Violence Against Women and Children campaign challenged South Africans to declare a truce on violence against women and children - and, ultimately, to make it a permanent one.

Physical abuse: Chronically ill children are 88% more likely to suffer physical

Children with chronic health conditions are 88% more likely to suffer physical abuse than healthy children, according to research.¹ They are also 154% more likely to suffer a combination of physical abuse and exposure to intimate partner violence than their healthy school friends.