Month: October 2024

Bedside Interdisciplinary Rounds Boost Satisfaction for Both Patients and Providers

Photo by RDNE Stock project

A study led by researchers at the University of Colorado Anschutz Medical Campus reveals that both patients and providers have more positive overall care experiences when the entire healthcare team is a part of bedside interdisciplinary rounds (BIDR).

The findings showed that BIDR, when the team meets at a patients’ bedside in the hospital to discuss care plans, helps build trust between patients and their healthcare providers and within healthcare teams by allowing everyone to observe and work together more closely. The study is out now in the Journal of General Internal Medicine.

“Traditional interdisciplinary rounds (IDR) consist of a clinical care team that coordinates a patient’s care together to help promote collaboration in hospitals. BIDR takes this process a step further by taking the team to the bedside and involving patients and their families,” said lead author Katarzyna Mastalerz, MD, associate professor of hospital medicine at University of Colorado School of Medicine. “BIDR transforms this traditional healthcare model by fostering trust through transparent communication, team collaboration and patient-centred care where every voice is heard, and every goal can be shared.”

 The study interviewed 14 patients and 18 members of a interdisciplinary teams that included nurses, pharmacists and care coordinators.

Patients who participated in BIDR expressed positive feelings about being involved in their healthcare plans, which enhanced their trust in providers. Healthcare professionals reported improved respect and trust among colleagues, which contributed to better patient care.

While results were mostly promising, patients and providers said there is room for improvement to make the process more streamlined.

For example, some patients reported being uncomfortable due to the use of technical jargon and unclear communication regarding their treatment plans. Meanwhile, the providers said they faced challenges related to lack of supportive structures for interprofessional collaboration and lengthy presentations by physicians.

“To build effective BIDR, we suggest healthcare teams use transparency by sharing goals with patients, employing accessible patient-centred language, clearly delineating team roles for each team member, and actively addressing team input in real time” said Mastalerz. “With the professional siloes and hectic workflow that often characterise hospitals, it’s especially important for hospital leadership to recognise, support, and create opportunities for collaborative work by interprofessional teams.”

Source: University of Colorado Anschutz Medical Campus

The New RSV Vaccine is Effective – But Uptake is Low

Creative artwork featuring 3D renderings of respiratory syncytial virus (RSV)—a common contagious virus that infects the human respiratory tract – colourised as follows: (the viral envelope is purple, G- glycoproteins are light blue, and F-glycoproteins are orange). F-glycoproteins allow the virus to fuse with and infect human cells. Credit: NIAID/NIH

Since their introduction last year, researchers have been monitoring the real-world impact of the new respiratory syncytial virus (RSV) vaccines. In a recent commentary in The Lancet, Angela Branche, MD, an infectious diseases researcher at the University of Rochester Medical Center (URMC), details what has been learned during the vaccine’s first season.

“The evidence is clear; individuals should get vaccinated if they have conditions that place them at risk for severe disease. For older adults and those with chronic conditions, RSV should be considered as serious as the flu, and they should get vaccinated,” said Branche.

RSV is a significant cause of severe respiratory illness among older adults, especially those with underlying health conditions. Worldwide, RSV causes millions of infections, hundreds of thousands of hospitalisations, and tens of thousands of deaths annually in adults aged 60 and older. Older people with RSV are at higher risk of severe illness compared to those with influenza or COVID.

In 2023, the FDA approved three RSV vaccines for older adults. Studies have shown these vaccines to be effective, with the Pfizer, GSK, and Moderna vaccines preventing RSV pneumonia and bronchitis in more than 80% of participants.

A recent study published in The Lancet assessed the effectiveness of RSV vaccines using data from a large electronic health record network involving the Centers for Disease Control and Prevention (CDC) and multiple US healthcare systems. The study found that RSV vaccines were 80% effective in preventing hospitalisation, ICU admission, and death among adults aged 60 and older. Vaccine effectiveness was consistent across age groups, including those 75 and older, and among immunocompromised individuals. The study did not find evidence of waning vaccine protection within the season.

The uptake of the RSV vaccine in the 2023-2024 winter season was low, however. An estimated 24% of US adults aged 60 years and older received the vaccine, compared to influenza vaccination rates, which approach 50% each year for the same group. “Providers were not sure how to apply the shared clinical decision-making recommendations in the first season, and there remains a general lack of knowledge among the medical community and the public on what constitutes a risk for severe disease and who needs to be protected,” said Branche.

Based on these findings, the US Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts that advises the CDC, updated guidelines in June 2024 to recommend RSV vaccination for all adults aged 75 and older, those 60 and older in long-term care facilities or with chronic and high-risk health conditions.

“This new data enabled the ACIP to make more definitive recommendations, which will build public confidence in the effectiveness of these vaccines and make implementation a lot easier for providers and pharmacies,” said Branche.

New research shows that vaccines that target multiple strains of the RSV virus, called bivalent vaccines, may provide longer protection. URMC infectious disease experts helped lead an international study of a bivalent RSV vaccine developed by Pfizer, the results of which were recently detailed in the New England Journal of Medicine. The vaccine effectively prevented severe RSV-related lower respiratory tract illnesses over two RSV seasons, with > 80% overall efficacy. The experimental vaccine was particularly effective in individuals aged 60-79.

Source: University of Rochester Medical Center

Highrises, Hellholes and Healthcare – Hillbrow’s Heritage Story

By Ufrieda Ho

Johannesburg’s first general hospital was built on the “brow of the hill” in 1890. The building is now abandoned and derelict. (Photo: Courtesy of WRHI)

Hillbrow started out as Johannesburg’s first health hub in the late 1880s. It’s also been a suburb associated with pimps and prostitution, a middle finger to the Nationalist Party, and a key site of the HIV crisis. Today, it’s the forgotten flatlands of inner city decay … but in small pockets it stays true to its heritage of bringing healthcare to the city’s most overlooked.

Putting some distance between people and disease can sometimes be a smart idea. It’s what early Johannesburg town planners had in mind when they decided that the city’s first hospital should rise on the “brow of the hill”, looking north away from the gold-flushed, but malady-stricken, mining centre.

Johannesburg’s first general hospital opened in 1890. It was four years after Johannesburg was proclaimed a city under the Transvaal government with Paul Kruger at its head. With the hospital as an anchor in the suburb, Hillbrow would grow to become the health node of the city as it rushed into the new century with heady intentions to become a modern metropolis.

The Johannesburg General Hospital would treat miners arriving with crushed limbs and broken bodies from mining accidents, which were frequent. Other patients were admitted with respiratory illnesses and ruined lungs from breathing in silica dust as the angled reef under the Witwatersrand was drilled and crudely blasted for its yellow treasure.

From the shanties and old mining camps came those burdened with diseases of absent hygiene and sanitation and overcrowding. Typhoid, tuberculosis (TB) and dysentery were common. There would be malaria and smallpox. In 1905, the Rand Plague Committee published a report detailing outbreaks of pneumonic plague and bubonic plague in those first years of the new century. There would be waves of influenza as the “Spanish Flu” of 1918 swept through the country.

Author of Johannesburg Then and Now Marc Latilla writes that the first Johannesburg hospital located in Hillbrow was described as “lofty with handsome fireplaces”. He writes that the hospital had 130 beds for black and white patients. More wards would come with expansion plans, but so would racially segregated healthcare. By 1895, a separate wing would be built for black patients.

Tumult and gold fever

The new city was being constructed against a backdrop of tumult and gold fever. Social tensions, divisions, and politics were also always in play. In 1896, there would be the abortive Jameson Raid, an insurgency meant to usurp Kruger’s government. The raid failed but it would ratchet up tensions between the Afrikaners and the British till the outbreak of the South African War in 1899. The war continued till 1902. By the end of the decade, in 1910, the country would become a union, uniting the four old colonies of South Africa. In another four years, World War I would break out.

Medical and health historian Professor Catherine Burns, of the University of Johannesburg’s Department of Historical Studies, says a more textured history reveals a story of whose health priorities ranked higher in the young city.

Joburg’s first medical officer of health, Dr Charles Porter, arrived from Scotland and he would have looked at Johannesburg framed against his Glaswegian childhood. “He would have encountered Johannesburg mining slums with Glasgow on his mind – seeing the conditions of crippled children and terrible miasmas; and an atmosphere of steam and filth as people staggered from the mines,” says Burn.

But importing a system of healthcare would have its limitations. Burns points out that even as the Johannesburg General Hospital would count as modern advancement for medicine, the melting pot of people drawn to early Joburg brought with them vastly different beliefs on healing, on warding off sickness, and the meaning of wellness.

 “Throughout the city – even today – we see the venerable men and women who seek out hilltops and high places to perform the rituals and prayers of healing and wellbeing. And of course many of these spots are in Hillbrow or Yeoville. It means we can’t flatten everything, ignoring the layers upon layers of health history in the city,” she says.

The melting pot was growing and “Hospital Hill” with it. The early part of the new century would see the establishment of facilities for nurses’ accommodation, a fever hospital, a children’s hospital, a mortuary, an operating theatre, nursing homes, maternity hospitals, medical research facility and a medical school. Most ominous was the establishment of the “non-European” hospital built to further entrench racially segregated healthcare.

Kathy Munro, emeritus professor and heritage expert with the Johannesburg Heritage Foundation, says of particular significance was that the first Johannesburg hospital was built on state owned land and with the intention of service. These were the nascent ideals of a public health service for the city. The hospital was run by the Catholic Church’s Holy Family Sisters until 1915.

The front and back view of Johannesburg's first general hospital, featuring the prominent laundry chutes that spiralled down the building.
The front and back view of Johannesburg’s first general hospital, featuring the prominent laundry chutes that spiralled down the building. (Photo: Ufrieda Ho/Spotlight)

Munro says: “You then had a clustering of private hospitals like the Florence Nightingale, the Colin Gordon and the Lady Dudley Gordon around the state hospital complex that ran from the top of the hill to the bottom. The South African Medical Research Institute, founded in 1912 and housed in a fine Herbert Baker building, also came up along Hospital Road.

“The health authorities would have had to deal with the fragmentation in society and the separated services for the Non-European hospital and a whites-only hospital,” she says.

By the time apartheid was written into the statute book with the Nationalist Party coming to power in 1948, Munro says segregation would further shape the distribution of medical services in the city in the way Wits University had to deploy its medical students across the city.

“One of the inadvertent consequences of the apartheid system was that the university’s medical faculty had to service many hospitals that were fragmented on the basis of race. But it also meant that more specialist professors in each discipline came to be stationed at these hospitals,” she says.

By the mid-1960s and the 1970s, Hillbrow as a health hub shifted. The new Johannesburg General Hospital – now Charlotte Maxeke Academic Hospital – would rise as a concrete hulk in Parktown in 1978 and the original Johannesburg Hospital was renamed the Hillbrow Hospital.

In these decades, Hillbrow also became the flatlands made up of residential highrises, distinct from the rest of suburbia. Its residents were mostly young European expat professionals, recruited to work in a South Africa that was in an era of economic boom. According to The Joburg Book, edited by Dr Nechama Brodie, the new arrivals from Europe boosted the white population in the country by 50% between 1963 and 1972.

Hillbrow was now a high density suburb with different pressures on health services. It was also a suburb, Brodie writes, that “acquired a cosmopolitan Bohemian character … and nurtured a subculture that incorporated elements of ‘swinging London’ and America’s hippie culture”.

Under the two iconic city landmarks of Ponte Towers and the Hillbrow Tower (Telkom Tower), Hillbrow was an unbounded playground, freer from the hang-ups of racial segregation and largely managing to evade the heavy hand of apartheid-era law enforcers and morality policing.

But by the mid-1980s, South Africa was in various States of Emergency and Hillbrow changed once again. White flight came on fast as more black people moved from the townships to Hillbrow, which was central, affordable and also anonymous. Hillbrow’s slide to urban decline came at the same time as the anxious steps towards democracy. Landlords absconded; the city council failed on upkeep, maintenance, and bylaw enforcement. Banks redlined the area, leaving Hillbrow to become an urban slum.

Professor Helen Rees, founder and executive director of the Wits Reproductive Health and HIV Institute (WRHI), picks up the story from the mid-1990s. She says: “I had set up the Institute in 1994 and it was at the same time when HIV was just exploding. We started out in Soweto but worked with a public clinic dedicated to treating sexually transmitted infections (STIs) on Esselen Street in Hillbrow.

“I remember one morning when I got to the clinic the queue stretched around the corner, with about 100 people waiting. Of course, what we hadn’t appreciated fully was that HIV was driving up the level of STIs hugely,” she says.

Hillbrow’s population included groups not easy to link to and retain on care. They were young people, migrants and sex workers. It was enlarging the HIV challenge, Rees says.

Rees didn’t baulk. She doubled down and decided that the WRHI should be located in Hillbrow, right next to the Esselen Street Clinic, one of the first clinics in the country to offer HIV testing.

Staying in Hillbrow means the WRHI has to invest in infrastructure, to have back-up for basics like water supply, generators, and security. These things are needed if the institute is to function as a global leader of science, innovation and research in fields like infectious and vaccine preventable diseases, sexual and reproductive health, antimicrobial resistance, and health in a time of climate change.

The Institute was involved in COVID-19 vaccine trials, studies of the CAB-LA HIV prevention injection, and now they are involved in research on Mpox vaccines and on trials of the experimental M72 tuberculosis vaccine.

WRHI sits at the heart of that which survives of the Hillbrow health precinct. The Shandukani Centre for Maternal and Child Health that opened to the public in 2012 is also here. Other WRHI facilities include a clinic for sex workers as well as a clinic for transgender people. Their neighbours are the Esselen Street Clinic, that endures in the distinctive Wilhelm B Pabst designed building from 1941, and the Hillbrow Clinic, that runs a 24-hour service. Along Hospital Street, the forensic pathology and national laboratory services still function.

Throbbing to a different pulse

But beyond the WRHI’s electric fencing and street corners monitored by private security, much of Hillbrow life throbs to a different pulse. Most noticeable is that one of the WRHI’s immediate neighbours is the condemned building of the one-time Florence Nightingale Maternity Hospital. The building is now a so-called dark building, simply not considered fit for life. The first Johannesburg Hospital stands derelict and abandoned, as does the chapel and the house the Catholic nursing sisters lived in when they tended to patients in the hospital.

And the Hillbrow streets live up to much of its bad reputation. It’s overcrowded with people and garbage. Drug users curl up slumped against urine-soaked concrete benches as hawkers are forced to retrieve water from the city’s smashed water pipes and it seems every bylaw is ignored.

Rees is clear though that WRHI, which marks its 30-year anniversary this year, is exactly where it needs to be. She says the coming needs for healthcare globally will focus on healthcare in slums and healthcare on society’s periphery because more people’s lives are precarious and more people will call slums home.

“The work we do is defined by the context and the needs of the population. But we have created a hugely professional context and run a state of the art institute,” she says. “You cannot do clinical research for the things that affect the majority of communities unless you’re actually working in those communities.”

It means some of WHRI’s budget does go into fixing things in their neighbours’ buildings – repairing pipes or cleaning up backyards turned to garbage dumps. It’s not technically their responsibility but it is a response that helps them remain a relevant and durable pillar. And in a place like Hillbrow, where so many people survive by transience and invisibility, something that holds firm a little longer can make a big difference.

Note: This article is part of a Spotlight special series on the history and ongoing relevance of several old hospitals in South Africa. Not only do we find the stories of these places fascinating, we think they provide valuable cultural and historical context for healthcare services today. Previously we wrote about Brooklyn Chest HospitalValkenberg Psychiatric HospitalMowbray Maternity Hospital, and Sizwe Tropical Diseases Hospital.

Republished from Spotlight under a Creative Commons licence.

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New Discovery could Treat a Rare, Severe Form of Amyloidosis

Photo by National Cancer Institute on Unsplash

In people with a rare condition called light chain amyloidosis, light chain proteins – which are a component of antibodies – mutate and build up in different organs. In new research published in The FEBS Journal, investigators have identified and characterised an antibody fragment that can bind to abnormal light chains to stabilise them and prevent their aggregation.

The findings could have an important clinical impact because the current prognosis for individuals with light chain amyloidosis is extremely poor, and current treatments, which rely on attacking the defective light chain–producing cells, are difficult to tolerate.

The results may also be applicable to other forms of amyloidosis, including Alzheimer’s disease.

“We are excited by this finding, which has potential to provide a much-needed treatment for people diagnosed with light chain amyloidosis,” said corresponding author Jillian Madine, PhD, of the University of Liverpool, in the UK.

Source: Wiley

Can Metabolic-bariatric Surgery help Prevent Pancreatic Cancer in Obesity?

Sleeve gastrectomy. Credit: Scientific Animations CC4.0

Obesity and type 2 diabetes are risk factors for various malignancies, including pancreatic cancer, which has a high death rate. A new analysis in Diabetes/Metabolism Research and Reviews suggests that metabolic-bariatric surgery may lower the risk of developing pancreatic cancer in people with obesity, especially in those who also have type 2 diabetes.

In the systematic review and meta-analysis, investigators identified 12 relevant studies that explored the effects of metabolic-bariatric surgery on pancreatic cancer incidence, with a total of 3 711 243 adults with obesity. Surgery was associated with a 44% reduction in pancreatic cancer risk among individuals with obesity but without type 2 diabetes and a 79% risk reduction in those with both obesity and type 2 diabetes.

“Metabolic-bariatric surgery not only has beneficial effects on obesity and type 2 diabetes but also may play a crucial role in reducing the risk of pancreatic cancer in these individuals,” said corresponding author Angeliki M. Angelidi, PhD, of the Broad Institute of MIT and Harvard. “These findings underscore the need for further research to elucidate the underlying mechanisms and understand the full spectrum of health benefits of metabolic-bariatric surgery beyond weight loss.”

Source: Wiley

A Diabetes Drug may Reduce Depression Symptoms

Photo by Sydney Sims on Unsplash

Research using animal models has shown that the diabetes drug dulaglutide, which is a glucagon-like peptide-1 (GLP-1) receptor agonist, may reduce symptoms of depression. A new study published in Brain and Behavior reveals the mechanisms that are likely involved.

By conducting a range of tests in mice treated with and without dulaglutide, investigators confirmed the effects of dulaglutide on depressive-like behaviours, and they identified 64 different metabolites and four major pathways in the brain associated with these effects.

Markers of depression and the antidepressant effects of dulaglutide were linked to lipid metabolism, amino acid metabolism, energy metabolism, and tryptophan metabolism.

“These primary data provide a new perspective for understanding the antidepressant-like effects of dulaglutide and may facilitate the use of dulaglutide as a potential therapeutic strategy for depression,” the authors wrote.

Source: Wiley

Alarming Rise in HIV among Drug Users as Government Fails to Implement Policy

Needle programs are officially supported, but the state often obstructs them

Photo by Raghavendra V Konkathi on Unsplash

By Jesse Copelyn

Rates of HIV and Hepatitis C are “extremely high” among people who inject illicit drugs, according to new research by TB HIV Care. The organisation tested over 1200 injecting drug users in Tshwane, eThekwini, Mashishing and Mbombela (formerly Nelspruit).

In Tshwane 72% tested positive for HIV and nearly 90% had antibodies for hepatitis C virus (HCV), which could indicate past or present infection.

HCV is a blood-borne virus which damages the liver. When left undiagnosed it can be fatal, though it’s usually curable if treated.

Less than half of those who tested positive for HIV in Tshwane were aware of their HIV status. As such they would not have been on treatment and could have been spreading the virus without knowing.

Survey SiteHIV Prevalence among people who inject drugsAntibodies for Hepatitis C among people who inject drugsShare of HIV positive people who knew their status
eThekwini49%75%76%
Mashishing45%41%77%
Mbombela30%91%64%
Tshwane72%89%48%
Results of the TB HIV Care survey of four cities.

People who inject drugs (such as heroin) are at a higher risk of contracting HIV and HCV when needles are shared – something which happens because drug users don’t have easy access to new ones.

This has long been a problem in South Africa and appears to be getting worse. Research conducted in eThekwini in 2013 found that 17% of injecting drug users were HIV-positive. According to the new research, a decade later the figure has nearly tripled to 49%.

Professor Harry Hausler, CEO of TB HIV Care and a former technical advisor to the National Department of Health on TB/HIV, believes the main reason for this “massive” uptick in blood-borne diseases among drug users is “the limited access to needle and syringe programs” in the country.

Government ignored its own solution

Research shows overwhelmingly that providing clean needles to drug users reduces the spread of HIV, not only by removing the need to share injecting equipment but often because needle programs offer other services such as health education and condoms.

large review published in 2017 identified 133 academic studies on needle and syringe programs (commonly known as NSP). The results were “supportive of the effectiveness of NSP in reducing HIV transmission among [people who inject drugs], as well as in reducing HCV infection, although the latter to a lesser extent”.

South Africa’s Drug Master Plan, government’s official policy document for managing illicit drug use, explicitly endorses needle and syringe programs, as does the National Strategic Plan on HIV, TB and STIs.

Yet despite these formal policy commitments, there is virtually no public funding for such interventions.

A person discards used needles in a specialised bin provided by TB HIV Care at a mobile clinic in Wynberg, Cape Town.

One exception is the Pretoria-based Community Oriented Substance Use Program, sponsored by the Tshwane Municipality. It has been left to non-profit groups, such as TB HIV Care, to provide these services. According to Hausler, the organisation currently provides clean needles to nearly 10 000 injecting drug users in Cape Town, Nelson Mandela Bay, eThekwini, Tshwane and Mbombela.

Users access needles from drop-in centres as well as mobile clinics – usually vans that get driven on set days to areas where injecting users congregate. Users discard their old needles in specialised bins provided by TB HIV Care. They will then receive a pack, which includes clean needles, alcohol swabs and sterile water.

Nurses are present at the mobile clinics so users can also get tested for HIV and HCV. They also offer ordinary medical services, such as cleaning and bandaging wounds.

Mobile clinics are also manned by psychosocial and human rights workers, and peer educators (people who were beneficiaries but now work for TB HIV Care) from whom users can get counselling or report abuses.

“We’re not just a needle provision organisation”, says Loraine Moses, who oversees quality standards for the program. “We’re a health services organisation”. Users have to register with peers and get health counselling and education before getting their needles, she says.

Beneficiaries have access to various amenities at TB HIV Care’s drop-in centres, including showers, lounging areas and washing machines.

Needle program as a first step to rehab

In many cases, needle and syringe programs also provide a first point of contact for people who want to stop using drugs.

Anthony (surname withheld), previously a heroin user for 15 years, who now volunteers for TB HIV Care, spoke to GroundUp at a drop-in centre in Cape Town.

“In the beginning, I started experimenting with friends in school [but] after my mother passed away, I found that there are those properties in [heroin] that calm you and numb pain, so that’s when I started to delve [into the drug] more.”

After ending up on the street and becoming “a slave to that drug”, he increasingly wanted to get sober. Fetching needles from a TB HIV Care site, he began speaking with one of the peers. The person told him about TB HIV Care’s opioid agonist program, which helps users to quit or reduce their heroin intake.

Opioid agonists are drugs which block heroin withdrawal. Methadone is the most widely known. Numerous clinical trials show that initiatives which offer methadone to heroin users over an extended period are more effective than rehab programs that force users to quit cold turkey.

Hausler says that TB HIV Care currently provides methadone to over 1100 people. Along with the medicine, they receive counselling and are assisted with finding shelter, and in some cases to reintegrate with their families.

Anthony says he’s been taking methadone since June last year. The program also helped him link up with a shelter and get an ID document so that he could find work.

“Being a client at TB HIV Care has helped me a lot to reintegrate back into society,” he says. “Being on the street, you lose a lot of yourself”.

A notice board at the TB HIV Care drop-in centre in central Cape Town.

Law enforcement continues to confiscate needles

Local governments have assisted TB HIV Care with some of its services. The City of Cape Town provides the HIV tests for use at mobile clinics, according to Hausler.

And yet, not only has the government failed to directly fund the sterile needle programs but in some cases it appears to work against them.

Research carried out by TB HIV Care shows that users frequently have their injecting equipment confiscated by law enforcement officers.

In Tshwane and eThekwini more than half of all people surveyed said that the authorities had seized or destroyed their needles at least once in the previous six months.

OutcomeMashishingMbombelaeThekwiniTshwane
No57%76%31%36%
Yes, In the last 6 months18%20%64%54%
Yes, but not in the last 6 months25%4%5%10%

Results of survey question: Have you ever had your needles and syringes confiscated or destroyed by a police officer/law enforcement? Source: TB HIV Care

“What’s very frustrating is that there are two arms of government,” says Hausler. “There’s health and then there’s police. And police are confiscating needles and syringes that we’ve been providing to clients – [even though what we’re doing] is a clearly endorsed health intervention.”

Hausler notes that in some cases the organisation has “really good alliances with local police”, but in other cases it is a constant battle.

“There needs to be better mainstreaming of education of officials across all government departments on the … HIV and TB response [plans],” says Hausler. “If people were really sensitised, we would not run up against as many obstacles.”

Asked for comment, Gauteng SAPS spokesperson Lieutenant Colonel Mavela Masondo told GroundUp that “possession of needles is not a criminal offence. Therefore, we cannot arrest a person [for] possession of needles, and neither can we confiscate needles”.

Note: The full report by TB HIV Care, which received assistance from the United States CDC, is not yet publicly available. A 16 page summary of some of the findings can be found here.

Professor Harry Hausler, CEO of TB HIV Care, at his office in Cape Town.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International Licence.

Read the original article.

The Price of a Bad Hire: When One Mistake Costs More than Just a Salary

Photo by Usman Yousaf on Unsplash

The modern complexities of the business world have meant that the cost of a bad hire can extend far beyond a salary, threatening your company’s financial health and reputation. With the rise of technology, background screening solutions can be a business’ best defense against costly hiring mistakes that may disrupt the workplace, writes Jennifer Barkhuizen, Head of Marketing at Managed Integrity Evaluation (MIE), the largest background screening and vetting company in Southern Africa, and a division of Mettus.

Hiring the wrong person can cost a lot more than just a salary. While the price tag of a bad hire isn’t always obvious, the damage to your bottom line, team morale, and reputation is undeniable. In South Africa’s competitive job market, where the cost of hiring is already high, ignoring the importance of thorough background screening can lead to financial damage.

It’s easy to focus on salary as the main expense when hiring, but the real costs go far deeper. The average cost of onboarding a new employee in South Africa equates to approximately R30 000, which increases significantly the more senior the position1. That’s just the tip of the iceberg. Factor in time spent on interviews, onboarding, and training, and those costs start climbing.

A poor hiring decision means more than just one person’s salary – it involves wasted hours training someone who doesn’t deliver, creating a ripple effect of lost productivity. While not the case in all instances, more extreme situations can see exit costs escalate, including severance packages, legal fees, or worse, disputes over wrongful dismissal that can spiral costs further.

A bad hire doesn’t just drain your wallet – it can poison the well. Think about it: a disruptive employee can damage team morale, slow down productivity, and ultimately drive good employees out the door. That’s a double whammy. Not only are you paying for the bad hire, but you’re also forking out for the damage they cause when valued staff start walking.

Then there’s the reputational fallout. What happens if you hire someone without doing proper due diligence, only to find out later they’ve lied about their qualifications or have a criminal record? These instances have been well-documented in South Africa over the past few years, and the financial cost of replacing them pales in comparison to the reputational hit. Fixing damaged trust with clients or partners can cost far more than a few months’ salary. 

When it comes to hiring, there’s no room for shortcuts. A thorough background screening process isn’t just a box-ticking exercise but the first line of defense against costly mistakes. Checking for criminal records, verifying qualifications, and digging into work history are critical steps that can save you from disaster down the line.

Imagine the consequences of hiring someone with a history of violence, only to place them in a role of authority. Without a proper check, you could be exposing your employees to serious risks. Should something happen on your watch, your business is on the line, potentially facing lawsuits, compensation claims, and a PR nightmare that could leave your reputation in tatters.

In roles where financial responsibility is key, skipping a thorough check could expose your company to fraud, theft, and more. Bad hires in this scenario don’t only drain your budget – they can sink the ship.

A strong background screening policy is like insurance for your business. Having a clear, consistent process in place ensures that every new hire goes through the same process, protecting your company from both financial and reputational damage.

Consistency is key. It’s not just about avoiding bad hires, but about showing your clients, stakeholders, and employees that you take hiring seriously. Trust is built on actions and your reputation benefits when people see that you’re committed to a thorough screening process.

In the end, the true cost of a bad hire goes beyond the numbers. A robust background screening process isn’t just an extra step in the recruitment procedure, but a necessary one to safeguard your business, team, and reputation. When the stakes are this high, a bad hire isn’t just a mistake, but a business risk many simply can’t afford to take.

To avoid these costly risks, businesses should turn to trusted solutions providers who specialise in comprehensive background screening and vetting services. By investing in the right tools and expertise, businesses can protect themselves from the financial, reputational, and operational fallout of a bad hire. In today’s competitive market, a proactive approach to screening isn’t just a safety net, but a strategic advantage.

AI Eye to Eye with Ophthalmologists in Diagnosing Corneal Infections

Photo by Victor Freitas on Pexels

A Birmingham-led study has found that AI-powered models match ophthalmologists in diagnosing infectious keratitis, offering promise for global eye care improvements.

Infectious keratitis (IK) is a leading cause of corneal blindness worldwide. This new study finds that deep learning models showed similar levels of accuracy in identifying infection.

In a meta-analysis study published in eClinicalMedicine, Dr Darren Ting from the University of Birmingham conducted a review with a global team of researchers analysing 35 studies that utilised Deep Learning (DL) models to diagnose infectious keratitis.

AI models in the study matched the diagnostic accuracy of ophthalmologists, exhibiting a sensitivity of 89.2% and specificity of 93.2%, compared to ophthalmologists’ 82.2% sensitivity and 89.6% specificity.

The models in the study had analysed a combined total of more than 136 000 corneal images, and the authors say that the results further demonstrate the potential use of artificial intelligence in clinical settings.

Dr Darren Ting, Senior author of the study, Birmingham Health Partners (BHP) Fellow and Consultant Ophthalmologist, University of Birmingham said: “Our study shows that AI has the potential to provide fast, reliable diagnoses, which could revolutionise how we manage corneal infections globally. This is particularly promising for regions where access to specialist eye care is limited, and can help to reduce the burden of preventable blindness worldwide.”

The AI models also proved effective at differentiating between healthy eyes, infected corneas, and the various underlying causes of IK, such as bacterial or fungal infections.

While these results highlight the potential of DL in healthcare, the study’s authors emphasised the need for more diverse data and further external validation to increase the reliability of these models for clinical use.

Infectious keratitis, an inflammation of the cornea, affects millions, particularly in low- and middle-income countries where access to specialist eye care is limited. As AI technology continues to grow and play a pivotal role in medicine, it may soon become a key tool in preventing corneal blindness globally.

Source: University of Birmingham

Novel Liver Patch could Help Treat and Prevent Liver Disease

Source: CC0

As described in research published in the Biotechnology Journal, investigators have developed a novel patch that can help liver tissue regenerate. The patch is a combination of decellularised liver matrix, a liver growth factor, and an anticoagulant. In lab tests with liver cells, the patch helped liver cells regain function after exposure to a toxin.

In rats, patches attached to the liver and gut promoted recovery from liver fibrosis, with notable decreases in scarring and inflammation.

“The decellularised liver matrix–based hepatic patch has demonstrated the ability to restore liver function and inhibit inflammation in fibrotic livers,” said corresponding author Yung-Te Hou, PhD, of National Taiwan University. “This approach shows great potential for treating various liver-related diseases, ranging from mild conditions such as fatty liver to severe conditions like liver cirrhosis.”

Source: Wiley