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Courses Directly related to Medical Practitioner

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Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study Overview South Africa faces a complex burden of disease consisting of infectious and non–communicable conditions, injury and interpersonal violence, and maternal and child mortality. Inequalities in income and opportunity push disease burdens towards vulnerable populations, a situation to which the health system struggles to respond. There is an urgent need for health planning to account for the needs of marginalized groups in this context. Objectives were to develop a process to elicit the perspectives of local communities in the established Agincourt health and socio-demographic surveillance site (HDSS) in rural north–east South Africa on two leading causes of death: HIV/AIDS and violent assault, and on health surveillance as a means to generate information on health in the locality. The groups identified a range of social and health systems issues including risky sexual health behaviors, entrenched traditional practices, alcohol and substance abuse, unstable relationships, and debt as causative. Participants also explained how compromised patient confidentiality in clinics, insensitive staff, and a biased judicial system were problematic for the treatment and reporting of both conditions. The discussions provided information not available from other sources on the social and health systems processes through which access to good quality health care is constrained in this setting. Acknowledgement Authors Nitya Hullur, Lucia D’Ambruoso, Kerstin Edin, Ryan G Wagner, Sizzy Ngobeni Kathleen Kahn, Stephen Tollman, Peter Byass Journal Global Health Action Volume 6 Issue 1	Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study Course Detail Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study R 460.00 \| 3 CEUs Add to Cart Online Course Overview South Africa faces a complex burden of disease consisting of infectious and non–communicable conditions, injury and interpersonal violence, and maternal and child mortality. Inequalities in income and opportunity push disease burdens towards vulnerable populations, a situation to which the health system struggles to respond. There is an urgent need for health planning to account for the needs of marginalized groups in this context. Objectives were to develop a process to elicit the perspectives of local communities in the established Agincourt health and socio-demographic surveillance site (HDSS) in rural north–east South Africa on two leading causes of death: HIV/AIDS and violent assault, and on health surveillance as a means to generate information on health in the locality. The groups identified a range of social and health systems issues including risky sexual health behaviors, entrenched traditional practices, alcohol and substance abuse, unstable relationships, and debt as causative. Participants also explained how compromised patient confidentiality in clinics, insensitive staff, and a biased judicial system were problematic for the treatment and reporting of both conditions. The discussions provided information not available from other sources on the social and health systems processes through which access to good quality health care is constrained in this setting. Acknowledgement Authors Nitya Hullur, Lucia D’Ambruoso, Kerstin Edin, Ryan G Wagner, Sizzy Ngobeni Kathleen Kahn, Stephen Tollman, Peter Byass Journal Global Health Action Volume 6 Issue 1	3	R 460.00
Commensal bacteria produce GPCR ligands that mimic human signalling molecules Commensal bacteria produce GPCR ligands that mimic human signalling molecules Overview Commensal bacteria are believed to play important roles in human health. The mechanisms by which they affect mammalian physiology are poorly understood; however, bacterial metabolites are likely to be key components of host interactions. Here, we use bioinformatics and synthetic biology to mine the human microbiota for N-acyl amides that interact with G-protein-coupled receptors. GPR119 is most highly expressed in the pancreas and duodenum, S1PR4 in the spleen and lymph node, G2A in the lymph node and appendix, PTGIR in the lung and appendix and PTGER4 in the bone marrow and small intestine. Commensal GPR119 agonists regulate metabolic hormones and glucose homeostasis as efficiently as human ligands although future studies are needed to define their potential physiologic role in humans. This work suggests that chemical mimicry of eukaryotic signaling molecules may be common among commensal bacteria and that manipulation of microbiota genes encoding metabolites that elicit host cellular responses represents a new small molecule therapeutic modality. Acknowledgement Author Louis J. Cohen, Daria Esterhazy, Seong-Hwan Kim, Christophe Lemetre, Rhiannon R. Aguilar, Emma A. Gordon, Amanda J. Pickard, Justin R. Cross, Ana B. Emiliano, Sun M. Han1, John Chu, Xavier Vila-Farres, Jeremy Kaplitt, Aneta Rogoz, Paula Y. Calle, Craig Hunter, J. Kipchirchir Bitok, and Sean F. Brady Journal Nature Publisher Department of Health & Human Services – USA	Commensal bacteria produce GPCR ligands that mimic human signalling molecules Course Detail Commensal bacteria produce GPCR ligands that mimic human signalling molecules R 395.00 \| 3 CEUs Add to Cart Online Course Overview Commensal bacteria are believed to play important roles in human health. The mechanisms by which they affect mammalian physiology are poorly understood; however, bacterial metabolites are likely to be key components of host interactions. Here, we use bioinformatics and synthetic biology to mine the human microbiota for N-acyl amides that interact with G-protein-coupled receptors. GPR119 is most highly expressed in the pancreas and duodenum, S1PR4 in the spleen and lymph node, G2A in the lymph node and appendix, PTGIR in the lung and appendix and PTGER4 in the bone marrow and small intestine. Commensal GPR119 agonists regulate metabolic hormones and glucose homeostasis as efficiently as human ligands although future studies are needed to define their potential physiologic role in humans. This work suggests that chemical mimicry of eukaryotic signaling molecules may be common among commensal bacteria and that manipulation of microbiota genes encoding metabolites that elicit host cellular responses represents a new small molecule therapeutic modality. Acknowledgement Author Louis J. Cohen, Daria Esterhazy, Seong-Hwan Kim, Christophe Lemetre, Rhiannon R. Aguilar, Emma A. Gordon, Amanda J. Pickard, Justin R. Cross, Ana B. Emiliano, Sun M. Han1, John Chu, Xavier Vila-Farres, Jeremy Kaplitt, Aneta Rogoz, Paula Y. Calle, Craig Hunter, J. Kipchirchir Bitok, and Sean F. Brady Journal Nature Publisher Department of Health & Human Services – USA	3	R 395.00
A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma Overview Cardiac angiosarcomas are extremely rare in childhood, they are rapidly progressive tumours that often present themselves as diagnostic dilemmas, resulting in delayed diagnosis. Also, extracardiac manifestations, including abdominal pain, are extremely rare in patients with intracardiac tumours. We herein present the case of a 15-year-old girl who presented with abdominal pain. Echocardiography and thoracic computed tomography showed right atrial mass. Primary cardiac angiosarcomas in all age groups mostly occur in the right atrium. The most common complaints presented are dyspnea and chest pain, usually related to a malignant cardiac effusion. The pericardium is frequently involved with a right sided angiosarcoma; cardiac tamponade and pericardial effusion are common complications. Our patient had a massive pericardial effusion and malignant cells were seen in cytologic examination. The patient underwent surgery, chemotherapy, and radiotherapy. Eight months after treatment, abdominal recurrence was detected. The abdominal mass was resected, and radiotherapy and new chemotherapy protocol were given. The present case illustrates a rare case of primary cardiac angiosarcoma posing a diagnostic dilemma in an adolescent girl. Acknowledgement Authors Elvan Caglar Citak, MD, PhD; Murat Ozeren, MD; M. Kerem Karaca, MD; Derya Karpuz, MD; Feryal Karahan, MD; Eda , Bengi Yilmaz, MD; Yuksel Balci, MD; Pelin Ozcan Kara, MD; Rabia Bozdogan Arpaci, MD Journal Brazilian Journal of Cardiovascular Surgery	A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma Course Detail A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma R 460.00 \| 3 CEUs Add to Cart Online Course Overview Cardiac angiosarcomas are extremely rare in childhood, they are rapidly progressive tumours that often present themselves as diagnostic dilemmas, resulting in delayed diagnosis. Also, extracardiac manifestations, including abdominal pain, are extremely rare in patients with intracardiac tumours. We herein present the case of a 15-year-old girl who presented with abdominal pain. Echocardiography and thoracic computed tomography showed right atrial mass. Primary cardiac angiosarcomas in all age groups mostly occur in the right atrium. The most common complaints presented are dyspnea and chest pain, usually related to a malignant cardiac effusion. The pericardium is frequently involved with a right sided angiosarcoma; cardiac tamponade and pericardial effusion are common complications. Our patient had a massive pericardial effusion and malignant cells were seen in cytologic examination. The patient underwent surgery, chemotherapy, and radiotherapy. Eight months after treatment, abdominal recurrence was detected. The abdominal mass was resected, and radiotherapy and new chemotherapy protocol were given. The present case illustrates a rare case of primary cardiac angiosarcoma posing a diagnostic dilemma in an adolescent girl. Acknowledgement Authors Elvan Caglar Citak, MD, PhD; Murat Ozeren, MD; M. Kerem Karaca, MD; Derya Karpuz, MD; Feryal Karahan, MD; Eda , Bengi Yilmaz, MD; Yuksel Balci, MD; Pelin Ozcan Kara, MD; Rabia Bozdogan Arpaci, MD Journal Brazilian Journal of Cardiovascular Surgery	3	R 460.00
Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis Overview Paediatric chronic pain is relatively common in the world. Although cognitive behaviour therapy (CBT) has been shown to be efficacious in children and adolescents, it is generally recognized that availability and accessibility of CBT are limited. However, Internet-delivered cognitive-behavioural therapy (ICBT) performs better in these areas. This systematic review aims to evaluate the clinical effects of ICBT for chronic pain in youth when compared with the control treatments. We searched electronic databases to identify randomized controlled trials that compared ICBT with the control therapy for paediatric chronic pain. The primary outcomes were 95% confidence intervals and mean difference or standardized mean difference in change of pain intensity and activity limitations. Four trials met the inclusion criteria with a total of 404 participants of whom 208 received ICBT. Compared with pre-treatment, children reported significant, medium to large benefits on pain intensity, activity limitations, and parental protective behaviours after receiving ICBT immediately. ICBT for physical and psychological conditions in youth with chronic pain is a full potential therapy; it can be successful on clinically effects and socioeconomic benefits. Acknowledgement Author Wen-Xin Tang, Lu-Feng Zhang, Yan-Qiu Ai and Zhi-Song Li Journal Medicine (Baltimore). Publisher Wolters Kluwer Health, Inc.	Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis Course Detail Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis R 390.00 \| 3 CEUs Add to Cart Online Course Overview Paediatric chronic pain is relatively common in the world. Although cognitive behaviour therapy (CBT) has been shown to be efficacious in children and adolescents, it is generally recognized that availability and accessibility of CBT are limited. However, Internet-delivered cognitive-behavioural therapy (ICBT) performs better in these areas. This systematic review aims to evaluate the clinical effects of ICBT for chronic pain in youth when compared with the control treatments. We searched electronic databases to identify randomized controlled trials that compared ICBT with the control therapy for paediatric chronic pain. The primary outcomes were 95% confidence intervals and mean difference or standardized mean difference in change of pain intensity and activity limitations. Four trials met the inclusion criteria with a total of 404 participants of whom 208 received ICBT. Compared with pre-treatment, children reported significant, medium to large benefits on pain intensity, activity limitations, and parental protective behaviours after receiving ICBT immediately. ICBT for physical and psychological conditions in youth with chronic pain is a full potential therapy; it can be successful on clinically effects and socioeconomic benefits. Acknowledgement Author Wen-Xin Tang, Lu-Feng Zhang, Yan-Qiu Ai and Zhi-Song Li Journal Medicine (Baltimore). Publisher Wolters Kluwer Health, Inc.	3	R 390.00
QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient Overview Life-threatening arrhythmia may be induced by corrected QT (QTc) interval prolongation. Several antimicrobial drugs have been associated with QTc interval prolongation. Favipiravir is an inhibitor of the RNA-dependent RNA polymerase of many RNA viruses, including influenza viruses, arenaviruses, phleboviruses, hantaviruses, flaviviruses, enteroviruses, and noroviruses. Favipiravir has also been used in the recent epidemic of Ebolavirus (EBOV) in West Africa. To date, no significant effects of favipiravir on the QT/QTc interval have been detected. We report a case of QTc interval prolongation during favipiravir therapy in an EBOV-infected patient treated at our institution. In conclusion, we suggest that favipiravir administered at high doses, together with the cofactors discussed above, may have contributed to inducing a QTc interval prolongation in our EBOV patient. If feasible, ECG monitoring could be advisable during high-dose favipiravir therapy, especially when patients experience electrolyte disturbances and concomitant use of drugs with QTc-prolonging potential. Encephalitis or central nervous system (CNS) pathology may have a role in prolonging QT interval. Acknowledgement Authors Pierangelo Chinello, Nicola Petrosillo, Silvia Pittalis, Gianluigi Biava, Giuseppe Ippolito, Emanuele Nicastri, on behalf of the INMI Ebola Team Journal PLoS Neglected Tropical Diseases Publisher Cross Mark	QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient Course Detail QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient R 390.00 \| 3 CEUs Add to Cart Online Course Overview Life-threatening arrhythmia may be induced by corrected QT (QTc) interval prolongation. Several antimicrobial drugs have been associated with QTc interval prolongation. Favipiravir is an inhibitor of the RNA-dependent RNA polymerase of many RNA viruses, including influenza viruses, arenaviruses, phleboviruses, hantaviruses, flaviviruses, enteroviruses, and noroviruses. Favipiravir has also been used in the recent epidemic of Ebolavirus (EBOV) in West Africa. To date, no significant effects of favipiravir on the QT/QTc interval have been detected. We report a case of QTc interval prolongation during favipiravir therapy in an EBOV-infected patient treated at our institution. In conclusion, we suggest that favipiravir administered at high doses, together with the cofactors discussed above, may have contributed to inducing a QTc interval prolongation in our EBOV patient. If feasible, ECG monitoring could be advisable during high-dose favipiravir therapy, especially when patients experience electrolyte disturbances and concomitant use of drugs with QTc-prolonging potential. Encephalitis or central nervous system (CNS) pathology may have a role in prolonging QT interval. Acknowledgement Authors Pierangelo Chinello, Nicola Petrosillo, Silvia Pittalis, Gianluigi Biava, Giuseppe Ippolito, Emanuele Nicastri, on behalf of the INMI Ebola Team Journal PLoS Neglected Tropical Diseases Publisher Cross Mark	3	R 390.00
Ebolaviruses: New roles for old proteins Ebolaviruses: New roles for old proteins Overview In 2014, the world witnessed the largest Ebolavirus outbreak in recorded history. The subsequent humanitarian effort spurred extensive research, significantly enhancing our understanding of ebolavirus replication and pathogenicity. The main functions of each ebolavirus protein have been studied extensively since the discovery of the virus in 1976; however, the recent expansion of ebolavirus research has led to the discovery of new protein functions. The international containment effort spurred extensive research that is enhancing. These newly discovered roles are revealing new mechanisms of virus replication and pathogenicity, whilst enhancing our understanding of the broad functions of each ebolavirus viral protein (VP). Many of these new functions appear to be unrelated to the protein's primary function during virus replication. Such new functions range from bystander T-lymphocyte death caused by VP40-secreted exosomes to new roles for VP24 in viral particle formation. This review highlights the newly discovered roles of ebolavirus proteins in order to provide a more encompassing view of ebolavirus replication and pathogenicity. This review highlights the newly discovered roles of ebolavirus proteins in order to provide a more encompassing view of ebolavirus replication and pathogenicity. Acknowledgement Authors Diego Cantoni and Jeremy S. Rossman Journal PLoS Neglected Tropical Diseases Publisher Cross Mark	Ebolaviruses: New roles for old proteins Course Detail Ebolaviruses: New roles for old proteins R 420.00 \| 3 CEUs Add to Cart Online Course Overview In 2014, the world witnessed the largest Ebolavirus outbreak in recorded history. The subsequent humanitarian effort spurred extensive research, significantly enhancing our understanding of ebolavirus replication and pathogenicity. The main functions of each ebolavirus protein have been studied extensively since the discovery of the virus in 1976; however, the recent expansion of ebolavirus research has led to the discovery of new protein functions. The international containment effort spurred extensive research that is enhancing. These newly discovered roles are revealing new mechanisms of virus replication and pathogenicity, whilst enhancing our understanding of the broad functions of each ebolavirus viral protein (VP). Many of these new functions appear to be unrelated to the protein's primary function during virus replication. Such new functions range from bystander T-lymphocyte death caused by VP40-secreted exosomes to new roles for VP24 in viral particle formation. This review highlights the newly discovered roles of ebolavirus proteins in order to provide a more encompassing view of ebolavirus replication and pathogenicity. This review highlights the newly discovered roles of ebolavirus proteins in order to provide a more encompassing view of ebolavirus replication and pathogenicity. Acknowledgement Authors Diego Cantoni and Jeremy S. Rossman Journal PLoS Neglected Tropical Diseases Publisher Cross Mark	3	R 420.00
Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas Overview Traditionally, minimal potential organ donor referrals emanate from general medicine departments. We use a clinical vignette to draw attention to challenges related to referral of potential organ donors from general internal medicine departments. In addition, we provide potential solutions to overcome challenges and reflect on the ethical issues of non-referral of potential organ donors. It is hoped that this paper will increase the awareness of organ donation in the medical fraternity in Africa and thus mitigate critical shortages of organs for transplantation. Ethical considerations are many. Organ donation and transplant in SA is imbued with ethical issues. These are shaped by the context in which health care is provided and then borne out in the clinical system where transplant referrals and the process of consenting to organ donation take place. In terms of context, there appears to be a distrust of transplant amongst the SA population. The non-referral of potential organ donors has societal and ethical ramifications. General internal medicine teams can increase the number of referrals to organ transplant coordinators. Consultant physicians have the knowledge and expertise to lead the referral of potential organ donors to transplant coordinators. Acknowledgement Author Poobalan Naidoo, Harriet Rosanne Etheredge, Virendra Rambiritch, Akira Singh, Scott Mahoney and Vanesha Naidu Journal Pan American Medical Journal June 2018, Vol. 29 Issue 223 Publisher CrossMark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080966/pdf/PAMJ-29-223.pdf	Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas Course Detail Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas R 470.00 \| 3 CEUs Add to Cart Online Course Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas Overview Traditionally, minimal potential organ donor referrals emanate from general medicine departments. We use a clinical vignette to draw attention to challenges related to referral of potential organ donors from general internal medicine departments. In addition, we provide potential solutions to overcome challenges and reflect on the ethical issues of non-referral of potential organ donors. It is hoped that this paper will increase the awareness of organ donation in the medical fraternity in Africa and thus mitigate critical shortages of organs for transplantation. Ethical considerations are many. Organ donation and transplant in SA is imbued with ethical issues. These are shaped by the context in which health care is provided and then borne out in the clinical system where transplant referrals and the process of consenting to organ donation take place. In terms of context, there appears to be a distrust of transplant amongst the SA population. The non-referral of potential organ donors has societal and ethical ramifications. General internal medicine teams can increase the number of referrals to organ transplant coordinators. Consultant physicians have the knowledge and expertise to lead the referral of potential organ donors to transplant coordinators. Acknowledgement Author Poobalan Naidoo, Harriet Rosanne Etheredge, Virendra Rambiritch, Akira Singh, Scott Mahoney and Vanesha Naidu Journal Pan American Medical Journal June 2018, Vol. 29 Issue 223 Publisher CrossMark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080966/pdf/PAMJ-29-223.pdf	3	R 470.00
Advances in Pharmacotherapy of Tuberculosis Advances in Pharmacotherapy of Tuberculosis Advances in Pharmacotherapy of Tuberculosis Overview Tuberculosis remains a growing threat of infectious diseases of twenty-first century. An attempt to find new anti-tuberculosis agents was made especially to treat multidrug resistant and extensively drug-resistant tuberculosis. One of the most promising drugs is bedaquiline - a new drug approved by Food and Drug Administration (FDA) and by the European Union countries. This compound is intended to treat multi drug-resistant pulmonary tuberculosis in adult patients in combination regimens in case of impossibility of using other drugs. Alarming epidemiological indicators suggesting increased amount of incidents of tuberculosis tended to search for new compounds with potential anti-tuberculosis activity. This paper is also focused on some interesting molecules in treating multidrug-resistant tuberculosis which are currently tested in clinical studies: delamanid, AZD5847, pretomanid , sutezolid and SQ109 - and some prospective molecules at the level of preclinical studies. Disturbing statistics of frequency of newly recognized tuberculosis or multi-drug resistant tuberculosis was a step to counteract this disease and give some perspectives in clinical trials. The hope in new anti-tuberculosis agents, still tested in clinical studies and the creation of new regimens. Acknowledgement Authors Michal Pstragowski, Malgorzata Zbrzezna and Magdalena Bujalska-ZadroØny Journal Acta Poloniae Pharmaceutica Publisher Pharmacodynamics, Medical University of Warsaw URL: http://ptfarm.pl/pub/File/Acta_Poloniae/2017/1/003.pdf	Advances in Pharmacotherapy of Tuberculosis Course Detail Advances in Pharmacotherapy of Tuberculosis R 460.00 \| 3 CEUs Add to Cart Online Course Advances in Pharmacotherapy of Tuberculosis Overview Tuberculosis remains a growing threat of infectious diseases of twenty-first century. An attempt to find new anti-tuberculosis agents was made especially to treat multidrug resistant and extensively drug-resistant tuberculosis. One of the most promising drugs is bedaquiline - a new drug approved by Food and Drug Administration (FDA) and by the European Union countries. This compound is intended to treat multi drug-resistant pulmonary tuberculosis in adult patients in combination regimens in case of impossibility of using other drugs. Alarming epidemiological indicators suggesting increased amount of incidents of tuberculosis tended to search for new compounds with potential anti-tuberculosis activity. This paper is also focused on some interesting molecules in treating multidrug-resistant tuberculosis which are currently tested in clinical studies: delamanid, AZD5847, pretomanid , sutezolid and SQ109 - and some prospective molecules at the level of preclinical studies. Disturbing statistics of frequency of newly recognized tuberculosis or multi-drug resistant tuberculosis was a step to counteract this disease and give some perspectives in clinical trials. The hope in new anti-tuberculosis agents, still tested in clinical studies and the creation of new regimens. Acknowledgement Authors Michal Pstragowski, Malgorzata Zbrzezna and Magdalena Bujalska-ZadroØny Journal Acta Poloniae Pharmaceutica Publisher Pharmacodynamics, Medical University of Warsaw URL: http://ptfarm.pl/pub/File/Acta_Poloniae/2017/1/003.pdf	3	R 460.00
Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s). Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s). Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s). Overview Gastrointestinal (GI) bleeding is a leading cause of death in dengue. This study aims to identify predictors for GI bleeding in adult dengue patients, emphasizing the impact of existing co-morbid disease(s). Of 1300 adults with dengue virus infection, 175 (mean age, 56.5±13.7 years) patients with GI bleeding and 1,125 (mean age, 49.2±15.6 years) without GI bleeding (controls) were retrospectively analyzed. Our study is the first to disclose that end stage renal disease and previous stroke, with additional co-morbidities, were strongly significant associated with the risk of GI bleeding in patients with dengue virus infection. Identification of these risk factors can be incorporated into the patient assessment and management protocol of dengue virus infection to reduce its mortality. Our study emphasizes that, in addition to older age and thrombocytopenia , end stage renal disease and previous stroke, with additional co-morbidities, are important clinical predictor of GI bleeding in adult patients with DENV infection. More studies, particularly prospective studies are required to validate these findings for better generalization of their clinical utility. Acknowledgement Author Wen-Chi Huang, Ing-Kit Lee, Yi-Chun Chen, Ching-Yen Tsai and Jien-Wei Liu. Journal PLoS ONE Volume 13 Issue 2 Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819790/pdf/pone.0192919.pdf	Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s). Course Detail Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s). R 470.00 \| 3 CEUs Add to Cart Online Course Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s). Overview Gastrointestinal (GI) bleeding is a leading cause of death in dengue. This study aims to identify predictors for GI bleeding in adult dengue patients, emphasizing the impact of existing co-morbid disease(s). Of 1300 adults with dengue virus infection, 175 (mean age, 56.5±13.7 years) patients with GI bleeding and 1,125 (mean age, 49.2±15.6 years) without GI bleeding (controls) were retrospectively analyzed. Our study is the first to disclose that end stage renal disease and previous stroke, with additional co-morbidities, were strongly significant associated with the risk of GI bleeding in patients with dengue virus infection. Identification of these risk factors can be incorporated into the patient assessment and management protocol of dengue virus infection to reduce its mortality. Our study emphasizes that, in addition to older age and thrombocytopenia , end stage renal disease and previous stroke, with additional co-morbidities, are important clinical predictor of GI bleeding in adult patients with DENV infection. More studies, particularly prospective studies are required to validate these findings for better generalization of their clinical utility. Acknowledgement Author Wen-Chi Huang, Ing-Kit Lee, Yi-Chun Chen, Ching-Yen Tsai and Jien-Wei Liu. Journal PLoS ONE Volume 13 Issue 2 Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819790/pdf/pone.0192919.pdf	3	R 470.00
The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery Overview Postsurgical infections represent an important cause of morbidity after abdominal surgery. The microbiological diagnosis is not achieved in at least 30% of culture with consequent worsening of patient outcome. In this study, procalcitonin measurement, during the first 3 days after abdominal surgery, has been evaluated for the early diagnosis of postsurgical infection. Receiver operating characteristic (ROC) analysis was performed to define the diagnostic ability of PCT in case of post-surgical infections. PCT values resulted significantly different between patients developing or not developing postsurgical infections. PCT >1.0ng/mL at first or second day after surgery and >0.5ng/mL at third day resulted diagnostic for infectious complication, whereas a value <0.5 ng/mL at the fifth day after surgery was useful for early and safety discharge of patients. In conclusion, PCT daily measurement could represent a useful diagnostic tool improving health care in the postsurgical period following major abdominal surgery and should be recommended. Acknowledgement Author Silvia Spoto, Emanuele Valeriani, Damiano Caputo, Eleonora Cella, Marta Fogolari, MDe, Elena Pesce, Maria Tea Mulè, Mariacristina Cartillone, Sebastiano Costantino, MDa, Giordano Dicuonzo, Roberto Coppola, Massimo Ciccozzi and Silvia Angeletti, Journal Medicine (2018) Volume 97 Issue 3 Publisher Wolters Kluwer Health, Inc. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779742/pdf/medi-97-e9496.pdf	The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery Course Detail The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery R 455.00 \| 3 CEUs Add to Cart Online Course The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery Overview Postsurgical infections represent an important cause of morbidity after abdominal surgery. The microbiological diagnosis is not achieved in at least 30% of culture with consequent worsening of patient outcome. In this study, procalcitonin measurement, during the first 3 days after abdominal surgery, has been evaluated for the early diagnosis of postsurgical infection. Receiver operating characteristic (ROC) analysis was performed to define the diagnostic ability of PCT in case of post-surgical infections. PCT values resulted significantly different between patients developing or not developing postsurgical infections. PCT >1.0ng/mL at first or second day after surgery and >0.5ng/mL at third day resulted diagnostic for infectious complication, whereas a value <0.5 ng/mL at the fifth day after surgery was useful for early and safety discharge of patients. In conclusion, PCT daily measurement could represent a useful diagnostic tool improving health care in the postsurgical period following major abdominal surgery and should be recommended. Acknowledgement Author Silvia Spoto, Emanuele Valeriani, Damiano Caputo, Eleonora Cella, Marta Fogolari, MDe, Elena Pesce, Maria Tea Mulè, Mariacristina Cartillone, Sebastiano Costantino, MDa, Giordano Dicuonzo, Roberto Coppola, Massimo Ciccozzi and Silvia Angeletti, Journal Medicine (2018) Volume 97 Issue 3 Publisher Wolters Kluwer Health, Inc. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779742/pdf/medi-97-e9496.pdf	3	R 455.00
Attempts to grow human noroviruses, a sapovirus, and a bovine norovirus in vitro Attempts to grow human noroviruses, a sapovirus, and a bovine norovirus in vitro Attempts to grow human noroviruses, a sapovirus, and a bovine norovirus in vitro Overview Noroviruses (NoVs) and Sapoviruses (SaVs) are enteric caliciviruses that have been detected in multiple mammalian species, including humans. Currently, efficient cell culture systems have been established only for murine NoVs and porcine SaV Cowden strain. Establishment of an efficient in vitro cell culture system for other NoVs and SaVs remains challenging; however, human NoV (HuNoV) replication in 3D cultured Caco-2 cells and a clone of Caco-2 cells, C2BBe1, human enteroids and in human B cells has been reported. In this study, we tested various cells and culture conditions to grow HuNoVs and a human SaV (HuSaV) to test the possibility of the propagation in different cells and culture conditions. We also attempted to grow a bovine NoV (BoNoV) in ex vivo organ cultures. Our results demonstrated that HuNoVs, BoNoV and HuSaV largely failed to grow in vitro under our test conditions. Our purpose is to share our findings with other researchers with the goal to develop efficient, reproducible simplified and cost-effective culture systems for human and animal NoVs and SaVs in the future. Acknowledgement Author Tomoichiro Oka, Garrett T. Stoltzfus, Chelsea Zhu, Kwonil Jung, Qiuhong Wang and Linda J. Saif. Journal PLoS ONE Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810978/pdf/pone.0178157.pdf	Attempts to grow human noroviruses, a sapovirus, and a bovine norovirus in vitro Course Detail Attempts to grow human noroviruses, a sapovirus, and a bovine norovirus in vitro R 445.00 \| 3 CEUs Add to Cart Online Course Attempts to grow human noroviruses, a sapovirus, and a bovine norovirus in vitro Overview Noroviruses (NoVs) and Sapoviruses (SaVs) are enteric caliciviruses that have been detected in multiple mammalian species, including humans. Currently, efficient cell culture systems have been established only for murine NoVs and porcine SaV Cowden strain. Establishment of an efficient in vitro cell culture system for other NoVs and SaVs remains challenging; however, human NoV (HuNoV) replication in 3D cultured Caco-2 cells and a clone of Caco-2 cells, C2BBe1, human enteroids and in human B cells has been reported. In this study, we tested various cells and culture conditions to grow HuNoVs and a human SaV (HuSaV) to test the possibility of the propagation in different cells and culture conditions. We also attempted to grow a bovine NoV (BoNoV) in ex vivo organ cultures. Our results demonstrated that HuNoVs, BoNoV and HuSaV largely failed to grow in vitro under our test conditions. Our purpose is to share our findings with other researchers with the goal to develop efficient, reproducible simplified and cost-effective culture systems for human and animal NoVs and SaVs in the future. Acknowledgement Author Tomoichiro Oka, Garrett T. Stoltzfus, Chelsea Zhu, Kwonil Jung, Qiuhong Wang and Linda J. Saif. Journal PLoS ONE Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810978/pdf/pone.0178157.pdf	3	R 445.00
Structure and assembly of the Ebola virus nucleocapsid Structure and assembly of the Ebola virus nucleocapsid Structure and assembly of the Ebola virus nucleocapsid Overview Ebola and Marburg viruses are filoviruses: filamentous, enveloped viruses that cause haemorrhagic fever1. Filoviruses are within the order Mononegavirales2 which also includes rabies virus, measles virus, and respiratory syncytial virus. Mononegaviruses have non-segmented, single-stranded negative-sense RNA genomes that are encapsidated by nucleoprotein (NP) and other viral proteins to form a helical nucleocapsid (NC). NC acts as a scaffold for virus assembly and as a template for genome transcription and replication. Insights into NP-NP interactions have been derived from structural studies of oligomerized, RNA-encapsidating NP3–6 and cryo-electron microscopy (cryo-EM) of NC7–12 or NC-like structures11–13. There have been no high-resolution reconstructions of complete mononegavirus NCs. Here, we have applied cryo-electron tomography and sub-tomogram averaging to determine the structure of Ebola virus NC within intact viruses and recombinant NC-like assemblies. These structures reveal the identity and arrangement of the NC components, and suggest that the formation of an extended alpha-helix from the disordered C-terminal region of NP-core links NP oligomerization, NC condensation, RNA encapsidation, and accessory protein recruitment. Acknowledgement Author William Wan, Larissa Kolesnikova, Mairi Clarke, Alexander Koehler, Takeshi Noda, Stephan Becker and John A. G. Briggs. Journal Nature. 2017 November 16; 551(7680-397) Publisher URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714281/pdf/emss-74396.pdf	Structure and assembly of the Ebola virus nucleocapsid Course Detail Structure and assembly of the Ebola virus nucleocapsid R 455.00 \| 3 CEUs Add to Cart Online Course Structure and assembly of the Ebola virus nucleocapsid Overview Ebola and Marburg viruses are filoviruses: filamentous, enveloped viruses that cause haemorrhagic fever1. Filoviruses are within the order Mononegavirales2 which also includes rabies virus, measles virus, and respiratory syncytial virus. Mononegaviruses have non-segmented, single-stranded negative-sense RNA genomes that are encapsidated by nucleoprotein (NP) and other viral proteins to form a helical nucleocapsid (NC). NC acts as a scaffold for virus assembly and as a template for genome transcription and replication. Insights into NP-NP interactions have been derived from structural studies of oligomerized, RNA-encapsidating NP3–6 and cryo-electron microscopy (cryo-EM) of NC7–12 or NC-like structures11–13. There have been no high-resolution reconstructions of complete mononegavirus NCs. Here, we have applied cryo-electron tomography and sub-tomogram averaging to determine the structure of Ebola virus NC within intact viruses and recombinant NC-like assemblies. These structures reveal the identity and arrangement of the NC components, and suggest that the formation of an extended alpha-helix from the disordered C-terminal region of NP-core links NP oligomerization, NC condensation, RNA encapsidation, and accessory protein recruitment. Acknowledgement Author William Wan, Larissa Kolesnikova, Mairi Clarke, Alexander Koehler, Takeshi Noda, Stephan Becker and John A. G. Briggs. Journal Nature. 2017 November 16; 551(7680-397) Publisher URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714281/pdf/emss-74396.pdf	3	R 455.00
Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening Overview The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region. Acknowledgement Authors Philomena Raftery, Orla Condell, Christine Wasunna, Jonathan Kpaka, Ruth Zwizwai, Mahmood Nuha, Mosoka Fallah, Maxwell Freeman, Victoria Harris, Mark Miller, April Baller, Moses Massaquoi, Victoria Katawera, John Saindon, Philip Bemah, Esther Hamblion, Evelyn Castle, Desmond Williams, Alex Gasasira, Tolbert Nyenswah. Journal PLoS Neglected Tropical Diseases Volume 12 Issue 1 Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755746/pdf/pntd.0006135.pdf	Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening Course Detail Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening R 465.00 \| 3 CEUs Add to Cart Online Course Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening Overview The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region. Acknowledgement Authors Philomena Raftery, Orla Condell, Christine Wasunna, Jonathan Kpaka, Ruth Zwizwai, Mahmood Nuha, Mosoka Fallah, Maxwell Freeman, Victoria Harris, Mark Miller, April Baller, Moses Massaquoi, Victoria Katawera, John Saindon, Philip Bemah, Esther Hamblion, Evelyn Castle, Desmond Williams, Alex Gasasira, Tolbert Nyenswah. Journal PLoS Neglected Tropical Diseases Volume 12 Issue 1 Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755746/pdf/pntd.0006135.pdf	3	R 465.00
Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein Overview We have produced a new Ebola virus pseudotype, E-S-FLU, that can be handled in biosafety level 1/2 containment for laboratory analysis. The E-SFLU virus is a single-cycle influenza virus coated with Ebolavirus glycoprotein, and it encodes enhanced green fluorescence protein as a reporter that replaces the influenza virus hemagglutinin. Infection of cells with the E-S-FLU virus was dependent on the Niemann-Pick C1 protein, which is the well-characterized receptor for Ebola virus entry at the late endosome/lysosome membrane. The E-S-FLU virus was neutralized specifically by an anti-Ebolavirus glycoprotein antibody and a variety of small drug molecules that are known to inhibit the entry of wild-type Ebola virus. To demonstrate the application of this new Ebola virus pseudotype, we show that a single laboratory batch was sufficient to screen a library of 1,280 pharmacologically active compounds for inhibition of virus entry. The E-S-FLU virus is a new tool for Ebola virus cell entry studies and is easily applied to high throughput screening assays for small-molecule inhibitors or antibodies. Acknowledgement Author Julie Huiyuan Xiao, Pramila Rijal, Lisa Schimanski, Arun Kumar Tharkeshwar, Edward Wright, Wim Annaert and Alain Townsend. Journal Journal of Virology Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790926/pdf/e00941-17.pdf	Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein Course Detail Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein R 445.00 \| 3 CEUs Add to Cart Online Course Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein Overview We have produced a new Ebola virus pseudotype, E-S-FLU, that can be handled in biosafety level 1/2 containment for laboratory analysis. The E-SFLU virus is a single-cycle influenza virus coated with Ebolavirus glycoprotein, and it encodes enhanced green fluorescence protein as a reporter that replaces the influenza virus hemagglutinin. Infection of cells with the E-S-FLU virus was dependent on the Niemann-Pick C1 protein, which is the well-characterized receptor for Ebola virus entry at the late endosome/lysosome membrane. The E-S-FLU virus was neutralized specifically by an anti-Ebolavirus glycoprotein antibody and a variety of small drug molecules that are known to inhibit the entry of wild-type Ebola virus. To demonstrate the application of this new Ebola virus pseudotype, we show that a single laboratory batch was sufficient to screen a library of 1,280 pharmacologically active compounds for inhibition of virus entry. The E-S-FLU virus is a new tool for Ebola virus cell entry studies and is easily applied to high throughput screening assays for small-molecule inhibitors or antibodies. Acknowledgement Author Julie Huiyuan Xiao, Pramila Rijal, Lisa Schimanski, Arun Kumar Tharkeshwar, Edward Wright, Wim Annaert and Alain Townsend. Journal Journal of Virology Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790926/pdf/e00941-17.pdf	3	R 445.00
Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview Cardiovascular evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published since 2016. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Sub-group analyses were implemented by study design, risk of bias (ROB) and co-prevalence of Schistosoma species infection. Influential studies were excluded in sensitivity analysis to examine stability of pooled estimates. Despite the empirical debate regarding the cognitive benefit of de-worming for STH, the current ethical, clinical and health policy environments remain strongly skewed in favor of de-worming for child growth, prevention of anaemia and potentially avoidance of preventable cognitive deficits Acknowledgement Author Noel Pabalan, Eloisa Singian, Lani Tabangay, Hamdi Jarjanazi, Michael J. Boivin, Amara E. Ezeamama Journal PLoS Neglected Tropical Diseases URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5766095/pdf/pntd.0005523.pdf Publisher Cross Mark	Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview Course Detail Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview R 465.00 \| 3 CEUs Add to Cart Online Course Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview Cardiovascular evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published since 2016. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Sub-group analyses were implemented by study design, risk of bias (ROB) and co-prevalence of Schistosoma species infection. Influential studies were excluded in sensitivity analysis to examine stability of pooled estimates. Despite the empirical debate regarding the cognitive benefit of de-worming for STH, the current ethical, clinical and health policy environments remain strongly skewed in favor of de-worming for child growth, prevention of anaemia and potentially avoidance of preventable cognitive deficits Acknowledgement Author Noel Pabalan, Eloisa Singian, Lani Tabangay, Hamdi Jarjanazi, Michael J. Boivin, Amara E. Ezeamama Journal PLoS Neglected Tropical Diseases URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5766095/pdf/pntd.0005523.pdf Publisher Cross Mark	3	R 465.00
Atezolizumab: feasible second-line therapy for patients with non-small cell lung cancer? A review of efficacy, safety and place in therapy Atezolizumab: feasible second-line therapy for patients with non-small cell lung cancer? A review of efficacy, safety and place in therapy Atezolizumab: feasible second-line therapy for patients with non-small cell lung cancer? A review of efficacy, safety and place in therapy Overview Advanced non-small cell lung cancer (NSCLC) prognosis is still poor and has recently been reformed by the development of immune checkpoint inhibitors and the approval of anti PD-1 (programmed cell-death 1) treatments such as nivolumab and pembrolizumab in second line. More recently, Atezolizumab (MDPL 3280A), a programmed cell-death-ligand 1 (PD-L1) inhibitor, was also studied in this setting. Here, we report a review of the literature assessing the efficacy, safety, and place of Atezolizumab in the second-line treatment of advanced NSCLC. We are still far from fully understanding cancer immunity and the mechanisms leading to the success or not of immunotherapy agents. For this reason, we should investigate to a greater level the factors of failure, such as EGFR-mutant tumours. We performed a literature search of PubMed, American Society of Clinical Oncology, European Society of Medical Oncology and World Conference on Lung Cancer meetings. Atezolizumab showed a good tolerance profile and efficacy in comparison with docetaxel for second-line treatment of advanced NSCLC. Potential predictive biomarkers also have to be assessed. Acknowledgement Author Fanny Jean, Pascale Tomasini and Fabrice Berlesi Journal Therapeutic Advances in Medical Oncology 2017, Vol. 9(12) 769-779 Special Collection/review Immunotherapy for Lung Cancer: Progress, Opportunities and Challenges journals. sagepub.com/home/tam	Atezolizumab: feasible second-line therapy for patients with non-small cell lung cancer? A review of efficacy, safety and place in therapy Course Detail Atezolizumab: feasible second-line therapy for patients with non-small cell lung cancer? A review of efficacy, safety and place in therapy R 445.00 \| 3 CEUs Add to Cart Online Course Atezolizumab: feasible second-line therapy for patients with non-small cell lung cancer? A review of efficacy, safety and place in therapy Overview Advanced non-small cell lung cancer (NSCLC) prognosis is still poor and has recently been reformed by the development of immune checkpoint inhibitors and the approval of anti PD-1 (programmed cell-death 1) treatments such as nivolumab and pembrolizumab in second line. More recently, Atezolizumab (MDPL 3280A), a programmed cell-death-ligand 1 (PD-L1) inhibitor, was also studied in this setting. Here, we report a review of the literature assessing the efficacy, safety, and place of Atezolizumab in the second-line treatment of advanced NSCLC. We are still far from fully understanding cancer immunity and the mechanisms leading to the success or not of immunotherapy agents. For this reason, we should investigate to a greater level the factors of failure, such as EGFR-mutant tumours. We performed a literature search of PubMed, American Society of Clinical Oncology, European Society of Medical Oncology and World Conference on Lung Cancer meetings. Atezolizumab showed a good tolerance profile and efficacy in comparison with docetaxel for second-line treatment of advanced NSCLC. Potential predictive biomarkers also have to be assessed. Acknowledgement Author Fanny Jean, Pascale Tomasini and Fabrice Berlesi Journal Therapeutic Advances in Medical Oncology 2017, Vol. 9(12) 769-779 Special Collection/review Immunotherapy for Lung Cancer: Progress, Opportunities and Challenges journals. sagepub.com/home/tam	3	R 445.00
Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population Diagnostic Approaches for Invasive Aspergillosis—Specific Considerations in the Pediatric Population Overview The Invasive aspergillosis (IA) is a major cause of morbidity and mortality in children with hematological malignancies and those undergoing hematopoietic stem cell transplantation. Similar to immune-compromised adults, clinical signs, and symptoms of IA are unspecific in the pediatric patient population. As early diagnosis and prompt treatment of IA is associated with better outcome, imaging and non-invasive antigen-based such as galactomannan or ß-D-glucan and molecular biomarkers in peripheral blood may facilitate institution and choice of antifungal compounds and guide duration of therapy. The early and reliable diagnosis of IA is difficult in immune-compromised patients, in particular in the pediatric population. In patients in whom imaging studies suggest IA or another mold infection, invasive diagnostics such as broncho-alveolar lavage and/or bioptic procedures should be considered. Here we review the current data of diagnostic approaches for IA in the pediatric setting and highlight the major differences of performance and clinical utility of the tests between children and adults. Acknowledgement Author Thomas Lehrnbecher , Angela Hassler , Andreas H. Groll and Konrad Bochennek Journal Frontiers in Microbiology Publisher Cross Mark	Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population Course Detail Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population R 480.00 \| 3 CEUs Add to Cart Online Course Diagnostic Approaches for Invasive Aspergillosis—Specific Considerations in the Pediatric Population Overview The Invasive aspergillosis (IA) is a major cause of morbidity and mortality in children with hematological malignancies and those undergoing hematopoietic stem cell transplantation. Similar to immune-compromised adults, clinical signs, and symptoms of IA are unspecific in the pediatric patient population. As early diagnosis and prompt treatment of IA is associated with better outcome, imaging and non-invasive antigen-based such as galactomannan or ß-D-glucan and molecular biomarkers in peripheral blood may facilitate institution and choice of antifungal compounds and guide duration of therapy. The early and reliable diagnosis of IA is difficult in immune-compromised patients, in particular in the pediatric population. In patients in whom imaging studies suggest IA or another mold infection, invasive diagnostics such as broncho-alveolar lavage and/or bioptic procedures should be considered. Here we review the current data of diagnostic approaches for IA in the pediatric setting and highlight the major differences of performance and clinical utility of the tests between children and adults. Acknowledgement Author Thomas Lehrnbecher , Angela Hassler , Andreas H. Groll and Konrad Bochennek Journal Frontiers in Microbiology Publisher Cross Mark	3	R 480.00
Sensitivity and specificity of CT scan in revealing skull fracture in medico-legal head injury victims. Sensitivity and specificity of CT scan in revealing skull fracture in medico-legal head injury victims. Overview: Aims: The study was conducted with the objective of knowing the sensitivity and specificity of ante-mortem CT scan findings indicating the presence or absence of skull fractures. Methods: Findings were confirmed during post-mortem examination of the subjects who had died during management but who had not had any surgical intervention. A comparative study of ante-mortem CT scan and autopsy findings with respect to fracture in traumatic head injuries was undertaken on 60 deceased individuals brought in for medico-legal post-mortem examination over a period of two years. Results: Considering the autopsy findings as the gold standard, we have concluded that 14.6 per cent of the fractures were missed on CT scan findings compared to fractures found during autopsy. The sensitivity of CT scan for skull fractures was found to be 85.4 per cent and specificity was 100 per cent. Kappa was 0.787, which shows good agreement with p<0.001, which was highly significant. Conclusion: In developing countries, images are interpreted in the axial plane only on a CT scan of the head, which may be due to a lack of financial and human resources. For better delineation of fractures, the use of techniques like multi-detector CT with sagittal and coronal reformations should be considered in the routine interpretation of a CT scan of the head. Acknowledgement Author: Chawla H, Yadav RK, Griwan MS, Malhotra R, Paliwal PK Journal: The Australasian medical journal. Publisher: The Australasian medical journal https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531150/pdf/AMJ-08-235.pdf	Sensitivity and specificity of CT scan in revealing skull fracture in medico-legal head injury victims. Course Detail Sensitivity and specificity of CT scan in revealing skull fracture in medico-legal head injury victims. R 385.00 \| 3 CEUs Add to Cart Online Course Overview: Aims: The study was conducted with the objective of knowing the sensitivity and specificity of ante-mortem CT scan findings indicating the presence or absence of skull fractures. Methods: Findings were confirmed during post-mortem examination of the subjects who had died during management but who had not had any surgical intervention. A comparative study of ante-mortem CT scan and autopsy findings with respect to fracture in traumatic head injuries was undertaken on 60 deceased individuals brought in for medico-legal post-mortem examination over a period of two years. Results: Considering the autopsy findings as the gold standard, we have concluded that 14.6 per cent of the fractures were missed on CT scan findings compared to fractures found during autopsy. The sensitivity of CT scan for skull fractures was found to be 85.4 per cent and specificity was 100 per cent. Kappa was 0.787, which shows good agreement with p<0.001, which was highly significant. Conclusion: In developing countries, images are interpreted in the axial plane only on a CT scan of the head, which may be due to a lack of financial and human resources. For better delineation of fractures, the use of techniques like multi-detector CT with sagittal and coronal reformations should be considered in the routine interpretation of a CT scan of the head. Acknowledgement Author: Chawla H, Yadav RK, Griwan MS, Malhotra R, Paliwal PK Journal: The Australasian medical journal. Publisher: The Australasian medical journal https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531150/pdf/AMJ-08-235.pdf	3	R 385.00
Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications. Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications. Overview Concerning recent Italian laws and jurisprudential statements, guidelines application involves several difficulties in clinical practice, regarding prevention, diagnosis and therapy of venous thromboembolism. International scientific community systematically developed statements about this disease in order to optimize the available resources in prophylaxis, diagnosis and therapy. Incongruous prevention, missed or delayed diagnosis and/or inadequate treatment of this disease can frequently give rise to medico-legal litigation. Acknowledgement Author: Vassalini M, Verzeletti A, De Ferrari F Journal: Monaldi archives for chest disease Publisher: PIME Editrice http://www.monaldi-archives.org/index.php/macd/article/view/25/728	Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications. Course Detail Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications. R 430.00 \| 3 CEUs Add to Cart Online Course Overview Concerning recent Italian laws and jurisprudential statements, guidelines application involves several difficulties in clinical practice, regarding prevention, diagnosis and therapy of venous thromboembolism. International scientific community systematically developed statements about this disease in order to optimize the available resources in prophylaxis, diagnosis and therapy. Incongruous prevention, missed or delayed diagnosis and/or inadequate treatment of this disease can frequently give rise to medico-legal litigation. Acknowledgement Author: Vassalini M, Verzeletti A, De Ferrari F Journal: Monaldi archives for chest disease Publisher: PIME Editrice http://www.monaldi-archives.org/index.php/macd/article/view/25/728	3	R 430.00
Medical tourism. Medical tourism. Overview BACKGROUND: Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. OBJECTIVE: This article provides an outline of the current research around medical tourism, especially its impact on Australians. DISCUSSION: Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad Acknowledgement Author: Leggat P Journal: Australian family physician. Publisher: Focus Environmental https://www.racgp.org.au/download/Documents/AFP/2015/January/February/focus-leggat.pdf	Medical tourism. Course Detail Medical tourism. R 360.00 \| 3 CEUs Add to Cart Online Course Overview BACKGROUND: Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. OBJECTIVE: This article provides an outline of the current research around medical tourism, especially its impact on Australians. DISCUSSION: Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad Acknowledgement Author: Leggat P Journal: Australian family physician. Publisher: Focus Environmental https://www.racgp.org.au/download/Documents/AFP/2015/January/February/focus-leggat.pdf	3	R 360.00
Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations. Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations. Overview Objective: To investigate injury-related mortality in South Africa using a nationally representative sample and compare the results with previous estimates. Methods: We conducted a retrospective descriptive study of medico-legal postmortem investigation data from mortuaries using a multistage random sample, stratified by urban and non-urban areas and mortuary size. We calculated age-specific and age-standardized mortality rates for external causes of death. Findings: Postmortem reports revealed 52,493 injury-related deaths in 2009 (95% confidence interval, CI: 46,930-58,057). Almost half (25,499) were intentionally inflicted. Age-standardized mortality rates per 100,000 population were as follows: all injuries: 109.0 (95% CI: 97.1-121.0); homicide 38.4 (95% CI: 33.8-43.0; suicide 13.4 (95% CI: 11.6-15.2) and road-traffic injury 36.1 (95% CI: 30.9-41.3). Using postmortem reports, we found more than three times as many deaths from homicide and road-traffic injury than had been recorded by vital registration for this period. The homicide rate was similar to the estimate for South Africa from a global analysis, but road-traffic and suicide rates were almost fourfold higher. Conclusion: This is the first nationally representative sample of injury-related mortality in South Africa. It provides more accurate estimates and cause-specific profiles that are not available from other sources. Acknowledgement Author: Matzopoulos R, Prinsloo M, Pillay-van Wyk V, Gwebushe N, Mathews S, Martin LJ, Laubscher R, Abrahams N, Msemburi W, Lombard C, Bradshaw D Journal: Bulletin of the World Health Organization Publisher: Bulletin of the World Health Organization https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4431514/pdf/BLT.14.145771.pdf	Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations. Course Detail Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations. R 380.00 \| 3 CEUs Add to Cart Online Course Overview Objective: To investigate injury-related mortality in South Africa using a nationally representative sample and compare the results with previous estimates. Methods: We conducted a retrospective descriptive study of medico-legal postmortem investigation data from mortuaries using a multistage random sample, stratified by urban and non-urban areas and mortuary size. We calculated age-specific and age-standardized mortality rates for external causes of death. Findings: Postmortem reports revealed 52,493 injury-related deaths in 2009 (95% confidence interval, CI: 46,930-58,057). Almost half (25,499) were intentionally inflicted. Age-standardized mortality rates per 100,000 population were as follows: all injuries: 109.0 (95% CI: 97.1-121.0); homicide 38.4 (95% CI: 33.8-43.0; suicide 13.4 (95% CI: 11.6-15.2) and road-traffic injury 36.1 (95% CI: 30.9-41.3). Using postmortem reports, we found more than three times as many deaths from homicide and road-traffic injury than had been recorded by vital registration for this period. The homicide rate was similar to the estimate for South Africa from a global analysis, but road-traffic and suicide rates were almost fourfold higher. Conclusion: This is the first nationally representative sample of injury-related mortality in South Africa. It provides more accurate estimates and cause-specific profiles that are not available from other sources. Acknowledgement Author: Matzopoulos R, Prinsloo M, Pillay-van Wyk V, Gwebushe N, Mathews S, Martin LJ, Laubscher R, Abrahams N, Msemburi W, Lombard C, Bradshaw D Journal: Bulletin of the World Health Organization Publisher: Bulletin of the World Health Organization https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4431514/pdf/BLT.14.145771.pdf	3	R 380.00
Suicide in Pretoria: A retrospective review, 2007 - 2010. Suicide in Pretoria: A retrospective review, 2007 - 2010. Overview Background: The World Health Organization has declared suicide a global ealth crisis, predicting that ~1.53 million people will commit suicide annually by 2020. Obejective: A study from South Africa reviewed 1 018 suicide cases in Pretoria over 4 years (1997 - 2000). Our study was undertaken to establish whether there have been substantial changes in the profile of suicide victims who died in Pretoria a decade later. Methods: Case records at the Pretoria Medico-Legal Laboratory were reviewed retrospectively from 2007 to 2010. Results: A total of 957 suicide cases were identified. Hanging was the most common method of suicide, followed by self-inflicted firearm injury. The true incidence of suicidal intake of prescription drugs/medication was difficult to determine, because of a backlog at the state toxicology laboratories. White males and females appeared to be over-represented among suicide victims, but there has been an increase in suicide among blacks. There seems to have been a substantial decrease in the use of firearms to commit suicide - possibly reflecting a positive outcome of gun control legislation that has been introduced in the interim. Conclusion: Suicide continues to constitute almost 10% of all fatalities admitted to the Pretoria Medico-Legal Laboratory, confirming suicide as a major cause of mortality in our society. Further research is needed to clarify the profile of suicidal deaths, with a view to informing resource allocation and to improve preventive strategies Acknowledgement Author: Engelbrecht C, Blumenthal R, Morris NK, Saayman G Journal: South African medical journal. Publisher: SAMJ Research http://www.samj.org.za/index.php/samj/article/view/12015/8182	Suicide in Pretoria: A retrospective review, 2007 - 2010. Course Detail Suicide in Pretoria: A retrospective review, 2007 - 2010. R 410.00 \| 3 CEUs Add to Cart Online Course Overview Background: The World Health Organization has declared suicide a global ealth crisis, predicting that ~1.53 million people will commit suicide annually by 2020. Obejective: A study from South Africa reviewed 1 018 suicide cases in Pretoria over 4 years (1997 - 2000). Our study was undertaken to establish whether there have been substantial changes in the profile of suicide victims who died in Pretoria a decade later. Methods: Case records at the Pretoria Medico-Legal Laboratory were reviewed retrospectively from 2007 to 2010. Results: A total of 957 suicide cases were identified. Hanging was the most common method of suicide, followed by self-inflicted firearm injury. The true incidence of suicidal intake of prescription drugs/medication was difficult to determine, because of a backlog at the state toxicology laboratories. White males and females appeared to be over-represented among suicide victims, but there has been an increase in suicide among blacks. There seems to have been a substantial decrease in the use of firearms to commit suicide - possibly reflecting a positive outcome of gun control legislation that has been introduced in the interim. Conclusion: Suicide continues to constitute almost 10% of all fatalities admitted to the Pretoria Medico-Legal Laboratory, confirming suicide as a major cause of mortality in our society. Further research is needed to clarify the profile of suicidal deaths, with a view to informing resource allocation and to improve preventive strategies Acknowledgement Author: Engelbrecht C, Blumenthal R, Morris NK, Saayman G Journal: South African medical journal. Publisher: SAMJ Research http://www.samj.org.za/index.php/samj/article/view/12015/8182	3	R 410.00
Sensitivity of plain radiography for pediatric cervical spine injury. Sensitivity of plain radiography for pediatric cervical spine injury. Overview Pediatric patients with suspected cervical spine injuries (CSI) often receive a computed tomography (CT) scan as an initial diagnostic imaging test. While sensitive, CT of the cervical spine carries significant radiation and risk of lethal malignant transformation later in life. Plain radiographs carry significantly less radiation and could serve as the preferred screening tool, provided they have a high functional sensitivity in detecting pediatric patients with CSI. We hypothesize that plain cervical spine radiographs can reliably detect pediatric patients with CSI and seek to quantify the functional sensitivity of plain radiography as compared to CT. We analyzed data from the NEXUS cervical spine study to assess the sensitivity of plain radiographs in the evaluation of CSI. We identified all pediatric patients who underwent plain radiographic imaging, and all pediatric patients found to have CSI. We then determined the sensitivity of plain radiographs in detecting pediatric patients with CSI. We identified 44 pediatric patients with CSI in the dataset with age ranging from 2 to 18 years old. Plain radiography was highly sensitive for the identification of CSI in our cohort of pediatric patients and is useful as a screening tool in the evaluation of pediatric CSI. Acknowledgement Author: Cui LW, Probst MA, Hoffman JR, Mower WR Journal: Emergency Radiology Publisher: Springer https://cloudfront.escholarship.org/dist/prd/content/qt95p3x9hg/qt95p3x9hg.pdf?t=odi6kh&v=lg	Sensitivity of plain radiography for pediatric cervical spine injury. Course Detail Sensitivity of plain radiography for pediatric cervical spine injury. R 380.00 \| 3 CEUs Add to Cart Online Course Overview Pediatric patients with suspected cervical spine injuries (CSI) often receive a computed tomography (CT) scan as an initial diagnostic imaging test. While sensitive, CT of the cervical spine carries significant radiation and risk of lethal malignant transformation later in life. Plain radiographs carry significantly less radiation and could serve as the preferred screening tool, provided they have a high functional sensitivity in detecting pediatric patients with CSI. We hypothesize that plain cervical spine radiographs can reliably detect pediatric patients with CSI and seek to quantify the functional sensitivity of plain radiography as compared to CT. We analyzed data from the NEXUS cervical spine study to assess the sensitivity of plain radiographs in the evaluation of CSI. We identified all pediatric patients who underwent plain radiographic imaging, and all pediatric patients found to have CSI. We then determined the sensitivity of plain radiographs in detecting pediatric patients with CSI. We identified 44 pediatric patients with CSI in the dataset with age ranging from 2 to 18 years old. Plain radiography was highly sensitive for the identification of CSI in our cohort of pediatric patients and is useful as a screening tool in the evaluation of pediatric CSI. Acknowledgement Author: Cui LW, Probst MA, Hoffman JR, Mower WR Journal: Emergency Radiology Publisher: Springer https://cloudfront.escholarship.org/dist/prd/content/qt95p3x9hg/qt95p3x9hg.pdf?t=odi6kh&v=lg	3	R 380.00
Application of cervical collars – An analysis of practical skills of professional emergency medical care providers. Application of cervical collars – An analysis of practical skills of professional emergency medical care providers. Overview: The application of a cervical collar is a standard procedure in trauma patients in emergency medicine. It is often observed that cervical collars are applied incorrectly, resulting in reduced immobilization of the cervical spine. The objective of this study was to analyze the practical skills of trained professional rescue personnel concerning the application of cervical collars. Within emergency medical conferences, n = 104 voluntary test subjects were asked to apply a cervical collar to a training doll, wherein each step that was performed received an evaluation. Furthermore, personal and occupational data of all study participants were collected using a questionnaire. The most common error consisted of incorrect adjustment of the size of the cervical collar (66%). No association was found between the correct application of the cervical collar and the occupational group of the test subjects (trained rescue personnel vs. emergency physicians) or the participation in certified trauma courses. In conclusion despite pronounced subjective confidence regarding the application of cervical collars, this study allows the conclusion that there are general deficits in practical skills when cervical collars are applied. A critical assessment of the current training contents about trauma care must, therefore, be demanded. ACKNOWLEDGEMENT AUTHORS: Michael Kreinest1,2, Sarah Goller1,2, Geraldine Rauch3, Christian Frank4,2, Bernhard Gliwitzky2, Christoph G. Wölfl1,2, Stefan Matschke1, Matthias Münzberg 1,2* JOURNAL: PLOS One PUBLISHER: Public Library of Science https://www.plos.org	Application of cervical collars – An analysis of practical skills of professional emergency medical care providers. Course Detail Application of cervical collars – An analysis of practical skills of professional emergency medical care providers. R 355.00 \| 3 CEUs Add to Cart Online Course Overview: The application of a cervical collar is a standard procedure in trauma patients in emergency medicine. It is often observed that cervical collars are applied incorrectly, resulting in reduced immobilization of the cervical spine. The objective of this study was to analyze the practical skills of trained professional rescue personnel concerning the application of cervical collars. Within emergency medical conferences, n = 104 voluntary test subjects were asked to apply a cervical collar to a training doll, wherein each step that was performed received an evaluation. Furthermore, personal and occupational data of all study participants were collected using a questionnaire. The most common error consisted of incorrect adjustment of the size of the cervical collar (66%). No association was found between the correct application of the cervical collar and the occupational group of the test subjects (trained rescue personnel vs. emergency physicians) or the participation in certified trauma courses. In conclusion despite pronounced subjective confidence regarding the application of cervical collars, this study allows the conclusion that there are general deficits in practical skills when cervical collars are applied. A critical assessment of the current training contents about trauma care must, therefore, be demanded. ACKNOWLEDGEMENT AUTHORS: Michael Kreinest1,2, Sarah Goller1,2, Geraldine Rauch3, Christian Frank4,2, Bernhard Gliwitzky2, Christoph G. Wölfl1,2, Stefan Matschke1, Matthias Münzberg 1,2* JOURNAL: PLOS One PUBLISHER: Public Library of Science https://www.plos.org	3	R 355.00
A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa. A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa. Overview The drugs that are used in treating any condition, be it an innocuous cough or a life-threatening cancer are the hard work of human clinical trials. Of course, these trials are the only credible way to determine the safety and efficiency of drugs. As a matter of fact, without clinical trials, pharmaceutical research will not advance to improve disease management as well and the quality of life in human beings. This study was therefore designed to assess the relation between the number of clinical trials conducted as well as respective new drug approvals in India and South Africa. The research was nonetheless conducted in four different settings, namely, USA, Europe, India and South Africa. The research was done though the construction and analysis of a comprehensive database of completed randomized controlled clinical trials based on clinical trials. The results from distribution of the market application approvals between the EU/USA as well as India and South Africa revealed that out of clinical trials with the participation of test centers in India and/or South Africa, 39.6% (India) clinical trials and 60.1% (South Africa) clinical trials led to market authorization in the EU/USA without a New Drug Application (NDA) approval in India or South Africa. ACKNOWLEDGEMENT AUTHORS: Dnyanesh Limaye, Janka Marisa Langer, Tjorben Rühling, Gerhard Fortwengel JOURNAL: BMJ Journals PUBLISHERS: group.bmj.com URL: http://bmjopen.bmj.com/	A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa. Course Detail A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa. R 345.00 \| 3 CEUs Add to Cart Online Course Overview The drugs that are used in treating any condition, be it an innocuous cough or a life-threatening cancer are the hard work of human clinical trials. Of course, these trials are the only credible way to determine the safety and efficiency of drugs. As a matter of fact, without clinical trials, pharmaceutical research will not advance to improve disease management as well and the quality of life in human beings. This study was therefore designed to assess the relation between the number of clinical trials conducted as well as respective new drug approvals in India and South Africa. The research was nonetheless conducted in four different settings, namely, USA, Europe, India and South Africa. The research was done though the construction and analysis of a comprehensive database of completed randomized controlled clinical trials based on clinical trials. The results from distribution of the market application approvals between the EU/USA as well as India and South Africa revealed that out of clinical trials with the participation of test centers in India and/or South Africa, 39.6% (India) clinical trials and 60.1% (South Africa) clinical trials led to market authorization in the EU/USA without a New Drug Application (NDA) approval in India or South Africa. ACKNOWLEDGEMENT AUTHORS: Dnyanesh Limaye, Janka Marisa Langer, Tjorben Rühling, Gerhard Fortwengel JOURNAL: BMJ Journals PUBLISHERS: group.bmj.com URL: http://bmjopen.bmj.com/	3	R 345.00
Effectiveness of multidisciplinary team case management: difference-indifferences analysis. Effectiveness of multidisciplinary team case management: difference-indifferences analysis. OVERVIEW Recently, there are increasing focus on increasing on the benefits of integrated care, to enable a more efficient and effective response to LTCs. This study was carried out in Single clinical commissioning group (CCG) in the UK’s National Health Service (NHS). The objective of this study was to evaluate a multidisciplinary team (MDT) case management intervention, at both the individual and practice levels. The design that was used for this study was the difference-in-differences design with multiple intervention start dates, that hospital admissions data. The participants for this study were 2049 intervention patients using propensity scoring one-to-one with control patients. During the research, 30 practices were compared using a natural experiment through staged implementation. The primary measures of direct intervention included accident and emergency (A&E) visits; inpatient non-elective stays, 30-day re-admissions; inpatient elective stays, outpatient visits and admissions for ambulatory care sensitive conditions. The secondary measures on the other hand included inpatient length of stay; total cost of secondary care Services and patient satisfaction. This study was nonetheless concluded that the intervention does not meet its primary aim, and the clinical significance and cost effectiveness of these small practice-level effects is debatable. ACKNOWLEDGEMENT AUTHORS: Jonathan Stokes, Søren Rud Kristensen, Kath Checkland, Peter Bower JOURNAL: Bmj Open PUBLISHER: group.bmj.com URL: http://bmjopen.bmj.com/	Effectiveness of multidisciplinary team case management: difference-indifferences analysis. Course Detail Effectiveness of multidisciplinary team case management: difference-indifferences analysis. R 350.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Recently, there are increasing focus on increasing on the benefits of integrated care, to enable a more efficient and effective response to LTCs. This study was carried out in Single clinical commissioning group (CCG) in the UK’s National Health Service (NHS). The objective of this study was to evaluate a multidisciplinary team (MDT) case management intervention, at both the individual and practice levels. The design that was used for this study was the difference-in-differences design with multiple intervention start dates, that hospital admissions data. The participants for this study were 2049 intervention patients using propensity scoring one-to-one with control patients. During the research, 30 practices were compared using a natural experiment through staged implementation. The primary measures of direct intervention included accident and emergency (A&E) visits; inpatient non-elective stays, 30-day re-admissions; inpatient elective stays, outpatient visits and admissions for ambulatory care sensitive conditions. The secondary measures on the other hand included inpatient length of stay; total cost of secondary care Services and patient satisfaction. This study was nonetheless concluded that the intervention does not meet its primary aim, and the clinical significance and cost effectiveness of these small practice-level effects is debatable. ACKNOWLEDGEMENT AUTHORS: Jonathan Stokes, Søren Rud Kristensen, Kath Checkland, Peter Bower JOURNAL: Bmj Open PUBLISHER: group.bmj.com URL: http://bmjopen.bmj.com/	3	R 350.00
How often are interventions in cluster randomised controlled trials of complex interventions in general practices effective and reasons for potential shortcomings? Protocol and results of a feasibility project for a systematic review. How often are interventions in cluster randomised controlled trials of complex interventions in general practices effective and reasons for potential shortcomings? Protocol and results of a feasibility project for a systematic review. ABSTRACT Introduction: Most studies conducted at general practices investigate complex interventions and increasingly use cluster-randomised controlled trail (c-RCT) designs to do so. Our primary objective is to evaluate how frequently complex interventions are shown to be more, equally or less effective than routine care in c RCTs with a superior design. The secondary aim is to discover whether the quality of a c-RCT determines the likelihood of the complex intervention being effective.	How often are interventions in cluster randomised controlled trials of complex interventions in general practices effective and reasons for potential shortcomings? Protocol and results of a feasibility project for a systematic review. Course Detail How often are interventions in cluster randomised controlled trials of complex interventions in general practices effective and reasons for potential shortcomings? Protocol and results of a feasibility project for a systematic review. R 330.00 \| 3 CEUs Add to Cart Online Course ABSTRACT Introduction: Most studies conducted at general practices investigate complex interventions and increasingly use cluster-randomised controlled trail (c-RCT) designs to do so. Our primary objective is to evaluate how frequently complex interventions are shown to be more, equally or less effective than routine care in c RCTs with a superior design. The secondary aim is to discover whether the quality of a c-RCT determines the likelihood of the complex intervention being effective.	3	R 330.00
Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month. Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month. OVERVIEW Shingles, or herpes zoster (HZ), is caused by reactivation, of varicella-zoster virus (VZV) from a latent infection in the dorsal root ganglion. The purpose of this study was thus to examine the burden of comorbidity, polypharmacy and herpes zoster (HZ), an infectious disease, and its main complication post-herpetic neuralgia (PHN) in young (50–70 years of age: 70-) and old (=70 years of age: 70+) patients. This study took place in primary care in France from November 20, 2006 to September 12, 2008. For this study, 644 general practitioners (GPs) collected data from 1358 patients aged 50 years or more with acute eruptive HZ. Validated questionnaires were used to investigate HZ and PHN burden, pain, quality of life (QoL). The results of this study indicated that older patients more frequently presented with comorbidities, frequently took analgesics and had poorer response on all questionnaires, indicating greater burden, at inclusion as compared with younger patients. ACKNOWLEDGEMENT AUTHORS: Gisèle Pickering et al. JOURNAL: BMJ Open PUBLISHER: BMJ Group URL: http://www.bmjopen.bmj.com	Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month. Course Detail Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month. R 330.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Shingles, or herpes zoster (HZ), is caused by reactivation, of varicella-zoster virus (VZV) from a latent infection in the dorsal root ganglion. The purpose of this study was thus to examine the burden of comorbidity, polypharmacy and herpes zoster (HZ), an infectious disease, and its main complication post-herpetic neuralgia (PHN) in young (50–70 years of age: 70-) and old (=70 years of age: 70+) patients. This study took place in primary care in France from November 20, 2006 to September 12, 2008. For this study, 644 general practitioners (GPs) collected data from 1358 patients aged 50 years or more with acute eruptive HZ. Validated questionnaires were used to investigate HZ and PHN burden, pain, quality of life (QoL). The results of this study indicated that older patients more frequently presented with comorbidities, frequently took analgesics and had poorer response on all questionnaires, indicating greater burden, at inclusion as compared with younger patients. ACKNOWLEDGEMENT AUTHORS: Gisèle Pickering et al. JOURNAL: BMJ Open PUBLISHER: BMJ Group URL: http://www.bmjopen.bmj.com	3	R 330.00
Point-of-care C reactive protein for the diagnosis of lower respiratory tract infection in NHS primary care. Point-of-care C reactive protein for the diagnosis of lower respiratory tract infection in NHS primary care. OVERVIEW Most often, majority of patients presenting to primary care with a suspected lower respiratory tract infection (LRTI) are prescribed antibiotics. That doesn’t however change the fact that most respiratory tract infections are viral and only marginal benefit is achieved from the prescription of antibiotics that in some cases does not outweigh the risk of harm. The aim of this research was thus to determine the barriers and facilitators to adoption of POC CRP testing in National Health Service (NHS) primary care for the diagnosis of lower respiratory tract infection. This study was however done following a qualitative methodology based on grounded theory. This study was however undertaken in two stages. The first consisted of semi structured interviews with 8 clinicians from Europe and the UK who use the test in routine practice, and focused on their subjective experience in the challenges of implementing POC CRP testing. The second stage on the other hand was a multidisciplinary-facilitated workshop with NHS stakeholders to discuss barriers to adoption, impact of adoption and potential adoption scenarios. The study concluded that Successful adoption models from the UK and abroad demonstrate a distinctive pattern and involve collaboration with central laboratory services. ACKNOWLEDGEMENT AUTHOR: Jeremy R Huddy, Melody Z Ni, James Barlow, Azeem Majeed, George B Hanna JOURNAL: Journal of Clinical Pathology PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com/	Point-of-care C reactive protein for the diagnosis of lower respiratory tract infection in NHS primary care. Course Detail Point-of-care C reactive protein for the diagnosis of lower respiratory tract infection in NHS primary care. R 355.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Most often, majority of patients presenting to primary care with a suspected lower respiratory tract infection (LRTI) are prescribed antibiotics. That doesn’t however change the fact that most respiratory tract infections are viral and only marginal benefit is achieved from the prescription of antibiotics that in some cases does not outweigh the risk of harm. The aim of this research was thus to determine the barriers and facilitators to adoption of POC CRP testing in National Health Service (NHS) primary care for the diagnosis of lower respiratory tract infection. This study was however done following a qualitative methodology based on grounded theory. This study was however undertaken in two stages. The first consisted of semi structured interviews with 8 clinicians from Europe and the UK who use the test in routine practice, and focused on their subjective experience in the challenges of implementing POC CRP testing. The second stage on the other hand was a multidisciplinary-facilitated workshop with NHS stakeholders to discuss barriers to adoption, impact of adoption and potential adoption scenarios. The study concluded that Successful adoption models from the UK and abroad demonstrate a distinctive pattern and involve collaboration with central laboratory services. ACKNOWLEDGEMENT AUTHOR: Jeremy R Huddy, Melody Z Ni, James Barlow, Azeem Majeed, George B Hanna JOURNAL: Journal of Clinical Pathology PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com/	3	R 355.00
Practice Issues. Practice Issues. OVERVIEW It is important to note that the responses to the various questions are the views independently expressed and are not necessarily opinions shared by cpdexpress.co.za. As matters involving Ethics and the law are subject to interpretation, the responses cannot, in any way, be regarded as binding or necessarily endorsed by the regulatory authorities. There are ethical dilemmas regarding patients, colleagues and associates that one doesn’t even consider until they become issues in their practice. There are many questions to be asked regarding ethics, touting, canvassing, advertising, competition and many other issues that need to be addressed and this article addresses most of them.	Practice Issues. Course Detail Practice Issues. R 450.00 \| 3 CEUs Add to Cart Online Course OVERVIEW It is important to note that the responses to the various questions are the views independently expressed and are not necessarily opinions shared by cpdexpress.co.za. As matters involving Ethics and the law are subject to interpretation, the responses cannot, in any way, be regarded as binding or necessarily endorsed by the regulatory authorities. There are ethical dilemmas regarding patients, colleagues and associates that one doesn’t even consider until they become issues in their practice. There are many questions to be asked regarding ethics, touting, canvassing, advertising, competition and many other issues that need to be addressed and this article addresses most of them.	3	R 450.00
Private Practice: The Do's And Don'ts. Private Practice: The Do's And Don'ts. OVERVIEW You have studied extensively to become a healthcare professional in your field of study. You have learned and become adept at identifying a vast range of conditions. You can diagnose and effectively treat those conditions within the scope of the discipline. Now you are faced with a plethora of dilemmas. What is fair value for your services? What appliances are appropriate and reasonable? What commercial and legal structures are appropriate for you? What influence may these commercial and legal structures have on your clinical recommendations? Who may have access to your record cards? What responsibility can you delegate to your staff? Who carries final responsibility for payment of your claims – member or medical aid? What constitutes anti-competitive behavior? This is a very informative article that will help you to run your practice within the various guidelines.	Private Practice: The Do's And Don'ts. Course Detail Private Practice: The Do's And Don'ts. R 400.00 \| 3 CEUs Add to Cart Online Course OVERVIEW You have studied extensively to become a healthcare professional in your field of study. You have learned and become adept at identifying a vast range of conditions. You can diagnose and effectively treat those conditions within the scope of the discipline. Now you are faced with a plethora of dilemmas. What is fair value for your services? What appliances are appropriate and reasonable? What commercial and legal structures are appropriate for you? What influence may these commercial and legal structures have on your clinical recommendations? Who may have access to your record cards? What responsibility can you delegate to your staff? Who carries final responsibility for payment of your claims – member or medical aid? What constitutes anti-competitive behavior? This is a very informative article that will help you to run your practice within the various guidelines.	3	R 400.00
Prognostic Factors for Disability and Sick Leave Patients with Subacute Non-Malignant Pain. Prognostic Factors for Disability and Sick Leave Patients with Subacute Non-Malignant Pain. OVERVIEW Pain is one of the most common reasons patients consult general practice. It has been observed that long-term disability and sick leave due to a pain conditions are associated with huge negative consequences for the individual and for society. The objective of this systematic review was therefore to identify generic prognostic factors for disability and sick leave in sub-acute pain patients. The setting of this study was nevertheless general practice and other primary care facilities. Participants in this study were adults (>18 years) with a sub-acute non-malignant pain condition. 19 studies were included, referring to a total of 6266 patients suffering from pain in the head, neck, back and shoulders. The primary outcome of this study was long-term disability (>3 months) due to a pain condition whereas the secondary outcome was sick leave, defined as ‘absence from work’ or ‘return-to-work. Data was obtained through a search via PubMed, EMBASE, CINAHL and PEDro databases from 16 from January 2003 to 16 January 2014. The study was concluded that multiple site pain, high pain severity, older age, baseline disability and longer pain duration were potential prognostic factors for disability across pain sites. ACKNOWLEDGEMENT AUTHOR: Gitte H Valentin, Marc S Pilegaard, Henrik B Vaegter, Marianne Rosendal, Lisbeth Ørtenblad, Ulla Væggemose, Robin Christensen JOURNAL: BMJ General Practice PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com	Prognostic Factors for Disability and Sick Leave Patients with Subacute Non-Malignant Pain. Course Detail Prognostic Factors for Disability and Sick Leave Patients with Subacute Non-Malignant Pain. R 365.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Pain is one of the most common reasons patients consult general practice. It has been observed that long-term disability and sick leave due to a pain conditions are associated with huge negative consequences for the individual and for society. The objective of this systematic review was therefore to identify generic prognostic factors for disability and sick leave in sub-acute pain patients. The setting of this study was nevertheless general practice and other primary care facilities. Participants in this study were adults (>18 years) with a sub-acute non-malignant pain condition. 19 studies were included, referring to a total of 6266 patients suffering from pain in the head, neck, back and shoulders. The primary outcome of this study was long-term disability (>3 months) due to a pain condition whereas the secondary outcome was sick leave, defined as ‘absence from work’ or ‘return-to-work. Data was obtained through a search via PubMed, EMBASE, CINAHL and PEDro databases from 16 from January 2003 to 16 January 2014. The study was concluded that multiple site pain, high pain severity, older age, baseline disability and longer pain duration were potential prognostic factors for disability across pain sites. ACKNOWLEDGEMENT AUTHOR: Gitte H Valentin, Marc S Pilegaard, Henrik B Vaegter, Marianne Rosendal, Lisbeth Ørtenblad, Ulla Væggemose, Robin Christensen JOURNAL: BMJ General Practice PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com	3	R 365.00
Understanding Tensions in Early Stage Chronic Kidney Disease. Understanding Tensions in Early Stage Chronic Kidney Disease. ABSTRACT Objectives: Since 2006, general practitioners (GPs) in England, UK, have been incentivised to keep a register and monitor patients with chronic kidney disease (CKD) stages 3–5. Despite tensions and debate around the merit of this activity, there has been little qualitative research exploring clinician perspectives on monitoring early-stage CKD in primary care. This study aimed to examine and understand a range of different healthcare professional views and experiences of identification and monitoring in primary care of early-stage CKD, in particular stage 3. Design: Qualitative design using semi-structured interviews	Understanding Tensions in Early Stage Chronic Kidney Disease. Course Detail Understanding Tensions in Early Stage Chronic Kidney Disease. R 380.00 \| 3 CEUs Add to Cart Online Course ABSTRACT Objectives: Since 2006, general practitioners (GPs) in England, UK, have been incentivised to keep a register and monitor patients with chronic kidney disease (CKD) stages 3–5. Despite tensions and debate around the merit of this activity, there has been little qualitative research exploring clinician perspectives on monitoring early-stage CKD in primary care. This study aimed to examine and understand a range of different healthcare professional views and experiences of identification and monitoring in primary care of early-stage CKD, in particular stage 3. Design: Qualitative design using semi-structured interviews	3	R 380.00

Other Courses which can earn you more CPD points

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Medical Ethics: Medical Students’ Perspectives on Euthanasia and Physician Assisted Suicide and Their Views on Legalising These Practices in SA Medical Ethics: Medical Students’ Perspectives on Euthanasia and Physician Assisted Suicide and Their Views on Legalising These Practices in SA Overview Euthanasia/physician assisted suicide have been a controversial and sometimes taboo topic for a long time, not only in SA but also internationally. A recent (SA) judicial case has seen the topic debated again. Consensus on accepting or abolishing these practices in SA has yet to be reached. All relevant role players need to be adequately engaged before policy can be informed. The objectives were to determine the views of future doctors (medical students) regarding euthanasia and physician-assisted suicide (PAS) and to ascertain their stance on its legalisation in South Africa (SA). Many factors influenced participants’ responses, but differences in opinion between and within the various religious groups were particularly evident in the responses received/ More than half the respondents in this study were open to legalising euthanasia/PAS, substantially more than in previous studies. However, only 41.9% of respondents would consider performing euthanasia/ PAS, for certain patients. Views of other healthcare workers as well as the public are required before policy can be informed. Acknowledgement Authors R K Jacobs and M Hendricks Journal SAMJ RESEARCH	Medical Ethics: Medical Students’ Perspectives on Euthanasia and Physician Assisted Suicide and Their Views on Legalising These Practices in SA Course Detail Medical Ethics: Medical Students’ Perspectives on Euthanasia and Physician Assisted Suicide and Their Views on Legalising These Practices in SA R 425.00 \| 3 CEUs Add to Cart Online Course Overview Euthanasia/physician assisted suicide have been a controversial and sometimes taboo topic for a long time, not only in SA but also internationally. A recent (SA) judicial case has seen the topic debated again. Consensus on accepting or abolishing these practices in SA has yet to be reached. All relevant role players need to be adequately engaged before policy can be informed. The objectives were to determine the views of future doctors (medical students) regarding euthanasia and physician-assisted suicide (PAS) and to ascertain their stance on its legalisation in South Africa (SA). Many factors influenced participants’ responses, but differences in opinion between and within the various religious groups were particularly evident in the responses received/ More than half the respondents in this study were open to legalising euthanasia/PAS, substantially more than in previous studies. However, only 41.9% of respondents would consider performing euthanasia/ PAS, for certain patients. Views of other healthcare workers as well as the public are required before policy can be informed. Acknowledgement Authors R K Jacobs and M Hendricks Journal SAMJ RESEARCH	3	R 425.00
Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights Overview South Africa is a country with two distinct health sectors, which are both characterised by inequalities. Within this context, patients with end stage renal disease face unique and sometimes impenetrable barriers to accessing dialysis. There are a number of reasons for this situation, which include the South African government’s endorsement of discordant, unequal policies, which disadvantage the most vulnerable; a lack of robust national guidelines; and divisive rationing practices, which are ad hoc and place the burden of responsibility for rationing dialysis on the clinician. In this paper, we trace the socio-economic mechanisms of how we have come to be in this situation, and overlay this with a detailed examination of South African legislation. Finally, we make comprehensive practical recommendations for rectifying the situation, which include engagement with key stakeholders, public-private partnerships, and more equitable funding mechanisms. Acknowledgement Authors Harriet Etheredge and June Fabian Journal Healthcare (Basel) Volume 5 Issue 3	Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights Course Detail Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights R 455.00 \| 3 CEUs Add to Cart Online Course Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights Overview South Africa is a country with two distinct health sectors, which are both characterised by inequalities. Within this context, patients with end stage renal disease face unique and sometimes impenetrable barriers to accessing dialysis. There are a number of reasons for this situation, which include the South African government’s endorsement of discordant, unequal policies, which disadvantage the most vulnerable; a lack of robust national guidelines; and divisive rationing practices, which are ad hoc and place the burden of responsibility for rationing dialysis on the clinician. In this paper, we trace the socio-economic mechanisms of how we have come to be in this situation, and overlay this with a detailed examination of South African legislation. Finally, we make comprehensive practical recommendations for rectifying the situation, which include engagement with key stakeholders, public-private partnerships, and more equitable funding mechanisms. Acknowledgement Authors Harriet Etheredge and June Fabian Journal Healthcare (Basel) Volume 5 Issue 3	3	R 455.00
Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia Overview A cohort of pediatric patients with AML treated at hospitals contributing to the Pediatric Health Information System was used to evaluate differences in opioid utilization by sex, age, race, and insurance. Billing data were used to compute the prevalence of opioid exposure and to quantify rates of utilization among those exposed to opioids as days of use per 1000 inpatient days. Multivariable regressions were used to compare opioid prevalence, and rates of utilization among those exposed. The proportion of opioid-exposed patients increased with age, but did not differ by gender, race, or insurance status. There was moderate hospital-level variability in both the prevalence of opioid utilization overall and preference for specific opioid medications. There was greater inconsistency in practice concerning choices for supplemental and alternative opioids than in first-line opioid utilization. Additional work is needed to discern whether observed differences in opioid utilization by age and race reflect a difference in treatment or a difference in the experience of pain. Future studies should also explore the factors which guide decisions on opioid selections in an attempt to explain the variability across institutions. Acknowledgement Authors Kelly D. Getz , Tamara P. Miller, Alix E. Seif , Yimei Li , Yuan-Shung V. Huang, Brian T. Fisher and Richard Aplenc. Journal PLoS Medicine 2018 Feb Volume 13 Issue 2 Publisher Cross Mark Open Access URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805309/pdf/pone.0192529.pdf	Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia Course Detail Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia R 460.00 \| 3 CEUs Add to Cart Online Course Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia Overview A cohort of pediatric patients with AML treated at hospitals contributing to the Pediatric Health Information System was used to evaluate differences in opioid utilization by sex, age, race, and insurance. Billing data were used to compute the prevalence of opioid exposure and to quantify rates of utilization among those exposed to opioids as days of use per 1000 inpatient days. Multivariable regressions were used to compare opioid prevalence, and rates of utilization among those exposed. The proportion of opioid-exposed patients increased with age, but did not differ by gender, race, or insurance status. There was moderate hospital-level variability in both the prevalence of opioid utilization overall and preference for specific opioid medications. There was greater inconsistency in practice concerning choices for supplemental and alternative opioids than in first-line opioid utilization. Additional work is needed to discern whether observed differences in opioid utilization by age and race reflect a difference in treatment or a difference in the experience of pain. Future studies should also explore the factors which guide decisions on opioid selections in an attempt to explain the variability across institutions. Acknowledgement Authors Kelly D. Getz , Tamara P. Miller, Alix E. Seif , Yimei Li , Yuan-Shung V. Huang, Brian T. Fisher and Richard Aplenc. Journal PLoS Medicine 2018 Feb Volume 13 Issue 2 Publisher Cross Mark Open Access URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805309/pdf/pone.0192529.pdf	3	R 460.00
Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa Overview Informed consent (IC) is a legally enforceable right in South Africa based on constitutionally protected rights to bodily integrity and well-being. In terms of the law, patients cannot be involved in medical treatment or research without IC. Healthcare providers must inform patients about diagnosis, risks, benefits, treatment options, and right of refusal in a language that patients understand based their literacy level. This study reports an empirical study on patients’ perceptions of IC as practiced by doctors and nurses in South Africa. This study reveals that South African patients are aware of the right to IC, but many were vulnerable due to indigence. Barriers to IC include poverty, language, and low educational level. South African patients prefer disclosure of all material risks, better communication skills by healthcare workers, and a shift toward informed or shared healthcare decision-making. Acknowledgement Author Chima SC Journal Nigerian Journal of Clinical Practice Suppl:S46-56. Publisher: Wolters Kluwer - Medknow	Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa Course Detail Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa R 455.00 \| 3 CEUs Add to Cart Online Course Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa Overview Informed consent (IC) is a legally enforceable right in South Africa based on constitutionally protected rights to bodily integrity and well-being. In terms of the law, patients cannot be involved in medical treatment or research without IC. Healthcare providers must inform patients about diagnosis, risks, benefits, treatment options, and right of refusal in a language that patients understand based their literacy level. This study reports an empirical study on patients’ perceptions of IC as practiced by doctors and nurses in South Africa. This study reveals that South African patients are aware of the right to IC, but many were vulnerable due to indigence. Barriers to IC include poverty, language, and low educational level. South African patients prefer disclosure of all material risks, better communication skills by healthcare workers, and a shift toward informed or shared healthcare decision-making. Acknowledgement Author Chima SC Journal Nigerian Journal of Clinical Practice Suppl:S46-56. Publisher: Wolters Kluwer - Medknow	3	R 455.00
Cumulative Sum Analysis of the Learning Curve for Video-assisted Miniliaparotomy Donor Nephrectomy in Healthy Kidney Donors (Nephrectomy) Cumulative Sum Analysis of the Learning Curve for Video-assisted Miniliaparotomy Donor Nephrectomy in Healthy Kidney Donors (Nephrectomy) Cumulative Sum Analysis of the Learning Curve for Video-assisted Miniliaparotomy Donor Nephrectomy in Healthy Kidney Donors (Nephrectomy) Overview Video-assisted mini-laparotomy surgery (VAMS) is a hybrid of open and laparoscopic surgical techniques, so has advantages of both approaches. The learning curve was evaluated using the cumulative sum (CUSUM) method. Measures of surgical performance included total operation time, warm ischemic time, and estimated blood loss. The mean patient age, body mass index, and body surface area were 43.5 years, 23.8kg/m2, and 1.7m2, respectively. In terms of warm ischemic time and estimated blood loss, the initial learning was achieved after 16 cases and after 9 to 10 cases, one could achieve competency. The VAMS donor nephrectomy learning curve is shorter than for laparoscopic or robotic hand-assisted donor nephrectomy. Surgeons can become familiar with the procedure and perform it without complications after approximately 16 to 17 operations. This is the first analysis with CUSUM identifying 3 unique learning curve phases for VAMS donor nephrectomy. Acknowledgement Jee Soo Park , Hyun Kyu Ahn , Joonchae Na , Hyung Ho Lee, Young Eun Yoon , Min Gee Yoon and Woong Kyu Han. Journal Medicine (2018) 97:17(e0560) Publisher Wolters Kluwer Health, Inc. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944565/pdf/medi-97-e0560.pdf	Cumulative Sum Analysis of the Learning Curve for Video-assisted Miniliaparotomy Donor Nephrectomy in Healthy Kidney Donors (Nephrectomy) Course Detail Cumulative Sum Analysis of the Learning Curve for Video-assisted Miniliaparotomy Donor Nephrectomy in Healthy Kidney Donors (Nephrectomy) R 445.00 \| 3 CEUs Add to Cart Online Course Cumulative Sum Analysis of the Learning Curve for Video-assisted Miniliaparotomy Donor Nephrectomy in Healthy Kidney Donors (Nephrectomy) Overview Video-assisted mini-laparotomy surgery (VAMS) is a hybrid of open and laparoscopic surgical techniques, so has advantages of both approaches. The learning curve was evaluated using the cumulative sum (CUSUM) method. Measures of surgical performance included total operation time, warm ischemic time, and estimated blood loss. The mean patient age, body mass index, and body surface area were 43.5 years, 23.8kg/m2, and 1.7m2, respectively. In terms of warm ischemic time and estimated blood loss, the initial learning was achieved after 16 cases and after 9 to 10 cases, one could achieve competency. The VAMS donor nephrectomy learning curve is shorter than for laparoscopic or robotic hand-assisted donor nephrectomy. Surgeons can become familiar with the procedure and perform it without complications after approximately 16 to 17 operations. This is the first analysis with CUSUM identifying 3 unique learning curve phases for VAMS donor nephrectomy. Acknowledgement Jee Soo Park , Hyun Kyu Ahn , Joonchae Na , Hyung Ho Lee, Young Eun Yoon , Min Gee Yoon and Woong Kyu Han. Journal Medicine (2018) 97:17(e0560) Publisher Wolters Kluwer Health, Inc. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944565/pdf/medi-97-e0560.pdf	3	R 445.00
Opioids and Immunosuppression in Oncological Postoperative Patients Opioids and Immunosuppression in Oncological Postoperative Patients Opioids and Immunosuppression in Oncological Postoperative Patients Overview Recent animal studies demonstrated immune-suppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anaesthesia Care Unit (PACU)-acquired infection after a schedule of sedo-analgesia of at least 6 days. All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion Recent animal studies demonstrated immune-suppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anaesthesia Care Unit (PACU)-acquired infection after a schedule of sedo-analgesia of at least 6 days. All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion Acknowledgement Authors José Luis Bonilla-García, Manuel Cortiñas-Sáenz and Esperanza del Pozo-Gavilán. Journal Rev Assoc Med Bras 2017; 63(9) URL: http://www.scielo.br/pdf/ramb/v63n9/0104-4230-ramb-63-09-0753.pdf	Opioids and Immunosuppression in Oncological Postoperative Patients Course Detail Opioids and Immunosuppression in Oncological Postoperative Patients R 485.00 \| 3 CEUs Add to Cart Online Course Opioids and Immunosuppression in Oncological Postoperative Patients Overview Recent animal studies demonstrated immune-suppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anaesthesia Care Unit (PACU)-acquired infection after a schedule of sedo-analgesia of at least 6 days. All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion Recent animal studies demonstrated immune-suppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anaesthesia Care Unit (PACU)-acquired infection after a schedule of sedo-analgesia of at least 6 days. All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion Acknowledgement Authors José Luis Bonilla-García, Manuel Cortiñas-Sáenz and Esperanza del Pozo-Gavilán. Journal Rev Assoc Med Bras 2017; 63(9) URL: http://www.scielo.br/pdf/ramb/v63n9/0104-4230-ramb-63-09-0753.pdf	3	R 485.00
A Qualitative Exploration of Chronic Pain and Opioid Treatment A Qualitative Exploration of Chronic Pain and Opioid Treatment A Qualitative Exploration of Chronic Pain and Opioid Treatment Overview The study explored high risk participants’ experiences with pain management regarding clinical access to and use of prescription opioids. First, participants perceived providers lacked empathy for their pain and/or were not adequately managing their pain. These interactions resulted in participants seeking new providers or mistrusting the medical system. Further, providers’ surveillance of participants’ pain treatment regimen contributed to distress surrounding pain management. Secondly, study centered on participants’ pain management experiences with prescribed opioid analgesics. Participants felt they were receiving dosages and classes of analgesics that did not sufficiently address their pain, and consequently modified their dosages or rationed prescription opioids. Other participants were reluctant to take analgesics due to their history of illicit drug use. Some participants relapsed to illicit drug use when they felt their prescription opioids did not adequately address their pain needs. Participant struggles with receiving and managing prescribed opioid analgesics suggest a need for: therapies beyond these medications; guidelines for providers specific to this population; and harm reduction trainings for providers. Acknowledgement Author Sarina R. Isenberg, Allysha C. Maragh-Bass, Kathleen Ridgeway, Mary Catherine Beach and Amy R. Knowlton. Journal J Opioid Manag. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560049/pdf/nihms871159.pdf	A Qualitative Exploration of Chronic Pain and Opioid Treatment Course Detail A Qualitative Exploration of Chronic Pain and Opioid Treatment R 455.00 \| 3 CEUs Add to Cart Online Course A Qualitative Exploration of Chronic Pain and Opioid Treatment Overview The study explored high risk participants’ experiences with pain management regarding clinical access to and use of prescription opioids. First, participants perceived providers lacked empathy for their pain and/or were not adequately managing their pain. These interactions resulted in participants seeking new providers or mistrusting the medical system. Further, providers’ surveillance of participants’ pain treatment regimen contributed to distress surrounding pain management. Secondly, study centered on participants’ pain management experiences with prescribed opioid analgesics. Participants felt they were receiving dosages and classes of analgesics that did not sufficiently address their pain, and consequently modified their dosages or rationed prescription opioids. Other participants were reluctant to take analgesics due to their history of illicit drug use. Some participants relapsed to illicit drug use when they felt their prescription opioids did not adequately address their pain needs. Participant struggles with receiving and managing prescribed opioid analgesics suggest a need for: therapies beyond these medications; guidelines for providers specific to this population; and harm reduction trainings for providers. Acknowledgement Author Sarina R. Isenberg, Allysha C. Maragh-Bass, Kathleen Ridgeway, Mary Catherine Beach and Amy R. Knowlton. Journal J Opioid Manag. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560049/pdf/nihms871159.pdf	3	R 455.00
The effect of group exercise frequency on health-related quality of life in institutionalised elderly. The effect of group exercise frequency on health-related quality of life in institutionalised elderly. Overview The study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. One hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures. Mental health and social health benefits can be obtained irrespective of exercise frequency 2X/week or 3X/week. The exercise intervention at a frequency 3X/ week was more effective in improving mental component summary due to a larger effect size obtained compared to the exercise frequency of 2X/week. Additional benefits in vitality were achieved by exercising 3X/week. This may assist the elderly in preserving their independence. Further targeted longitudinal intervention based studies are required to investigate the impact of intensity, frequency, duration and type of physical activity that is required to obtain mental and physical health benefits. Acknowledgement Author Nivash Rugbeer, Serela Ramklass, Andrew Mckune, Johan van Heerden Journal Pan African Medical Journal Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398226/pdf/PAMJ-26-35.pdf	The effect of group exercise frequency on health-related quality of life in institutionalised elderly. Course Detail The effect of group exercise frequency on health-related quality of life in institutionalised elderly. R 400.00 \| 3 CEUs Add to Cart Online Course Overview The study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. One hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures. Mental health and social health benefits can be obtained irrespective of exercise frequency 2X/week or 3X/week. The exercise intervention at a frequency 3X/ week was more effective in improving mental component summary due to a larger effect size obtained compared to the exercise frequency of 2X/week. Additional benefits in vitality were achieved by exercising 3X/week. This may assist the elderly in preserving their independence. Further targeted longitudinal intervention based studies are required to investigate the impact of intensity, frequency, duration and type of physical activity that is required to obtain mental and physical health benefits. Acknowledgement Author Nivash Rugbeer, Serela Ramklass, Andrew Mckune, Johan van Heerden Journal Pan African Medical Journal Publisher Cross Mark URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398226/pdf/PAMJ-26-35.pdf	3	R 400.00
Relation Between Periodontal Status and Pre-Cancerous Condition (Oral Lichen Planus): A Pilot Study. Relation Between Periodontal Status and Pre-Cancerous Condition (Oral Lichen Planus): A Pilot Study. Overview Objectives: The purpose of the study was to evaluate the periodontal status of OLP patients and compare it with that of healthy controls. Plaque control and rigorous oral hygiene are primary requisites for the treatment of any oro-mucosal disease. Material and Methods: Thirty patients with the erosive and reticular form of OLP as a study group and 30 healthy subjects as a control group were selected. The periodontal status of all subjects including gingival index (GI), Russell's periodontal index (PI) and bleeding on probing (BOP) were evaluated in both groups. Finally, the data was analyzed by a paired t-test using SPSS software v. 22. Results: The mean values of GI, PI and BOP were observed to be higher in the study group compared to the control group, and this was statistically significant (p < 0.05). The results shown are suggestive that periodontal status was poor in the study group as compared to the control group. Conclusions: Further studies need to investigate periodontal status in oral lichen planus patients with larger sample size, and careful follow-up of these will assure an increase in the quality of life of these patients. The patient should be informed regarding the risk of periodontal problems in OLP and should be advised to have regular dental checkups to avoid a worsening of the condition Acknowledgement Author: Rai NP, Kumar P, Mustafa SM, Divakar DD, Kheraif AA, Ramakrishnaiah R, Vellapally S, Dalati MH, Parine NR, Anil S Journal: Advances in clinical and experimental medicine Publisher: Wroclaw Medical University http://www.advances.umed.wroc.pl/pdf/2016/25/4/763.pdf	Relation Between Periodontal Status and Pre-Cancerous Condition (Oral Lichen Planus): A Pilot Study. Course Detail Relation Between Periodontal Status and Pre-Cancerous Condition (Oral Lichen Planus): A Pilot Study. R 380.00 \| 3 CEUs Add to Cart Online Course Overview Objectives: The purpose of the study was to evaluate the periodontal status of OLP patients and compare it with that of healthy controls. Plaque control and rigorous oral hygiene are primary requisites for the treatment of any oro-mucosal disease. Material and Methods: Thirty patients with the erosive and reticular form of OLP as a study group and 30 healthy subjects as a control group were selected. The periodontal status of all subjects including gingival index (GI), Russell's periodontal index (PI) and bleeding on probing (BOP) were evaluated in both groups. Finally, the data was analyzed by a paired t-test using SPSS software v. 22. Results: The mean values of GI, PI and BOP were observed to be higher in the study group compared to the control group, and this was statistically significant (p < 0.05). The results shown are suggestive that periodontal status was poor in the study group as compared to the control group. Conclusions: Further studies need to investigate periodontal status in oral lichen planus patients with larger sample size, and careful follow-up of these will assure an increase in the quality of life of these patients. The patient should be informed regarding the risk of periodontal problems in OLP and should be advised to have regular dental checkups to avoid a worsening of the condition Acknowledgement Author: Rai NP, Kumar P, Mustafa SM, Divakar DD, Kheraif AA, Ramakrishnaiah R, Vellapally S, Dalati MH, Parine NR, Anil S Journal: Advances in clinical and experimental medicine Publisher: Wroclaw Medical University http://www.advances.umed.wroc.pl/pdf/2016/25/4/763.pdf	3	R 380.00
Postoperative Pain in Children After Dentistry Under General Anesthesia. Postoperative Pain in Children After Dentistry Under General Anesthesia. Overview The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4-6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use. The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R = 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P < .001, Wilcoxon matched pairs signed rank test). Moderately good correlation between the 2 pain measures existed 2 and 12 hours from discharge (Spearman rhos correlation coefficients of 0.604 and 0.603, P < .005). In conclusion, children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics. Acknowledgement Author: Wong M, Copp PE, Haas DA Journal: Anesthesia progress Publisher: American Dental Society of Anesthesiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675339/pdf/i0003-3006-62-4-140.pdf	Postoperative Pain in Children After Dentistry Under General Anesthesia. Course Detail Postoperative Pain in Children After Dentistry Under General Anesthesia. R 450.00 \| 3 CEUs Add to Cart Online Course Overview The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4-6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use. The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R = 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P < .001, Wilcoxon matched pairs signed rank test). Moderately good correlation between the 2 pain measures existed 2 and 12 hours from discharge (Spearman rhos correlation coefficients of 0.604 and 0.603, P < .005). In conclusion, children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics. Acknowledgement Author: Wong M, Copp PE, Haas DA Journal: Anesthesia progress Publisher: American Dental Society of Anesthesiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675339/pdf/i0003-3006-62-4-140.pdf	3	R 450.00
Medical Ethics: Sex differences in medico-legal action against doctors: a systematic review and meta-analysis. Medical Ethics: Sex differences in medico-legal action against doctors: a systematic review and meta-analysis. Overview: Methods: Studies reporting original data, written in English or French, examining the association between sex and medico-legal action against doctors were included. Two reviewers independently extracted study characteristics and outcome data from the full texts of the studies meeting the eligibility criteria. Study quality was assessed using the Newcastle-Ottawa scale. A random effect meta-analysis model was used to summarize and assess the effect of doctors' sex on medico-legal action. Extracted outcomes included disciplinary action by a medical regulatory board, malpractice experience, referral to a medical regulatory body, complaints received by a healthcare complaints body, criminal cases, and medico-legal matter with a medical defence organisation. Results: Overall, 32 reports examining the association between doctors' sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female doctors. Heterogeneity was present in all meta-analyses. Conclusion: Male doctors are more likely to have had experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time. Acknowledgement Author: Unwin E, Woolf K, Wadlow C, Potts HW, Dacre J Journal: BMC medicine. Publisher: Crossmark https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-015-0413-5?site=bmcmedicine.biomedcentral.com	Medical Ethics: Sex differences in medico-legal action against doctors: a systematic review and meta-analysis. Course Detail Medical Ethics: Sex differences in medico-legal action against doctors: a systematic review and meta-analysis. R 400.00 \| 3 CEUs Add to Cart Online Course Overview: Methods: Studies reporting original data, written in English or French, examining the association between sex and medico-legal action against doctors were included. Two reviewers independently extracted study characteristics and outcome data from the full texts of the studies meeting the eligibility criteria. Study quality was assessed using the Newcastle-Ottawa scale. A random effect meta-analysis model was used to summarize and assess the effect of doctors' sex on medico-legal action. Extracted outcomes included disciplinary action by a medical regulatory board, malpractice experience, referral to a medical regulatory body, complaints received by a healthcare complaints body, criminal cases, and medico-legal matter with a medical defence organisation. Results: Overall, 32 reports examining the association between doctors' sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female doctors. Heterogeneity was present in all meta-analyses. Conclusion: Male doctors are more likely to have had experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time. Acknowledgement Author: Unwin E, Woolf K, Wadlow C, Potts HW, Dacre J Journal: BMC medicine. Publisher: Crossmark https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-015-0413-5?site=bmcmedicine.biomedcentral.com	3	R 400.00
Denial of abortion in legal settings. Denial of abortion in legal settings. Overview Background: Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however, are scarce. Methods: In this article we present data from studies among women seeking legal abortion services in four countries (Colombia, Nepal, South Africa and Tunisia) to assess sociodemographic characteristics of legal abortion seekers, as well as the frequency and reasons that women are denied abortion care. Results: The proportion of women denied abortion services and the reasons for which they were denied varied widely by country. In Colombia, 2% of women surveyed did not receive the abortions they were seeking; in South Africa, 45% of women did not receive abortions on the day they were seeking abortion services. In both Tunisia and Nepal, 26% of women were denied their wanted abortions. Conclusions: The denial of legal abortion services may have serious consequences for women's health and wellbeing. Additional evidence on the risk factors for presenting later in pregnancy, predictors of seeking unsafe illegal abortion, and the health consequences of illegal abortion and childbirth after an unwanted pregnancy is needed. Such data would assist the development of programmes and policies aimed at increasing access to and utilisation of safe abortion services where abortion is legal, and harm reduction models for women who are unable to access legal abortion services. Acknowledgement Author: Gerdts C, DePiñeres T, Hajri S, Harries J, Hossain A, Puri M, Vohra D, Foster DG Journal: The journal of family planning and reproductive health care. Publisher: BMJ Publishing Group Limited	Denial of abortion in legal settings. Course Detail Denial of abortion in legal settings. R 420.00 \| 3 CEUs Add to Cart Online Course Overview Background: Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however, are scarce. Methods: In this article we present data from studies among women seeking legal abortion services in four countries (Colombia, Nepal, South Africa and Tunisia) to assess sociodemographic characteristics of legal abortion seekers, as well as the frequency and reasons that women are denied abortion care. Results: The proportion of women denied abortion services and the reasons for which they were denied varied widely by country. In Colombia, 2% of women surveyed did not receive the abortions they were seeking; in South Africa, 45% of women did not receive abortions on the day they were seeking abortion services. In both Tunisia and Nepal, 26% of women were denied their wanted abortions. Conclusions: The denial of legal abortion services may have serious consequences for women's health and wellbeing. Additional evidence on the risk factors for presenting later in pregnancy, predictors of seeking unsafe illegal abortion, and the health consequences of illegal abortion and childbirth after an unwanted pregnancy is needed. Such data would assist the development of programmes and policies aimed at increasing access to and utilisation of safe abortion services where abortion is legal, and harm reduction models for women who are unable to access legal abortion services. Acknowledgement Author: Gerdts C, DePiñeres T, Hajri S, Harries J, Hossain A, Puri M, Vohra D, Foster DG Journal: The journal of family planning and reproductive health care. Publisher: BMJ Publishing Group Limited	3	R 420.00
Creating a Culture of Mindfulness in Medicine. Creating a Culture of Mindfulness in Medicine. OVERVIEW It is becoming increasingly complex to provide primary care since there is always the need to frequently address multiple medical issues at each patient visit. However, well-documented challenges faced by primary care clinicians have brought growing awareness to the issues of physician wellness and burnout and the potential subsequent impact on patients. Thus, the objective of this study was to promote the cultivation of mindful awareness throughout our health system, creating a culture of mindfulness in medicine. During this research, a systems-level strategy was developed to promote health and resilience for clinicians and patients by preparing a group of clinician leaders to serve as catalysts to practice and teach mindfulness. The strategy nonetheless included three major steps, namely: (1) Select 5 primary care leaders to help foster mindful¬ness within both health care delivery and education; (2) Provide funds for these leaders to attend advanced mindfulness training designed specifically for clinicians; and (3) Foster mindfulness within our health system and beyond via collaborative planning meetings and seed money for implemen¬tation of projects. Results indicated that all 5 leaders endorsed the personal value of the mindfulness training, with some describ¬ing it as life-changing. ACKNOWLEDGEMENT AUTHOR: Charlene Luchterhand, David Rakel, Cynthia Haq, Lisa Grant, DO, Angela Byars-Winston, Steve Tyska, Kathleen Engles, JOURNAL: Health Innovations PUBLISHER: Health Policy Publishing URL: http://www.healthpolicypublishing.com	Creating a Culture of Mindfulness in Medicine. Course Detail Creating a Culture of Mindfulness in Medicine. R 400.00 \| 3 CEUs Add to Cart Online Course OVERVIEW It is becoming increasingly complex to provide primary care since there is always the need to frequently address multiple medical issues at each patient visit. However, well-documented challenges faced by primary care clinicians have brought growing awareness to the issues of physician wellness and burnout and the potential subsequent impact on patients. Thus, the objective of this study was to promote the cultivation of mindful awareness throughout our health system, creating a culture of mindfulness in medicine. During this research, a systems-level strategy was developed to promote health and resilience for clinicians and patients by preparing a group of clinician leaders to serve as catalysts to practice and teach mindfulness. The strategy nonetheless included three major steps, namely: (1) Select 5 primary care leaders to help foster mindful¬ness within both health care delivery and education; (2) Provide funds for these leaders to attend advanced mindfulness training designed specifically for clinicians; and (3) Foster mindfulness within our health system and beyond via collaborative planning meetings and seed money for implemen¬tation of projects. Results indicated that all 5 leaders endorsed the personal value of the mindfulness training, with some describ¬ing it as life-changing. ACKNOWLEDGEMENT AUTHOR: Charlene Luchterhand, David Rakel, Cynthia Haq, Lisa Grant, DO, Angela Byars-Winston, Steve Tyska, Kathleen Engles, JOURNAL: Health Innovations PUBLISHER: Health Policy Publishing URL: http://www.healthpolicypublishing.com	3	R 400.00
Development and Validation of a New Prognostic System for Patients with Hepatocellular Carcinoma. Development and Validation of a New Prognostic System for Patients with Hepatocellular Carcinoma. OVERVIEW Liver Cancer is the sixth most common type of cancer in the world. It is equally the second most common cause of cancer death in the world. However, prognostic assessment in patients with hepatocellular carcinoma (HCC) remains controversial. Thus, this study sort to develop and validate a new prognostic system for patients with HCC using the Italian Liver Cancer (ITA.LI.CA) database. During this study, ITA.LI.CA stages were first of all defined using only tumor characteristics. A parametric multivariable survival model was then used to calculate the relative prognostic value of ITA.LI. However, The ITA.LI.CA integrated prognostic score showed optimal discrimination and calibration abilities in Italian patients. Findings from this study further revealed that observed as well as predicted median survival in the training and internal validation sets largely coincided. The study equally concluded that the ITA.LI.CA prognostic system shows a strong ability to predict individual survival in European and Asian population. ACKNOWLEDGEMENT AUTHORS: Fabio Farinati1, Alessandro Vitale1, Gaya Spolverato, Timothy M. Pawlik, TehlaHuo Yun-Hsuan Lee, Anna Chiara Frigo, Anna Giacomin, Edoardo G. Giannini, Francesca Ciccarese, Fabio Piscaglia, Gian Lodovico Rapaccini, Mariella Di Marco, Eugenio Caturelli, Marco Zoli, Franco Borzio, Giuseppe Cabibbo, Martina Felder, Rodolfo Sacco, Filomena Morisco, Elisabetta Biasini, Francesco Giuseppe Foschi, Antonio Gasbarrini, Gianluca Svegliati Baroni, Roberto Virdone, Alberto Masotto, Franco Trevisani, Umberto Cillo1, ITA.LI.CA study group JOURNAL: PLOS Medicine PUBLISHER: Public Library of Sciences (PLOS) URL: https://www.plos.org	Development and Validation of a New Prognostic System for Patients with Hepatocellular Carcinoma. Course Detail Development and Validation of a New Prognostic System for Patients with Hepatocellular Carcinoma. R 330.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Liver Cancer is the sixth most common type of cancer in the world. It is equally the second most common cause of cancer death in the world. However, prognostic assessment in patients with hepatocellular carcinoma (HCC) remains controversial. Thus, this study sort to develop and validate a new prognostic system for patients with HCC using the Italian Liver Cancer (ITA.LI.CA) database. During this study, ITA.LI.CA stages were first of all defined using only tumor characteristics. A parametric multivariable survival model was then used to calculate the relative prognostic value of ITA.LI. However, The ITA.LI.CA integrated prognostic score showed optimal discrimination and calibration abilities in Italian patients. Findings from this study further revealed that observed as well as predicted median survival in the training and internal validation sets largely coincided. The study equally concluded that the ITA.LI.CA prognostic system shows a strong ability to predict individual survival in European and Asian population. ACKNOWLEDGEMENT AUTHORS: Fabio Farinati1, Alessandro Vitale1, Gaya Spolverato, Timothy M. Pawlik, TehlaHuo Yun-Hsuan Lee, Anna Chiara Frigo, Anna Giacomin, Edoardo G. Giannini, Francesca Ciccarese, Fabio Piscaglia, Gian Lodovico Rapaccini, Mariella Di Marco, Eugenio Caturelli, Marco Zoli, Franco Borzio, Giuseppe Cabibbo, Martina Felder, Rodolfo Sacco, Filomena Morisco, Elisabetta Biasini, Francesco Giuseppe Foschi, Antonio Gasbarrini, Gianluca Svegliati Baroni, Roberto Virdone, Alberto Masotto, Franco Trevisani, Umberto Cillo1, ITA.LI.CA study group JOURNAL: PLOS Medicine PUBLISHER: Public Library of Sciences (PLOS) URL: https://www.plos.org	3	R 330.00
Ebola Virus Disease: Clinical Review. Ebola Virus Disease: Clinical Review. Overview Ebola transmission may occur as a result of close contact with body fluids of infected patients. The incubation period for Ebola after infection is said to be 5-9 days, with a range of 1-21 days in 95% or more of patients,2 3 with the patients not considered infectious until they develop symptoms. This article is therefore a clinical review whose objective is to investigate what makes the differential diagnosis of Ebola broad. This article therefore examines the causes of the Ebola virus as we as the pathophysiology of this infection. This article equally went further to examine the infection prevention and control measures are used to curb the spread of Ebola from one country to another. The hypothesis here was that there is high likelihood of infected people travelling, thus, all countries are expected to have tested and practiced protocols ready for screening and managing Ebola patients. Of course the article also outlined some of the clinical features as well as the symptoms of the virus. ACKNOWLEDGEMENT AUTHORS: Nicholas J Beeching, Manuel Fenech, Catherine F Houlihan JOURNAL: BMJ Open PUBLISHER: The BMJ group URL: http://www.bmj.com	Ebola Virus Disease: Clinical Review. Course Detail Ebola Virus Disease: Clinical Review. R 400.00 \| 3 CEUs Add to Cart Online Course Overview Ebola transmission may occur as a result of close contact with body fluids of infected patients. The incubation period for Ebola after infection is said to be 5-9 days, with a range of 1-21 days in 95% or more of patients,2 3 with the patients not considered infectious until they develop symptoms. This article is therefore a clinical review whose objective is to investigate what makes the differential diagnosis of Ebola broad. This article therefore examines the causes of the Ebola virus as we as the pathophysiology of this infection. This article equally went further to examine the infection prevention and control measures are used to curb the spread of Ebola from one country to another. The hypothesis here was that there is high likelihood of infected people travelling, thus, all countries are expected to have tested and practiced protocols ready for screening and managing Ebola patients. Of course the article also outlined some of the clinical features as well as the symptoms of the virus. ACKNOWLEDGEMENT AUTHORS: Nicholas J Beeching, Manuel Fenech, Catherine F Houlihan JOURNAL: BMJ Open PUBLISHER: The BMJ group URL: http://www.bmj.com	3	R 400.00
First Aid Course. First Aid Course. Dr Cyril Harrisberg. This self taught Course and Tutorial is designed for Medical or Non Medical Professionals, and will teach vital medical and immediate practical steps to be taken when administering First Aid, or in an Emergency Medical Situation. It can be used by Non Medical Professionals or personnel, or as a refresher for those Medically Trained or in the allied health professions. It can be self taught as a stand alone tutorial, although practise of the maneuvers would add further benefit.	First Aid Course. Course Detail First Aid Course. R 330.00 \| 3 CEUs Add to Cart Online Course Dr Cyril Harrisberg. This self taught Course and Tutorial is designed for Medical or Non Medical Professionals, and will teach vital medical and immediate practical steps to be taken when administering First Aid, or in an Emergency Medical Situation. It can be used by Non Medical Professionals or personnel, or as a refresher for those Medically Trained or in the allied health professions. It can be self taught as a stand alone tutorial, although practise of the maneuvers would add further benefit.	3	R 330.00
Hearing Loss in Workers Exposed to Epoxy Adhesives and Noise. Hearing Loss in Workers Exposed to Epoxy Adhesives and Noise. OVERVIEW Organic solvents are heavily used in industries and there are evidences that exposure to organic solvents has hazardous effects on hearing. Yet, the effects of organic solvents on hearing are difficult to evaluate. The reason is that workers are usually exposed to a mixture of solvents with widely varying compositions and concentrations. However, the objective of this cross-sectional study was thus to investigate the risk of hearing loss among workers exposed to epoxy adhesives and noise. During the study, 182 stone workers who were exposed to both epoxy adhesives and noise were recruited. Other participants of the study composed of 89 stone workers who were exposed to noise only, and 43 workers from the administrative staff who had not been exposed to adhesives or noise. The demographic data, occupational history as well as the medical history of participants were obtained through face to-face interviews, arranged physical examinations as well as through pure-tone audiometric tests. Results from the study however indicated that epoxy adhesives exacerbate hearing impairment in noisy environments, with the main impacts occurring in the middle and high frequencies. ACKNOWLEDGEMENT AUTHORS: Hsiao-Yu Yang, Ruei-Hao Shie, Pau-Chung Chen JOURNAL: Journal of Epidemiology and Community Health PUBLISHER: BMJ Open Group URL: http://www.group.bmj.com	Hearing Loss in Workers Exposed to Epoxy Adhesives and Noise. Course Detail Hearing Loss in Workers Exposed to Epoxy Adhesives and Noise. R 335.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Organic solvents are heavily used in industries and there are evidences that exposure to organic solvents has hazardous effects on hearing. Yet, the effects of organic solvents on hearing are difficult to evaluate. The reason is that workers are usually exposed to a mixture of solvents with widely varying compositions and concentrations. However, the objective of this cross-sectional study was thus to investigate the risk of hearing loss among workers exposed to epoxy adhesives and noise. During the study, 182 stone workers who were exposed to both epoxy adhesives and noise were recruited. Other participants of the study composed of 89 stone workers who were exposed to noise only, and 43 workers from the administrative staff who had not been exposed to adhesives or noise. The demographic data, occupational history as well as the medical history of participants were obtained through face to-face interviews, arranged physical examinations as well as through pure-tone audiometric tests. Results from the study however indicated that epoxy adhesives exacerbate hearing impairment in noisy environments, with the main impacts occurring in the middle and high frequencies. ACKNOWLEDGEMENT AUTHORS: Hsiao-Yu Yang, Ruei-Hao Shie, Pau-Chung Chen JOURNAL: Journal of Epidemiology and Community Health PUBLISHER: BMJ Open Group URL: http://www.group.bmj.com	3	R 335.00
Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain. Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain. OVERVIEW Chronic pain among workers is not only an economic burden but also a major public health concern. Working is also a cause of chronic pain although most people need to continue working despite the pain to make a living except they get a sick leave or retirement. The hypothesis of this study was that the therapeutic effect of vocational rehabilitation may depend on psychosocial factors related to the workplace. Thus, the aim of the study was to test this hypothesis as well as examine the association of work-related psychosocial factors with the prevalence of chronic pain or health related quality of life (HRQoL) among workers with chronic pain. During this study, 1764 workers aged 20–59 years were examined in the pain-associated cross-sectional epidemiological survey in Japan. The outcomes of this study were chronic pain prevalence among all workers and low Euro QoL prevalence among workers with chronic pain according to the degree of workplace social support and job satisfaction. One of the significant results of this study was that chronic pain prevalence was higher among males reporting job dissatisfaction compared with those reporting job satisfaction. ACKNOWLEDGEMENT AUTHORS: Keiko Yamada, Ko Matsudaira, Hironori Imano, Akihiko Kitamura, Hiroyasu Iso JOURNAL: Esmo Open: Cancer Horizons PUBLISHER: BMJ Group URL: https://www.bmjopen.bmj.com	Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain. Course Detail Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain. R 360.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Chronic pain among workers is not only an economic burden but also a major public health concern. Working is also a cause of chronic pain although most people need to continue working despite the pain to make a living except they get a sick leave or retirement. The hypothesis of this study was that the therapeutic effect of vocational rehabilitation may depend on psychosocial factors related to the workplace. Thus, the aim of the study was to test this hypothesis as well as examine the association of work-related psychosocial factors with the prevalence of chronic pain or health related quality of life (HRQoL) among workers with chronic pain. During this study, 1764 workers aged 20–59 years were examined in the pain-associated cross-sectional epidemiological survey in Japan. The outcomes of this study were chronic pain prevalence among all workers and low Euro QoL prevalence among workers with chronic pain according to the degree of workplace social support and job satisfaction. One of the significant results of this study was that chronic pain prevalence was higher among males reporting job dissatisfaction compared with those reporting job satisfaction. ACKNOWLEDGEMENT AUTHORS: Keiko Yamada, Ko Matsudaira, Hironori Imano, Akihiko Kitamura, Hiroyasu Iso JOURNAL: Esmo Open: Cancer Horizons PUBLISHER: BMJ Group URL: https://www.bmjopen.bmj.com	3	R 360.00
Medical Ethics: A Private Right Called Bill. Medical Ethics: A Private Right Called Bill. OVERVIEW Privacy is defined by a number of English dictionaries as the quality or condition of being secluded from the presence or view of others. More appropriately privacy is also defined as’ the state of being free from unsanctioned intrusion’. In 2014, with the advent information technology advances, social networking, sale of database information and negligent protection of personal information, in general, amongst others, the necessity to protect personal and private information has been recognized by the law makers. As such, protection of personal information has been incorporated in various forms of legislation, including the SA Constitution, The Patients’ Rights Charter, the Health Professions Act and the very recent Protection of Personal Information Act (POPI). The Health Professions Council obligates all registered practitioners to comply with Continuing Professional Development (CPD). The importance of Ethics, Human Rights and Medical Law is emphasized. This article thus encompasses all three in the form of an overview related to the respect for privacy. Of significance is the Bill of Rights.	Medical Ethics: A Private Right Called Bill. Course Detail Medical Ethics: A Private Right Called Bill. R 400.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Privacy is defined by a number of English dictionaries as the quality or condition of being secluded from the presence or view of others. More appropriately privacy is also defined as’ the state of being free from unsanctioned intrusion’. In 2014, with the advent information technology advances, social networking, sale of database information and negligent protection of personal information, in general, amongst others, the necessity to protect personal and private information has been recognized by the law makers. As such, protection of personal information has been incorporated in various forms of legislation, including the SA Constitution, The Patients’ Rights Charter, the Health Professions Act and the very recent Protection of Personal Information Act (POPI). The Health Professions Council obligates all registered practitioners to comply with Continuing Professional Development (CPD). The importance of Ethics, Human Rights and Medical Law is emphasized. This article thus encompasses all three in the form of an overview related to the respect for privacy. Of significance is the Bill of Rights.	3	R 400.00
Medical Ethics: Communication in the Doctor Patient Relationship. Medical Ethics: Communication in the Doctor Patient Relationship. OVERVIEW The word ‘communication’ is derived from the Latin, ‘communis’ meaning ‘commonness’. In essence, effective communication is the establishment of a common frame of reference between practitioner and patient i.e. ‘all on the same page‘. At least as long ago as the writing of the Hippocratic Oath, it was well understood that physicians’ communication with their patients was an essential part of successful therapy. The relationship between a practitioner and patient should be based upon trust, which develops primarily through communication. In much of health care, accurate diagnosis and appropriate treatment depend upon the patient’s truthful and complete disclosure of personal health information. Communication is also a process involving the ‘transmitter’ and receivers. These roles, with particular reference to the practitioner/patient relationship, are interchangeable. There are skills required as there are ethical considerations.	Medical Ethics: Communication in the Doctor Patient Relationship. Course Detail Medical Ethics: Communication in the Doctor Patient Relationship. R 350.00 \| 3 CEUs Add to Cart Online Course OVERVIEW The word ‘communication’ is derived from the Latin, ‘communis’ meaning ‘commonness’. In essence, effective communication is the establishment of a common frame of reference between practitioner and patient i.e. ‘all on the same page‘. At least as long ago as the writing of the Hippocratic Oath, it was well understood that physicians’ communication with their patients was an essential part of successful therapy. The relationship between a practitioner and patient should be based upon trust, which develops primarily through communication. In much of health care, accurate diagnosis and appropriate treatment depend upon the patient’s truthful and complete disclosure of personal health information. Communication is also a process involving the ‘transmitter’ and receivers. These roles, with particular reference to the practitioner/patient relationship, are interchangeable. There are skills required as there are ethical considerations.	3	R 350.00
Medical Ethics: Decision Making in a Professional Practice. Medical Ethics: Decision Making in a Professional Practice. OVERVIEW The terms "Ethics" and "Morals" are derived respectively from the Greek and Latin words for "customs, practices and rituals", and what ethicist Robert Bellal has called "the habits of the heart". Although customs may appear to be superficial behaviors, they often reflect the society's deepest, conscious sense of right and wrong. Ethics as a discipline is the study and analysis of values and standards related to duty, responsibility and right and wrong behaviour. The obligations that health care professionals have towards their patients, each other and society, derive from ethical values held by the Practitioners discipline and the larger community. Since the time of Hippocrates, some of the more important moral values in health care have included trust, respect for life, benefiting others, avoiding harm to others, confidentiality and collegiality. Reflection of ethical issues is an essential compliment to the professional's specialised knowledge and skills in meeting basic human needs.	Medical Ethics: Decision Making in a Professional Practice. Course Detail Medical Ethics: Decision Making in a Professional Practice. R 350.00 \| 3 CEUs Add to Cart Online Course OVERVIEW The terms "Ethics" and "Morals" are derived respectively from the Greek and Latin words for "customs, practices and rituals", and what ethicist Robert Bellal has called "the habits of the heart". Although customs may appear to be superficial behaviors, they often reflect the society's deepest, conscious sense of right and wrong. Ethics as a discipline is the study and analysis of values and standards related to duty, responsibility and right and wrong behaviour. The obligations that health care professionals have towards their patients, each other and society, derive from ethical values held by the Practitioners discipline and the larger community. Since the time of Hippocrates, some of the more important moral values in health care have included trust, respect for life, benefiting others, avoiding harm to others, confidentiality and collegiality. Reflection of ethical issues is an essential compliment to the professional's specialised knowledge and skills in meeting basic human needs.	3	R 350.00
Medical Ethics: Ethics of the Placebo in Clinical Practice. Medical Ethics: Ethics of the Placebo in Clinical Practice. OVERVIEW The placebo is not easy to define. As a matter of fact, some scholars are despaired of the possibility of ever finding an adequate definition for the term. However, many current definitions invoke the non-specific nature of the treatment effects as the leading feature of the placebo. The object of this article was however to address the question of the placebo in clinical practice. This article nonetheless argued that the placebo could be an effective treatment. The article further argued that the use of the placebo does not entail deception. This article equally highlighted guidelines under which the placebo may be used for clinical purposes. This article further suggested that in selected cases, the use of the placebo may also be morally imperative. It is imperative to state that the arguments in this article were presented by three case vignettes. The article was concluded that the placebo can be beneficial to physicians of many clinical situations ACKNOWLEDGEMENT AUTHORS: Lichtenberg U Heresco-Levy, U Nitzan JOURNAL: BMJ Journal of Medical Ethics PUBLISHER: BMJ Open URL: http://www.group.bmj.com	Medical Ethics: Ethics of the Placebo in Clinical Practice. Course Detail Medical Ethics: Ethics of the Placebo in Clinical Practice. R 425.00 \| 3 CEUs Add to Cart Online Course OVERVIEW The placebo is not easy to define. As a matter of fact, some scholars are despaired of the possibility of ever finding an adequate definition for the term. However, many current definitions invoke the non-specific nature of the treatment effects as the leading feature of the placebo. The object of this article was however to address the question of the placebo in clinical practice. This article nonetheless argued that the placebo could be an effective treatment. The article further argued that the use of the placebo does not entail deception. This article equally highlighted guidelines under which the placebo may be used for clinical purposes. This article further suggested that in selected cases, the use of the placebo may also be morally imperative. It is imperative to state that the arguments in this article were presented by three case vignettes. The article was concluded that the placebo can be beneficial to physicians of many clinical situations ACKNOWLEDGEMENT AUTHORS: Lichtenberg U Heresco-Levy, U Nitzan JOURNAL: BMJ Journal of Medical Ethics PUBLISHER: BMJ Open URL: http://www.group.bmj.com	3	R 425.00
Medical Ethics: Healthcare Professional’s Patient Relationship. Medical Ethics: Healthcare Professional’s Patient Relationship. OVERVIEW This online course discusses respect and equal treatment; ending a patient-HP relationship; HIV/Aids; sexual attraction; treating family members; communication and consent with a case study included; obstacles for good communication plus case study; abusing medical resources including case study; futile treatment. The health care profession-patient relationship is the cornerstone of medical practice and therefore of medical ethics. The Declaration of Geneva requires of the health care profession that “The health of my patient will be my first consideration,” and the International Code of Medical Ethics states, “A health care profession shall owe his patients complete loyalty and all the resources of his science.” The traditional interpretation of the health care professional-patient relationship as a paternalistic one, in which the health care professional made the decision and the patient submitted to them, has been widely rejected in recent years, both in ethics and in law. Since many patients are either unable or unwilling to make decisions about their medical care, however, patient autonomy is often very problematic. This on-line course will deal with two topics that pose particularly vexing problems to Health Care Professionals in their daily practice: respect and equal treatment, communication and consent.	Medical Ethics: Healthcare Professional’s Patient Relationship. Course Detail Medical Ethics: Healthcare Professional’s Patient Relationship. R 420.00 \| 3 CEUs Add to Cart Online Course OVERVIEW This online course discusses respect and equal treatment; ending a patient-HP relationship; HIV/Aids; sexual attraction; treating family members; communication and consent with a case study included; obstacles for good communication plus case study; abusing medical resources including case study; futile treatment. The health care profession-patient relationship is the cornerstone of medical practice and therefore of medical ethics. The Declaration of Geneva requires of the health care profession that “The health of my patient will be my first consideration,” and the International Code of Medical Ethics states, “A health care profession shall owe his patients complete loyalty and all the resources of his science.” The traditional interpretation of the health care professional-patient relationship as a paternalistic one, in which the health care professional made the decision and the patient submitted to them, has been widely rejected in recent years, both in ethics and in law. Since many patients are either unable or unwilling to make decisions about their medical care, however, patient autonomy is often very problematic. This on-line course will deal with two topics that pose particularly vexing problems to Health Care Professionals in their daily practice: respect and equal treatment, communication and consent.	3	R 420.00
Medical Ethics: How parents and practitioners experience research without consent involving Children with life threatening conditions. Medical Ethics: How parents and practitioners experience research without consent involving Children with life threatening conditions. INTRODUCTION Improvements to life-saving treatments for critically ill children have been limited by the ethical and practical challenges involved in seeking consent for clinical trial entry.¹ The process of seeking informed consent requires time, but this is severely constrained in emergency situations, such as acute resuscitation and critical care,² where even minimal treatment delays are likely to be harmful.³ Parents are not always present when a child requires emergency treatment or a mother of a critically ill neonate may be sedated. Children’s critical care set-tings are intensely emotional, and some parents may not wish to be approached about research when their child is critically ill.⁴ Such challenges pose dif?culties for doctors and nurses recruiting to clinical trials in ensuring that parental consent has been informed, the participation voluntary and the recruitment process adhered to ethical principles.⁵ The last decade has seen inter-national efforts to ?nd alternatives to prospective informed consent so that vital research can continue to advance evidence-based children’s medicine.¹	Medical Ethics: How parents and practitioners experience research without consent involving Children with life threatening conditions. Course Detail Medical Ethics: How parents and practitioners experience research without consent involving Children with life threatening conditions. R 460.00 \| 3 CEUs Add to Cart Online Course INTRODUCTION Improvements to life-saving treatments for critically ill children have been limited by the ethical and practical challenges involved in seeking consent for clinical trial entry.¹ The process of seeking informed consent requires time, but this is severely constrained in emergency situations, such as acute resuscitation and critical care,² where even minimal treatment delays are likely to be harmful.³ Parents are not always present when a child requires emergency treatment or a mother of a critically ill neonate may be sedated. Children’s critical care set-tings are intensely emotional, and some parents may not wish to be approached about research when their child is critically ill.⁴ Such challenges pose dif?culties for doctors and nurses recruiting to clinical trials in ensuring that parental consent has been informed, the participation voluntary and the recruitment process adhered to ethical principles.⁵ The last decade has seen inter-national efforts to ?nd alternatives to prospective informed consent so that vital research can continue to advance evidence-based children’s medicine.¹	3	R 460.00
Medical Ethics: The Truth Be Told. Medical Ethics: The Truth Be Told. OVERVIEW “We're having a little problem with lying at my house: My son won't do it”. "Do you like my new car?" asks his work colleague. My son is paralyzed into muteness by his conscience. His friend is hurt. "Couldn't you find something nice to say about it, like the colour?" I ask. I am thinking of the story about Judy Garland, who, after seeing a pal in a terrible play, swept into her friend's dressing room with the line, "How do you do it, my dear, night after night?" The philosopher Immanuel Kant argued that truth-telling is a "perfect duty," one so basic that it cannot be overridden by other values—not even saving the life of a friend, let alone sparing someone's feelings. In Kant's formulation, if asked outright, a person would be obligated to tell a murderer the whereabouts of his intended victim. Of course, many have responded to Kant with penetrating philosophical counter-arguments Philosophers Maguire and Fargnoli use Kant's stance on lying to explore the limits of the quest for universal moral principles. "Universalization is an unrealistic and inaccurate abstraction that passes over the fact that there are exceptions to valid moral principles," they write. "To protect other values, like the life of an intended victim or a legitimate secret, exceptions to truth-telling must be made."	Medical Ethics: The Truth Be Told. Course Detail Medical Ethics: The Truth Be Told. R 420.00 \| 3 CEUs Add to Cart Online Course OVERVIEW “We're having a little problem with lying at my house: My son won't do it”. "Do you like my new car?" asks his work colleague. My son is paralyzed into muteness by his conscience. His friend is hurt. "Couldn't you find something nice to say about it, like the colour?" I ask. I am thinking of the story about Judy Garland, who, after seeing a pal in a terrible play, swept into her friend's dressing room with the line, "How do you do it, my dear, night after night?" The philosopher Immanuel Kant argued that truth-telling is a "perfect duty," one so basic that it cannot be overridden by other values—not even saving the life of a friend, let alone sparing someone's feelings. In Kant's formulation, if asked outright, a person would be obligated to tell a murderer the whereabouts of his intended victim. Of course, many have responded to Kant with penetrating philosophical counter-arguments Philosophers Maguire and Fargnoli use Kant's stance on lying to explore the limits of the quest for universal moral principles. "Universalization is an unrealistic and inaccurate abstraction that passes over the fact that there are exceptions to valid moral principles," they write. "To protect other values, like the life of an intended victim or a legitimate secret, exceptions to truth-telling must be made."	3	R 420.00
Medical Ethics: Uninformed Consent. Medical Ethics: Uninformed Consent. OVERVIEW There is an argument put forward by medical schemes, administrators and their agents that access to record cards of patients is an automatic right as members of medical schemes, when joining a medical scheme, acknowledge that they are obligated to adhere to the scheme rules which includes provision of personal information; hence consent has been granted. Importantly, the HPCSA Ethical Rules and recently introduced legislation such as the Protection of Private Information Act dictate that express informed consent must be obtained prior to the performance of professional acts or sharing of personal information. Consent, therefore based on an assumption or in the absence of express informed consent can only be regarded as uninformed consent. This includes implied consent whereby a patient pitches for an examination or sits in the chair and interpreted by the practitioner as consent.	Medical Ethics: Uninformed Consent. Course Detail Medical Ethics: Uninformed Consent. R 320.00 \| 3 CEUs Add to Cart Online Course OVERVIEW There is an argument put forward by medical schemes, administrators and their agents that access to record cards of patients is an automatic right as members of medical schemes, when joining a medical scheme, acknowledge that they are obligated to adhere to the scheme rules which includes provision of personal information; hence consent has been granted. Importantly, the HPCSA Ethical Rules and recently introduced legislation such as the Protection of Private Information Act dictate that express informed consent must be obtained prior to the performance of professional acts or sharing of personal information. Consent, therefore based on an assumption or in the absence of express informed consent can only be regarded as uninformed consent. This includes implied consent whereby a patient pitches for an examination or sits in the chair and interpreted by the practitioner as consent.	3	R 320.00
Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics OVERVIEW The question of ‘which is an ethical issue and which is not’ often arises doing research ethics. There are however many internationally known ethic guidelines and depending on which ethics guideline we consult, we may have various answers to this question. It is however ironical that we do not have a harmonized document which tells us what these various guidelines say and shows us the areas of consensus. For this study, we extracted relevant information or imperatives from five internationally-known ethics guidelines and took note where the imperatives came from. Results of this research nonetheless indicated that there is no consensus on many of the imperatives and that in only 8.2 % of the imperatives were there at least moderate consensus. The results further indicated that there was a lack of consensus in most of imperatives from the five internationally-known ethics guidelines. The reason was however partly attributed to the differences among the guidelines in terms of their levels of specification as well as conceptual/ideological differences. ACKNOWLEDGEMENT AUTHORS: Rosemarie D. L. C. Bernabe, Ghislaine J. M. W. van Thiel and Johannes J. M. van Delden JOURNAL: BMC Medical Ethics PUBLISHER: BioMed Central URL: https://www.biomedcentral.com	Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics Course Detail Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics R 330.00 \| 3 CEUs Add to Cart Online Course OVERVIEW The question of ‘which is an ethical issue and which is not’ often arises doing research ethics. There are however many internationally known ethic guidelines and depending on which ethics guideline we consult, we may have various answers to this question. It is however ironical that we do not have a harmonized document which tells us what these various guidelines say and shows us the areas of consensus. For this study, we extracted relevant information or imperatives from five internationally-known ethics guidelines and took note where the imperatives came from. Results of this research nonetheless indicated that there is no consensus on many of the imperatives and that in only 8.2 % of the imperatives were there at least moderate consensus. The results further indicated that there was a lack of consensus in most of imperatives from the five internationally-known ethics guidelines. The reason was however partly attributed to the differences among the guidelines in terms of their levels of specification as well as conceptual/ideological differences. ACKNOWLEDGEMENT AUTHORS: Rosemarie D. L. C. Bernabe, Ghislaine J. M. W. van Thiel and Johannes J. M. van Delden JOURNAL: BMC Medical Ethics PUBLISHER: BioMed Central URL: https://www.biomedcentral.com	3	R 330.00
Occupational science: An important contributor to occupational therapists’ clinical reasoning Occupational science: An important contributor to occupational therapists’ clinical reasoning Overview Occupational science has a strong influence in the theoretical as well as research based knowledge within occupational therapy. More so, various studies have revealed that the contributions from occupational science are also reflected in clinical reasoning which is a key occupational therapy competence. Clinical reasoning is also considered as an important element of health professional practice as it provides a link between research and practice. The purpose of this research is for occupational therapists to strive hard to develop their knowledge of occupational science literature and clinical reasoning competence. Thus, the objective of this research is therefore to debate and discuss ways in which occupational science could contribute even further to occupational therapists’ clinical reasoning and inform the occupational therapy curriculum. After analyzing different point of views of various occupational therapist, it was concluded that more research on the meanings of occupations is important for occupational therapy as a health care profession. It was equally recommended that the subsequent researches should include explorations of the relationship between occupation and development, how occupation changes over the lifespan, how people organize and engage in their daily occupations, as well as the personal and sociocultural meanings of occupation. ACKNOWLEDGEMENT AUTHORS: Hanne Kaae Kristensen & Kirsten Schultz Petersen JOURNAL: Scandinavian Journal of Occupational Therapy PUBLISHERS: Tylor & Francis Group URL: http://dx.doi.org/10.3109/11038128.2015.1083054	Occupational science: An important contributor to occupational therapists’ clinical reasoning Course Detail Occupational science: An important contributor to occupational therapists’ clinical reasoning R 425.00 \| 3 CEUs Add to Cart Online Course Overview Occupational science has a strong influence in the theoretical as well as research based knowledge within occupational therapy. More so, various studies have revealed that the contributions from occupational science are also reflected in clinical reasoning which is a key occupational therapy competence. Clinical reasoning is also considered as an important element of health professional practice as it provides a link between research and practice. The purpose of this research is for occupational therapists to strive hard to develop their knowledge of occupational science literature and clinical reasoning competence. Thus, the objective of this research is therefore to debate and discuss ways in which occupational science could contribute even further to occupational therapists’ clinical reasoning and inform the occupational therapy curriculum. After analyzing different point of views of various occupational therapist, it was concluded that more research on the meanings of occupations is important for occupational therapy as a health care profession. It was equally recommended that the subsequent researches should include explorations of the relationship between occupation and development, how occupation changes over the lifespan, how people organize and engage in their daily occupations, as well as the personal and sociocultural meanings of occupation. ACKNOWLEDGEMENT AUTHORS: Hanne Kaae Kristensen & Kirsten Schultz Petersen JOURNAL: Scandinavian Journal of Occupational Therapy PUBLISHERS: Tylor & Francis Group URL: http://dx.doi.org/10.3109/11038128.2015.1083054	3	R 425.00
Patient Safety Strategies Targeted at Diagnostic Errors. Patient Safety Strategies Targeted at Diagnostic Errors. OVERVIEW It is apparent that missed, delayed or incorrect diagnosis can lead to inappropriate patient care, poor patient outcome and increased cost. An operational definition of diagnostic errors include diagnosis that are either unintentionally delayed, wrong or missed. This study was therefore a systematic review aimed at analysing evaluations of interventions to prevent diagnostic errors. Data for this research was however collected through searches from MEDLINE (1966 to October 2012), the Agency for Healthcare Research and Quality’s Patient Safety Network, bibliographies, and prior systematic reviews. During the study, two independent reviewers extracted study data and rated study quality. There were 109 studies that addressed 1 or more interventions such as personnel changes. The interventions included educational interventions, technique, structured process changes, technology-based systems interventions as well as review methods. However, evidence seemed strongest for technology-based systems (e.g., text message alerting) as well as specific techniques like testing equipment adaptations. ACKNOWLEDGEMENT AUTHOR: Kathryn M. McDonald MM, Brian Matesic BS, Despina G. Contopoulos-Ioannidis MD, Julia Lonhart BS BA, Eric Schmidt BA, Noelle Pineda BA, and John P.A. Ioannidis MD DSc JOURNAL: Annals of Internal Medicine PUBLISHER: ACP URL: https://www.acponline.org/	Patient Safety Strategies Targeted at Diagnostic Errors. Course Detail Patient Safety Strategies Targeted at Diagnostic Errors. R 400.00 \| 3 CEUs Add to Cart Online Course OVERVIEW It is apparent that missed, delayed or incorrect diagnosis can lead to inappropriate patient care, poor patient outcome and increased cost. An operational definition of diagnostic errors include diagnosis that are either unintentionally delayed, wrong or missed. This study was therefore a systematic review aimed at analysing evaluations of interventions to prevent diagnostic errors. Data for this research was however collected through searches from MEDLINE (1966 to October 2012), the Agency for Healthcare Research and Quality’s Patient Safety Network, bibliographies, and prior systematic reviews. During the study, two independent reviewers extracted study data and rated study quality. There were 109 studies that addressed 1 or more interventions such as personnel changes. The interventions included educational interventions, technique, structured process changes, technology-based systems interventions as well as review methods. However, evidence seemed strongest for technology-based systems (e.g., text message alerting) as well as specific techniques like testing equipment adaptations. ACKNOWLEDGEMENT AUTHOR: Kathryn M. McDonald MM, Brian Matesic BS, Despina G. Contopoulos-Ioannidis MD, Julia Lonhart BS BA, Eric Schmidt BA, Noelle Pineda BA, and John P.A. Ioannidis MD DSc JOURNAL: Annals of Internal Medicine PUBLISHER: ACP URL: https://www.acponline.org/	3	R 400.00
Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis. Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis. OVERVIEW The objective of this study was to analyse the impact of placebo effects on outcome in trials of selected minimally invasive procedures and to assess reported adverse events in both trial arms. The design for this study was nonetheless a systematic review and meta-analysis. The data for this study was selected by searching MEDLINE and Cochrane library so as to identify systematic reviews of musculoskeletal, neurological and cardiac conditions that were published between January 2009 and January 2014 comparing selected minimally invasive with placebo (sham) procedures. During this research, effect sizes (ES) in the active and placebo arms in the trials’ primary and pooled secondary end points were calculated. The association between end points in the active and sham groups were nevertheless analysed using the linear regression. This study was however concluded that the generally small differences in ES between active treatment and sham suggest that nonspecific mechanisms, including placebo, are major predictors of the observed effects ACKNOWLEDGEMENT AUTHOR: Robin Holtedahl, Jens Ivar Brox, Ole Tjomsland JOURNAL: Stroke and Vascular Neurology PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com/	Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis. Course Detail Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis. R 375.00 \| 3 CEUs Add to Cart Online Course OVERVIEW The objective of this study was to analyse the impact of placebo effects on outcome in trials of selected minimally invasive procedures and to assess reported adverse events in both trial arms. The design for this study was nonetheless a systematic review and meta-analysis. The data for this study was selected by searching MEDLINE and Cochrane library so as to identify systematic reviews of musculoskeletal, neurological and cardiac conditions that were published between January 2009 and January 2014 comparing selected minimally invasive with placebo (sham) procedures. During this research, effect sizes (ES) in the active and placebo arms in the trials’ primary and pooled secondary end points were calculated. The association between end points in the active and sham groups were nevertheless analysed using the linear regression. This study was however concluded that the generally small differences in ES between active treatment and sham suggest that nonspecific mechanisms, including placebo, are major predictors of the observed effects ACKNOWLEDGEMENT AUTHOR: Robin Holtedahl, Jens Ivar Brox, Ole Tjomsland JOURNAL: Stroke and Vascular Neurology PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com/	3	R 375.00
Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models. Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models. OVERVIEW The three types of peer review models mostly operated by scholarly journals include single blind, where the reviewers know the identity of the authors but not vice versa; open peer review, where authors and reviewers both know each other’s identity, and finally, the double-blind peer review where the author and reviewer names are both blinded. The objective of this research was to assess whether reports from reviewers recommended by authors show a bias in quality and recommendation for editorial decision, compared with reviewers suggested by other parties, and whether reviewer reports for journals operating on open or single-blind peer review models differ about report quality and reviewer recommendations. The design of this study was nonetheless, a retrospective analysis of the quality of reviewer reports using an established Review Quality Instrument, and analysis of reviewer recommendations and author satisfaction surveys. The samples used for this research were two hundred reviewer reports submitted to BMC Infectious Diseases, 200 reviewer reports submitted to BMC Microbiology and 400 reviewer reports submitted to the Journal of Inflammation. ACKNOWLEDGEMENT AUTHORS: Maria K Kowalczuk, Frank Dudbridge, Shreeya Nanda, Stephanie L Harriman, Jigisha Patel, Elizabeth C Moylan JOURNAL: Communication Research PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com	Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models. Course Detail Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models. R 355.00 \| 3 CEUs Add to Cart Online Course OVERVIEW The three types of peer review models mostly operated by scholarly journals include single blind, where the reviewers know the identity of the authors but not vice versa; open peer review, where authors and reviewers both know each other’s identity, and finally, the double-blind peer review where the author and reviewer names are both blinded. The objective of this research was to assess whether reports from reviewers recommended by authors show a bias in quality and recommendation for editorial decision, compared with reviewers suggested by other parties, and whether reviewer reports for journals operating on open or single-blind peer review models differ about report quality and reviewer recommendations. The design of this study was nonetheless, a retrospective analysis of the quality of reviewer reports using an established Review Quality Instrument, and analysis of reviewer recommendations and author satisfaction surveys. The samples used for this research were two hundred reviewer reports submitted to BMC Infectious Diseases, 200 reviewer reports submitted to BMC Microbiology and 400 reviewer reports submitted to the Journal of Inflammation. ACKNOWLEDGEMENT AUTHORS: Maria K Kowalczuk, Frank Dudbridge, Shreeya Nanda, Stephanie L Harriman, Jigisha Patel, Elizabeth C Moylan JOURNAL: Communication Research PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com	3	R 355.00
Systematic review of prognostic models for recurrent venous thromboembolism (VTE) post-treatment of first unprovoked VTE. Systematic review of prognostic models for recurrent venous thromboembolism (VTE) post-treatment of first unprovoked VTE. OVERVIEW Venous thromboembolism (VTE) is a chronic condition with estimated incidence at 1 per 1000 person years. In fact, it is the third most common cardiovascular disease after heart attack. This condition often presents as deep vein thrombosis (DVT), with some patients suffering an embolism in the lungs known as a pulmonary embolism. Therefore, the objective of this study was to review studies developing or validating a prognostic model for individual venous thromboembolism (VTE) recurrence risk following cessation of therapy for a first unprovoked VTE0. This review basically aims at determining whether reliable prognostic models exist and, if not, what further research is needed within the field. For this study, bibliographic databases including MEDLINE, EMBASE and the Cochrane Library were searched using index terms relating to the clinical field and prognosis.by the end of the study, 3 unique prognostic models were identified including the HERDOO2 score, Vienna prediction model and DASH score. ACKNOWLEDGEMENT AUTHORS: Joie Ensor, Richard D Riley, David Moore, Kym E Snell, Susan Bayliss, David Fitzmaurice JOURNAL: BMJ Open PUBLISHER: BMJ Gourp URL: http://bmjopen.bmj.com	Systematic review of prognostic models for recurrent venous thromboembolism (VTE) post-treatment of first unprovoked VTE. Course Detail Systematic review of prognostic models for recurrent venous thromboembolism (VTE) post-treatment of first unprovoked VTE. R 325.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Venous thromboembolism (VTE) is a chronic condition with estimated incidence at 1 per 1000 person years. In fact, it is the third most common cardiovascular disease after heart attack. This condition often presents as deep vein thrombosis (DVT), with some patients suffering an embolism in the lungs known as a pulmonary embolism. Therefore, the objective of this study was to review studies developing or validating a prognostic model for individual venous thromboembolism (VTE) recurrence risk following cessation of therapy for a first unprovoked VTE0. This review basically aims at determining whether reliable prognostic models exist and, if not, what further research is needed within the field. For this study, bibliographic databases including MEDLINE, EMBASE and the Cochrane Library were searched using index terms relating to the clinical field and prognosis.by the end of the study, 3 unique prognostic models were identified including the HERDOO2 score, Vienna prediction model and DASH score. ACKNOWLEDGEMENT AUTHORS: Joie Ensor, Richard D Riley, David Moore, Kym E Snell, Susan Bayliss, David Fitzmaurice JOURNAL: BMJ Open PUBLISHER: BMJ Gourp URL: http://bmjopen.bmj.com	3	R 325.00
Understanding quit decisions in primary care: a qualitative study of older GPs Understanding quit decisions in primary care: a qualitative study of older GPs OVERVIEW The UK, notably England faces a major and imminent problem in respect of general practitioner (GP) workforce capacity. According to a recent work survey, 54.1% of GPs aged 50 years and older reported a ‘considerable’ or ‘high’ likelihood of quitting direct patient care within 5 years. The objective of this study was to investigate the reasons behind intentions to quit direct patient care among experienced general practitioners (GPs) aged 50–60 years. This research was a qualitative study based on semi structured interviews with GPs in the South West region of England. The participants for this study were 23 GPs aged 50–60 years. 3 of these GPs had retired from direct patient care before the age of 60, meanwhile 20 intended to quit direct patient care within the next 5 years. Conclusively, this research highlights aspects of the current professional climate for GPs that are having an impact on retirement decisions. ACKNOWLEDGEMENT AUTHORS: Anna Sansom, Raff Calitri, Mary Carter, John Campbell JOURNAL: Journal of General Practice PUBLISHER: BMJ Group URL: http://bmjopen.bmj.com	Understanding quit decisions in primary care: a qualitative study of older GPs Course Detail Understanding quit decisions in primary care: a qualitative study of older GPs R 360.00 \| 3 CEUs Add to Cart Online Course OVERVIEW The UK, notably England faces a major and imminent problem in respect of general practitioner (GP) workforce capacity. According to a recent work survey, 54.1% of GPs aged 50 years and older reported a ‘considerable’ or ‘high’ likelihood of quitting direct patient care within 5 years. The objective of this study was to investigate the reasons behind intentions to quit direct patient care among experienced general practitioners (GPs) aged 50–60 years. This research was a qualitative study based on semi structured interviews with GPs in the South West region of England. The participants for this study were 23 GPs aged 50–60 years. 3 of these GPs had retired from direct patient care before the age of 60, meanwhile 20 intended to quit direct patient care within the next 5 years. Conclusively, this research highlights aspects of the current professional climate for GPs that are having an impact on retirement decisions. ACKNOWLEDGEMENT AUTHORS: Anna Sansom, Raff Calitri, Mary Carter, John Campbell JOURNAL: Journal of General Practice PUBLISHER: BMJ Group URL: http://bmjopen.bmj.com	3	R 360.00
What Drives Quality Improvement in Chronic Kidney Disease in Primary Care. What Drives Quality Improvement in Chronic Kidney Disease in Primary Care. OVERVIEW Chronic kidney disease (CKD) is increasingly becoming a public health issue because it’s very common. More so, CKD is an established, independent risk factor for cardiovascular disease and there are indications that a significant number of patients with CKD die from cardiovascular complications than progress to end-stage kidney disease. This study was process of evaluating the Quality Improvement in Chronic Kidney Disease (QICKD) study, comparing audit-based education (ABE) and sending clinical guidelines and prompts (G&P) with usual practice, in improving systolic blood pressure control in primary care. This study however took place in 4 primary care practices in England (2received ABE, and 2 G&P). The participants of this study were focus groups conducted with staff from each of the 4 primary care practices. Based on results of the study, it was concluded that improving quality in CKD is complex. The results also indicated that lack of awareness of clinical guidelines and scepticism about their validity are barriers to change. ACKNOWLEDGEMENT AUTHORS: Akin Nihat, Simon de Lusignan, Nicola Thomas, Mohammad Aumran Tahir, Hugh Gallagher JOURNAL: General Practice PUBLISHER: BMJ Open URL: http://www.bmjopen.bmj.com/	What Drives Quality Improvement in Chronic Kidney Disease in Primary Care. Course Detail What Drives Quality Improvement in Chronic Kidney Disease in Primary Care. R 365.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Chronic kidney disease (CKD) is increasingly becoming a public health issue because it’s very common. More so, CKD is an established, independent risk factor for cardiovascular disease and there are indications that a significant number of patients with CKD die from cardiovascular complications than progress to end-stage kidney disease. This study was process of evaluating the Quality Improvement in Chronic Kidney Disease (QICKD) study, comparing audit-based education (ABE) and sending clinical guidelines and prompts (G&P) with usual practice, in improving systolic blood pressure control in primary care. This study however took place in 4 primary care practices in England (2received ABE, and 2 G&P). The participants of this study were focus groups conducted with staff from each of the 4 primary care practices. Based on results of the study, it was concluded that improving quality in CKD is complex. The results also indicated that lack of awareness of clinical guidelines and scepticism about their validity are barriers to change. ACKNOWLEDGEMENT AUTHORS: Akin Nihat, Simon de Lusignan, Nicola Thomas, Mohammad Aumran Tahir, Hugh Gallagher JOURNAL: General Practice PUBLISHER: BMJ Open URL: http://www.bmjopen.bmj.com/	3	R 365.00
Zika Virus Outbreak in Rio de Janeiro, Brazil. Zika Virus Outbreak in Rio de Janeiro, Brazil. OVERVIEW Brazil was faced with the cocirculation of three above viruses of major public health importance in the year 2015. The emergence of the Zika (ZIKV) virus however brought about serious public health challenges to both public health authorities and clinicians. It is however imperative to note that clinical features between diseases caused ZIKV, Dengue (DENV) and Chikungunya (CHIKV) as well as the lack of validated serological assays for ZIKV makes accurate diagnosis difficult. This article was therefore the firs published description of the outbreak of Zika virus in Latin America. Recent findings about Zika virus suggest that in a minority of ZIKV cases, neurological diseases can develop and that babies born from mothers with a ZIKV-illness during pregnancy could suffer from congenital abnormalities such as a small brain or a small head. After analysing the virus, it was then suggested that the clinical characteristics of both the confirmed and the unconfirmed cases proved to be very similar. ACKNOWLEDGEMENT AUTHORS: Patricia Brazil et al JOURNAL: PLOS Negleted Tropical Disease PUBLISHER: PLOS URL: http://journals.plos.o	Zika Virus Outbreak in Rio de Janeiro, Brazil. Course Detail Zika Virus Outbreak in Rio de Janeiro, Brazil. R 375.00 \| 3 CEUs Add to Cart Online Course OVERVIEW Brazil was faced with the cocirculation of three above viruses of major public health importance in the year 2015. The emergence of the Zika (ZIKV) virus however brought about serious public health challenges to both public health authorities and clinicians. It is however imperative to note that clinical features between diseases caused ZIKV, Dengue (DENV) and Chikungunya (CHIKV) as well as the lack of validated serological assays for ZIKV makes accurate diagnosis difficult. This article was therefore the firs published description of the outbreak of Zika virus in Latin America. Recent findings about Zika virus suggest that in a minority of ZIKV cases, neurological diseases can develop and that babies born from mothers with a ZIKV-illness during pregnancy could suffer from congenital abnormalities such as a small brain or a small head. After analysing the virus, it was then suggested that the clinical characteristics of both the confirmed and the unconfirmed cases proved to be very similar. ACKNOWLEDGEMENT AUTHORS: Patricia Brazil et al JOURNAL: PLOS Negleted Tropical Disease PUBLISHER: PLOS URL: http://journals.plos.o	3	R 375.00

ETHICS & OTHER FEATURED COURSES

Denial of abortion in legal settings.

R 420.00

Denial of abortion in legal settings.

Ebola Virus Disease: Clinical Review.

R 400.00

Ebola Virus Disease: Clinical Review.

Efficacy of Internet-delivered

R 390.00

Efficacy of Internet-delivered

First Aid Course.

R 330.00

First Aid Course.

How Does Physical Activity Intervention Improve

R 410.00

How Does Physical Activity Intervention Improve

Medical Ethics: A Private Right Called Bill.

R 400.00

Medical Ethics: A Private Right Called Bill.

Medical Ethics: Challenges in Expanding Access to

R 455.00

Medical Ethics: Challenges in Expanding Access to

Medical Ethics: Communication in the Doctor

R 350.00

Medical Ethics: Communication in the Doctor

Medical Ethics: Decision Making in a Professional

R 350.00

Medical Ethics: Decision Making in a Professional

Medical Ethics: Ethics of the Placebo in Clinical

R 425.00

Medical Ethics: Ethics of the Placebo in Clinical

Medical Ethics: Healthcare Professional’s Patient

R 420.00

Medical Ethics: Healthcare Professional’s Patient

Medical Ethics: How parents and practitioners

R 460.00

Medical Ethics: How parents and practitioners

Medical Ethics: Medical Students’ Perspectives on

R 425.00

Medical Ethics: Medical Students’ Perspectives on

Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study

Course Detail

Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study

Commensal bacteria produce GPCR ligands that mimic human signalling molecules

Course Detail

Commensal bacteria produce GPCR ligands that mimic human signalling molecules

A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma

Course Detail

A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma

Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis

Course Detail

Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis

QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient

Course Detail

QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient

Ebolaviruses: New roles for old proteins

Course Detail

Ebolaviruses: New roles for old proteins

Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas

Course Detail

Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas

Advances in Pharmacotherapy of Tuberculosis

Course Detail

Advances in Pharmacotherapy of Tuberculosis

Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s).

Course Detail

Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s).

The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery

Course Detail

The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery

Attempts to grow human noroviruses, a sapovirus, and a bovine norovirus in vitro

Course Detail

Attempts to grow human noroviruses, a sapovirus, and a bovine norovirus in vitro

Structure and assembly of the Ebola virus nucleocapsid

Course Detail

Structure and assembly of the Ebola virus nucleocapsid

Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

Course Detail

Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein

Course Detail

Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein

Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview

Course Detail

Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview

Atezolizumab: feasible second-line therapy for patients with non-small cell lung cancer? A review of efficacy, safety and place in therapy

Course Detail

Atezolizumab: feasible second-line therapy for patients with non-small cell lung cancer? A review of efficacy, safety and place in therapy

Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population

Course Detail

Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population

Sensitivity and specificity of CT scan in revealing skull fracture in medico-legal head injury victims.

Course Detail

Sensitivity and specificity of CT scan in revealing skull fracture in medico-legal head injury victims.

Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.

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Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.

Medical tourism.

Course Detail

Medical tourism.

Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations.

Course Detail

Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations.

Suicide in Pretoria: A retrospective review, 2007 - 2010.

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Suicide in Pretoria: A retrospective review, 2007 - 2010.

Sensitivity of plain radiography for pediatric cervical spine injury.

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Sensitivity of plain radiography for pediatric cervical spine injury.

Application of cervical collars – An analysis of practical skills of professional emergency medical care providers.

Course Detail

Application of cervical collars – An analysis of practical skills of professional emergency medical care providers.

A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa.

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A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa.

Effectiveness of multidisciplinary team case management: difference-indifferences analysis.

Course Detail

Effectiveness of multidisciplinary team case management: difference-indifferences analysis.

How often are interventions in cluster randomised controlled trials of complex interventions in general practices effective and reasons for potential shortcomings? Protocol and results of a feasibility project for a systematic review.

Course Detail