University of Cape Town

Module no: 42

Contact: Dr Karen Fieggen

[e-mail]

Tel. [phone]

Title: Ehlers Danlos Syndrome

No. of students: 1

Type: Literature review and retrospective audit of

patient cohort.

Summary: Ehlers Danlos syndrome is a heterogenous group of genetic connective

tissue disorders. Clinical characterization of subtype is often difficult but is importants

the implication for both inheritance and prognosis may be difficult. The Division of

Human Genetics have close to 100 patients with EDS recorded on their clinical

database The purpose of this study would be to retrospectively analyze from records the

clinical features of those patients with a view to establishing local epidemiology for the

disorder so that consideration may be given to setting up diagnostic testing in the

future. The students would be exposed to the medical genetic environment. They

would attend adult genetic clinic as well as paediatric genetic clinics to gain more

insight into genetic disorders and counselling about inheritance. They would also be

exposed to the molecular genetic laboratory and learn something of the complexities of

molecular genetic testing. There is potential for presentation or even publication if good

quality information is obtained as there is little published data on EDS in South Africa

and we have the advantage of a large cohort.

Module no: 43
Contact: Dr Ambroise WONKAM & Prof Alan Davidson

[e-mail]

[e-mail]

Tel: [phone]

Number of students: 1

Title: FREQUENCY and BURDEN OF SICKLE CELL DISEASE IN HEMATOLOGY CLINIC

(RED CROSS HOSPITAL)

Type: Exploratory study (retrospective

socio-demographic evaluation and question

survey)

Summary:

Introduction:

Sickle Cell Disease (SCD) is the most common monogenic disease. In sub-Saharan Africa (SSA) SCD occurs at its highest frequency. The prevalence of sickle cell trait in SSA is estimated to be 5 to 40% with up to 300,000 affected babies born each year. With migration of populations from Central Africa, it is anticipated that SCD will become a significant issue in hematology and genetic clinics in South Africa.

The objectives:

The main objectives are to evaluate retrospectively the prevalence of cases of SCD patients in the Hematology clinic at Red Cross Children’s Hospital) and to pilot a study of genetic knowledge and attitudes of parents concerning SCD and Genetic Prenatal diagnosis (PND).

Methods:

1. 
   To review the literature on SCD
   
2. 
   To develop an instrument for exploration of socio-demographic data of SCD patients to record all the of SCD consultations for the last 10 years in hematology clinic at Red Cross Children’s Hospital.
   
3. 
   To develop an instrument for exploration of genetic knowledge and attitudes of parents concerning PND for SCD, and administer it to ~ 20 parents attending out patients clinics
   
4. 
   Statistical analysis and interpretation of data
   

Conclusion:

The present study will help to explore perspectives of Genetic and Hematology consultations for Sickle Disease and to adapt appropriate genetic counseling communication that will not conflict with patients’ behaviors and culture.

Module no: 44

Contact: Professor Jacquie Greenberg

Dr Ian Lewis & Ms Fiona Baine

[e-mail]

[e-mail]

Tel: [phone] & 0214042165

Title: Huntington disease and Psychotic symptoms.

No. of students : 2

Type: A literature review of psychostic symptoms in

HD patients and a retrospective folder review

of clinical notes and follow-up of selected HD patients.

Summary: Huntington disease (HD) is a late onset neurodegenerative disease, inherited as an autosomal dominant disorder and characterised by progressive movement impairment, affective disturbance and cognitive dysfunction. Genetically it is caused by an expanded trinucleotide (CAG) repeat in the huntingtin (HTT) gene. The CAG repeat length is less than 27 repeats in the unaffected population. Alleles with 27-35 repeats do not cause HD but may expand into the disease-causing range on transmission. Alleles with 36-39 repeats show variable penetrance, while those with more than 39 repeats are fully penetrant. There are however, cases where patients show variations in phenotype independent of the length of the CAG repeat expansion.

The aim of this study is to investigate the HD phenotype in some patients with an uncertain clinical diagnosis of HD, with an emphasis on the psychiatric symptoms. The objective is to compile a data capture sheet for future clinical use and to compare the psychiatric features of family members in 3 specific core families from the clinical records.

Project Plan: The student/s will attend at least one Neurogenetic clinic to become familiar with exactly how clinical evaluations of HD patients are currently performed and documented. Thereafter, the student/s will be given all the clinical records in the Division of Human Genetics and will be introduced to the database/HD registry and familiarized with the methods of data capture related to the HD project. The student/s will then interrogate patient hospital files, assess the accuracy and thoroughness of the already documented clinical data and ascertain trends in phenotype. Ultimately the goal will be to identify unusual/interesting cases with regard to age of onset and progression of symptoms in relation to the genotype (i.e. the size of the expanded repeat). The module will also involve the student/s observing the molecular testing procedures in the NHLS diagnostic laboratory so as to develop an understanding of how the genetic mutation is assessed and reported on. The data accumulated will then be evaluated to identify either intra-and/or inter-familial phenotypic variation in a few selected SA families with a history of HD. The student/s will be required to write a review of the current literature (at least 20 publications) relating to psychiatric symptoms of HD, with particular emphasis on psychotic symptoms. By comparing published findings with the information recorded on our patients, a data capture sheet for clinical use and future research projects will be compiled.
Pathology:
Module no: 45
Contact: Dr Di Hawarden & Prof Paul Potter

[e-mail] and [e-mail]

Tel: [phone]

Number of students: 1

Title: Follow up and analysis of clinical and immune

responses to latex in 100 health care workers

Summary:Latex allergy affects 15% of the health care workers (including nurses,

doctors and other staff) at Groote Schuur Hospital. We have interviewed 100 health

care workers with a questionnaire and taken blood samples to study their immune

responses to latex allergy. This project will involve the analysis of the outcome of

these questionnaires on the progress of the health care workers since diagnosis, their

clinical profiles, remission status and the results of the laboratory tests completed to

date. The study is already approved by the UCT Ethics Department. The student will

also have the opportunity to interview some of the latex allergic subjects and to learn

about medical and occupational health interventions for this important allergy.
Module no: 46
Contact: Dr Maia Lesosky

[e-mail]

Tel: [phone]

Title: Characterisation of current and historical emergent

zoonotic diseases

No. of students: 1

Type: Literature review

Summary: Wolfe et al. presented an interesting and useful classification of human infectious diseases originating from animal populations. This classification ranged from Stage I - exclusive toanimals to Stage V - exclusive to humans. I’m interested in studying the disease transmission dynamics of diseases in the middle stages II-IV where there is some zoonotic (animal to human) transmission occurring. This module will require a literature review to identify and characterize a large number of diseases currently in stages II-IV. In addition to classification as per Wolfe et al., additional defining characteristics may be analysed and added to the model. A well done literature review and write up could result in publication. The supervisor is a statistician and will provide extensive guidance with any statistical analysis done. The module presents anopportunity to acquire a good overview into the evolutionary history and impact of major human infectious diseases.

Wolfe, Nathan D, Claire Panosian Dunavan, and Jared Diamond. 2007. “Origins of major human infectious diseases.” Nature 447 (7142) (May 17): 279-83. doi:10.1038/nature05775. http://www.ncbi.nlm.nih.gov/pubmed/17507975.

Module no: 47
Contact: Dr Maia Lesosky

[e-mail]

Tel: [phone]

Title: Disease functional types

Type: Literature review

Summary: Botanists tend to classify plant species by “functional type” where for a certain model the functional types might be grass, shrub, tree. This has immense use in modelling terms as one doesn’t have to deal with the details of each species but still accounts for all of the important functional characteristics. Infectious diseases have historically been classified a number of different ways, by pathogen type (eg. bacteria, prion, virus), by transmission method (direct,vector, environment), or by deduced quantities, such as the reproduction rate and generation time. I think a classification of more utility is doable, ie to classify diseases into functional types. The first stage is to perform a literature survey to record the important functional characteristics together and then to attempt to categorise the diseases into functional types based on these

characteristics. Because of the vast number of infectious diseases, a subclass (eg. tropical) will have to be decided on depending on the interests of the student and potential for results. A well done survey and write up could result in a publication.

Module no: 48

Contact: Dr Jane Yeats

Email: [e-mail]

Tel. [phone]

Title: Pathology mini exhibition on chosen topic

No. of students: 2

Type: Exhibition based on structured review

Summary: There are about 4000 pathology specimens in the Pathology Learning Centre, dating from the 1920’s. All of these specimens were kept because they were considered either to be “classic” examples of pathological conditions or because they were very rare entities. The majority of these specimens are sadly never viewed by students or even staff. For this project you would choose a single disease (e.g. syphilis) or group of disorders (e.g. tumours of the skin) that is well represented in the collection and which interests you. You would research the topic, select specimen bottles, prepare text, diagrams/ illustrations and photographs and put together an interesting mini-exhibition designed to educate your fellow students in the topic you have chosen, as well as inspire them to explore the teaching collection themselves. Your exhibition will be on display for students and staff to view in an open venue, as well as in digital format on the UC T Digital Pathology website.
Module no: 49

Contact: Dr Jane Yeats

Email: [e-mail]

Tel. [phone]

Title: Post mortem video records, topics based on available subjects

No. of students: 2 (N.B. For this project prior experience of home video editing is essential, so that the emphasis can be on content rather than technical challenges.)

Type: Audiovisual presentation, with interpretation

Summary: Medical autopsies are becoming a fairly rare event due to the costs involved. We would therefore like to record autopsies for teaching purposes. For this project you would make video recordings of a small number of adult and/or infant autopsies while they are performed by a pathologist. From the raw material you would make one or two short (max 30 minute) coherent video records of complete autopsies, including preceding clinical information, macro pathology and subsequent histology findings or other results. The video record would require narration in the form of recorded commentary and/or voice over. The finished DVD will be held in a library of autopsy recordings in the Pathology Learning centre.
Forensics:
Module no: 50
Contact: Dr Linda Liebenberg

[e-mail]

Tel: [phone]

Title: Foetal alcohol syndrome (FAS) in murdered

children: is there a link?

No of students: 6

Type: Qualitative and quantitative comparison.

Summary: Foetal alcohol syndrome and unnatural deaths in children are both rife in Cape Town. This study will examine cases of unnatural death of children in the Cape Western Metropole over a period of 6 months. Then a comparison will be done between victims of homicide vs victims of other types of unnatural deaths such as road traffic accidents. The aim is to find out if there is any difference in the two groups when they are evaluated for morphological features of FAS. Qualitative evaluation of features of FAS will be done using autopsy photographs of all the children.

Quantitative comparison will be done to establish if there is a statistically significant difference between the two groups regarding FAS features. The students will be introduced to the topics of FAS and unnatural deaths by a literature search. Data collection and interpretation will be done on autopsy reports and photographs.

Evaluation will be done and then a statistical comparison will be performed for write up.
Module no: 51

Contact: Dr. IJ Molefe

[e-mail]

Tel. [phone]

Title: The incidence and method of death of female

homicides in Cape Town in 2010

No. of students: 2

Type: Collection and interpretation of data ?

Summary: Violence against women (VAW) and girls is a major health and human rights issue. At least one in five of the world’s female population has been physically or sexually abused by a man or men at some time in their life.ⁱ VAW is defined by the Declaration on the Elimination of VAW, as adopted by the United Nations General Assembly as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life. VAW shall be understood to encompass, but not be limited to, amongst others, physical, sexual and psychological violence occurring within the family or general community, including rape, sexual abuse, and sexual harassmentⁱⁱ. VAW includes among other categories rape homicide.

According to the survey for the period 1998-2000 compiled by the United Nations Office on Drugs and Crime, South Africa (SA) was ranked second (to Columbia) for assault and murder (by all means) per capita.

According to the South African Police Services (SAPS) annual report, the rate of murder was reported to have decreased by 7.2%; from 37.1/100000 in 2008/2009 to 34.1/10000 in 2009/2010 financial year; this represent a significant decrease when compared with the incidence of sexual offences (including rape) in the same period which only deceased by 4.4%. The SAPS reports that murder is the one crime trend which can virtually not be influenced by over or under-reporting and/or the non-registration of cases. It is therefore believed to be the most consistent indicator of increases and decreases in crime. ¹³,¹⁴

According to SAPS report since the dawn of democracy in 1994, the murder incidence has decreased between the 1994/95 and 2002/03 financial years by an average ration of 3.7% percent. In January 2004 the government of South Africa decided that active steps were needed to aggressively address and reduce the prevalence all forms of serious contact crime, which include murder and rape by 7 - 10% annually. The murder incidence was reported to have reduced from 142.7/100000 population in the 2003/04 financial year to 37.3/100000 in the 2008/009 financial year, representing a 3.4% percentage reduction. This reduction was seen as a positive sign, but was still below the decrease of 4.7% experienced in 2007/2008. This percentage reduction translates into 2.5% which is still below the 7 – 10% reduction target desired by the government. ¹⁴

However, a further reduction in this incidence was experienced in the 2009/2010 financial year to 34.1/100 000 population, representing an 8.6% decrease in murder ratio since 2008/2009, and translating to 7.2% decrease in real figures. For the first time in the history of SAPS (which came into being in 1995), this figure met the target reduction of 7-10%; the murder rate fell below the 17000 hallmark.¹³

In the Western Cape (WC) the murder rate has shown marginal constant reduction since the 2003/2004 financial year from 2,839 reported cases to 2,274 cases in 2009/2010. Although in terms of absolute numbers the WC comes 4^th in the country for reported murders (after KZN, Gauteng and EC, respectively), this province had the highest murder ratio of 63.1% in 2003/04, and was at the same position with the aforementioned provinces in 2009/2010 with the incidence of 48.4/100000 population. ¹⁵

A National study of female homicides published by the MRC in 2004 showed that “Every six hours a woman is killed by her intimate partner”.ⁱⁱⁱ Using data from 1999 mortuary samples, this study found that there were 3,797 female homicides of which 50.3 % were from intimate partner violence (IPV) showing a rate of 8.8 /100,000 women, most of whom were of Coloured race and more than 14years of age. Their most common method of death was blunt force trauma, followed by sharp trauma and gunshot injuries.^iv The National study published in 2009 found that the most common cause of homicide (intimate and non-intimate) was gunshot injury, with a firearm mortality rate of 7.5/100,000 women 14years and older compared to 6.1/100,000 for blunt force injury .^v Although mortality data from Statistics SA and the National injury Mortality Surveillance System (NIMSS) from 2000 showed an overall decrease in gun-related homicide, it is still unknown whether this also applies to femicides (female homicides) in SA^vi.

Although the killing of the women by her intimate partner is considered the most extreme form of domestic violence, only 37,3% of female homicide cases resulted in convictions with lack of evidence given as the reason for in 69,9% of those who were acquitted. ¹⁰
RATIONALE FOR THE SSM

I am currently in the process of collecting data on the epidemiology and injury patterns of female homicide and rape homicide in Cape Town from the year 2000 to 2009. This is a 10-year follow up retrospective study.

My preliminary findings indicate that in 2009 we had significantly higher numbers of female homicide of with a total of 92 cases, compared to a total of 18, 25, 13, 12 cases in 2005, 2006, 2007 and 2008 respectively. This created great interest and curiosity for me and I immediately wanted to know what the trend was in 2010. My MMed research study will not include the year 2010,but I believe studying the year 2010 will give great insight into whether this public health problem is really increasing or decreasing as claimed by the SAPS annual report, and may help shed light into what happened in 2009.

References – a complete list of references is available from my original research proposal

Violence Against women: Definition and scope of the problem; www.who.int/gneder/violence/en/v4.pdf. accessed 07/02/2011

Declaration on the Elimination of violence against women, New York, United Nations, 23 February 1994 (Resolution No. A/RES/48/104). www.un.org/documents/ga/res/48/a48r104.htm, accessed 14/02/2011
Mathews S et al. A National study of female homicide in South Africa, MRC policy brief, no.5 June 2004

Abrahams N, et al. Mortality of women from intimate partner violence in South Africa: a national epidemiological study. Violence Vict, 2009; 24(4):546-556

Mathews S, et al. Injury patterns of female homicide victims in South Africa. J. Trauma 2009; 67(1): 168-172

Abrahams N, et al. Guns and gender based violence in South Africa. SAMJ. Vol 100 (9) September 2010.

Anatomical Pathology:
Module no: 52
Contact: Dr Shumani Malaka

Tel.     [phone]

Title:     Epidermiology of cervical carcinoma, in

Anatomical Pathology data base at Groote Schuur hospital,in the years 2002 and 2011

No. of students:   1

Type:     Interpretive

Summary:   Cervical carcinoma is the second most common cancer in women and the most common in developing countries. Cervical biopsy, usually after abnormal pap smear results, is essential to confirm the diagnosis before treating the patient.

The study aims to compare the epidermiology of cervical carcinoma diagnosed on biopsy specimen, in our Windows data base (DISA) at Groote Schuur Hospital, paying attention to patient’s age, HIV status and tumour differentiation in the years 2004 and 2011. The year 2004 was chosen as it was the first full year since DISA was introduced in 2003

Module No: 53

Contact: Dr R Sookhayi

Tel: [phone]

Title: Cytomegalovirus within the Gastrointestinal Tract

Type: Interpretative

No of students: 1

Summary: Cytomegalovirus is a species of virus that belongs to the viral family known as herpesviruses. CMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised, such as HIV-infected persons, organ transplant recipients, or new born infants. Hence, diagnosis is done histologically by looking for characteristic inclusion bodies. This study aims at looking at CMV infection in patients at Groote Schuur hospital for the last 10 years within the GIT tract, and specifically in what background conditions and locations. In those patient’s that are HIV infected, correlation with CD4 counts would also be looked at.
Module no: 54
Contact: A/Prof Helen Wainwright

[e-mail]

No of students: 1

Title: To determine the frequency of placental involvement by tuberculosis in 100 placentas from mothers with

co-infection of HIV and tuberculosis

Type: Review

METHOD: Go through the placental records of 2010 & 2011 from the Division of Anatomical Pathology, D7 laboratory reading the clinical history and selecting the cases with maternal HIV & TB until 100 cases have been obtained.

Enter all the clinical details and placental findings from the reports in a database/excel spreadsheet. Determine the frequency of TB in your series.

Read up on TB of the female genital tract. Do a literature review on placental tuberculosis. Look at the histology of the cases with placental tuberculosis and take photographs.

RESULTS: Watch how a placenta is examined and dissected for histology. Give a 10 minute presentation to the Division of Anatomical Pathology on the last Thursday morning of your elective. You will be scored on your presentation. Write a report on your findings for submission for your SSM.

Module no: 55

Contact: A/Prof Helen Wainwright

[e-mail]

No of students: 1

Type: Review

Title: To determine the frequency of chorioamnionitis in 100 consecutive placental reports from the Division of Anatomical Pathology.

METHOD: Go through the placental records of 2010 & 2011 from the division’s records in D7 laboratory in GSH. Select cases with a diagnosis of chorioamnionitis and enter all the clinical findings and placental findings from the reports in a database/excel spreadsheet. Read up on chorioamnionitis. Do a literature review on chorioamnionitis in South African and Africa. Look at the typical histology of chorioamnionitis from several cases from your study and take photographs.

RESULTS: Determine the frequency of chorioamnionitis. Determine at what gestational age chorioamnionitis most frequently occurs.

Observe how a placenta is examined and dissected for histology. Give a 10 minute presentation to the Division of Anatomical Pathology on the last Thursday morning of your elective. You will be scored on your presentation. Write a report on your findings for submission for your SSM

Module no: 56

Contact: Dr Hue-Tsi Wu (Anatomical Pathology)

Tel. [phone]

Title: Sensitivity and specificity of cytology in diagnosing breast carcinomas

No. of students: 1

Type: Interpretive

Summary: The breast clinic at Groote Schuur hospital uses breast FNA as one of the diagnostic pillars for breast carcinoma. The aim of this study is to review the cytology and histology reports of breast cancer cases and to determine the sensitivity and specificity of the breast FNA. The following information will be recorded and correlated: Age group of patient, size of mass, clinical impression at time of FNA, type of clinician performing the FNA, and the diagnostic category reported by cytology.

Medical Biochemistry:

Module no: 57

Contact: Professors Ed Sturrock and Peter Smith

Email: [e-mail] and [e-mail]

Tel. [phone]

Title: Comparison of two assays for angiotensin-converting enzyme

No. of students: 1

Type: Laboratory

Summary: The burgeoning clinical importance of angiotensin-converting enzyme (ACE) in cardiovascular and renal disease, and more specifically in hypertension, underscores the need for accurate, sensitive and rapid techniques for measuring the enzyme’s activity in biological fluids and tissue homogenates as well as its purified forms. Furthermore, elevated levels of ACE are associated with active sarcoidosis, and the disease can be diagnosed and followed by measuring ACE activity in plasma, bronchoalveolar lavage fluid and cerebrospinal fluid. In this module the student will compare two methods for determining ACE activity in cell culture medium and purified somatic and testis ACE using well established methods. The one uses the substrate hippuryl-L-histidyl-L-leucine, and the fluorescent adduct of the enzyme-catalyzed product L-histidyl-L-leucine is quantified fluorimetrically. The other method is a kit-based colorimetric method which is carried out on the Abbott Architect 4000 analyser. They will analyse the data generated and write a report providing a brief introduction, their aims, methods, results and conclusions.
Haematopatologist:
Module no: 58
Contact: Dr Almero Du Pisani

[e-mail]

021 4043081

Title: Malaria in the Western Cape –

Groote Schuur Hospital perspective

No of Students: 2

Type: Laboratory – audit / retrospective

Summary: Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists (a type of microorganism) of the genus Plasmodium. The protists act as parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases progressing to coma or death. The disease is widespread in tropical and subtropical regions in a broad band around the equator, including much of Sub-Saharan Africa, Asia, and the Americas. In 2010 around 655,000 people died from the disease, most of whom were children under the age of five. Audit all tests done for the diagnosis of malaria between 2009 and 2011. Evaluate the sensitivity and specificity of the malaria antigen test compared to microscopy

Learn methods for the diagnosis of malaria including making of stains, smears and microscopy. Establish if increased numbers of malaria diagnosis are being made in the Western Cape and which species are being identified. Determine the origin of the patients being diagnosed. Review prevention and treatment of malaria. Read:Blood cells – Bain - 4^th Edition & Practical Haematology, Dacie and Lewis, 10^th Edition

Immunlogy:

Module no: 59

Contact: Dr Heather Jaspan

Mr Elvis Kidzeru

Tel [phone] or 084 925 7456;

Email: [e-mail]; [e-mail]

Title: Infant feeding practices in informal settlements in Cape Town

No of students: 2 (working as pair)

Type: Interpretive

Summary: Exclusive breastfeeding until 6 months of age improves the morbidity and mortality of infants in developing and developed countries. This project assesses the feeding practices among HIV-negative mothers and their infants in Khayelitsha, and the factors associated with failure to exclusively breastfeed. It will involve chart review of an ongoing clinical trial around infant feeding practices, as well as some basic statistical analysis. Students will visit the clinic in Khayelitsha at the start to understand clinical trials and the setting in which this study is taking place.

MEDICINE – MDN2001S

Cardiology:

Module no: 60

Contact: Dr Deon Bezuidenhout

[e-mail]

Tel. [phone]

Title: Vascular Graft Prostheses

No. of students: 1

Type: Structured review

Summary: Current synthetic (ePTFE or Dacron) vascular grafts used in clinical applications have relatively high occlusion rates in small diameter applications due to insufficient healing and lack of transanastomotic endothelialization. The CRU has developed polyurethane grafts with well-defined, angiogenic permissive porosity to improve long-term patency by achieving transmural endiothelialization. In order to span the first few weeks after implantation of the grafts (the time it takes for the endothelium to form), a strategy is required to also improve the acute thrombogenicity of the prostheses. The student will perform a structured literature review on graft occlusion in general, with specific reference to factors (porosity, compliance, physiochemical and biological properties) that influence patency, and approaches that have been used (e.g. surface modification, coating, drug release) to reduce graft thrombogenicity. The review should not only summarize the prior art, but also discuss the interrelationships between the identified parameters and conclude with an opinion on the most feasible way of achieving the stated goal. The student will additionally be exposed to, and gain insight into, the manufacturing and in vivo evaluation of experimental vascular grafts.

Module no: 61

Contact: Dr Deon Bezuidenhout

[e-mail]

Tel. [phone]

Title: Percutaneous Heart Valves

No. of students: 1

Type: Structured Review

Summary: Approximately 300,000 replacement heart valve devices are required annually in the developed world, most of which are implanted using open-heart surgery. In developing nations, there is an even greater need for replacement heart valves, as poor socioeconomic conditions leads to the staggering statistic that an estimate 32 million (mostly young) people require a replacement valve due to rheumatic heart disease. Most of these patients have no access to specialist cardiovascular surgery facilities, and the majority will die at a very young age.
Recently, valves have been developed that can be implanted percutaneously (through a small incision in the skin, either through via an artery or vein in the leg or through the apex of the heart). The concept behind catheter-based valve delivery is simple: a valved stent is collapsed into a catheter, the catheter tip is positioned at the site of the valve to be replaced, and the stent is balloon-expanded to unfurl the new valve. The execution of the concept, however, is very complex. In addition to the strenuous demands already placed on surgically implanted valves, and to the ingenious stent and catheter designs required to deliver them, catheter-based valves must withstand being forced into a tube at a fraction of their expanded diameter, and then be able to unfold into the precise geometries required for function and durability.
The student will review the literature pertaining to catheter based valves, summarize and discuss the state of the art in terms of the valves used, and compare the advantages and disadvantages of the different techniques of valve placement (antegrade vs. retrograde vs. transapical).
Pharmacology:

Module no: 62

Convenor: Dr Eric Decloedt

Contact: [e-mail]

No. of students: 2

Type: Folder review

Title: The safety of adjusted dose lopinavir/ritonavir in patients on antituberculosis treatment.

Summary: Tuberculosis remains the most common opportunistic infection in HIV-infected patients despite the use of ART. Lopinavir/ritonavir is the cornerstone of our 2^nd line antiretroviral regimen (ART). However, there is limited data on the safety of co-treatment with antituberculosis- and lopinavir/ritonavir based ART treatment. In this module students will review identified folders of patients on 2^nd line ART and select the patients that were treated with antituberculosis treatment. Students will perform causality assessment of adverse events during the period that patients received co-treatment. The data recorded and analysed using appropriate methods and software.
In this module the students will learn how to assess adverse event causality, and how to accurately record, analyze and interpret data. The findings will be written up and submitted to an appropriate journal for publication.

Module no: 63

.

Convenor: Prof Marc Blockman

Contact: [e-mail]

Title: The patterns of vancomycin use in GSH

No. of students: 2

Type: Retrospective review

Summary: Vancomycin is a restricted antibiotic that requires specific dosing and monitoring to be effective and prevent antimicrobial resistance. However, vancomycin is frequently prescribed and monitored incorrectly. In GSH we recently implemented a system where we provide a prescription note to guide vancomycin prescribing with every vancomycin script. In this module students will determine whether this intervention was effective. Students will integrate data from pharmacy electronic records, pharmacology electronic records and clinical files. In this module the students will learn how to accurately record, analyze and interpret data. The findings will be written up and submitted to an appropriate journal for publication.
Module no: 64

Convenor: Prof Marc Blockman & Ms Annoesjka Swart

Contact: [e-mail]

Title: A guide to interpret laboratory results when initiating antiretroviral therapy (ART)

No. of students: 2

Type: Poster project

Summary: The Medicines Information Centre (MIC) is based in the Division of Clinical Pharmacology and provides a national free HIV information service. The MIC has identified a need to provide guidance to primary health care providers on interpreting laboratory results when initiating ART. In this module students will design a poster with the aim to publish and circulate nationally to primary health care facilities. In this module students will reason critically around the information to be included in the poster, provide decision rules and present the information in a visually pleasing manner.
Endrocrinology:

Module no: 65

Contact: Drs M Setshedi and I Ross

Tel: [phone] or 406 6209

Title: The prevalence of liver function test abnormalities in patients undergoing transgender reassignment

No. of students: 2

Type: Audit

Summary: Patients undergoing gender reassignment are typically prescribed hormone replacement therapy (HRT) to cause the development of the secondary sexual characteristics in order to effect the desired phenotype. HRT however, is associated with a multitude of liver diseases, including intrahepatic cholestasis; vascular complications such as peliosis hepatitis and Budd-Chiari syndrome; hyperplasia and neoplasia e.g. focal nodular hyperplasia, hepatocellular adenoma and hepatocellular carcinoma. As a result, during the initial evaluation for transitioning, LFTs are mandatory before commencement of HRT. Some patients present with de novo liver function test (LFT) abnormalities. There is no data about the prevalence of de novo LFT abnormalities in these patients, and LFT abnormalities induced by HRT. Indeed there is no data about the outcomes of these patients, once HRT is commenced. In this module the students will retrieve the folders of all patients that have undergone or are undergoing gender reassignment at GSH. All relevant demographic data will be captured. In addition, the student will access laboratory records and note down liver function tests at baseline, during and after commencement of HRT. Furthermore, the student will record the outcome of patients with LFT abnormalities i.e. resolution of LFT abnormalities, time to resolution, and whether the patient completed their gender reassignment. During the 4th week they will write a report, describing their findings and including a literature review of liver disease with the use of HRT.

Dermatology:

Module no: 66

Convenor: G Todd and G Louw

Contact: [e-mail] tel. [phone]

Title: Sensory anatomy and physiology and anatomy of smell in the context of perfumery.

No. of students: 6-8 students

Type: Laboratory and survey

Summary: Perfumes have had an important role in society for many reasons.

Currently our senses are overpowered by multiple fragrances used at every level of

our activities of daily living. Textile manufacture includes various fragrances which

release the scent on crushing the fabric. In some places of work the environment is

manipulated via the air-conditioning with various fragrances to stimulate appetite,

activity and calmness. Fragrances (which include perfumes) are currently the second

most common cause of allergic skin disease worldwide. In this module, the students

will dissect the nerves of smell and will develop an understanding of the physiology of

smell. In this context they can suggest what this perfume overload does to smell

perception as well as understanding the science of perfumery, alternate

aspects of smell appreciation can also be explored
OBS &GYNAE – OBS2001S

Module no: 67

Convener: Dr LJ Walmsley

Contact: Linda Walmsley

[e-mail]

Tel: [phone]

No of students: 1

Type of project: audit

Summary: The Reproductive Medicine Unit at Groote Schuur hospital offers assisted reproductive techniques to couples in state and private. A database exists for our IVF (in vitro fertilization) and intra uterine insemination cycles. Annually performance is assessed by pregnancy rates in each of these cycles.

We would like to further delineate our cycles according to age, BMI, indication, ovarian reserve, medication used and outcome. Students will be expected to have basic science knowledge of the female reproductive system and process of fertilization. They will receive an introduction to assisted reproductive techniques and cycle management. They will be required to perform a folder review of each existing case in the database and to give a report of the findings. Knowledge of excel is essential.

PAEDIATRICS – PED2001S

Developmental Paeds
Module no: 68
Contact: Dr K Donald

Tel: [phone]

Title: The role of Physiotherapy in Cerebral Palsy

No of students: 2

Summary: Cerebral Palsy is the commonest cause of physical disability in children worldwide. Neurodevelopmental therapy (NDT) is a widely used physiotherapy treatment modality, despite a lack of good evidence supporting its use. SMART ( specific, measurable, attainable, realistic and have a specific time frame)

goal setting has been shown to change behaviour, enhance motivation and improve outcomes (Eckstrom et al, 2005; Mastos M et al 2007). It has also been shown to encourage active involvement of parents of children with cerebral palsy and facilitates the practice of functional tasks on a daily basis (Oien et al, 2009). Research has shown that in the paediatric cerebral palsy population, there is a lack of formal goal setting procedures (Darrah J et al, 2010). Student s will review the role of physiotherapy in the CP clinic at RXH by examining the evidence( literature review ). In addition one student will conduct an audit amongst physiotherapy staff at CP clinic and report on goal setting in clinical practice. The other student will do a folder reviews of patients attending CP clinic and report on documentation of goal setting and achievement in clinical practice.

Module no: 69
Contact: Dr Reneva Petersen

Tel: [e-mail]/ 082 4162035

Title: Cerebral Palsy and Nutrition

No of students: 2

Type: Interpretive

Summary: Children with cerebral palsy (CP) frequently have problems with oro-pharyngeal control, oesophageal motility and gastro-oesophageal reflux. Among the consequent health problems of these feeding difficulties are malnutrition, oesophagitis, recurrent chest infections, and progressive lung disease. Children most at risk for these problems are those with spastic quadriplegic and dystonic CP. Students will review the literature regarding Cerebral palsy, feeding problems and malnutrition and will then do an audit of the nutritional state of 100 children attending Cerebral Palsy clinic.

Child & Adolescent Psychiatry:
Module no: 70
Contact: Dr Lesley Carew

Rehana Effendi ([e-mail])

No of students: 2

Title: Depression in children and adolescents with Diabetes Mellitus: the search for an appropriate screening tool

Type of project: Literature review

Summary: Diabetes Mellitus (DM) is a chronic, debilitating illness affecting 1.7 per 1000 of the paediatric population. There is an increased risk of psychiatric co-morbidity associated with the illness. Studies report that children with DM have a two-fold increased risk of being diagnosed with depression, and there is a three-fold increased risk of depression in adolescents with DM. Children with psychiatric co-morbidities have a poorer physical outcome with greater cognitive difficulties, more frequent hospital admissions for diabetic keto-acidotic comas and more episodes of hypoglycaemia.
The Diabetic clinic at the Red Cross Children’s Hospital provides a service to children in the Western Cape suffering from this illness. There is an awareness of the increased risk of mood disorder in this population. A screening instrument could assist in detecting children most at risk who could then be referred for psychiatric assessment and intervention.
In this SSM, two students will work with Dr Lesley Carew, Consultant Child & Adolescent psychiatrist to perform a literature review of depression and mood disorders in DM, and to use the literature review to identify a sensitive, specific and user-friendly screening instrument to be used in an ‘at risk’ clinic setting

Module no: 71

Contact: Prof Petrus de Vries

Contact: Rehana Effendi ([e-mail])

No of Students: 2

Title: Autism in Africa

Type of project: Literature Review

Summary: There is an increasing global awareness of autism. The rates of the disorder is said to be similar to that of schizophrenia at around 1%. The vast majority of publications about autism come from North America or Europe with only a tiny fraction from Africa and other low and middle income countries. As a result, the world perspective of autism is a very US-Eurocentric one. In this SSM, students will work under the direction of Prof de Vries to peform a literature review of all publications around autism and related disorders in Africa over the last 10 years. During weeks 1-3 the students will have regular supervision discussions with Prof de Vries and his group to support the review process. In week 4 students will be expected to write a report summarising and performing a critical appraisal of African research on autism.

Paediatric Endocrinology:

Module no: 72

Contact: Dr Michelle Carrihill

[e-mail]

Tel. [phone]

Title: HBA1C results of paediatric diabetic patients seen at the Red Cross Children’s Hospital Diabetes Outpatient Clinic, compared

with current age of patient, age of diagnosis and frequency

of attendance.

No. of students: 2

Type: Interpretive

Summary: Students will exam the clinical records (kept in the diabetes clinic) of patients who attended the Red Cross Children’s Hospital Diabetes Outpatient Clinic January 2008 – December 2009. They will document the age of onset of diabetes, the current age of the patient (at their last attendance) and the number of clinic attendances in the preceding 12 months of their last attendance. Their HBA1C values at the last attendance will be documented. The students will then answer the following questions:

• 
  Does HBA1C correlate with current age?
  
• 
  Does HBA1C correlate with age of diagnosis?
  
• 
  Does HBA1C correlate with duration of diabetes (current age minus age at diagnosis)?
  
• 
  Does HBA1C correlate with frequency of clinic attendance?
  

Paediatric Medicine:
Module no: 73
Contact: Dr Mark Richards

Contact: 021 402 6911 or [e-mail]

Title: Babies with Birth Associated Brain Injuries at New

Somerset Hospital.

No of students: 2

Type: Descriptive

Summary: Hypoxic-Ischaemic Encephalopathy (HIE) is a potentially devastating condition for a newborn with the potential for significant long term morbidity and mortality. New Somerset Hospital (NSH) has a neonatal nursery which cares for newborns with HIE and it is also responsible for co-ordinating their follow up care.

There are ways of defining the severity of this brain injury and these can be used to define longer term prognosis. They rely on both clinical and electrophysiological features. There is a cohort of newborns who have had documented HIE at NSH. The characteristics of this cohort of children need to be defined, including the birth associated factors leading to the injury, their injury severity and their current neurological status. Your study will involve becoming familiar with this disease condition, exposure to its acute management and helping to define the characteristics of this cohort of children at the time of the injury and their current neurological status.

Child Health:

Module no: 74

Contact: Prof Michael Hendricks & Tony Westwood

[e-mail]

Tel: [phone]

Title: Missing data relating to child mortality in South Africa:

how feasible is it to fill in the blanks?

No. of students: 4

Type: Descriptive

Summary: Deficiencies in child mortality data in South Africa are hampering targeted interventions to improve child survival. The death notification form (DNF) is the source of much of this essential data but, for significant numbers of children who die, where they died and what they died of is difficult to glean when forms are reviewed in routine data collection and epidemiological studies.

In this module, the students will explore the feasibility of abstracting some of the missing information from the electronic hospital records system in Cape Town (Clinicom) for a sample of the 2011 data for neonates and children.

PUBLIC HEALTH AND FAMILY MEDICINE – PPH2002S
Family Medicine:
Module no: 75
Contact: Dr Feroza Amien

[e-mail]

Tel: [phone]

No of students: 5

Type: Survey

Title: Patients perceptions of the need for dental services

with SHAWCO.

Summary: The student health and welfare centre’s organization is run by medical students whereby they perform basic primary care services after hours in informal settlements. In this module students will conduct a survey to assess whether patients would attend a mobile dental clinic if it accompanies SHAWCO to these areas. They will design the questionnaire themselves (with my guidance). At the end of the module they will hand in a report consisting of a brief literature review of the integration of oral health into general medical services, together with the methodology, results and discussion section.

Module no: 76
Contact: Dr Feroza Amien

[e-mail]

Tel: [phone]

No of students: 5

Type: Survey

Title: Senior medical students’ knowledge regarding prevalent oral health conditions and their attitudes towards screening for these conditions.

No of students: 4

Summary: In this module students will conduct a survey with final year medical students to determine their knowledge about prevalent oral health conditions such as dental caries, gingivitis, oral ulcers etc. They will also record medical students’ perceived need for the incorporation of this kind of information into the curriculum. At the end of the module they will be expected to submit a report with a literature review of the five most prevalent oral conditions in South Africa. The report should also consist of a methodology, results and disc
Module no: 77
Contact: Sarah Crawford-Browne and Dion Benetatos

[e-mail]

Tel. [phone]

Title: Developing media for research participants

No of students: 3

Type: Interpretive

Summary:

Are short films useful in recruiting and retaining participants in a microbicide study?

The Desmond Tutu HIV Foundation is researching the effectiveness of microbicides to prevent the transmission of HIV. The research study is based in Masiphumelele, a community near Noordhoek with a HIV prevalence of around 28%. The recruitment team is tasked with recruiting 300 study participants. It is thought that a short video explaining the research and answering frequently asked questions may motivate community members to participate (recruitment). Similarly, it is hoped that a second film outlining the number of visits participants are required to attend may motivate community members to stay in the study (retention) and that a third film could be used to educate the patients using the clinic. The students may use the Centre’s shuttle service to Masiphumelele, which departs each morning from UCT Medical school on Anzio Road.

Each student will need to:

1)     read the Desmond Tutu HIV Foundation website, annual report and relevant studies to understand the project

2)     access and read available literature regarding participant recruitment for HIV studies with a particular focus on the cultural and psycho social issues that may be a barrier to, or motivator for participation in this study

3)     interview team members, DTHF outreach workers, clinic-goers, and community members to understand the barriers to and motivators for participation within this context

4)     attend film making training, make a 4 minute film to either a) recruit or b) retain or c) educate participants

5)     premier the films in the community and evaluate the response.

6)     write a reflective report that outlines the project, summarises the literature that you used to inform your film making, discusses the choices that you made in designing your film, and reflects on the response of the recruitment team and study participants.

Module no: 78

Contact: Dr Elma de Vries

[e-mail]

Tel. [phone]

Title: The value of blood cultures in a district hospital

No. of students: 2

Type: Retrospective folder review

Summary: Patients who present very ill at Mitchell’s Plain District Hospital often have blood cultures done as part of their investigations. No audit has been done at the hospital of how often the blood cultures are positive and how useful it is in clinical practice. This study will review folders of patients admitted to Mitchell’s Plain District Hospital, who had blood cultures done. A list of blood cultures done will be obtained from NHLS Greenpoint. An audit tool to review the folders will be developed by the student with assistance from the supervisor, to include information such as HIV status, CD4 count, temperature, symptoms of sepsis, choice of antibiotics, blood culture result, and outcome of the patient. The student will join ward rounds at Mitchell’s Plain District Hospital to observe how patients with sepsis present and how they are managed. During the 4^th week the student will write a report, describing their findings and including a literature review of blood cultures in the emergency centre setting.

Module no: 79

Contact: Elma de Vries

[e-mail]

Tel. [phone]

Title: General practitioner knowledge, attitudes and beliefs about Transgender issues

No. of students: 2

Type: Survey questionnaire

Summary:

Internationally there is an increased awareness of the health needs of transgender persons, but very little research has been done on transgender health in South Africa. There is a perception that many doctors do not have much knowledge about transgender health, about how to approach and appropriately manage a transgender client. This is experienced by many transgender persons as a barrier to accessing health care. There is a need to develop educational material for general practitioners, in order to empower them to be able to comfortably and competently manage the primary health care needs of transgender persons.

The tasks for this SSM will include the following:

• 
  Review of existing literature on general practitioner knowledge, attitudes and beliefs on transgender issues
  
• 
  Students will develop a survey questionnaire based on the literature
  
• 
  Students will administer the questionnaire to a group of general practitioners
  
• 
  Analysis and write up of results
  
• 
  Recommendations for general practitioner education priorities as part of continued professional development
  

Module no: 80

Contact: Prof D.A. Hellenberg

[e-mail]

Tel. [phone]

Title: Doctor-patient communication in isiXhosa

No. of students: 4

Type: Survey / Interpretive

Summary: The primary language of communication between medical students at UCT and their patients is English, but the majority of patients are first language Xhosa or Afrikaans speakers. This creates problems for both the practitioner and the patient. This SSM intends to assess the success of ‘immersion’ language programmes for students. Four students will live with the Xhosa-speaking family of a health practitioner for 2 and a-half weeks of the SSM period, Mondays to Fridays. During the day, students will engage in the activities of the health facility under the supervision of their host. After-hours, students are encouraged to integrate socially and culturally with the host family. Besides reporting on their project, students are required to provide written reflection on the effectiveness or otherwise, of language/cultural immersion within the clinical context. Students will complete a research project relating to an aspect of doctor-patient communication. The students will collect, group and analyse data and produce a research report in which they will report on their experience of cultural and language immersion and its effect on their understanding of and proficiency in the language. Students interested in doing research on a topic related to Family Medicine and who are keen to also improve their Xhosa language skills, are encouraged to apply for this SSM. We require that the students involved in the Xhosa project are not first language Nguni speakers (isiXhosa, isiZulu, siSwati, siNdebele). Interested students are asked to contact Professor Hellenberg in advance for further details of the module.

Module no: 81

Contact: Prof D.A. Hellenberg

[e-mail]

Tel. [phone]

Title: Doctor-patient communication in Afrikaans

No. of students: 2

Type: Survey / Interpretive

Summary: The primary language of communication between medical students at UCT and their patients is English, but the majority of patients are first language Xhosa or Afrikaans speakers. This creates problems for both the practitioner and the patient. This SSM intends to assess the success of ‘immersion’ language programmes for students.Two students will live with the Afrikaans-speaking family of a health practitioner for 2 and a-half weeks of the SSM period, Mondays to Fridays. During the day, students will engage in the activities of the health facility under the supervision of their host. After-hours, students are encouraged to integrate socially and culturally with the host family. Besides reporting on their project, students are required to provide written reflection on the effectiveness or otherwise, of language/cultural immersion within the clinical context. Students will complete a research project relating to an aspect of doctor-patient communication. The students will collect, group and analyse data and produce a research report in which they will report on their experience of cultural and language immersion and its effect on their understanding of and proficiency in the language.Students interested in doing research on a topic related to Family Medicine and who are keen to also improve their Afrikaans language skills, are encouraged to apply for this SSM. We require that the students involved in the Afrikaans project are either beginners in Afrikaans or not first language English or Afrikaans speakers. Interested students are asked to contact Professor Hellenberg in advance for further details of the module.

Module no: 82

Contact: Ms Johannah Keikelame [e-mail]

Title: Using observations to understand factors impacting on care of patients with epilepsy

No. of students: 4

Type: Qualitative

Summary: The purpose of this project is to give students an opportunity to learn to do observations to get a layered picture on approaches that may overlook or exclude issues that are important to effective management and care of marginalized groups of patients such as those suffering from epilepsy. Students will use a structured observation guide to collect data in support group meetings run by Epilepsy South Africa, Western Cape Branch. They will each write a report to describe one or two behaviors that they have observed during the support group meetings. Students will meet with the module convener on the first day in week one for orientation on the topic. In the 3^rd week, they will analyze the data and produce a written report of their findings and literature reviewed on the topic.
Module no: 83
Contact: Prof Steve Reid (UCT)

Contact: Dr Patricia Repar (UNM)

Tel: [phone]

Title: Arts and Healthcare

No. of Students: 6

Type: Interpretive

Summary: This project will explore the links and integration of the creative / expressive arts and health care in the South African context. The creative and expressive arts include visual arts, music, dance and movement, poetry and drama.

Where and how does art happen in a medical or healthcare context? What are the underlying paradigms of these two disparate fields, and what are the issues and areas where they converge? Is there benefit in working across disciplinary boundaries in this way, and what could those benefits be? This is not a course in art or music therapy, although it may contain some elements of these established fields. It is an exploration of ideas, theory and practice, in bringing the worlds of biomedical science and creative arts together explicitly and practically.

The group will be joined by 6 senior students from The University of New Mexico (UNM) who are majoring in various areas of the fine arts including music, film studies, photography, theater, and dance. They are the first participants in a new UNM College of Fine Arts initiative designed to promote and support courses based in community-engaged learning (see Arts Learning Laboratory at the University of New Mexico http://artslearninglab.unm.edu). The course is closely affiliated with a clinical program by the same name based at The University of New Mexico Hospitals (see Arts-in-Medicine Program at the University of New Mexico http://artsinmedicine.unm.edu ).

Students will meet with the facilitators once a week and will take on various tasks. Students will be required to carry out literature reviews in different subject areas, interview key informants, facilitate creative encounters in medical environments, and plan events as a group. Community-engaged learning opportunities will be arranged at Vredenberg District Hospital, St Luke’s Hospice in Kenilworth and Mitchell’s Plain. Students may either choose to write a research report, literature review or critical analysis, or produce a digital story (including the events) as per the SSM rules for disser

Module no: 84

Convenors: Prof. S. Reid and Dr N. van der Schyff

Contact: Dr Des Michaels [e-mail] or

Tel: [phone]

Title: Follow-up of patients after discharge from Victoria Hospital

No. of students: 4

Type: Record Review and Patient follow-up study

Summary: This module will explore the experiences of patients after discharge from Victoria Hospital. We do not know enough about how they cope and what happens to them. The purpose of the module is to better understand the post-discharge experience of patients and to address potential gaps in the discharge and follow-up process. The questions that such a project could answer are:

• 
  How do the patients and their families cope with the illness after discharge from hospital?
  
• 
  What is the degree of post-hospitalization morbidity and mortality for different conditions?
  
• 
  What is the proportion of long-term disability by condition?
  
• 
  What proportion of patients return to work or their pre-surgical levels of activity?
  
• 
  What resources (e.g. rehabilitation) do they access (or not) for help at home?
  
• 
  What is the rate of readmission or consultations that might be prevented?
  
• 
  How could the discharge and follow-up process be improved?
  

Students will be expected to conduct a literature review, review patient folders of patients discharged from Victoria Hospital and development of an appropriate folder review tool. Follow-up will include three points of data collection - one home visit, at the follow-up clinic and a later telephone call. Each student will identify one patient for a follow-up home visit, which will be conducted in pairs and result in a narrative report. Students will be linked to NGOs and CBOs involved in home-based care in the areas that patients live. Student reports will include a critical appraisal of the literature, a narrative report of their home visit, and an analysis of data extracted from patients’ folders from a certain number of discharges.

PSYCHIATRY – PRY2001S
Module no: 85

Contact: Dr Imthiaz Hoosen (Lentegeur Hospital)

Tel. [phone] or

Title: Audit of psychiatric notes/records at Lentegeur

and Valkenberg Hospitals.

No. of students: 5

Type: Audit

Summary: Audit of psychiatric note/records at Lentegeur and Valkenberg Hospitals.

 Audit 100 patient case notes (50 per hospital) - in order to assess quality of medical notes made on admission. e.g. have the main areas of the assessment been recorded: history, diagnosis, physical exam, treatment plan, mental state exam, risk assessment, contact info, etc Also to assess if the medical notes meets national standards for medical records. (students will need to establish if there are South African national standards)

 

Module no: 86

Contact: Dr Louise Frenkel / Dan Stein

Tel. [phone]

Cell: 083 947 1370

email: [e-mail]

Title: Living with Chronic Pain

No. of students: 2

Type: Research

Summary: The stories told by patients who attend the GSH Pain Clinic.

The research will involve 2 stages; The first stage will be a file audit of all the new referrals to the pain clinic from the 30th April 2011 to the 30^th April 2012 (There are approximately 12 new referrals a month, so this will cover about 150 patients. Information regarding age, sex, living arrangement, diagnosis, employment, Disability Grant, when first treated and their score on a Brief Pain Inventory, will be recorded (The scores are documented in their patient files). The 2^nd stage of the research will be to identify a homogenous subgroup from this initial group of 150, (e.g. women between the ages of 30 and 55 who suffer with fibromyalgia) and to do semi-structured, in-depth interviews with them. The purpose of the interviews will be to gain some insight into what it is like for this group of people to live with chronic pain; how they experience and make sense of the pain, and what impact it has on their lives, and their important relationships.

What I will require of the students (hopefully 2 students) will be:

1. 
   To do a literature search for any articles on chronic pain in South Africa, and in Africa in the last decade (from 2002 – 2012)
   
2. 
   To collect the information for the file audit and enter it onto a spreadsheet, and identify trends.
   
3. 
   To then write a brief review of recent literature, and a patient profile for the GSH Pain Clinic.
   

In the month in which they undertake the research, I will allow them to sit in on interviews with some of the pain patients (with the patient’s permission). These will not be the formal research interviews, but part of the ongoing therapeutic interviews conducted with pain clinic patients.