Subjects -> HEALTH AND SAFETY (Total: 1464 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (686 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (686 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted by number of followers
American Journal of Public Health     Full-text available via subscription   (Followers: 220)
Journal of Public Health     Hybrid Journal   (Followers: 153)
Journal of Epidemiology & Community Health     Hybrid Journal   (Followers: 64)
Health and Social Work     Hybrid Journal   (Followers: 64)
Health Psychology     Full-text available via subscription   (Followers: 63)
Journal of Health Psychology     Hybrid Journal   (Followers: 59)
British Journal of Health Psychology     Hybrid Journal   (Followers: 55)
Journal of Child Sexual Abuse     Hybrid Journal   (Followers: 54)
Health Policy     Hybrid Journal   (Followers: 52)
Safer Communities     Hybrid Journal   (Followers: 50)
Health Psychology Review     Hybrid Journal   (Followers: 47)
Ageing & Society     Hybrid Journal   (Followers: 40)
Journal of Occupational Health Psychology     Full-text available via subscription   (Followers: 40)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 39)
American Journal of Health Education     Hybrid Journal   (Followers: 36)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 34)
Qualitative Health Research     Hybrid Journal   (Followers: 33)
Psychology & Health     Hybrid Journal   (Followers: 33)
Journal of Traumatic Stress     Hybrid Journal   (Followers: 29)
Journal of Health and Social Behavior     Hybrid Journal   (Followers: 27)
Social Work in Health Care     Hybrid Journal   (Followers: 27)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 27)
Journal of Occupational Science     Hybrid Journal   (Followers: 27)
Health Promotion International     Hybrid Journal   (Followers: 26)
Journal of Public Health     Hybrid Journal   (Followers: 26)
Journal of Exercise Science & Fitness     Open Access   (Followers: 26)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 25)
Implementation Science     Open Access   (Followers: 25)
International Journal of Mental Health     Full-text available via subscription   (Followers: 25)
Health & Place     Hybrid Journal   (Followers: 23)
Quality in Primary Care     Open Access   (Followers: 23)
Journal of Public Health Policy     Partially Free   (Followers: 23)
BMC Pregnancy and Childbirth     Open Access   (Followers: 20)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 20)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 19)
Applied Ergonomics     Hybrid Journal   (Followers: 18)
International Journal of Social Welfare     Hybrid Journal   (Followers: 18)
Journal of Integrated Care     Hybrid Journal   (Followers: 18)
Mental Health Review Journal     Hybrid Journal   (Followers: 18)
Psychology, Health & Medicine     Hybrid Journal   (Followers: 17)
Ethnicity & Health     Hybrid Journal   (Followers: 16)
Health Promotion Practice     Hybrid Journal   (Followers: 16)
Social Work in Mental Health     Hybrid Journal   (Followers: 16)
Tobacco Control     Hybrid Journal   (Followers: 16)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 16)
Global Health Promotion     Hybrid Journal   (Followers: 16)
Open Journal of Safety Science and Technology     Open Access   (Followers: 16)
Health Research Policy and Systems     Open Access   (Followers: 15)
Journal of Family Social Work     Hybrid Journal   (Followers: 15)
Journal of Behavioral Health Services & Research     Hybrid Journal   (Followers: 15)
Journal of Religion and Health     Hybrid Journal   (Followers: 14)
Policy and Practice in Health and Safety     Hybrid Journal   (Followers: 14)
International Journal of Healthcare Management     Hybrid Journal   (Followers: 14)
Canadian Family Physician     Partially Free   (Followers: 14)
Systematic Reviews     Open Access   (Followers: 14)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 13)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 13)
Journal of Creativity in Mental Health     Hybrid Journal   (Followers: 13)
Perspectives in Public Health     Hybrid Journal   (Followers: 13)
Archives of Suicide Research     Hybrid Journal   (Followers: 13)
Social Work in Public Health     Hybrid Journal   (Followers: 13)
Family & Community Health     Hybrid Journal   (Followers: 13)
Scandinavian Journal of Work, Environment & Health     Partially Free   (Followers: 13)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 13)
Health Care Analysis     Hybrid Journal   (Followers: 12)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 12)
Public Health Ethics     Hybrid Journal   (Followers: 12)
Childhood Obesity and Nutrition     Open Access   (Followers: 12)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 12)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 11)
Family Relations     Partially Free   (Followers: 11)
International Journal for Equity in Health     Open Access   (Followers: 11)
Health, Risk & Society     Hybrid Journal   (Followers: 11)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 11)
International Journal of Health Economics and Management     Hybrid Journal   (Followers: 10)
Journal of Spirituality in Mental Health     Hybrid Journal   (Followers: 10)
Women & Health     Hybrid Journal   (Followers: 10)
Diversity and Equality in Health and Care     Open Access   (Followers: 10)
School Mental Health     Hybrid Journal   (Followers: 10)
Journal of Healthcare Risk Management     Hybrid Journal   (Followers: 10)
Journal of Family Medicine and Primary Care     Open Access   (Followers: 10)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 9)
Journal of Community Health     Hybrid Journal   (Followers: 9)
Journal of Mental Health Counseling     Full-text available via subscription   (Followers: 9)
Healthcare Quarterly     Full-text available via subscription   (Followers: 9)
Journal of Public Health Research     Open Access   (Followers: 9)
Conflict and Health     Open Access   (Followers: 8)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
International Journal of Health Geographics     Open Access   (Followers: 8)
Journal of Immigrant and Minority Health     Hybrid Journal   (Followers: 8)
Journal of Public Child Welfare     Hybrid Journal   (Followers: 8)
Theoretical Issues in Ergonomics Science     Hybrid Journal   (Followers: 8)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 8)
Revista Brasileira de Medicina de Família e Comunidade     Open Access   (Followers: 8)
Globalization and Health     Open Access   (Followers: 7)
International Journal of Health Services     Full-text available via subscription   (Followers: 7)
International Journal of Hygiene and Environmental Health     Hybrid Journal   (Followers: 7)
Journal of Workplace Behavioral Health     Hybrid Journal   (Followers: 7)
Medicine, Health Care and Philosophy     Hybrid Journal   (Followers: 7)
Hastings Center Report     Hybrid Journal   (Followers: 7)
The Journal of Rural Health     Hybrid Journal   (Followers: 7)
American Journal of Family Therapy     Hybrid Journal   (Followers: 7)
Journal Of Allied Health     Full-text available via subscription   (Followers: 7)
Revue d'Épidémiologie et de Santé Publique     Full-text available via subscription   (Followers: 7)
Journal of Multidisciplinary Healthcare     Open Access   (Followers: 7)
Epidemics     Open Access   (Followers: 7)
Rehabilitation Process and Outcome     Open Access   (Followers: 7)
Journal of School Nursing     Hybrid Journal   (Followers: 7)
Journal of Primary Prevention     Hybrid Journal   (Followers: 7)
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 7)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 7)
EcoHealth     Hybrid Journal   (Followers: 6)
International Journal of Sexual Health     Hybrid Journal   (Followers: 6)
Journal of Muslim Mental Health     Open Access   (Followers: 6)
Risk Management and Healthcare Policy     Open Access   (Followers: 6)
Journal of Developing Areas     Full-text available via subscription   (Followers: 6)
International Journal of Healthcare Information Systems and Informatics     Hybrid Journal   (Followers: 6)
BMC Oral Health     Open Access   (Followers: 5)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Population Health Metrics     Open Access   (Followers: 5)
Journal of Infection and Public Health     Open Access   (Followers: 5)
Journal of Development Effectiveness     Hybrid Journal   (Followers: 5)
International Health     Hybrid Journal   (Followers: 5)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 5)
Journal of Public Health Management and Practice     Hybrid Journal   (Followers: 5)
Journal of Consumer Health on the Internet     Hybrid Journal   (Followers: 4)
Sexual Health     Hybrid Journal   (Followers: 4)
Southern African Journal of Critical Care     Open Access   (Followers: 4)
Journal of Communication in Healthcare     Hybrid Journal   (Followers: 4)
International Research in Children's Literature     Hybrid Journal   (Followers: 4)
Progress in Community Health Partnerships: Research, Education, and Action     Full-text available via subscription   (Followers: 4)
Health Promotion & Physical Activity     Open Access   (Followers: 4)
Journal of Health Care Chaplaincy     Hybrid Journal   (Followers: 3)
Reproductive Health     Open Access   (Followers: 3)
South African Family Practice     Open Access   (Followers: 3)
Social Theory & Health     Hybrid Journal   (Followers: 3)
World Health & Population     Full-text available via subscription   (Followers: 3)
Journal of Public Health in Africa     Open Access   (Followers: 3)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 3)
Public Health Genomics     Full-text available via subscription   (Followers: 3)
International Journal of Health & Allied Sciences     Open Access   (Followers: 3)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy     Full-text available via subscription   (Followers: 2)
Vascular Health and Risk Management     Open Access   (Followers: 2)
Health SA Gesondheid     Open Access   (Followers: 2)
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 2)
Noise and Health     Open Access   (Followers: 2)
ElectronicHealthcare     Full-text available via subscription   (Followers: 2)
Atención Primaria     Open Access   (Followers: 2)
Gaceta Sanitaria     Open Access   (Followers: 2)
Water Quality, Exposure and Health     Hybrid Journal   (Followers: 2)
World Medical & Health Policy     Hybrid Journal   (Followers: 2)
Environmental Sciences Europe     Open Access   (Followers: 2)
Drogues, santé et société     Open Access   (Followers: 2)
Journal of Biology, Agriculture and Healthcare     Open Access   (Followers: 2)
SMAD, Revista Electronica en Salud Mental, Alcohol y Drogas     Open Access   (Followers: 2)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
Dramatherapy     Hybrid Journal   (Followers: 2)
FASEB BioAdvances     Open Access   (Followers: 1)
South African Journal of Child Health     Open Access   (Followers: 1)
Health Services Insights     Open Access   (Followers: 1)
Internationale Revue Fur Soziale Sicherheit     Hybrid Journal   (Followers: 1)
Research Methods in Medicine & Health Sciences     Open Access   (Followers: 1)
médecine/sciences     Hybrid Journal   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
Journal of The Egyptian Public Health Association     Open Access   (Followers: 1)
Revista Facultad Nacional de Salud Pública     Open Access   (Followers: 1)
Poblacion y Salud en Mesoamerica     Open Access   (Followers: 1)
International Journal of Healthcare Delivery Reform Initiatives     Full-text available via subscription   (Followers: 1)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Tidsskrift for Forskning i Sygdom og Samfund     Open Access  
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Journal of Dr. NTR University of Health Sciences     Open Access  
Israel Journal of Health Policy Research     Open Access  
Revista de Ciencias Médicas de Pinar del Río     Open Access  
Revista Médica Electrónica     Open Access  
Saúde Coletiva     Open Access  
Revista Ciencias de la Salud     Open Access  
Psicologia, Saúde e Doenças     Open Access  
Portularia     Open Access  
Motricidade     Open Access  
Investigaciones Andina     Open Access  
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Salud Colectiva     Open Access  
Revista de la Universidad Industrial de Santander. Salud     Open Access  
Revista U.D.C.A Actualidad & Divulgación Científica     Open Access  
Revista Peruana de Medicina Experimental y Salud Pública     Open Access  
Revista Gerencia y Políticas de Salud     Open Access  
Hacia la Promoción de la Salud     Open Access  
CES Medicina     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Face à face     Open Access  
Iranian Journal of Health and Environment     Open Access  
Iranian Journal of Public Health     Open Access  
Revista Chilena de Terapia Ocupacional     Open Access  
Revista Chilena de Salud Pública     Open Access  
Revista de Comunicación y Salud     Open Access  
Prävention und Gesundheitsförderung     Hybrid Journal  
Child's Nervous System     Hybrid Journal  

        1 2 3 4 | Last

Similar Journals
Journal Cover
Southern African Journal of Critical Care
Journal Prestige (SJR): 0.159
Number of Followers: 4  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1562-8264 - ISSN (Online) 2078-676X
Published by African Journals Online Homepage  [261 journals]
  • An investigation into specialist practice nurses’ knowledge of
           cardiopulmonary resuscitation guidelines in a tertiary hospital in Gauteng
           Province, South Africa

    • Authors: M L Botes, M Moepeng
      Pages: 68 - 72
      Abstract: Background. Cardiac arrest is among the major causes of sudden deaths globally. Although out-of-hospital cardiac arrest occurs more commonly, in-hospital cardiac arrest is still a major health problem. Critical care areas provide care to critically ill patients who are at risk of cardiac arrest. It is important that nurses are knowledgeable and competent in cardiopulmonary resuscitation (CPR) in order to optimise the patient’s chances of survival and quality of life after cardiac arrest.
      Objective. To investigate specialist practice nurses’ knowledge of evidence-based guidelines for CPR.
      Methods. A descriptive cross-sectional survey was utilised. We sampled all critical care registered nurses (N=96) currently working in the adult emergency departments and intensive care units at Charlotte Maxeke Johannesburg Academic Hospital in Johannesburg, South Africa. A selfadministered instrument, the ‘evaluation questionnaire on CPR knowledge for health personnel from emergency services’ was used. Data were analysed using descriptive and comparative statistics.
      Results. The mean CPR knowledge score was 46%. A score of 84% was considered adequate for a pass, and no respondents achieved this score. The majority of the respondents (80.85%; n=76) were specialists in the field of intensive care nursing.
      Conclusion. The CPR knowledge of specialist practice nurses was suboptimal for the care required in high-risk settings. Further training is indicated.
      PubDate: 2023-04-26
      Issue No: Vol. 36, No. 2 (2023)
  • Low albumin levels are associated with mortality in the critically ill: A
           retrospective observational study in a multidisciplinary intensive care

    • Authors: A K Atrash, K de Vasconcellos
      Pages: 74 - 79
      Abstract: Background. Albumin is a determinant of plasma colloid oncotic pressure and buffering capacity. It is a carrier protein for drugs and is important for normal functioning of the glycocalyx. Hypoalbuminaemia is common in the critically ill and has been associated with adverse outcomes. The association between hypoalbuminaemia and outcome has not been specifically explored in the South African context.
      Objectives. To determine whether albumin levels on admission and changes in albumin levels were associated with intensive care unit (ICU) mortality in a heterogenous critically ill population.
      Methods. This was a retrospective observational study of 247 adult patients who were admitted to a multidisciplinary ICU. Albumin levels were measured on admission and 48 hours later, alongside other biochemical and clinical parameters to determine whether they were predictive of ICU mortality.
      Results. The lowest level of albumin on admission was 8 g/L and the highest was 43 g/L. The incidence of hypoalbuminaemia (using the laboratory reference range) was 93.9% on admission and 99.4% at 48 hours. Receiver operating characteristic curve analysis provided an optimal albumin cut-off of 18.5 g/L. Using this cut-off, hypoalbuminaemia at admission and at 48 hours was associated with increased ICU mortality. Hypoalbuminaemia at admission was an independent predictor of mortality using multivariable analysis (OR 3.74; 95% confidence interval 1.87 - 4.48).
      Conclusion. Hypoalbuminaemia is associated with increased ICU mortality. There is currently no evidence to support the use of albumin replacement therapy. Further research is required to determine its role in critically ill patients.
      PubDate: 2023-04-26
      Issue No: Vol. 36, No. 2 (2023)
  • The incidence and outcomes of patients with acute kidney injury in a
           multidisciplinary intensive care unit in Durban, South Africa

    • Authors: M A Khuweldi, D L Skinner, K de Vasconcellos
      Pages: 80 - 84
      Abstract: Background. Acute kidney injury (AKI) in critically ill and resource-limited settings is under investigated.
      Objectives. To describe the incidence, outcomes and healthcare burden of AKI in a multidisciplinary intensive care unit (ICU) in Durban, South Africa (SA).
      Methods. All adult patients admitted to the ICU at King Edward VIII Hospital from January 2016 to June 2016, who did not have end-stage renal disease and survived for more than 6 hours after admission were evaluated for AKI using the kidney disease improving global outcomes (KDIGO) creatinine criteria. Potential risk factors for AKI and an association between AKI and outcomes including ICU mortality and length of stay were analysed.
      Results. We screened 204 patients for inclusion into the study and 26 patients were excluded. About half of the patients (50.5%; n=90/178) who were included in the study were diagnosed with AKI at the time of admission and 16.3% (n= 29/178 developed AKI in the ICU. Among the patients who had AKI on admission, 50% (n=45/90) were classified as KDIGO stage1, 21.1% (n=19/90) as stage 2 and 28.8% (n=26/90) as stage 3. Less than one-third (24.7%; n=44/178) of the patients who developed AKI in the ICU were classified as KDIGO stage 1, 14% (n=25/178) were stage 2, and 28% (n=50/178) were stage 3. The mortality rate for patients with AKI on admission was 40.0% (n=36/90) compared with 39.8% (n=35/88) for those without AKI on admission (p=0.975). The mortality rate for all patients with AKI was 46.2% (n=55/119) compared with 27.1%  n=16/59) in patients who did not develop AKI (p=0.014).
      Conclusion. AKI is common in critically ill patients presenting to a tertiary ICU in Durban, SA. AKI is associated with increased mortality and length of stay in the ICU. Strategies to prevent the development or worsening of AKI must be emphasised. These include prevention or at least early treatment of sepsis, adequate fluid resuscitation, aggressive haemodynamic optimisation and avoidance of nephrotoxins. This is especially important in settings where there is limited access to renal replacement therapy (RRT).
      PubDate: 2023-04-29
      Issue No: Vol. 36, No. 2 (2023)
  • Physiotherapists’ perceptions of collaborations with inter-professional
           team members in an ICU setting

    • Authors: M N Ntinga, H van Aswegen
      Pages: 86 - 91
      Abstract: Background. In the intensive care unit (ICU) environment, inter-professional team collaborations have direct impact on patient care outcomes. Current evidence shows that providing physiotherapy to ICU patients shortens their length of stay and reduces their incidence of ventilator associated pneumonia and severity of critical illness neuropathy. Physiotherapists’ perceptions of their interactions with nurses and doctors as inter-professional team members in the ICU is important.
      Objectives. To identify barriers and enablers of physiotherapists’ interactions with inter-professional team members in adult ICU settings, identify solutions to the barriers and determine if perceptions of interactions with ICU team members differ between junior and senior physiotherapists.
      Methods. A qualitative study was done using semi-structured group discussions. Participants were recruited using convenience sampling. Participants were junior and senior physiotherapists from four private and four public sector hospitals in urban Johannesburg, South Africa. Interviews were audio recorded. Recordings were transcribed and direct content analysis of data was done to create categories, subcategories and themes.
      Results. Twenty-two junior and 17 senior ICU physiotherapists participated in the study. Barriers raised by physiotherapists regarding communication with inter-professional team members in the ICU were non-ICU trained staff working in ICU, personality types, lack of professional etiquette, and frequent rotation of ICU staff. Enablers of communication with inter-professional team members were presence of team members in ICU during the day, good time management, teamwork approach to care and sharing of knowledge. Differing paradigms of teamwork among health professionals was highlighted as a cause of tension in the ICU inter-professional collaborations.
      Conclusion. Physiotherapists are important members of the inter-professional ICU team. Exploring their interactions with other team members identified solutions that may improve collaboration between inter-professional team members to facilitate improved patient outcomes. Inter-professional education should inform ICU policies to create an environment that fosters teamwork. Finding creative ways to adequately staff the ICU without losing quality or driving up costs of care are matters that should take priority among policy makers.
      PubDate: 2023-04-29
      Issue No: Vol. 36, No. 2 (2023)
  • qSOFA as a predictor of ICU outcomes in a resource-limited setting in
           KwaZulu-Natal Province, South Africa

    • Authors: S M Savarimuthu, C Cairns, N L Allorto, G E Weissman, R Kohn, R D Wise, G L Anesi
      Pages: 92 - 95
      Abstract: Background. Sepsis is a major cause of morbidity and mortality, especially in critical care patients. Developing tools to identify patients who are at risk of poor outcomes and prolonged length of stay in intensive care units (ICUs) is critical, particularly in resource-limited settings.
      Objective. To determine whether the quick sequential organ failure assessment (qSOFA) score based on bedside assessment alone was a promising tool for risk prediction in low-resource settings.
      Methods. A retrospective cohort of adult patients admitted to the intensive care unit (ICU) at Edendale Hospital in Pietermaritzburg, South Africa (SA), was recruited into the study between 2014 and 2018. The association of qSOFA with in-ICU mortality was measured using multivariable logistic regression. Discrimination was assessed using the area under the receiver operating characteristic curve and the additive contribution to a baseline model using likelihood ratio testing.
      Results. The qSOFA scores of 0, 1 and 2 were not associated with increased odds of in-ICU mortality (adjusted odds ratio (aOR) 1.24, 95% confidence interval (CI) 0.86 - 1.79; p=0.26) in patients with infection, while the qSOFA of 3 was associated with in-ICU mortality in infected patients (aOR 2.82; 95% CI 1.91 - 4.16; p<0.001). On the other hand, the qSOFA scores of 2 (aOR 3.25; 95% CI 1.91 - 5.53; p<0.001) and 3 (aOR 6.26, 95% CI 0.38 - 11.62, p<0.001) were associated with increased odds of in-ICU mortality in patients without infection. Discrimination for mortality was fair to poor and adding qSOFA to a baseline model yielded a statistical improvement in both cases (p<0.001).
      Conclusions. qSOFA was associated with, but weakly discriminant, for in-ICU mortality for patients with and without infection in a resourcelimited, public hospital in SA. These findings add to the growing body of evidence that support the use of qSOFA to deliver low-cost, high-value critical care in resource-limited settings.
      PubDate: 2023-04-29
      Issue No: Vol. 36, No. 2 (2023)
  • Empirical antibiotic choice alters microbiological outcomes: Findings from
           comparative antibiograms in a trauma intensive care unit

    • Authors: S Savage-Reid, M S Moeng, T Thomas
      Pages: 96 - 103
      Abstract: Background. Inappropriate empirical antibiotics promote antibiotic resistance. Antibiograms guide empirical antibiotic therapy by outlining the percentage susceptibility of each pathogen to individual antibiotics. In 2016, the Trauma Intensive Care Unit at Charlotte Maxeke Johannesburg Academic Hospital escalated empirical antibiotic therapy for nosocomial infections from piperacillin-tazobactam to imipenem plus amikacin.
      Objectives. This study assessed the impact of escalation in empirical antimicrobial treatment on organism prevalence and resistance profile.
      Methods. A retrospective analysis of bacterial and fungal microscopy, culture and susceptibility reports from the laboratory information system of the National Health Laboratory Services, from 1 January 2015 to 31 December 2015 and 1 January 2017 to 31 December 2017, was conducted. Data were de-duplicated according to standard guidelines. Fisher’s exact test was used to determine p-values.
      Results. Organism prevalence shifted between the years, with a 2.7% increase in streptococci (p=0.0199), 1.7% increase in Candida auris (p=0.0031) and 4.6% and 4.4% reduction in Acinetobacter baumannii (p=0.0508) and Pseudomonas aeruginosa (p=0.0196), respectively. Similarly, there was a change in the resistance profile, with a 28.9% reduction in multi-drug resistant (MDR) A. baumannii (p=0.0001), 60.4% reduction in MDR P. aeruginosa (p=0.0001) and a 6.5% increase in carbapenem-resistant Enterobacterales (p=0.007). The predominant specimen type differed between the years, with significantly more pus, tissue and fluid samples and fewer respiratory samples sent for investigation in 2017 than 2015.
      Conclusion. Escalation in the use of empirical antibiotics showed a change in organism prevalence and an improvement in the susceptibility profile of MDR non-fermenters.
      PubDate: 2023-04-29
      Issue No: Vol. 36, No. 2 (2023)
  • Exploring moral distress among critical care nurses at a private hospital
           in Kwa-Zulu Natal, South Africa

    • Authors: W Emmamally, O Chiyangwa
      Pages: 104 - 108
      Abstract: Background. Moral distress resulting from frequent and intense exposures to morally challenging encounters with critically ill patients, their families and other healthcare professionals negatively impacts on the personal and professional wellbeing of critical care nurses.
      Objective. To determine the frequency, intensity and overall severity of moral distress among critical care nurses working in the critical care environment of a private hospital in the eThekwini district of KwaZulu-Natal Province, South Africa.
      Methods. A descriptive survey was conducted using a 21-item moral distress scale revised questionnaire. We assessed the influence of sociodemographic variables of the respondents on the moral distress composite scores.
      Results. The moral distress composite scores of the 74 critical care nurses who completed the questionnaires ranged from 0 - 303 out of a possible 336. The mean (standard deviation (SD)) composite moral distress score was 112.12 (73.21). Analysis of the relationship between sociodemographic variables and the moral distress composite scores revealed that female respondents experienced higher distress scores than males (p=0.013). There was an inverse relationship between composite scores and an increase in age (p=0.009) and years of service (p=0.022).
      Conclusion. The mean composite score of the critical care nurses was suggestive of moderate levels of moral distress. Counselling services and empowerment skills training are advocated to support critical care nurses to manage moral distress.
      PubDate: 2023-04-29
      Issue No: Vol. 36, No. 2 (2023)
  • High-flow oxygen therapy v. standard care in infants with viral

    • Authors: S Murphy, E Bruckmann, L G Doedens, A B Khan, A Salloo, S Omar
      Pages: 109 - 113
      Abstract: Background. High-flow humidified oxygen (HFHO) therapy has demonstrated benefit in infants with bronchiolitis.
      Objectives. To investigate the efficacy of HFHO in infants with moderate to severe viral bronchiolitis, when used outside the paediatric intensive care unit (PICU), in a hospital with limited PICU resources.
      Methods. A randomised controlled trial, which enrolled 28 infants between 1 month and 2 years of age, with a clinical diagnosis of acute viral bronchiolitis and moderate to severe respiratory distress. Participants were randomised to receive HFHO 2L/kg/min or oxygen by nasal cannula/face mask. Respiratory rate, heart rate, oxygen saturations, and modified TAL (M-TAL) score were measured at baseline, 60 - 90 minutes after starting therapy and at 6- and 12-hourly intervals. The primary outcome evaluated was the improvement in respiratory distress (M-TAL score). The secondary outcome assessed was the need for intubation and ventilation.
      Results. There was a significant improvement in respiratory distress (M-TAL score), in infants who received HFHO therapy. Additionally, there was also a reduction in heart rate in the HFHO group as well as a trend to lower intubation rates.
      Conclusion. HFHO is a beneficial therapy for infants with moderate-severe viral bronchiolitis. It can be safely used outside the PICU and could potentially reduce the need for intubation and admission to PICU in resource-limited settings.
      PubDate: 2023-04-29
      Issue No: Vol. 36, No. 2 (2023)
  • Haemophagocytic lymphohistiocytosis: Five years’ experience at tertiary
           hospitals in Free State Province, South Africa

    • Authors: M Nienkemper, J Malherbe, C Barrett
      Pages: 114 - 119
      Abstract: Background. Haemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening syndrome if not recognised and managed early. It involves an uncontrolled pathological activation of the immune system, and it is either genetic or acquired. It presents with clinical and laboratory features of severe inflammation. Early initiation of effective therapy may reduce mortality from 95% to 35%.
      Objective. To raise awareness of HLH among healthcare professionals, particularly intensivists.
      Methods. We report nine cases of secondary HLH seen at tertiary hospitals in Bloemfontein, South Africa.
      Results. All patients presented with fever, hypertriglyceridaemia, hyperferritinaemia, transaminitis and cytopenia. Haemophagocytosis was noted on bone marrow biopsy in 66.7% (n=6/9) of the patients. More than one-third (44.4%; n=4/9) of the cases were triggered by a lymphoma, 44% (n=4/9) were associated with infection and 11% (n=1/9) were associated HIV. Finally, 11.1% (n=1) of the patients were triggered by an underlying autoimmune disease. More than half (55.6%; n=5/9) of the cases had a fatal outcome.
      Conclusion. A high index of suspicion may promote the accurate diagnosis of HLH in patients presenting with fever, transaminitis and unexplained cytopenia.
      PubDate: 2023-04-29
      Issue No: Vol. 36, No. 2 (2023)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762

Your IP address:
Home (Search)
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-