Download Module no. 02 - UCT health sciences

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University of Cape Town
Faculty of Health Sciences
Special Study Module
Options Menu
July to August
2012
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ANAESTHESIA – AAE2001S
Module no.01
Contact:
Dr Rob Nieuwveldt
[email protected]
021-4045143/5003
Peri-operative neuromuscular blockade and reversal
2
Interpretive
Tel.
Title:
No. of students:
Type:
Summary:
Drugs antagonising acetyl-choline receptors at the neuromuscular junction are
extensively used in modern anaesthetic practice. These drugs require reversal at the
end of the surgical procedure and anaesthetic. Residual weakness has potential
adverse effects. There is a recent change in the degree of recovery required for safe
extubation of patients with residual neuromuscular blockade.
In this SSM the students will do a literature review of current neuromuscular blockade
and its reversal and associated complications. They will then audit admissions to the
post-anaesthetic recovery unit at GSH over a 1 week period using suitable equipment.
This will be written up as a formal report together with any recommendations and a
literature review.
Module no. 02
Contact:
Tel.
Title:
Dr Owen Porrill
[email protected]
021-4045001
Acute and chronic pain in primary care - assessment and
management
2
Interpretive
No. of students:
Type:
Summary:
Pain is commonly experienced by many patients. Pain is a common presenting
symptom at primary care level. The incidence of pain may be even higher than as a
presenting symptom. There is little detail available on pain experienced at primary care
level in Cape Town and the clinical skills required to manage this pain have not been
quantified.
In this SSM the students will review the physiology of pain, summarise current pain
management options and perform an analysis of the incidence of pain experienced by
patients to a primary care facility/day hospital in the Cape Town Metropolitan area.
This SSM will also interrogate the clinical skills requirement for pain assessment and
treatment, as well as the availability of pain medication and referral pathways for
patients experiencing pain.
Students will need to spend the 3rd week of the SSM as at Community Health Centre
interviewing patients and staff. This will be written up as a formal report together with
recommendations and a literature review. There is potential for this to be submitted as
a report to a local medical journal.
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Module no: 03
Contact:
Tel.
Title:
Dr Owen Porrill
[email protected]
021-4045143/5003
Acute pain assessment and management in a central
hospital
2
Interpretive
No. of students:
Type:
Summary:
Pain is commonly experienced by many patients presenting to emergency units
and is an expected consequence that follows most surgical procedures. The
assessment and treatment of this pain has important implications for the patient
as well as the medical staff caring for the patient. At Groote Schuur Hospital
there is no recent data on how patients experience management of their pain.
In this SSM the students will summarise current pain management options and
perform an analysis of current pain treatment and its effectiveness in the
emergency centre, on medical wards and following surgery, at Groote Schuur
Hospital. Students will be introduced to assessment tools for pain evaluation
and then use these tools to audit current practice. This will be written up as a
formal report together with recommendations and a literature review. There is
potential for this to be submitted as a report to a local medical journal.
Module no: 04
Contact:
Tel:
Title:
Dr Anthony Reed
[email protected]
021-4045143/5003
Acute pain assessment and management in a regional
hospital
2
Interpretive
No. of students:
Type:
Summary:
Pain is commonly experienced by many patients presenting to emergency units
and is an expected consequence that follows most surgical procedures. The
assessment and treatment of this pain has important implications for the patient
as well as the medical staff caring for the patient. At New Somerset Hospital
there is no recent data on how patients experience management of their pain.
In this SSM the students will review the physiology of pain, summarise current
pain management options and perform an analysis of current pain treatment
and its effectiveness in the emergency centre and following surgery, at New
Somerset Hospital. Students will be introduced to assessment tools for pain
evaluation and then use these tools to audit current practice. This will be written
up as a formal report together with recommendations and a literature review.
There is potential for this to be submitted as a report to a local medical journal.
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Module no: 05
Contact:
Tel:
Title:
No. of students:
Type:
Summary:
Dr Anthony Reed
[email protected]
021-4045143/5003
Acute and chronic pain in a district hospital - assessment
and management
2
Interpretive
Pain is commonly experienced by many patients in hospital, either when presenting to
emergency units, following surgical or medical procedures or as part of the disease
process in hospital or at home. In addition untreated or poorly treated acute pain can
result in a syndrome of chronic pain.
In this SSM the students will review the physiology of pain, summarise current pain
management options and perform an analysis of current pain treatment and its
effectiveness in the emergency centre and following surgery, at Vredenberg District
Hospital. Students will be introduced to assessment tools for pain evaluation and then
use these tools to audit current practice. Students will then need to spend a week at
Vredenberg, collecting the data during the 3rd week of the SSM. This will be written up
as a formal report together with recommendations and a literature review. There is
potential for this to be submitted as a report to a local medical journal
Module no: 06
Contact:
Tel:
Title:
Professor Jenny Thomas
[email protected]
021-4045143/5003
Acute pain assessment and management in
children at a tertiary hospital
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Interpretive
No. of students:
Type:
Summary:
Pain and is an expected consequence that follows most surgical procedures.
However pain is also commonly experienced by many patients presenting to
emergency units and in the medical wards of hospitals. The assessment and
treatment of this pain has important implications for the patient as well as the
medical staff caring for the patient. At Red Cross War Memorial Children’s
Hospital there is no recent data on how non-surgical patients experience
management of their pain.
In this SSM the students will review pain physiology, summarise current pain
management options and perform an analysis of current pain treatment and its
effectiveness in the emergency centre and in medical wards, at Red Cross War
Memorial Children’s Hospital. Students will be introduced to assessment tools
for pain evaluation and then use these tools to audit current pain in the nonsurgical wards of the hospital. This will be written up as a formal report together
with recommendations and a literature review. There is potential for this to be
submitted as a report to a local medical journal.
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Module no: 07
Contact:
Tel:
Title:
Dr Janieke Van Nugteren
[email protected]
021-4045143/5003
Chronic pain assessment and management
in a central hospital
2
Interpretive
No. of students:
Type:
Summary:
The multi-disciplinary Pain Referral Clinic at Groote Schuur manages patients
referred from medical specialists in different disciplines, who are unable to
manage the pain in their own discipline. The patients often experience pain as
part of a complex syndrome and many are long-term attendees at the pain
clinic. At Groote Schuur Hospital there is no recent data on how patients
experience management of their chronic pain.
In this SSM the students will summarise current thinking in chronic pain
pathophysiology and the management options for chronic pain, and then
perform an analysis of the chronic pain clinic’s patients satisfaction of their
management, at Groote Schuur Hospital. This will be written up as a formal
report together with recommendations and a literature review. There is potential
for this to be submitted as a report to a local medical journal.
Module no: 08
Contact:
Tel:
Title:
Dr Janieke Van Nugteren
[email protected]
021-4045143/5003
Orthopaedic pain in a central hospital’s
outpatient clinic
2
Interpretive
No. of students:
Type:
Summary:
There is no recent data on the incidence of orthopaedic pain in the population
of Cape Town. Pain accounts for much of the symptomatology in orthopaedics.
Operative solutions do not exist for much of the pain, and even when surgery is
a treatment option, waiting lists can result in long delays.
In this SSM the students will review the physiology of pain, summarise current
pain management options for orthopaedic pain and perform an analysis of the
incidence of pain as a symptom and current pain assessment and treatment in
patients presenting to the orthopaedic OPD, at Groote Schuur Hospital.
Students will be introduced to assessment tools for pain evaluation and then
use these tools to audit pain experienced by patients presenting to the
orthopaedic OPD. This will be written up as a formal report together with
recommendations and a literature review. There is potential for this to be
submitted as a report to a local medical journal
.
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HEALTH AND REHABILITATION SCIENCES – AHS2054S
Module no: 09
Contact:
Associate Professor Sinegugu Duma
[email protected]
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Literature Review
Gender-based violence as public health issue.
Number of students:
Type:
Title:
Summary:
Gender-based violence is associated with various physical, mental, and reproductive
health problems. It is reported that women who present to health care settings with
trauma and injuries are often victims of intimate-partner violence. Unfortunately the
health practitioners do not always know how to manage the victims of intimate partner
violence when they present for health care. The purpose of this module is to introduce
the students to gender-based violence as a public health issue. In this case study based
module, the student will review the provided case study and conduct literature review
to address the following:
(a) Distinguish the features of intimate partner violence.
(b) Discuss the effects of intimate partner violence on health.
(c) Describe the barriers to screening for intimate partner violence.
(d) Describe principles of effective screening for intimate-partner violence.
A written report, with a minimum of 2000 word count shall be submitted at the end of
the module. Opportunities for the discussion of the case study and literature review
with convenor will be provided per appointment where necessary
SURGERY – CHM2001S
Module no: 10 (Plastic Surgery)
Contact:
Dr Kevin Adams
Email:
[email protected]
Phone:
083 234 1449
Title:
Surgery for Transgender patients at GSH
Number of students:
2
Type:
Data capturing and analysis
Summary: A transgender person may have a male body but feel inside that they are
female, or vice versa. They experience a deep incongruence between their physiological
gender and their basic internal sense of gender self (or core gender identity). They may
choose hormone treatment and/or surgery to address this or simply live their lives
according to their preferred sense of their ‘gender’. Unfortunately, attempts to access
care in the public sector often result in humiliation, up to 6 years on surgical waiting
lists and sometimes being routed via the private sector at major expense, and with no
guarantee of an outcome. Furthermore, many transgender persons continue to battle the
medical prejudice and ignorance of the healthcare professionals they come into contact
with.
The Dept of Psychiatry and Mental Health, UCT, runs one of only two public sector
transgender clinics in South Africa. This GSH clinic consists of a multi-disciplinary
team that offers a comprehensive service to transgender persons. It uses the services of
a dedicated clinical psychologist, psychiatrist, clinical social worker, endocrinologist,
plastic surgeon, gynaecologist, family physician and has links with the main referral
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NGO’s – the Triangle Project and Gender DynamiX. The transgender clinic has been
offering a service for several years, however, the database for the surgical services have
not been systematically captured and/or analysed.
The tasks for this SSM include the following:
 Reviewing the clinic’s retrospective records, and capturing the Surgery
dept data (incl. surgical waiting lists) into a comprehensive data set.


Reviewing existing literature on TG patients and access to surgery in
low-to-middle income countries
Writing up a research report
Module no: 11 (Orthopaedic Surgery)
Convenor:
Prof. Robert Dunn
HOD Orthopaedic Surgery
Contact:
[email protected]
/
[email protected]
Title:
Impact of cervical spine cord injury
No. of students:
2
Type:
Clinical review
Spinal cord injury is devastating both to the patient and the community. GSH’s
Acute Spinal Cord injury Unit (ASCI) manages around 200 cases a year.
This module will allow the student to review the inpatients of the unit as to the
injury and progress with the patients to the Western cape rehabilitation unit.
They will be asked to write a review on the impact on the patients and the
family’s that they are exposed to.
During this period they will be exposed to the clinical and surgical management
of these patients in a world class dedicated unit
Module no: 12
Contact:
Dr Nick Kruger
[email protected]
Tel:
0833915694 speed dial GSH 76841 rooms 021 4220699
Title:
Patient recall mechanisms for clinical review
No. of students:
4
Type:
Survey
Summary: Students are to compare the various mechanisms available for clinicians to recall
patients for research purposes at Groote Schuur Hospital. The normal methods of looking up
patient details in the hospital folder are limited. Usually the contact numbers are out of date or
incorrect or the patients have moved address or have no fixed address. This is particularly a
problem with long term follow up. For the purpose of this study a select group of patients who
have spinal cord injuries will be looked at and an effort made to contact them via their disability
grant payment channels. All these patients will be on grants which are more regulated than the
hospital records and require the patients or their helpers to physically come fetch the grants.
Thus patients lost to the system may be easier to contact via this approach and this study will
attempt to streamline a method of contacting them.
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Module no: 13
Convenor:
Contact:
No. of students:
Title:
Dr Sithombo Maqungo and Dr Dave Chivers.
Dr S Maqungo. GSH speed-dial 76163. [email protected]
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Subtrochanteric gunshot fractures outcome
after intramedullary nailing
Retrospective review
Type:
Summary:
Subtrochanteric fractures as a result of gunshot injuries pose many problems to the
orthopaedic surgeon regarding implant choice, fracture reduction and fracture union. Many
advancements have been made regarding implants used and surgical techniques, however
outcomes have yet to be evaluated. We aim to investigate the outcomes of these difficult to
treat and complication prone injuries at our institution in a retrospective study. The data
collected from 2004 – 2011 will enable us to make informed management decisions for
subtrochanteric gunshot fractures.
In this module students will assist with data collection from theatre records. The students will
also be invited to attend theatre sessions when their schedules allow to participate in
intramedullary nailing of femur fractures.
This study will be presented at the annual South African Orthopaedic Society congress in 2013
and published in the South African Orthopaedic Journal.
Module no: 14
Convenor:
Dr S Roche Dept of Orthopaedics
[email protected]
No. of students:
5
Type:
Review
Title:
Rugby injuries - an epidemic?
Rugby injuries are increasing in number in the literature. Anecdotally there is an increase of
rugby related injuries locally.
The students will be expected to do a literature search with respect to the epidemiology of
these injuries. They will also be expected to contact all the local hospital emergency units on
two consecutive weekends and ask if they can collect the number of the patients who present
there with rugby related injuries as a percentage of the number of patients and as a percentage
of sports related injuries. They will then be expected to propose a research proposal to identify
the problem more clearly and as such to see if they can come up with a prevention program.
Module no: 15
Convenor:
Dr S Roche Dept of Orthopaedics
[email protected]
No. of students:
4
Type:
Review
Title:
Anabolic steroids as a treatment for musculoskeletal problems.
Summary: The students will be expected to review the literature on anabolic steroids with
respect to their effects on the musculoskeletal system, the side effects and contraindications.
They will then interview selected patients from the orthopaedic outpatients to see whether they
would be willing to take these steroids in the treatment for their orthopaedic condition after the
indications /side effects and complications are explained to them.
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Module no: 16 (Colorectal Surgery)
Convenor:
Paul Goldberg
Paul.Goldberg@uct,ac,za
Tel:
021 4043053
Title:
Epidemiology of colorectal cancer
No. of students:
3
Type:
Retrospective study
Summary: The colorectal services at Groote Schuur Hospital treats about 150 new patients
with colorectal cancer per year. We have no data about how well or poorly we manage this
disease. This study will has 3 parts:
1. Establishment of the basic demographics of the patients we see.
2. Establish current delays in management from first presentation to first definitive
therapy.
3. Establish perioperative and 30 day mortality.
Module no: 17
Convenor:
Paul Goldberg
Paul.Goldberg@uct,ac,za
Tel:
Title:
021 4043053
Follow up of patients who have had
restorative proctocolectomies
No. of students:
2
Type:
Telephonic survey
Summary: About 260 patients have undergone restorative proctocolectomies at GSH for
ulcerative colitis and familial adenomatous polyposis over the last 20 years. This telephonic
survey will contact patients and establish stool frequency and continence.
Module no: 18 (General Surgery)
Contact:
Tel:
Professor Anwar Mall
Ext 6168 (secretary, Ms Warda Brown)
[email protected]
Title:
Mucus and Mucous Glycoproteins (Mucins)
in Respiratory Diseases
No. of Students:
10
Type:
Essay and observation
Summary: Respiratory diseases are a major cause of death in South Africa and
variations in mortality of the different ethnic groups have been reported.
Hypersecretion and alterations in the type of mucus have been implicated in the
morbidity and mortality of respiratory diseases such as chronic obstructive pulmonary
disease (COPD) and asthma. TB is a major cause of respiratory illness in adults and
children.The physiochemical and biological properties of mucus are largely conferred
by mucous glycoproteins (mucins), large O-glycosylated, sticky, viscoelastic
glycoproteins responsible for the rheological properties of normal mucus gels. The
airway mucus layer coats the epithelium, provides a protective barrier against infectious
agents, and participates in the mucosal response to inflammation and infection. Two
mucin gene products in particular i.e. MUC5AC and MUC5B gene products that
originate in the goblet cells of the surface mucosa and submucosal glands respectively,
have been identified as major contributors to the respiratory secretions. In addition
MUC2 has been identified in the sputa of cystic fibrosis patients and tends to be up-
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regulated in inflammatory disease. A number of clinical studies have highlighted the
differences between asthma and COPD. There is however a dearth in the literature on
the biochemical properties of mucus secretions in asthma, COPD, cystic fibrosis and
mainly TB. One review indicated that the mucus in COPD differed to that in asthma in
that it was less viscous, had a reduced MUC5AC:MUC5B ratio and there was a full
release of mucin into the airway lumen rather than ‘tethering’ of mucus as in asthma.
The airways in asthma have been reported to be occluded by tenacious plugs of mucus
which is often unusually solid and contributes to airway hyper-responsiveness.
You are expected to:
1. Review the literature and write an essay (maximum 10 pages) on the “The role of
mucus in the pathogenesis of respiratory diseases such as asthma, COPD, cystic fibrosis
and tuberculosis (TB)”. An opening paragraph or two should focus on mucus and
mucins in disease in general.
Please use clear sub-headings for each of the sections
2. You will have to provide a comprehensive reference list with your essay.
3. You will visit the mucus research laboratory (J50-30, J Floor, Dept of Surgery- times
will be arranged with Professor A Mall), and observe laboratory techniques employed
in purifying mucins from crude mucus secretions.
Module no: 19 (Ophthalmology)
Contact:
James Rice
[email protected]
Tel:
021 4045063
No of students:
2
Title:
Glucometer use among diabetics with severe
diabetic retinopathy
Type:
Cross sectional survey
Summary: To report the prevalence of home glucose monitoring among a sample of diabetics
with advanced diabetic retinopathy.
This data can be obtained by means of a patient questionnaire administered in the retinal clinic
(Eye outpatient department). Students will be expected to design an appropriate questionnaire
in which they should also examine the barriers to home glucose monitoring. Following their
assessment of the problems they should propose possible strategies to improve glucose
monitoring.
Module No: 20
Contact:
James Rice
[email protected]
Tel:
0214045063
No of students:
2
Title:
Diabetic retinopathy screening history among patients with
advanced diabetic retinopathy
Type:
Cross sectional survey
Summary: To report the time between diagnosis of diabetes and first retinal screening
examination among a sample of diabetics with advanced diabetic retinopathy. To examine
whether patients underwent any form of systematic screening for progressive retinopathy. To
identify reasons for delayed ocular examination and barriers to screening. To suggest
strategies to overcome these problems.
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Module no: 21
Convenor:
Contact:
No. of students:
Type:
Title:
Dr Delva Shamley;
[email protected]
2
Survey
Prevalence of upper limb morbidity
following treatment for breast cancer.
Summary: In spite of less invasive surgery incidence of breast cancer patients in
western countries presenting with decreased shoulder and/or arm mobility, tightness,
oedema, weakness, pain and numbness after treatment varies from 17% to 79% and
can occur as long as 6 years after treatment. Breast cancer survivors who experience
shoulder and arm problems have significantly reduced functional use of their upper
limb which limits their quality of life and their ability to return to work. These effects are
believed to be partly due to the systemic effects of radiotherapy and chemotherapy.
The prevalence and nature of morbidity in the South African populations is not known.
This project will involve a survey of a large sample of patients treated in the last 5
years. The questionnaire will be sent by post or completed on annual check-up at
GSH. The results will be correlated to clinical data.
Module no: 22 (Neurosurgery)
Convenors:
Contact:
Prof G. Fieggen and Dr S. Rothemeyer
Dr Des Michaels [email protected]
or telephone: 021 406 6111
No. of students:
4
Title:
Follow-up of Neurosurgical Patients
Type:
Record Review and Patient follow-up study
Summary: This module will explore the experiences of neurosurgical patients after
discharge. In our local context, patient follow-up rates after neurosurgery as low as
20% have been reported, and we do not know enough about what happens to them.
The purpose of the module is to better understand the post-discharge experience of
patients and to identify potential gaps in the discharge and follow-up process. The
questions that such a project could answer are:
 How do the patients and their families cope with the illness after discharge from
hospital?
 What is the degree of post-surgical morbidity and mortality for different
conditions?
 What is the proportion of long-term disability by condition?
 What proportion of patients return to work or their pre-surgical levels of
activity?
 What resources (e.g. rehabilitation) do they access (or not) for help at home?
 What is the rate of readmission or consultations that might be prevented?
 How could the discharge and follow-up process be improved?
Students will be expected to review patient folders of discharged neuro-surgical
patients and contact one patient for a follow-up home visit each. Home visits will be
conducted in pairs. They will contribute to the development of an appropriate folder
review tool. They will be offered the opportunity to observe the work of ComaCare®
amongst patients with neurological conditions resulting from neurosurgical conditions.
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Students will write a report of their experience including a critical appraisal of the
literature and submit this for assessment.
HUMAN BIOLOGY: HUB2020S
Module no: 23 (Sports Science)
Contact:
A/Prof Andrew Bosch
[email protected]
Tel:
021-650 4578
Title:
The effect of ingestion of a protein supplement
during exercise on performance and recovery
No. of students:
1
Type:
Litterature review
Summary: There have been a number of studies in recent years on the effect that
ingestion of a protein supplement taken prior to, during, or post-exercise may have on
exercise performance and recovery. The experimental results have not been
conclusive, with some studies showing a positive effect, while others have shown no
benefit. Partly, this may be attributable to when the protein is ingested (prior to
exercise, during exercise, or post-exercise), whether the study participants were
trained or untrained, the exercise modality (running, cycling, weight training), and the
specific type of protein used in the study (whey, casein, soy, protein hydrolysate, free
amino acids). In this module, a review of the literature will be undertaken, focusing
specifically on the results obtained in experiments in which a protein supplement was
ingested during exercise. This could result in publication of a review manuscript.
Module no: 24
Contact:
A/Prof Andrew Bosch
[email protected]
Tel:
021-650 4578
Title:
The effect of ingestion of a protein supplement
post-exercise on subsequent performance and recovery
No. of students:
1
Type:
Litterature review
Summary: There have been a number of studies in recent years on the effect that
ingestion of a protein supplement taken prior to, during, or post-exercise may have on
exercise performance and recovery. The experimental results have not been
conclusive, with some studies showing a positive effect, while others have shown no
benefit. Partly, this may be attributable to when the protein is ingested (prior to
exercise, during exercise, or post-exercise), whether the study participants were
trained or untrained, the exercise modality (running, cycling, weight training), and the
specific type of protein used in the study (whey, casein, soy, protein hydrolysate, free
amino acids). In this module, a review of the literature will be undertaken, focusing
specifically on the results obtained in experiments in which a protein supplement was
ingested post-exercise. This could result in publication of a review manuscript.
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Module no: 25
Contact:
A/Prof Andrew Bosch
[email protected]
Tel:
021- 650 4578
Title:
The effect of pre-exercise ingestion of
a protein supplement on exercise performance
and recovery
No. of students:
1
Type:
Literature review
Summary: There have been a number of studies in recent years on the effect that
ingestion of a protein supplement taken prior to, during, or post-exercise may have on
exercise performance and recovery. The experimental results have not been
conclusive, with some studies showing a positive effect, while others have shown no
benefit. Partly, this may be attributable to when the protein is ingested (prior to
exercise, during exercise, or post-exercise), whether the study participants were
trained or untrained, the exercise modality (running, cycling, weight training), and the
specific type of protein used in the study (whey, casein, soy, protein hydrolysate, free
amino acids). In this module, a review of the literature will be undertaken, focusing
specifically on the results obtained in experiments in which a protein supplement was
ingested prior to exercise. This could result in publication of a review manuscript.
Module no: 26
Convenor:
Andrew Bosch
[email protected]
Tel:
021 6504578
Title:
Using marathon time prediction equations
to identify physiological demands and determinants of
success in the marathon
No. of students:
2
Type:
Literature review
Summary: In this SSM, a literature search will be conducted to identify various regression
equations that have been published over the years to "predict" marathon running performance
i.e predicting a time for the marathon, based on various parameters that are entered into each
of the predictive equations, such as distance trained, number of runs in training over 30km,
speed over 5 km, etc. The aim of the SSM, after identifying the different equations, is to
examine the specific parameters of each equation and to then, based on these, to draw
conclusions about the physiological demands and physiological determinants of marathon
performance
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Module no: 27
Convenor:
Catherine Draper
[email protected]
Tel:
650 4570
Title:
Engendering wellness through exercise
No. of Students:
4
Type:
Interpretive
Summary: This project looks at the importance of exercise in maintaining wellbeing in
individuals and across communities, and will take place in partnership with the Sports
Science Institute of South Africa (SSISA). Students will each receive access cards to the
institute to participate in activities and conduct research (facilities will be available to
them). The students will be divided into groups to observe organized exercise
sessions at the SSISA that cater for individuals who are suffering from a chronic illness,
who are aiming to lose weight, or are aiming to improve their fitness and wellbeing; as
well as community-based exercise sessions with children and adults through the
Community Health Intervention Programmes (CHIPs) which are run by the SSISA.
Some lectures will be given during the four-week period by health professionals.
Students will be required to carry out a literature review in the subject area they
choose to study. Students can choose to write a research report, literature review, or
critical analysis as per the SSM rules for dissertation.
Module no: 28 (Human Biology)
Convenor:
Dr Lester Davids
lester.davids@uct,ac.za
No. of students:
2
Type:
Review
Title:
Worldwide Incidence ofClinicalVitiligo
Summary: Vitiligo is a disorder ofunknown aetiology which presents as a hypomelanosis of the
skin, eyes and hair.Its current incidence is 0.1-4% worldwide. Clinically, it presents in various
forms from segmental to non-segmental vitiligo. It is hugeley uner-reported in South Africa and
Africa. The aim of this module will be to do a detailed Pubmedsearch and begin to plot/consruct
an epidemiological map of the incidence/casesreported on vitiligo throughout the world with
particular emphasis on Africa andits relation to the rest of the world. The database
will include a number ofdescriptors.
A written report will be submitted at the end of the module with the aim of getting it published in
an international peer-reviewed journal
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Module no: 29
Contact:
Dr Geney Gunston
[email protected]
Tel.
021 406 6249
Title:
Development of Spatial Visualisation Ability
No. of students:
2 (working as a pair)
Type:
Design, Implementation and Review of Practical Intervention
Summary: There is evidence that poor spatial visualisation ability correlates with poor
performance in anatomy learning and that interventions can improve students’ spatial
visualisation ability.
A pilot intervention was implemented in 2011 to assist students, with the aid of tactile physical
engagement with shapes, to improve their ability to visualise (and sketch on paper) the crosssections of a structure in given planes and to visualise (and create a 3D model of) a threedimensional structure from limited information given in cross-sections in three orthogonal
planes. The results of the ‘pre-and post-testing’ were positive and student evaluation results
indicated that the intervention was beneficial and relevant. These factors suggest that the
intervention should be continued and expanded.
The aim of this SSM is to critically reflect on the 2011 intervention, in the light of current
literature on the topic and feedback received on presentation of the pilot intervention at the
Anatomical Associations of Southern Africa conference, and then to design an improved
intervention, with an appropriate pre- and post- test and evaluation questionnaire. The
intervention will be then be implemented during semester 2 HUB practical sessions and the
impact reviewed.
See http://www.teachingandlearning.uct.ac.za/podcasts/
Vera Frith & Geney Gunston - Developing Medical Students’ Spatial Visualisation Ability
[Podcast] [Presentation] for more info on pilot intervention.
+y
+x
+z
+x
+y
+z
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Module no: 30
Contact:
Tel:
Prof Graham Louw
021 406 6302
[email protected]
No of students:
12
Title:
Model building in Gross Anatomy
Summary: These six students, working in pairs, will be required to build large 3-D
models of specific regions of the body. The models will be based on ones that are
commercially available, and will be used for teaching and learning in our various
undergraduate and postgraduate courses. The students will experiment with, and use,
various forms of modeling materials. The regions to be built will be negotiated with
students and staff. This is a fun and appropriate way to learn 3-D anatomy!
Module no: 31
Contact:
Tel:
Dr C Slater
021 4066276
[email protected]
No of students:
2
Title:
Medical student attitudes towards and experiences of
cadaver dissection
Summary: Cadaver dissection can be a traumatic experience for some medical
students and an uncomplicated one for others. In this project, students will be required
to review the literature on their peers’ attitudes towards cadaver dissection. A
questionnaire will be designed to explore issues of particular importance at this
University and of those commonly encountered in the literature. The questionnaire is to
be answered voluntarily and anonymously by first and second year medical students.
The students are to analyse their data, report back on their findings and make
recommendations to minimise psychological discomfort that some students
experience.
Module no: 32
Contact:
Tel:
No of students:
Dr C Slater & Dr Owen Porrill
021 4066276
[email protected] / [email protected]
2
Regional anaesthesia of the upper limb:
a clinical anatomical review
Summary: Regional anaesthesia of the upper limb requires a precise knowledge of the
nerves, their relations and surface anatomical markings. In this project students will be
required to review the current literature on regional anaesthetic techniques in the upper
limb and observe some of these procedures in theatre. They will then be required make
a cadaver dissection of the origin and course of the upper limb nerves demonstrating
features (e.g. relations and landmarks) that are particularly relevant to regional
anaesthetic techniques. In addition to the literature review and written reflection on the
dissection, students will be invited to make a short oral presentation of their findings to
the Department of Anaesthetics.
Title:
17
Module No: 33 (Physiology)
Contact:
Dr Roisin Kelly/ Dr Asfree Gwanyanya
[email protected]/ [email protected]
Tel.
021-4047707/021-6506400
Title:
ECG changes during positional changes and
cardiovascular procedures
No. of students:
4
Type:
Laboratory /Interpretation
Summary: The incidence of heart disease has increased greatly in South Africa due to
urbanization and an increase of obesity and diabetes. The electrocardiogram (ECG) is a noninvasive diagnostic and monitoring tool that is widely used in the evaluation of heart diseases.
In this module the student(s) will analyze electrocardiograms (ECG) pre-recorded in a rat model
of myocardial infarction. This data includes ECG recordings taken in both the supine and lateral
recumbent position together with data recorded during intraarterial cannulation, thoracotomy
and coronary artery ligation.
During the course of the project, the student(s) will learn how to analyse the ECG using Chart
Pro software and to interpret the findings. They will also perform a literature search on cardiac
electrocardiography in order to gain a deeper understanding of cardiac electrical abnormalities.
They will conduct basic statistical analyses on the data generated. During their final week the
student will write a report that will include the literature review, the experimental findings, and a
discussion of the study and its clinical implications.
Module no: 34 (Biomedical Engineering)
Contact:
Mladen Poluta
Tel:
021 406 6545
Title:
Process improvement in functional units at a tertiary hospital
No. of Students:
4x2 = 8
Type:
Situational analysis
Summary: At least four different functional units should be assessed, two of which should be
similar in nature (to highlight possible commonalities). For each functional unit:
 Analyse key functions, processes and interactions within the functional units (and their
interaction with their external environments)
 Identify obstacles, including lack of information and/or technology
 Identify areas for improvement and what else can be done to improve the situation (e.g.
task shifting).
 Report on your findings (written report and presentation)
Module no: 35
Contact:
Mladen Poluta
Tel:
021 406 6545
Title:
Clinical Engineering staffing requirements for a tertiary hospital
No. of Students:
2
Type:
Situational analysis
Summary:
 Review the different models (provided) for CES activities and responsibilities, and
related in-house staffing needs.
 Interview CES personnel and other CES stakeholders/key informants.
 Formulate a model that is most appropriate to a tertiary hospital.
 Test this model at the two local tertiary institutions (GSH and Red Cross Childrens
Hospital) and make necessary adjustments if needed.
 Report on your findings (written report and presentation)
18
Module no: 36
Contact:
Dept:
Tel:
Title:
Mladen Poluta
Human Biology (HTM Programme)
021 406 6545
Clinical Technologist staffing requirements for a
tertiary hospital
2
Situational analysis
No. of Students:
Type:
Summary:
 Review the activities and responsibilities of clinical technologists, and related staffing
needs.
 Interview clinical technologists from different clinical specialties and other key
informants.
 Formulate a Clinical Technologist staffing model that is most appropriate to a tertiary
hospital.
 Test this model and make necessary adjustments if needed.
Report on your findings (written report and presentation)
CLS – LAB2002S
Module no: 37 (Microbiology)
Convenor:
Dr Colleen Bamford
[email protected]
Tel:
021-4046415
Title:
Review of the quality of blood culture practices in
local hospitals
No of students:
4
Summary: The detection and characterisation of bloodstream pathogens is a key task of
the diagnostic microbiology laboratory. This impacts significantly on the management
of individual patients and also determines local antibiotic susceptibility patterns, which
in turn influence the empiric antibiotic therapy choices. A number of seldomconsidered factors such as the volume of blood inoculated and the time to incubation of
the bottle, as well as the sterile technique of the phlebotomist, influence the yield and
time to positivity of blood culture samples.
This SSM project will encompass a critical evaluation of the quality of local blood
culture practices in the emergency units of local adult and paediatric hospitals. The
students will be exposed to both laboratory and clinical environments and to the role of
microbiologists in liaison between the two. Study methods are likely to include direct
observation, weighing of blood culture bottles, and review of laboratory and patient
records. The information gained through this SSM has the potential to improve patient
management.
19
Module no: 38
Contact:
Dr M Hsiao ([email protected])
Tel:
021 4045200
Title:
Evaluation of Infant HIV diagnosis tests
No of Students:
4
Summary: Mother to child transmission (MTCT) of HIV may occur either during pregnancy,
during labour, or through breast feeding. Despite effort to prevent MTCT, HIV infections
unfortunately still occur. The identification of early infant HIV infection, commonly referred to as
“Early Infant Diagnosis” or EID, is important because these HIV infected infants can benefit
from early antiretrovirals therapy.
Currently HIV polymerase chain reaction (HIV PCR) is the diagnostic test of choice for EID in
South Africa. PCR requires large, costly equipment that needs to be operated by trained staff.
For this reason PCRs are largely performed in centralised virology laboratories in each of the
provinces and diagnosis of infant HIV in remote areas is therefore delayed. In order to reduce
the delay, there is substantial interest in developing a cheap and easy assay that can be used
at the remote clinics or laboratories.
This module will require the student to read up on the rationale and technologies behind infant
diagnosis of HIV infection. Students will be introduced to laboratory tools of EID during their
time in the laboratory. Once they are familiar with the performance, strengths and weaknesses
for each of the tools, they will write a report on the appropriate placement of these tools at
various levels of health and laboratory facilities.
Module no: 39
Contact:
Dr Andrew Whitelaw
[email protected]
021 404 5295
Title:
Antibiotic stewardship – are antibiotics being
used appropriately
No of students:
4
Summary: The misuse of antibiotics is a growing global concern. Inappropriate use is
one of the main drivers of antibiotic resistance. However, inadequate dosing and
inappropriate administration may also impact on clinical outcomes. The South African
Antibiotic Stewardship programme thus aims to encourage use of antibiotics only when
needed, a well as to optimise the way they drugs are administered. wo of the issues that
have been identified as potential problems are the hang time (the time it takes for an
antibiotic to be administered once it has been ordered), as well as the use of therapeutic
drug monitoring to ensure adequate dosing.
Two students will be assigned to review the “hang time” of antimicrobials. This will be
done by a combination of prospective monitoring, as well as retrospective review of
records. More importantly, factors that affect the hang time need to be identified in
order to effect improvements. The other two students will review the use of
vancomycin. The students will identify patients receiving vancomycin, and will assess
what the indication for vancomycin was, as well as whether appropriate therapeutic
drug monitoring is taking place.
20
Module No: 40
Contact:
Charles Shey Wiysonge
[email protected]
Tel:
021 404 7620
No of students:
6
Type:
Systematic review
Title:
Mobile phone text messaging for increasing
childhood vaccination coverage
Summary: Vaccination is widely acknowledged as one of the most powerful
interventions for improving child survival. However, more than seven million children
in Africa do not receive the full series of recommended vaccines before reaching one
year of age. As wireless telecommunications networks have spread rapidly throughout
Africa, sending text-messages on wireless mobile telephones has become an extremely
popular means of communication among people in all sectors of society. Mobile phone
text-messaging, also called short messaging service (SMS), has been proposed as an
approach to improve vaccination coverage. This module will enhance students’
knowledge of systematic reviews. The students will be expected to conduct a literature
review to determine whether mobile phone text-messaging is efficacious in improving
vaccination coverage. A written report will be submitted at the end of the module.
Human Genetics:
Module no: 41
Contact:
Dr Karen Fieggen
[email protected]
Tel.
406 6298
Title:
The role of amniocentesis at Groote Schuur
Hospital in antenatally detected club feet and
ventriculomegaly.
No. of students:
2
Type:
Cohort study
Summary: Ventriculomegaly and club feet (talipes equinovarus) are both fetal
abnormalities which are quite commonly detected in isolation yet have an association
with chromosome abnormalities. The pregnancy counselling clinic at Groote Schuur
Hospital is a referral fetal medicine unit where level 3 ultrasounds are performed on
women at risk for or suspected of having a congenital abnormality. Counselling is
provided and further investigations and management as appropriate are discussed and
planned. The study would involve identification cases of club feet and of
ventriculomegaly of diagnosed antenatal at GSH> Information on whether
amniocentesis was offered / accepted and the results would be collated. This would be
expected to inform future practice and improve consistency and provide local data on
the risk of chromosome abnormality in these settings. The students would be exposed
to the medical genetic environment. They would attend the pregnancy counseling
clinic as well as paediatric genetic clinics to gain more insight into counselling and
congenital abnormalities. They would also be exposed to the cytogenetic laboratory and
learn how chromosomes are analysed. Expected outcome would be to assist in
formalising a policy document for management of isolated ventriculomegaly and club
foot. There is potential for presentation or even publication if good quality information
is obtained as there is no published data on this in South Africa or Sub-Saharan Africa.
21
Module no: 42
Contact:
Dr Karen Fieggen
[email protected]
Tel.
021 406 6298
Title:
Ehlers Danlos Syndrome
No. of students:
1
Type:
Literature review and retrospective audit of
patient cohort.
Summary: Ehlers Danlos syndrome is a heterogenous group of genetic connective
tissue disorders. Clinical characterization of subtype is often difficult but is importants
the implication for both inheritance and prognosis may be difficult. The Division of
Human Genetics have close to 100 patients with EDS recorded on their clinical
database The purpose of this study would be to retrospectively analyze from records the
clinical features of those patients with a view to establishing local epidemiology for the
disorder so that consideration may be given to setting up diagnostic testing in the
future. The students would be exposed to the medical genetic environment. They
would attend adult genetic clinic as well as paediatric genetic clinics to gain more
insight into genetic disorders and counselling about inheritance. They would also be
exposed to the molecular genetic laboratory and learn something of the complexities of
molecular genetic testing. There is potential for presentation or even publication if good
quality information is obtained as there is little published data on EDS in South Africa
and we have the advantage of a large cohort.
Module no: 43
Contact:
Tel:
Number of students:
Title:
Type:
Dr Ambroise WONKAM & Prof Alan Davidson
[email protected]
[email protected]
021-4066698
1
FREQUENCY and BURDEN OF SICKLE CELL
DISEASE IN HEMATOLOGY CLINIC
(RED CROSS HOSPITAL)
Exploratory study (retrospective
socio-demographic evaluation and question
survey)
Summary:
Introduction:
Sickle Cell Disease (SCD) is the most common monogenic disease. In sub-Saharan
Africa (SSA) SCD occurs at its highest frequency. The prevalence of sickle cell trait in
SSA is estimated to be 5 to 40% with up to 300,000 affected babies born each year.
With migration of populations from Central Africa, it is anticipated that SCD will
become a significant issue in hematology and genetic clinics in South Africa.
The objectives:
The main objectives are to evaluate retrospectively the prevalence of cases of SCD
patients in the Hematology clinic at Red Cross Children’s Hospital) and to pilot a study
of genetic knowledge and attitudes of parents concerning SCD and Genetic Prenatal
diagnosis (PND).
22
Methods:
1. To review the literature on SCD
2. To develop an instrument for exploration of socio-demographic data of SCD
patients to record all the of SCD consultations for the last 10 years in
hematology clinic at Red Cross Children’s Hospital.
3. To develop an instrument for exploration of genetic knowledge and attitudes of
parents concerning PND for SCD, and administer it to ~ 20 parents attending
out patients clinics
4. Statistical analysis and interpretation of data
Conclusion:
The present study will help to explore perspectives of Genetic and Hematology
consultations for Sickle Disease and to adapt appropriate genetic counseling
communication that will not conflict with patients’ behaviors and culture.
Module no: 44
Contact:
Professor Jacquie Greenberg
Dr Ian Lewis & Ms Fiona Baine
[email protected]
[email protected]
Tel:
0214066299 & 0214042165
Title:
Huntington disease and Psychotic symptoms.
No. of students :
2
Type:
A literature review of psychostic symptoms in
HD patients and a retrospective folder review
of clinical notes and follow-up of selected HD patients.
Summary: Huntington disease (HD) is a late onset neurodegenerative disease, inherited as an
autosomal dominant disorder and characterised by progressive movement impairment, affective
disturbance and cognitive dysfunction. Genetically it is caused by an expanded trinucleotide
(CAG) repeat in the huntingtin (HTT) gene. The CAG repeat length is less than 27 repeats in
the unaffected population. Alleles with 27-35 repeats do not cause HD but may expand into the
disease-causing range on transmission. Alleles with 36-39 repeats show variable penetrance,
while those with more than 39 repeats are fully penetrant. There are however, cases where
patients show variations in phenotype independent of the length of the CAG repeat expansion.
The aim of this study is to investigate the HD phenotype in some patients with an uncertain
clinical diagnosis of HD, with an emphasis on the psychiatric symptoms. The objective is to
compile a data capture sheet for future clinical use and to compare the psychiatric features of
family members in 3 specific core families from the clinical records.
Project Plan: The student/s will attend at least one Neurogenetic clinic to become familiar
with exactly how clinical evaluations of HD patients are currently performed and documented.
Thereafter, the student/s will be given all the clinical records in the Division of Human
Genetics and will be introduced to the database/HD registry and familiarized with the methods
of data capture related to the HD project. The student/s will then interrogate patient hospital
files, assess the accuracy and thoroughness of the already documented clinical data and
ascertain trends in phenotype. Ultimately the goal will be to identify unusual/interesting cases
with regard to age of onset and progression of symptoms in relation to the genotype (i.e. the
size of the expanded repeat). The module will also involve the student/s observing the
molecular testing procedures in the NHLS diagnostic laboratory so as to develop an
understanding of how the genetic mutation is assessed and reported on. The data accumulated
will then be evaluated to identify either intra-and/or inter-familial phenotypic variation in a few
selected SA families with a history of HD. The student/s will be required to write a review of
the current literature (at least 20 publications) relating to psychiatric symptoms of HD, with
23
particular emphasis on psychotic symptoms. By comparing published findings with the
information recorded on our patients, a data capture sheet for clinical use and future research
projects will be compiled.
Pathology:
Module no: 45
Contact:
Dr Di Hawarden & Prof Paul Potter
[email protected] and [email protected]
Tel:
(021) 406-6883/7
Number of students:
1
Title:
Follow up and analysis of clinical and immune
responses to latex in 100 health care workers
Summary:Latex allergy affects 15% of the health care workers (including nurses,
doctors and other staff) at Groote Schuur Hospital. We have interviewed 100 health
care workers with a questionnaire and taken blood samples to study their immune
responses to latex allergy. This project will involve the analysis of the outcome of
these questionnaires on the progress of the health care workers since diagnosis, their
clinical profiles, remission status and the results of the laboratory tests completed to
date. The study is already approved by the UCT Ethics Department. The student will
also have the opportunity to interview some of the latex allergic subjects and to learn
about medical and occupational health interventions for this important allergy.
Module no: 46
Contact:
Dr Maia Lesosky
[email protected]
Tel:
021406 6815
Title:
Characterisation of current and historical emergent
zoonotic diseases
No. of students:
1
Type:
Literature review
Summary: Wolfe et al. presented an interesting and useful classification of human
infectious diseases originating from animal populations. This classification ranged from
Stage I - exclusive toanimals to Stage V - exclusive to humans. I’m interested in
studying the disease transmission dynamics of diseases in the middle stages II-IV
where there is some zoonotic (animal to human) transmission occurring. This module
will require a literature review to identify and characterize a large number of diseases
currently in stages II-IV. In addition to classification as per Wolfe et al., additional
defining characteristics may be analysed and added to the model. A well done
literature review and write up could result in publication. The supervisor is a statistician
and will provide extensive guidance with any statistical analysis done. The module
presents anopportunity to acquire a good overview into the evolutionary history and
impact of major human infectious diseases.
Wolfe, Nathan D, Claire Panosian Dunavan, and Jared Diamond. 2007. “Origins of
major human infectious diseases.” Nature 447 (7142) (May 17): 279-83.
doi:10.1038/nature05775. http://www.ncbi.nlm.nih.gov/pubmed/17507975.
Module no: 47
Contact:
Tel:
Dr Maia Lesosky
[email protected]
021406 6815
24
Title:
Disease functional types
Type:
Literature review
Summary: Botanists tend to classify plant species by “functional type” where for a
certain model the functional types might be grass, shrub, tree. This has immense use
in modelling terms as one doesn’t have to deal with the details of each species but still
accounts for all of the important functional characteristics. Infectious diseases have
historically been classified a number of different ways, by pathogen type (eg. bacteria,
prion, virus), by transmission method (direct,vector, environment), or by deduced
quantities, such as the reproduction rate and generation time. I think a classification of
more utility is doable, ie to classify diseases into functional types. The first stage is to
perform a literature survey to record the important functional characteristics together
and then to attempt to categorise the diseases into functional types based on these
characteristics. Because of the vast number of infectious diseases, a subclass (eg.
tropical) will have to be decided on depending on the interests of the student and
potential for results. A well done survey and write up could result in a publication.
Module no: 48
Contact:
Dr Jane Yeats
Email:
[email protected]
Tel.
Title:
No. of students:
406 6910
Pathology mini exhibition on chosen topic
2
Type:
Exhibition based on structured review
Summary: There are about 4000 pathology specimens in the Pathology Learning
Centre, dating from the 1920’s. All of these specimens were kept because they were
considered either to be “classic” examples of pathological conditions or because they
were very rare entities. The majority of these specimens are sadly never viewed by
students or even staff. For this project you would choose a single disease (e.g. syphilis)
or group of disorders (e.g. tumours of the skin) that is well represented in the collection
and which interests you. You would research the topic, select specimen bottles, prepare
text, diagrams/ illustrations and photographs and put together an interesting miniexhibition designed to educate your fellow students in the topic you have chosen, as
well as inspire them to explore the teaching collection themselves. Your exhibition will
be on display for students and staff to view in an open venue, as well as in digital
format on the UC T Digital Pathology website.
Module no: 49
Contact:
Dr Jane Yeats
Email:
[email protected]
Tel.
Title:
No. of students:
406 6910
Post mortem video records, topics based on available subjects
2 (N.B. For this project prior experience of home video editing is
essential, so that the emphasis can be on content rather than
technical challenges.)
Type:
Audiovisual presentation, with interpretation
Summary: Medical autopsies are becoming a fairly rare event due to the costs
involved. We would therefore like to record autopsies for teaching purposes. For this
project you would make video recordings of a small number of adult and/or infant
autopsies while they are performed by a pathologist. From the raw material you would
make one or two short (max 30 minute) coherent video records of complete autopsies,
25
including preceding clinical information, macro pathology and subsequent histology
findings or other results. The video record would require narration in the form of
recorded commentary and/or voice over. The finished DVD will be held in a library of
autopsy recordings in the Pathology Learning centre.
Forensics:
Module no: 50
Contact:
Dr Linda Liebenberg
[email protected]
Tel:
021-406 6452
Title:
Foetal alcohol syndrome (FAS) in murdered
children: is there a link?
No of students:
6
Type:
Qualitative and quantitative comparison.
Summary: Foetal alcohol syndrome and unnatural deaths in children are both rife in
Cape Town. This study will examine cases of unnatural death of children in the Cape
Western Metropole over a period of 6 months. Then a comparison will be done
between victims of homicide vs victims of other types of unnatural deaths such as road
traffic accidents. The aim is to find out if there is any difference in the two groups
when they are evaluated for morphological features of FAS. Qualitative evaluation of
features of FAS will be done using autopsy photographs of all the children.
Quantitative comparison will be done to establish if there is a statistically significant
difference between the two groups regarding FAS features. The students will be
introduced to the topics of FAS and unnatural deaths by a literature search. Data
collection and interpretation will be done on autopsy reports and photographs.
Evaluation will be done and then a statistical comparison will be performed for write
up.
Module no: 51
Contact:
Tel.
Title:
Dr. IJ Molefe
[email protected]
0214066412
The incidence and method of death of female
homicides in Cape Town in 2010
2
Collection and interpretation of data ?
No. of students:
Type:
Summary: Violence against women (VAW) and girls is a major health and human rights
issue. At least one in five of the world’s female population has been physically or sexually
abused by a man or men at some time in their life.i VAW is defined by the Declaration on the
Elimination of VAW, as adopted by the United Nations General Assembly as “any act of
gender-based violence that results in, or is likely to result in, physical, sexual or psychological
harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of
liberty, whether occurring in public or in private life.
VAW shall be understood
to encompass, but not be limited to, amongst others, physical, sexual and psychological
violence occurring within the family or general community, including rape, sexual abuse, and
sexual harassmentii. VAW includes among other categories rape homicide.
According to the survey for the period 1998-2000 compiled by the United Nations Office on
Drugs and Crime, South Africa (SA) was ranked second (to Columbia) for assault and
murder (by all means) per capita.
According to the South African Police Services (SAPS) annual report, the rate of murder was
reported to have decreased by 7.2%; from 37.1/100000 in 2008/2009 to 34.1/10000 in
26
2009/2010 financial year; this represent a significant decrease when compared with the
incidence of sexual offences (including rape) in the same period which only deceased by 4.4%.
The SAPS reports that murder is the one crime trend which can virtually not be influenced by
over or under-reporting and/or the non-registration of cases. It is therefore believed to be the
most consistent indicator of increases and decreases in crime. 13,14
According to SAPS report since the dawn of democracy in 1994, the murder incidence has
decreased between the 1994/95 and 2002/03 financial years by an average ration of 3.7%
percent. In January 2004 the government of South Africa decided that active steps were
needed to aggressively address and reduce the prevalence all forms of serious contact crime,
which include murder and rape by 7 - 10% annually. The murder incidence was reported to
have reduced from 142.7/100000 population in the 2003/04 financial year to 37.3/100000 in the
2008/009 financial year, representing a 3.4% percentage reduction. This reduction was seen as
a positive sign, but was still below the decrease of 4.7% experienced in 2007/2008. This
percentage reduction translates into 2.5% which is still below the 7 – 10% reduction target
desired by the government. 14
However, a further reduction in this incidence was experienced in the 2009/2010 financial year
to 34.1/100 000 population, representing an 8.6% decrease in murder ratio since 2008/2009,
and translating to 7.2% decrease in real figures. For the first time in the history of SAPS (which
came into being in 1995), this figure met the target reduction of 7-10%; the murder rate fell
below the 17000 hallmark.13
In the Western Cape (WC) the murder rate has shown marginal constant reduction since the
2003/2004 financial year from 2,839 reported cases to 2,274 cases in 2009/2010. Although in
terms of absolute numbers the WC comes 4th in the country for reported murders (after KZN,
Gauteng and EC, respectively), this province had the highest murder ratio of 63.1% in 2003/04,
and was at the same position with the aforementioned provinces in 2009/2010 with the
incidence of 48.4/100000 population. 15
A National study of female homicides published by the MRC in 2004 showed that “Every six
hours a woman is killed by her intimate partner”.iii Using data from 1999 mortuary samples, this
study found that there were 3,797 female homicides of which 50.3 % were from intimate partner
violence (IPV) showing a rate of 8.8 /100,000 women, most of whom were of Coloured race
and more than 14years of age. Their most common method of death was blunt force trauma,
followed by sharp trauma and gunshot injuries. iv The National study published in 2009 found
that the most common cause of homicide (intimate and non-intimate) was gunshot injury, with a
firearm mortality rate of 7.5/100,000 women 14years and older compared to 6.1/100,000 for
blunt force injury .v Although mortality data from Statistics SA and the National injury Mortality
Surveillance System (NIMSS) from 2000 showed an overall decrease in gun-related homicide,
it is still unknown whether this also applies to femicides (female homicides) in SA vi.
Although the killing of the women by her intimate partner is considered the most extreme form
of domestic violence, only 37,3% of female homicide cases resulted in convictions with lack of
evidence given as the reason for in 69,9% of those who were acquitted. 10
RATIONALE FOR THE SSM
I am currently in the process of collecting data on the epidemiology and injury patterns of
female homicide and rape homicide in Cape Town from the year 2000 to 2009. This is a 10year follow up retrospective study.
My preliminary findings indicate that in 2009 we had significantly higher numbers of female
homicide of with a total of 92 cases, compared to a total of 18, 25, 13, 12 cases in 2005, 2006,
2007 and 2008 respectively. This created great interest and curiosity for me and I immediately
wanted to know what the trend was in 2010. My MMed research study will not include the year
2010,but I believe studying the year 2010 will give great insight into whether this public health
problem is really increasing or decreasing as claimed by the SAPS annual report, and may help
shed light into what happened in 2009.
References – a complete list of references is available from my original research proposal
Violence Against women: Definition and scope of the problem;
www.who.int/gneder/violence/en/v4.pdf. accessed 07/02/2011
Declaration on the Elimination of violence against women, New York, United Nations, 23
February 1994 (Resolution No. A/RES/48/104). www.un.org/documents/ga/res/48/a48r104.htm,
accessed 14/02/2011
27
Mathews S et al. A National study of female homicide in South Africa, MRC policy brief, no.5
June 2004
Abrahams N, et al. Mortality of women from intimate partner violence in South Africa: a
national epidemiological study. Violence Vict, 2009; 24(4):546-556
Mathews S, et al. Injury patterns of female homicide victims in South Africa. J. Trauma 2009;
67(1): 168-172
Abrahams N, et al. Guns and gender based violence in South Africa. SAMJ. Vol 100 (9)
September 2010.
Anatomical Pathology:
Module no: 52
Contact:
Tel.
Title:
Dr Shumani Malaka
021 404-3463
Epidermiology of cervical carcinoma, in
Anatomical Pathology data base at Groote Schuur hospital,in
the years 2002 and 2011
No. of students:
1
Type:
Interpretive
Summary: Cervical carcinoma is the second most common cancer in women and the
most common in developing countries. Cervical biopsy, usually after abnormal pap
smear results, is essential to confirm the diagnosis before treating the patient.
The study aims to compare the epidermiology of cervical carcinoma diagnosed on
biopsy specimen, in our Windows data base (DISA) at Groote Schuur Hospital, paying
attention to patient’s age, HIV status and tumour differentiation in the years 2004 and
2011. The year 2004 was chosen as it was the first full year since DISA was
introduced in 2003
Module No: 53
Contact:
Dr R Sookhayi
Tel:
021-404 5346
Title:
Cytomegalovirus within the Gastrointestinal Tract
Type:
Interpretative
No of students:
1
Summary: Cytomegalovirus is a species of virus that belongs to the viral family
known as herpesviruses. CMV infection is typically unnoticed in healthy people, but
can be life-threatening for the immunocompromised, such as HIV-infected persons,
organ transplant recipients, or new born infants. Hence, diagnosis is done
histologically by looking for characteristic inclusion bodies. This study aims at looking
at CMV infection in patients at Groote Schuur hospital for the last 10 years within the
GIT tract, and specifically in what background conditions and locations. In those
patient’s that are HIV infected, correlation with CD4 counts would also be looked at.
Module no: 54
Contact:
No of students:
Title:
Type:
A/Prof Helen Wainwright
[email protected]
1
To determine the frequency of placental involvement by
tuberculosis in 100 placentas from mothers with
co-infection of HIV and tuberculosis
Review
28
METHOD: Go through the placental records of 2010 & 2011 from the Division of
Anatomical Pathology, D7 laboratory reading the clinical history and selecting the
cases with maternal HIV & TB until 100 cases have been obtained.
Enter all the clinical details and placental findings from the reports in a database/excel
spreadsheet. Determine the frequency of TB in your series.
Read up on TB of the female genital tract. Do a literature review on placental
tuberculosis. Look at the histology of the cases with placental tuberculosis and take
photographs.
RESULTS: Watch how a placenta is examined and dissected for histology. Give a
10 minute presentation to the Division of Anatomical Pathology on the last Thursday
morning of your elective. You will be scored on your presentation. Write a report on
your findings for submission for your SSM.
Module no: 55
Contact:
A/Prof Helen Wainwright
[email protected]
No of students:
1
Type:
Review
Title:
To determine the frequency of chorioamnionitis in 100
consecutive placental reports from the Division of Anatomical
Pathology.
METHOD: Go through the placental records of 2010 & 2011 from the division’s
records in D7 laboratory in GSH. Select cases with a diagnosis of chorioamnionitis and
enter all the clinical findings and placental findings from the reports in a database/excel
spreadsheet. Read up on chorioamnionitis. Do a literature review on chorioamnionitis
in South African and Africa. Look at the typical histology of chorioamnionitis from
several cases from your study and take photographs.
RESULTS: Determine the frequency of chorioamnionitis. Determine at what
gestational age chorioamnionitis most frequently occurs.
Observe how a placenta is examined and dissected for histology. Give a 10 minute
presentation to the Division of Anatomical Pathology on the last Thursday morning of
your elective. You will be scored on your presentation. Write a report on your findings
for submission for your SSM
Module no: 56
Contact:
Dr Hue-Tsi Wu (Anatomical Pathology)
Tel.
021 404-4252
Title:
Sensitivity and specificity of cytology in diagnosing breast carcinomas
No. of students:
1
Type:
Interpretive
Summary: The breast clinic at Groote Schuur hospital uses breast FNA as one of the diagnostic
pillars for breast carcinoma. The aim of this study is to review the cytology and histology reports
of breast cancer cases and to determine the sensitivity and specificity of the breast FNA. The
following information will be recorded and correlated: Age group of patient, size of mass, clinical
impression at time of FNA, type of clinician performing the FNA, and the diagnostic category
reported by cytology.
29
Medical Biochemistry:
Module no: 57
Contact:
Professors Ed Sturrock and Peter Smith
Email:
[email protected] and [email protected]
Tel.
021 406-6312
Title:
Comparison of two assays for angiotensin-converting enzyme
No. of students:
1
Type:
Laboratory
Summary: The burgeoning clinical importance of angiotensin-converting enzyme (ACE) in
cardiovascular and renal disease, and more specifically in hypertension, underscores the need
for accurate, sensitive and rapid techniques for measuring the enzyme’s activity in biological
fluids and tissue homogenates as well as its purified forms. Furthermore, elevated levels of ACE
are associated with active sarcoidosis, and the disease can be diagnosed and followed by
measuring ACE activity in plasma, bronchoalveolar lavage fluid and cerebrospinal fluid. In this
module the student will compare two methods for determining ACE activity in cell culture medium
and purified somatic and testis ACE using well established methods. The one uses the substrate
hippuryl-L-histidyl-L-leucine, and the fluorescent adduct of the enzyme-catalyzed product Lhistidyl-L-leucine is quantified fluorimetrically. The other method is a kit-based colorimetric
method which is carried out on the Abbott Architect 4000 analyser. They will analyse the data
generated and write a report providing a brief introduction, their aims, methods, results and
conclusions.
Haematopatologist:
Module no: 58
Contact:
Dr Almero Du Pisani
[email protected]
021 4043081
Title:
Malaria in the Western Cape –
Groote Schuur Hospital perspective
No of Students:
2
Type:
Laboratory – audit / retrospective
Summary: Malaria is a mosquito-borne infectious disease of humans and other
animals caused by eukaryotic protists (a type of microorganism) of the genus
Plasmodium. The protists act as parasites within red blood cells, causing symptoms
that typically include fever and headache, in severe cases progressing to coma or
death. The disease is widespread in tropical and subtropical regions in a broad band
around the equator, including much of Sub-Saharan Africa, Asia, and the Americas. In
2010 around 655,000 people died from the disease, most of whom were children
under the age of five. Audit all tests done for the diagnosis of malaria between 2009
and 2011. Evaluate the sensitivity and specificity of the malaria antigen test compared
to microscopy
Learn methods for the diagnosis of malaria including making of stains, smears and
microscopy. Establish if increased numbers of malaria diagnosis are being made in
the Western Cape and which species are being identified. Determine the origin of the
patients being diagnosed. Review prevention and treatment of malaria. Read:Blood
th
th
cells – Bain - 4 Edition & Practical Haematology, Dacie and Lewis, 10 Edition
30
Immunlogy:
Module no: 59
Contact:
Dr Heather Jaspan
Mr Elvis Kidzeru
Tel
021 4066823 or 084 925 7456;
Email:
[email protected]; [email protected]
Title:
Infant feeding practices in informal settlements in Cape Town
No of students:
2 (working as pair)
Type:
Interpretive
Summary: Exclusive breastfeeding until 6 months of age improves the morbidity and
mortality of infants in developing and developed countries. This project assesses the
feeding practices among HIV-negative mothers and their infants in Khayelitsha, and the
factors associated with failure to exclusively breastfeed. It will involve chart review of
an ongoing clinical trial around infant feeding practices, as well as some basic
statistical analysis. Students will visit the clinic in Khayelitsha at the start to understand
clinical trials and the setting in which this study is taking place.
MEDICINE – MDN2001S
Cardiology:
Module no: 60
Contact:
Dr Deon Bezuidenhout
[email protected]
Tel.
021 406 6349
Title:
Vascular Graft Prostheses
No. of students:
1
Type:
Structured review
Summary: Current synthetic (ePTFE or Dacron) vascular grafts used in clinical
applications have relatively high occlusion rates in small diameter applications due to
insufficient healing and lack of transanastomotic endothelialization. The CRU has
developed polyurethane grafts with well-defined, angiogenic permissive porosity to
improve long-term patency by achieving transmural endiothelialization. In order to
span the first few weeks after implantation of the grafts (the time it takes for the
endothelium to form), a strategy is required to also improve the acute thrombogenicity
of the prostheses. The student will perform a structured literature review on graft
occlusion in general, with specific reference to factors (porosity, compliance,
physiochemical and biological properties) that influence patency, and approaches that
have been used (e.g. surface modification, coating, drug release) to reduce graft
thrombogenicity. The review should not only summarize the prior art, but also discuss
the interrelationships between the identified parameters and conclude with an opinion
on the most feasible way of achieving the stated goal. The student will additionally be
exposed to, and gain insight into, the manufacturing and in vivo evaluation of
experimental vascular grafts.
31
Module no: 61
Contact:
Dr Deon Bezuidenhout
[email protected]
Tel.
021406 6349
Title:
Percutaneous Heart Valves
No. of students:
1
Type:
Structured Review
Summary: Approximately 300,000 replacement heart valve devices are required
annually in the developed world, most of which are implanted using open-heart
surgery. In developing nations, there is an even greater need for replacement heart
valves, as poor socioeconomic conditions leads to the staggering statistic that an
estimate 32 million (mostly young) people require a replacement valve due to
rheumatic heart disease. Most of these patients have no access to specialist
cardiovascular surgery facilities, and the majority will die at a very young age.
Recently, valves have been developed that can be implanted percutaneously (through
a small incision in the skin, either through via an artery or vein in the leg or through the
apex of the heart). The concept behind catheter-based valve delivery is simple: a
valved stent is collapsed into a catheter, the catheter tip is positioned at the site of the
valve to be replaced, and the stent is balloon-expanded to unfurl the new valve. The
execution of the concept, however, is very complex. In addition to the strenuous
demands already placed on surgically implanted valves, and to the ingenious stent and
catheter designs required to deliver them, catheter-based valves must withstand being
forced into a tube at a fraction of their expanded diameter, and then be able to unfold
into the precise geometries required for function and durability.
The student will review the literature pertaining to catheter based valves, summarize
and discuss the state of the art in terms of the valves used, and compare the
advantages and disadvantages of the different techniques of valve placement
(antegrade vs. retrograde vs. transapical).
Pharmacology:
Module no: 62
Convenor:
Contact:
No. of students:
Type:
Title:
Dr Eric Decloedt
[email protected]
2
Folder review
The safety of adjusted dose lopinavir/ritonavir in patients on
antituberculosis treatment.
Summary: Tuberculosis remains the most common opportunistic infection in HIV-infected
patients despite the use of ART. Lopinavir/ritonavir is the cornerstone of our 2 nd line
antiretroviral regimen (ART). However, there is limited data on the safety of co-treatment with
antituberculosis- and lopinavir/ritonavir based ART treatment. In this module students will
review identified folders of patients on 2nd line ART and select the patients that were treated
with antituberculosis treatment. Students will perform causality assessment of adverse events
during the period that patients received co-treatment. The data recorded and analysed using
appropriate methods and software.
In this module the students will learn how to assess adverse event causality, and how to
accurately record, analyze and interpret data. The findings will be written up and submitted to
an appropriate journal for publication.
32
Module no: 63
.
Convenor:
Prof Marc Blockman
Contact:
[email protected]
Title:
The patterns of vancomycin use in GSH
No. of students:
2
Type:
Retrospective review
Summary: Vancomycin is a restricted antibiotic that requires specific dosing and monitoring to
be effective and prevent antimicrobial resistance. However, vancomycin is frequently
prescribed and monitored incorrectly. In GSH we recently implemented a system where we
provide a prescription note to guide vancomycin prescribing with every vancomycin script. In
this module students will determine whether this intervention was effective. Students will
integrate data from pharmacy electronic records, pharmacology electronic records and clinical
files. In this module the students will learn how to accurately record, analyze and interpret data.
The findings will be written up and submitted to an appropriate journal for publication.
Module no: 64
Convenor:
Contact:
Title:
Prof Marc Blockman & Ms Annoesjka Swart
[email protected]
A guide to interpret laboratory results when initiating antiretroviral
therapy (ART)
No. of students:
2
Type:
Poster project
Summary: The Medicines Information Centre (MIC) is based in the Division of Clinical
Pharmacology and provides a national free HIV information service. The MIC has identified a
need to provide guidance to primary health care providers on interpreting laboratory results
when initiating ART. In this module students will design a poster with the aim to publish and
circulate nationally to primary health care facilities. In this module students will reason critically
around the information to be included in the poster, provide decision rules and present the
information in a visually pleasing manner.
Endrocrinology:
Module no: 65
Contact:
Tel:
Title:
Drs M Setshedi and I Ross
021- 404 7619 or 406 6209
The prevalence of liver function test abnormalities in patients
undergoing transgender reassignment
No. of students:
2
Type:
Audit
Summary: Patients undergoing gender reassignment are typically prescribed hormone
replacement therapy (HRT) to cause the development of the secondary sexual characteristics
in order to effect the desired phenotype. HRT however, is associated with a multitude of liver
diseases, including intrahepatic cholestasis; vascular complications such as peliosis hepatitis
and Budd-Chiari syndrome; hyperplasia and neoplasia e.g. focal nodular hyperplasia,
hepatocellular adenoma and hepatocellular carcinoma. As a result, during the initial evaluation
for transitioning, LFTs are mandatory before commencement of HRT. Some patients present
with de novo liver function test (LFT) abnormalities. There is no data about the prevalence of de
novo LFT abnormalities in these patients, and LFT abnormalities induced by HRT. Indeed there
is no data about the outcomes of these patients, once HRT is commenced. In this module the
students will retrieve the folders of all patients that have undergone or are undergoing gender
reassignment at GSH. All relevant demographic data will be captured. In addition, the student
will access laboratory records and note down liver function tests at baseline, during and after
commencement of HRT. Furthermore, the student will record the outcome of patients with LFT
abnormalities i.e. resolution of LFT abnormalities, time to resolution, and whether the patient
completed their gender reassignment. During the 4th week they will write a report, describing
their findings and including a literature review of liver disease with the use of HRT.
33
Dermatology:
Module no: 66
Convenor:
Contact:
Title:
G Todd and G Louw
[email protected] tel. 4043376
Sensory anatomy and physiology and anatomy of smell in the
context of perfumery.
No. of students:
6-8 students
Type:
Laboratory and survey
Summary:
Perfumes have had an important role in society for many reasons.
Currently our senses are overpowered by multiple fragrances used at every level of
our activities of daily living. Textile manufacture includes various fragrances which
release the scent on crushing the fabric. In some places of work the environment is
manipulated via the air-conditioning with various fragrances to stimulate appetite,
activity and calmness. Fragrances (which include perfumes) are currently the second
most common cause of allergic skin disease worldwide. In this module, the students
will dissect the nerves of smell and will develop an understanding of the physiology of
smell. In this context they can suggest what this perfume overload does to smell
perception as well as understanding the science of perfumery, alternate
aspects of smell appreciation can also be explored
OBS &GYNAE – OBS2001S
Module no: 67
Convener:
Contact:
Dr LJ Walmsley
Linda Walmsley
[email protected]
Tel:
021 404 6026
No of students:
1
Type of project:
audit
Summary: The Reproductive Medicine Unit at Groote Schuur hospital offers assisted
reproductive techniques to couples in state and private. A database exists for our IVF
(in vitro fertilization) and intra uterine insemination cycles. Annually performance is
assessed by pregnancy rates in each of these cycles.
We would like to further delineate our cycles according to age, BMI, indication,
ovarian reserve, medication used and outcome. Students will be expected to have basic
science knowledge of the female reproductive system and process of fertilization. They
will receive an introduction to assisted reproductive techniques and cycle management.
They will be required to perform a folder review of each existing case in the database
and to give a report of the findings. Knowledge of excel is essential.
34
PAEDIATRICS – PED2001S
Developmental Paeds
Module no: 68
Contact:
Dr K Donald
Tel:
021 6585033
Title:
The role of Physiotherapy in Cerebral Palsy
No of students:
2
Summary: Cerebral Palsy is the commonest cause of physical disability in children
worldwide. Neurodevelopmental therapy (NDT) is a widely used physiotherapy
treatment modality, despite a lack of good evidence supporting its use. SMART (
specific, measurable, attainable, realistic and have a specific time frame)
goal setting has been shown to change behaviour, enhance motivation and improve
outcomes (Eckstrom et al, 2005; Mastos M et al 2007). It has also been shown to
encourage active involvement of parents of children with cerebral palsy and facilitates
the practice of functional tasks on a daily basis (Oien et al, 2009). Research has shown
that in the paediatric cerebral palsy population, there is a lack of formal goal setting
procedures (Darrah J et al, 2010). Student s will review the role of physiotherapy in the
CP clinic at RXH by examining the evidence( literature review ). In addition one
student will conduct an audit amongst physiotherapy staff at CP clinic and report on
goal setting in clinical practice. The other student will do a folder reviews of patients
attending CP clinic and report on documentation of goal setting and achievement in
clinical practice.
Module no: 69
Contact:
Dr Reneva Petersen
Tel:
[email protected]/ 082 4162035
Title:
Cerebral Palsy and Nutrition
No of students:
2
Type:
Interpretive
Summary: Children with cerebral palsy (CP) frequently have problems with oropharyngeal control, oesophageal motility and gastro-oesophageal reflux. Among the
consequent health problems of these feeding difficulties are malnutrition, oesophagitis,
recurrent chest infections, and progressive lung disease. Children most at risk for these
problems are those with spastic quadriplegic and dystonic CP. Students will review the
literature regarding Cerebral palsy, feeding problems and malnutrition and will then do
an audit of the nutritional state of 100 children attending Cerebral Palsy clinic.
35
Child & Adolescent Psychiatry:
Module no: 70
Contact:
Dr Lesley Carew
Rehana Effendi ([email protected])
No of students:
2
Title:
Depression in children and adolescents with Diabetes Mellitus:
the search for an appropriate screening tool
Type of project:
Literature review
Summary: Diabetes Mellitus (DM) is a chronic, debilitating illness affecting 1.7 per
1000 of the paediatric population. There is an increased risk of psychiatric co-morbidity
associated with the illness. Studies report that children with DM have a two-fold
increased risk of being diagnosed with depression, and there is a three-fold increased
risk of depression in adolescents with DM. Children with psychiatric co-morbidities
have a poorer physical outcome with greater cognitive difficulties, more frequent
hospital admissions for diabetic keto-acidotic comas and more episodes of
hypoglycaemia.
The Diabetic clinic at the Red Cross Children’s Hospital provides a service to children
in the Western Cape suffering from this illness. There is an awareness of the increased
risk of mood disorder in this population. A screening instrument could assist in
detecting children most at risk who could then be referred for psychiatric assessment
and intervention.
In this SSM, two students will work with Dr Lesley Carew, Consultant Child &
Adolescent psychiatrist to perform a literature review of depression and mood disorders
in DM, and to use the literature review to identify a sensitive, specific and user-friendly
screening instrument to be used in an ‘at risk’ clinic setting
Module no: 71
Contact:
Prof Petrus de Vries
Contact:
Rehana Effendi ([email protected])
No of Students:
2
Title:
Autism in Africa
Type of project:
Literature Review
Summary: There is an increasing global awareness of autism. The rates of the disorder
is said to be similar to that of schizophrenia at around 1%. The vast majority of
publications about autism come from North America or Europe with only a tiny
fraction from Africa and other low and middle income countries. As a result, the world
perspective of autism is a very US-Eurocentric one. In this SSM, students will work
under the direction of Prof de Vries to peform a literature review of all publications
around autism and related disorders in Africa over the last 10 years. During weeks 1-3
the students will have regular supervision discussions with Prof de Vries and his group
to support the review process. In week 4 students will be expected to write a report
summarising and performing a critical appraisal of African research on autism.
36
Paediatric Endocrinology:
Module no: 72
Contact:




Dr Michelle Carrihill
[email protected]
Tel.
021-4044468
Title:
HBA1C results of paediatric diabetic patients seen at the Red
Cross Children’s Hospital Diabetes Outpatient Clinic, compared
with current age of patient, age of diagnosis and frequency
of attendance.
No. of students:
2
Type:
Interpretive
Summary: Students will exam the clinical records (kept in the diabetes clinic) of
patients who attended the Red Cross Children’s Hospital Diabetes Outpatient Clinic
January 2008 – December 2009. They will document the age of onset of diabetes, the
current age of the patient (at their last attendance) and the number of clinic
attendances in the preceding 12 months of their last attendance. Their HBA1C values
at the last attendance will be documented. The students will then answer the following
questions:
Does HBA1C correlate with current age?
Does HBA1C correlate with age of diagnosis?
Does HBA1C correlate with duration of diabetes (current age minus age at
diagnosis)?
Does HBA1C correlate with frequency of clinic attendance?
Paediatric Medicine:
Module no: 73
Contact:
Contact:
Title:
Dr Mark Richards
021 402 6911 or [email protected]
Babies with Birth Associated Brain Injuries at New
Somerset Hospital.
No of students:
2
Type:
Descriptive
Summary: Hypoxic-Ischaemic Encephalopathy (HIE) is a potentially devastating
condition for a newborn with the potential for significant long term morbidity and
mortality. New Somerset Hospital (NSH) has a neonatal nursery which cares for
newborns with HIE and it is also responsible for co-ordinating their follow up care.
There are ways of defining the severity of this brain injury and these can be used to
define longer term prognosis. They rely on both clinical and electrophysiological
features. There is a cohort of newborns who have had documented HIE at NSH. The
characteristics of this cohort of children need to be defined, including the birth
associated factors leading to the injury, their injury severity and their current
neurological status. Your study will involve becoming familiar with this disease
condition, exposure to its acute management and helping to define the characteristics of
this cohort of children at the time of the injury and their current neurological status.
37
Child Health:
Module no: 74
Contact:
Prof Michael Hendricks & Tony Westwood
[email protected]
Tel:
021-4026433
Title:
Missing data relating to child mortality in South Africa:
how feasible is it to fill in the blanks?
No. of students:
4
Type:
Descriptive
Summary: Deficiencies in child mortality data in South Africa are hampering targeted
interventions to improve child survival. The death notification form (DNF) is the source
of much of this essential data but, for significant numbers of children who die, where
they died and what they died of is difficult to glean when forms are reviewed in routine
data collection and epidemiological studies.
In this module, the students will explore the feasibility of abstracting some of the
missing information from the electronic hospital records system in Cape Town
(Clinicom) for a sample of the 2011 data for neonates and children.
PUBLIC HEALTH AND FAMILY MEDICINE – PPH2002S
Family Medicine:
Module no: 75
Contact:
Dr Feroza Amien
[email protected]
Tel:
021 406 6221
No of students:
5
Type:
Survey
Title:
Patients perceptions of the need for dental services
with SHAWCO.
Summary: The student health and welfare centre’s organization is run by medical
students whereby they perform basic primary care services after hours in informal
settlements. In this module students will conduct a survey to assess whether patients
would attend a mobile dental clinic if it accompanies SHAWCO to these areas. They
will design the questionnaire themselves (with my guidance). At the end of the
module they will hand in a report consisting of a brief literature review of the
integration of oral health into general medical services, together with the
methodology, results and discussion section.
38
Module no: 76
Contact:
Dr Feroza Amien
[email protected]
Tel:
021 406 6221
No of students:
5
Type:
Survey
Title:
Senior medical students’ knowledge regarding prevalent oral
health conditions and their attitudes towards screening for
these conditions.
No of students:
4
Summary: In this module students will conduct a survey with final year medical
students to determine their knowledge about prevalent oral health conditions such
as dental caries, gingivitis, oral ulcers etc. They will also record medical students’
perceived need for the incorporation of this kind of information into the
curriculum. At the end of the module they will be expected to submit a report with
a literature review of the five most prevalent oral conditions in South Africa. The
report should also consist of a methodology, results and disc
Module no: 77
Contact:
Sarah Crawford-Browne and Dion Benetatos
[email protected]
021 406 6369
Developing media for research participants
3
Interpretive
Tel.
Title:
No of students:
Type:
Summary:
Are short films useful in recruiting and retaining participants in a microbicide
study?
The Desmond Tutu HIV Foundation is researching the effectiveness of microbicides to
prevent the transmission of HIV. The research study is based in Masiphumelele, a
community near Noordhoek with a HIV prevalence of around 28%. The recruitment
team is tasked with recruiting 300 study participants. It is thought that a short video
explaining the research and answering frequently asked questions may motivate
community members to participate (recruitment). Similarly, it is hoped that a second
film outlining the number of visits participants are required to attend may motivate
community members to stay in the study (retention) and that a third film could be used
to educate the patients using the clinic. The students may use the Centre’s shuttle
service to Masiphumelele, which departs each morning from UCT Medical school on
Anzio Road.
Each student will need to:
1) read the Desmond Tutu HIV Foundation website, annual report and relevant
studies to understand the project
2) access and read available literature regarding participant recruitment for HIV
studies with a particular focus on the cultural and psycho social issues that may
be a barrier to, or motivator for participation in this study
3) interview team members, DTHF outreach workers, clinic-goers, and
community members to understand the barriers to and motivators for
participation within this context
4) attend film making training, make a 4 minute film to either a) recruit or b)
retain or c) educate participants
39
5)
6)
premier the films in the community and evaluate the response.
write a reflective report that outlines the project, summarises the literature that
you used to inform your film making, discusses the choices that you made in
designing your film, and reflects on the response of the recruitment team and
study participants.
Module no: 78
Contact:
Dr Elma de Vries
[email protected]
Tel.
021-3703700
Title:
The value of blood cultures in a district hospital
No. of students:
2
Type:
Retrospective folder review
Summary: Patients who present very ill at Mitchell’s Plain District Hospital often have
blood cultures done as part of their investigations. No audit has been done at the
hospital of how often the blood cultures are positive and how useful it is in clinical
practice. This study will review folders of patients admitted to Mitchell’s Plain District
Hospital, who had blood cultures done. A list of blood cultures done will be obtained
from NHLS Greenpoint. An audit tool to review the folders will be developed by the
student with assistance from the supervisor, to include information such as HIV status,
CD4 count, temperature, symptoms of sepsis, choice of antibiotics, blood culture
result, and outcome of the patient. The student will join ward rounds at Mitchell’s Plain
District Hospital to observe how patients with sepsis present and how they are
managed. During the 4th week the student will write a report, describing their findings
and including a literature review of blood cultures in the emergency centre setting.
Module no: 79
Contact:
Tel.
Title:
Elma de Vries
[email protected]
021-3703700 / 082 8286259
General practitioner knowledge, attitudes and beliefs
about Transgender issues
2
Survey questionnaire
No. of students:
Type:
Summary:
Internationally there is an increased awareness of the health needs of transgender
persons, but very little research has been done on transgender health in South Africa.
There is a perception that many doctors do not have much knowledge about
transgender health, about how to approach and appropriately manage a transgender
client. This is experienced by many transgender persons as a barrier to accessing
health care. There is a need to develop educational material for general practitioners,
in order to empower them to be able to comfortably and competently manage the
primary health care needs of transgender persons.
The tasks for this SSM will include the following:
 Review of existing literature on general practitioner knowledge, attitudes and
beliefs on transgender issues
 Students will develop a survey questionnaire based on the literature
 Students will administer the questionnaire to a group of general practitioners
 Analysis and write up of results
 Recommendations for general practitioner education priorities as part of continued
professional development
40
Module no: 80
Contact:
Prof D.A. Hellenberg
[email protected]
Tel.
021406 6510
Title:
Doctor-patient communication in isiXhosa
No. of students:
4
Type:
Survey / Interpretive
Summary: The primary language of communication between medical students at UCT and
their patients is English, but the majority of patients are first language Xhosa or Afrikaans
speakers. This creates problems for both the practitioner and the patient. This SSM intends to
assess the success of ‘immersion’ language programmes for students. Four students will live
with the Xhosa-speaking family of a health practitioner for 2 and a-half weeks of the SSM
period, Mondays to Fridays. During the day, students will engage in the activities of the health
facility under the supervision of their host. After-hours, students are encouraged to integrate
socially and culturally with the host family. Besides reporting on their project, students are
required to provide written reflection on the effectiveness or otherwise, of language/cultural
immersion within the clinical context. Students will complete a research project relating to an
aspect of doctor-patient communication. The students will collect, group and analyse data and
produce a research report in which they will report on their experience of cultural and language
immersion and its effect on their understanding of and proficiency in the language. Students
interested in doing research on a topic related to Family Medicine and who are keen to also
improve their Xhosa language skills, are encouraged to apply for this SSM. We require that the
students involved in the Xhosa project are not first language Nguni speakers (isiXhosa, isiZulu,
siSwati, siNdebele). Interested students are asked to contact Professor Hellenberg in advance
for further details of the module.
Module no: 81
Contact:
Prof D.A. Hellenberg
[email protected]
Tel.
021406 6510
Title:
Doctor-patient communication in Afrikaans
No. of students:
2
Type:
Survey / Interpretive
Summary: The primary language of communication between medical students at UCT and
their patients is English, but the majority of patients are first language Xhosa or Afrikaans
speakers. This creates problems for both the practitioner and the patient. This SSM intends to
assess the success of ‘immersion’ language programmes for students.Two students will live
with the Afrikaans-speaking family of a health practitioner for 2 and a-half weeks of the SSM
period, Mondays to Fridays. During the day, students will engage in the activities of the health
facility under the supervision of their host. After-hours, students are encouraged to integrate
socially and culturally with the host family. Besides reporting on their project, students are
required to provide written reflection on the effectiveness or otherwise, of language/cultural
immersion within the clinical context. Students will complete a research project relating to an
aspect of doctor-patient communication. The students will collect, group and analyse data and
produce a research report in which they will report on their experience of cultural and language
immersion and its effect on their understanding of and proficiency in the language.Students
interested in doing research on a topic related to Family Medicine and who are keen to also
improve their Afrikaans language skills, are encouraged to apply for this SSM. We require that
the students involved in the Afrikaans project are either beginners in Afrikaans or not first
language English or Afrikaans speakers. Interested students are asked to contact Professor
Hellenberg in advance for further details of the module.
41
Module no: 82
Contact:
Ms Johannah Keikelame
[email protected]
Title:
Using observations to understand factors impacting on care of
patients with epilepsy
No. of students:
4
Type:
Qualitative
Summary: The purpose of this project is to give students an opportunity to learn to do
observations to get a layered picture on approaches that may overlook or exclude
issues that are important to effective management and care of marginalized groups of
patients such as those suffering from epilepsy. Students will use a structured
observation guide to collect data in support group meetings run by Epilepsy South
Africa, Western Cape Branch. They will each write a report to describe one or two
behaviors that they have observed during the support group meetings. Students will
meet with the module convener on the first day in week one for orientation on the
topic. In the 3rd week, they will analyze the data and produce a written report of their
findings and literature reviewed on the topic.
Module no: 83
Contact:
Prof Steve Reid (UCT)
Contact:
Dr Patricia Repar (UNM)
Tel:
406 6781
Title:
Arts and Healthcare
No. of Students:
6
Type:
Interpretive
Summary: This project will explore the links and integration of the creative / expressive arts
and health care in the South African context. The creative and expressive arts include visual
arts, music, dance and movement, poetry and drama.
Where and how does art happen in a medical or healthcare context? What are the underlying
paradigms of these two disparate fields, and what are the issues and areas where they
converge? Is there benefit in working across disciplinary boundaries in this way, and what could
those benefits be? This is not a course in art or music therapy, although it may contain some
elements of these established fields. It is an exploration of ideas, theory and practice, in
bringing the worlds of biomedical science and creative arts together explicitly and practically.
The group will be joined by 6 senior students from The University of New Mexico (UNM) who
are majoring in various areas of the fine arts including music, film studies, photography, theater,
and dance. They are the first participants in a new UNM College of Fine Arts initiative designed
to promote and support courses based in community-engaged learning (see Arts Learning
Laboratory at the University of New Mexico http://artslearninglab.unm.edu). The course is
closely affiliated with a clinical program by the same name based at The University of New
Mexico Hospitals (see Arts-in-Medicine Program at the University of New Mexico
http://artsinmedicine.unm.edu ).
Students will meet with the facilitators once a week and will take on various tasks. Students will
be required to carry out literature reviews in different subject areas, interview key informants,
facilitate creative encounters in medical environments, and plan events as a group. Communityengaged learning opportunities will be arranged at Vredenberg District Hospital, St Luke’s
Hospice in Kenilworth and Mitchell’s Plain. Students may either choose to write a research
report, literature review or critical analysis, or produce a digital story (including the events) as
per the SSM rules for disser
42
Module no: 84
Convenors:
Prof. S. Reid and Dr N. van der Schyff
Contact:
Dr Des Michaels [email protected] or
Tel:
021 406 6111
Title:
Follow-up of patients after discharge from Victoria Hospital
No. of students:
4
Type:
Record Review and Patient follow-up study
Summary: This module will explore the experiences of patients after discharge from
Victoria Hospital. We do not know enough about how they cope and what happens to
them. The purpose of the module is to better understand the post-discharge experience
of patients and to address potential gaps in the discharge and follow-up process. The
questions that such a project could answer are:
 How do the patients and their families cope with the illness after discharge from
hospital?
 What is the degree of post-hospitalization morbidity and mortality for different
conditions?
 What is the proportion of long-term disability by condition?
 What proportion of patients return to work or their pre-surgical levels of
activity?
 What resources (e.g. rehabilitation) do they access (or not) for help at home?
 What is the rate of readmission or consultations that might be prevented?
 How could the discharge and follow-up process be improved?
Students will be expected to conduct a literature review, review patient folders of
patients discharged from Victoria Hospital and development of an appropriate folder
review tool. Follow-up will include three points of data collection - one home visit, at
the follow-up clinic and a later telephone call. Each student will identify one patient for
a follow-up home visit, which will be conducted in pairs and result in a narrative report.
Students will be linked to NGOs and CBOs involved in home-based care in the areas
that patients live. Student reports will include a critical appraisal of the literature, a
narrative report of their home visit, and an analysis of data extracted from patients’
folders from a certain number of discharges.
43
PSYCHIATRY – PRY2001S
Module no: 85
Contact:
Tel.
Title:
Dr Imthiaz Hoosen (Lentegeur Hospital)
021 370 1111 or <[email protected]>
Audit of psychiatric notes/records at Lentegeur
and Valkenberg Hospitals.
No. of students:
5
Type:
Audit
Summary: Audit of psychiatric note/records at Lentegeur and Valkenberg Hospitals.
Audit 100 patient case notes (50 per hospital) - in order to assess quality of medical
notes made on admission. e.g. have the main areas of the assessment been recorded:
history, diagnosis, physical exam, treatment plan, mental state exam, risk assessment,
contact info, etc Also to assess if the medical notes meets national standards for
medical records. (students will need to establish if there are South African national
standards)
Module no: 86
Contact:
Tel.
Cell:
email:
Title:
No. of students:
Type:
Dr Louise Frenkel / Dan Stein
021 404 2035
083 947 1370
[email protected]
Living with Chronic Pain
2
Research
Summary: The stories told by patients who attend the GSH Pain Clinic.
The research will involve 2 stages; The first stage will be a file audit of all the new referrals to
the pain clinic from the 30th April 2011 to the 30th April 2012 (There are approximately 12
new referrals a month, so this will cover about 150 patients. Information regarding age, sex,
living arrangement, diagnosis, employment, Disability Grant, when first treated and their
score on a Brief Pain Inventory, will be recorded (The scores are documented in their patient
files). The 2nd stage of the research will be to identify a homogenous subgroup from this initial
group of 150, (e.g. women between the ages of 30 and 55 who suffer with fibromyalgia) and
to do semi-structured, in-depth interviews with them. The purpose of the interviews will be
to gain some insight into what it is like for this group of people to live with chronic pain; how
they experience and make sense of the pain, and what impact it has on their lives, and their
important relationships.
What I will require of the students (hopefully 2 students) will be:
1. To do a literature search for any articles on chronic pain in South Africa, and in Africa
in the last decade (from 2002 – 2012)
2. To collect the information for the file audit and enter it onto a spreadsheet, and
identify trends.
3. To then write a brief review of recent literature, and a patient profile for the GSH Pain
Clinic.
In the month in which they undertake the research, I will allow them to sit in on interviews
with some of the pain patients (with the patient’s permission). These will not be the formal
research interviews, but part of the ongoing therapeutic interviews conducted with pain clinic
patients.
44
Module no: 87
Contact:
Email:
Tel:
Title:
Dr Adele Marais
[email protected]
021 404 5416/ 021 404 2151
Undergraduate and postgraduate medical students’ knowledge,
attitudes and beliefs about Transgender issues
No of students:
4
Type:
Survey questionnaires
Summary: Medical schools are increasingly focusing on developing interpersonal
skills and ‘cultural competence’ of medical students. We know that deep-seated biases
often negatively affect doctor-patient relationships, as well as patients’ access to quality
healthcare. This is especially relevant in working with marginalised communities –
which includes the transgender population. Certainly, many transgender persons face
significant prejudice and ignorance when coming into contact with medical
professionals. The Dept of Psychiatry and Mental Health at GSH runs one of only two
public sector transgender clinics in South Africa. The clinic consists of a multidisciplinary team that offers a comprehensive service to transgender persons. It uses the
services of a clinical psychologist, psychiatrist, sexologist, social worker,
endocrinologist, plastic surgeon, family physician and has links with the main referral
NGO’s, i.e. Triangle Project and Gender DynamiX.
The GSH clinic is invested in identifying the Transgender knowledge, attitudes and
beliefs of undergraduate and postgraduate medical students in order to develop
appropriate multi-disciplinary curricula which can address these concerns.
The tasks for this SSM will include the following:
 Review of existing literature on students’ knowledge, attitudes and
beliefs/ medical school curricula, etc.
 2 students will construct and administer a survey questionnaire to a
group of undergraduate medical students
 2 students will construct and administer a survey questionnaire to a
group of postgraduate students
 Analysis and write up of results
 Recommendations for issues to be addressed in medical curricula at
undergraduate and postgraduate level
Module no: 88
Contact:
Dr Adele Marais
Email:
[email protected]
Tel:
021 404 5416/ 021 404 2151
Title:
Patient satisfaction with transgender health services
No of students:
2
Type:
Survey questionnaire
Summary: Measuring how patients subjectively evaluate the healthcare services they
receive (i.e. patient satisfaction) is recognised as integral to the assessment of health
care outcomes. Today there is an increased emphasis on good quality relationships
between doctors and their patients, however, transgender patients often experience
ignorance, insensitivity and prejudice when engaging with a range of medical
practitioners. Given their desire to change their biological sex (by using hormones or
surgery), transgender persons have specific healthcare needs which need to be
addressed appropriately. The Dept of Psychiatry and Mental Health at GSH runs one of
45
only two public sector transgender clinics in South Africa. The clinic consists of a
multi-disciplinary team that offers a comprehensive service to transgender persons. It
uses the services of a clinical psychologist, psychiatrist, sexologist, social worker,
endocrinologist, plastic surgeon, family physician and has links with the main referral
NGO’s, i.e. Triangle Project and Gender DynamiX. The clinic is invested in identifying
how Transgender patients experience the healthcare provided by the various clinics
they come into contact with at GSH. This information will help identify areas in need
of improvement, and will ensure quality assurance (e.g. friendliness and courtesy of
staff; being addressed by preferred name and pronouns, respectful physical
examinations, etc.).
The tasks for this SSM will include the following:
 Review of existing literature on TG patient expectations/satisfaction
regarding trans-specific medical care
 Construction of a patient satisfaction survey questionnaire to be used
across the multi-disciplinary clinics at GSH
 Writing up a research report, with recommendations for issues to be
addressed in TG medical care
Module no:89
Contact:
Dr Don Wilson
Tel.
021 404 2182 or 2164
Title:
Alcohol
No. of students:
2
Type:
Review
Summary:
Substance use is a major cause of disability. Alcohol is the
commonest substances used world-wide and in South Africa. This substance impacts on the
whole of the South African community. Alcohol dependence leads to some major psychiatric
disorders, significant loss of working hours and has a major impact on quality of life for affected
individuals and their families.
During this module, students can:
1. Select one aspect of Alcohol Dependence [genes that influence dependence, ideal
withdrawal regimes, acute psychiatric conditions, chronic psychiatric sequelae] and
conduct a literature review on an aspect of the disorder.
2. Or do a general review of the current literature and produce an overview suitable for
medical students.
You will also have an opportunity to meet patients with substance use problems at an
Addictions clinic at GSH or at the Cape Town Drug Counselling Centre during the module.
Please meet with Dr Wilson before the start of the module to make specific plans on what is to
be reviewed.
Module no: 90
Contact:
Dr Don Wilson
Tel.
021 404 2182 or 2164
Title:
Cannabis
No. of students:
2
Type:
Review
Summary:
Substance use is a major cause of disability. One of the
commonest substances used world-wide is cannabis (dagga), the chronic use of which leads to
significant loss of working hours and has a major impact on quality of life for affected individuals
and their families.
During this module you can:
1.
Select one aspect of cannabis [affect on genes, independent risk factor for
schizophrenia, acute psychiatric conditions, chronic psychiatric sequelae] and
conduct a literature review on that aspect of the disorder.
46
2.
Or do a general review of the current literature to produce an overview suitable for
medical students.
You will have an opportunity to meet patients with substance use problems at an Addictions
clinic at GSH or at the Cape Town Drug Counselling Centre during the module.
Please meet with Dr Wilson before the start of the module to make specific plans on what is to
be reviewed.
Module no: 91
Contact:
Dr Don Wilson
Tel.
021 404 2182 or 2164
Title:
Methamphetamine (Tik)
No. of students:
2
Type:
Review
Summary:
Substance use is a major cause of disability. Second commonest illicit
substances used world-wide are the amphetamines and in South Africa the substances used is
Methamphetamine (Tik), the chronic use of which leads to some major psychiatric disorders,
significant loss of working hours and has a major impact on quality of life for affected individuals
and their families.
During this module, students can:
1. Select one aspect of Methamphetamine [possible affect on genes, independent risk
factor for schizophrenia, acute psychiatric conditions, chronic psychiatric sequelae] and
conduct a literature review on an aspect of the disorder.
2. Or do a general review of the current literature and produce an overview suitable for
medical students.
You will also have an opportunity to meet patients with substance use problems at an
Addictions clinic at GSH or at the Cape Town Drug Counselling Centre during the module.
Please meet with Dr Wilson before the start of the module to make specific plans on what is to
be reviewed.
MEDICINE – MDN2001S
Module no: 92
Contact:
Contact:
Dr N. van der Schyff
Dr N van der Schyff ([email protected]),
Ms Nichola Daniels- 021 7991161 ([email protected])
Title:
Cardiac rehabilitation in a resource limited setting
No. of students:
4
Type:
Programme Review and Patient follow-up study
Summary: This module will explore the experiences of patients that have completed
the cardiac rehabilitation programme at Victoria hospital. Being one of the only
programmes of its type available to patients with ischaemic heart disease in the state
sector in the Western Cape, this cardiac rehabilitation programme has done excellent
work in educating many patients from disadvantaged communities. As a consequence
of the high incidence of hypertension, diabetes mellitus, hypercholestralemia and
smoking in patients attending Victoria hospital, many patients with symptomatic
coronary artery disease are seen at the hospital. The purpose of the module is to gain a
much greater understanding of the factors contributing to the high incidence of
atherosclerosis and coronary artery disease at Victoria hospital. The students will
evaluate the impact that the cardiac rehabilitation programme has on a selected group of
participants completing the course. They will follow up these patients in the community
and assess the challenges they face in their attempt to change their often unhealthy
lifestyles. Students will also assess the community facilities and resources available to
these patients upon completion of the programme. Students will be expected to
47
conduct a literature review, create a patient questionnaire which needs to be used when
they meet the patients for the first time (in the last week of the cardiac rehab
programme). Follow-up will include - one home visit 2 weeks upon completion of the
programme and the evaluation and utilization of resources available within the
community. Students will be linked to relevant NGOs and CBOs in the areas that
patients live. Student reports will include a critical appraisal of the literature, the
results of the questionnaire, a narrative report of their home visit and will be required to
discuss the community resources available to patients
Module no: 93
Contact:
Dr N. van der Schyff
[email protected]
Ms Nichola Daniels- 021 7991161 ([email protected])
Title:
Complication(s) of diabetes mellitus.
No. of students:
2
Type:
Clinical and review.
Summary: In this module, basic science and clinical medicine are closely linked.
Diabetes mellitus is a major and common metabolic disorder, with multiple clinical
manifestations and complications.
The student undertaking this RM must be equipped with
 an understanding of glucose metabolism and the abnormal physiology that
characterizes diabetes and determines its classification and
 an understanding of the pathogenesis and pathology of the complications.
These complications affect all body systems, and develop as a direct
consequence of disordered physiology.
In the module, students will examine patients admitted with complications of diabetes
and write-up a portfolio of 5 such patients.
The aim of a survey of such a cohort of patients will be to develop and show an
understanding of the pathophysiologic disturbance(s) leading to the patient’s
complication(s) and/or decompensation and need for treatment in hospital.
All 3 students are too meet on the morning of the 19th June at 09:30 in the G8
Seminar Room to plan the SSM's
Module no: 94 – LAB2002S
Contact:
e-mail:
Title:
Ryan Goosen, Janique Peyper and Jonathan Blackburn,
[email protected] or [email protected]
Colorectal Cancer epidemiological statistics at
Groote Schuur Hospital: A retrospective folder review
No. of students:
4
Type:
Research hypothesis
Summary of project:
1. Rationale
Colorectal cancer (CRC) is the third leading cause of cancer-related mortality in the United
States
(U.S). In South Africa (ZA), the most recent available statistics estimate that CRC is one of the
top five
cancers, thought to be a gross underestimation. The burden of this disease in the WC is
complicated
by the prevelance of various risk factors, a resource-limited screening protocol compared to
that in the
U.S, and the observation that most patients present with advanced disease.
There is a deficiency of current local epidemiological statistics regarding CRC in ZA. The
National
48
Cancer Registry does not routinely publish such data, and literature is sparse. Since such
information
is required in order to implement effective control and intervention measures, as well as to
assess
performance of current and future management protocols, its collection is paramount.
Specifically, we
require such data in the Western Cape (WC), which represents a multi-ethnic population with
presumable differences in distribution characteristics, and where communicable diseases
represent
the majority of the disease burden, significantly reducing funds available for treatment of
noncommunicable
disease. Better statistics will lead to more informed healthcare budget policy decisions.
A retrospective folder review design is well-suited to providing such statistics.
2. Research Hypothesis
Recent, representative local epidemiological CRC statistics may be obtained via a retrospective
folder
review of all CRC patients treated at Groote Schuur Hospital between 2005 and 2011.
3. Aims & Objectives
a. Formulate epidemiological statistics of CRC patients at GSH and stratify distribution and
outcomes of CRC by whether or not radiotherapy was received prior to surgery, anatomical
site of disease, stage of disease at presentation, and surgeon.
b. Determine clinical and practical significance of the information obtained and generate
recommendations that will positively impact on CRC management, by critically analysing
information and linking inferences to existing literature/mechanistic hypotheses or applying
relevant models/classification hierarchies, followed by presentation of data and
recommendations to stakeholders.
4. Methodology
In a standardised manner, trained reviewers will extract pre-defined data from a randomised
folder
selection at the GSH Radiation Oncology folder repository, representing CRC patients treated
between 2005 and 2011 (≥50 per year, yielding a final folder sample of ≥ 350). Generate simple
statistics, and perform simple comparative statistical tests between variables and outcomes of
interest. Students will be required to assist in data capture and to produce a literature
review.
5. Projected Outcomes
Results and recommendations will be presented to stakeholders in order to improve policymaking
and management practice. This data will be used to augment an existing study, with the view to
publish the resultant epidemiological data in international scientific journals