University of Cape Town

University of Cape Town

Faculty of Health Sciences

Special Study Module

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July to August

2012

ANAESTHESIA – AAE2001S
Module no.01

Contact: Dr Rob Nieuwveldt

[e-mail]

Tel. [phone]

Title: Peri-operative neuromuscular blockade and reversal

No. of students: 2

Type: Interpretive

Summary:

Drugs antagonising acetyl-choline receptors at the neuromuscular junction are extensively used in modern anaesthetic practice. These drugs require reversal at the end of the surgical procedure and anaesthetic. Residual weakness has potential adverse effects. There is a recent change in the degree of recovery required for safe extubation of patients with residual neuromuscular blockade.

In this SSM the students will do a literature review of current neuromuscular blockade and its reversal and associated complications. They will then audit admissions to the post-anaesthetic recovery unit at GSH over a 1 week period using suitable equipment. This will be written up as a formal report together with any recommendations and a literature review.

Module no. 02

Contact: Dr Owen Porrill

[e-mail]

Tel. [phone]

Title: Acute and chronic pain in primary care - assessment and management

No. of students: 2

Type: Interpretive

Summary:

Pain is commonly experienced by many patients. Pain is a common presenting symptom at primary care level. The incidence of pain may be even higher than as a presenting symptom. There is little detail available on pain experienced at primary care level in Cape Town and the clinical skills required to manage this pain have not been quantified.

In this SSM the students will review the physiology of pain, summarise current pain management options and perform an analysis of the incidence of pain experienced by patients to a primary care facility/day hospital in the Cape Town Metropolitan area. This SSM will also interrogate the clinical skills requirement for pain assessment and treatment, as well as the availability of pain medication and referral pathways for patients experiencing pain.

Students will need to spend the 3^rd week of the SSM as at Community Health Centre interviewing patients and staff. This will be written up as a formal report together with recommendations and a literature review. There is potential for this to be submitted as a report to a local medical journal.

Module no: 03
Contact: Dr Owen Porrill

[e-mail]

Tel. [phone]

Title: Acute pain assessment and management in a central hospital

No. of students: 2

Type: Interpretive

Summary:

Pain is commonly experienced by many patients presenting to emergency units and is an expected consequence that follows most surgical procedures. The assessment and treatment of this pain has important implications for the patient as well as the medical staff caring for the patient. At Groote Schuur Hospital there is no recent data on how patients experience management of their pain.

In this SSM the students will summarise current pain management options and perform an analysis of current pain treatment and its effectiveness in the emergency centre, on medical wards and following surgery, at Groote Schuur Hospital. Students will be introduced to assessment tools for pain evaluation and then use these tools to audit current practice. This will be written up as a formal report together with recommendations and a literature review. There is potential for this to be submitted as a report to a local medical journal.

Module no: 04

Contact: Dr Anthony Reed

[e-mail]

Tel: [phone]

Title: Acute pain assessment and management in a regional hospital

No. of students: 2

Type: Interpretive

Summary:

Pain is commonly experienced by many patients presenting to emergency units and is an expected consequence that follows most surgical procedures. The assessment and treatment of this pain has important implications for the patient as well as the medical staff caring for the patient. At New Somerset Hospital there is no recent data on how patients experience management of their pain.

In this SSM the students will review the physiology of pain, summarise current pain management options and perform an analysis of current pain treatment and its effectiveness in the emergency centre and following surgery, at New Somerset Hospital. Students will be introduced to assessment tools for pain evaluation and then use these tools to audit current practice. This will be written up as a formal report together with recommendations and a literature review. There is potential for this to be submitted as a report to a local medical journal.

Module no: 05

Contact: Dr Anthony Reed

[e-mail]

Tel: [phone]

Title: Acute and chronic pain in a district hospital - assessment and management

No. of students: 2

Type: Interpretive

Summary:

Pain is commonly experienced by many patients in hospital, either when presenting to emergency units, following surgical or medical procedures or as part of the disease process in hospital or at home. In addition untreated or poorly treated acute pain can result in a syndrome of chronic pain.

In this SSM the students will review the physiology of pain, summarise current pain management options and perform an analysis of current pain treatment and its effectiveness in the emergency centre and following surgery, at Vredenberg District Hospital. Students will be introduced to assessment tools for pain evaluation and then use these tools to audit current practice. Students will then need to spend a week at Vredenberg, collecting the data during the 3^rd week of the SSM. This will be written up as a formal report together with recommendations and a literature review. There is potential for this to be submitted as a report to a local medical journal
Module no: 06
Contact: Professor Jenny Thomas

[e-mail]

Tel: [phone]

Title: Acute pain assessment and management in

children at a tertiary hospital

No. of students: 2

Type: Interpretive

Summary:

Pain and is an expected consequence that follows most surgical procedures. However pain is also commonly experienced by many patients presenting to emergency units and in the medical wards of hospitals. The assessment and treatment of this pain has important implications for the patient as well as the medical staff caring for the patient. At Red Cross War Memorial Children’s Hospital there is no recent data on how non-surgical patients experience management of their pain.

In this SSM the students will review pain physiology, summarise current pain management options and perform an analysis of current pain treatment and its effectiveness in the emergency centre and in medical wards, at Red Cross War Memorial Children’s Hospital. Students will be introduced to assessment tools for pain evaluation and then use these tools to audit current pain in the non-surgical wards of the hospital. This will be written up as a formal report together with recommendations and a literature review. There is potential for this to be submitted as a report to a local medical journal.

Module no: 07

Contact: Dr Janieke Van Nugteren

[e-mail]

Tel: [phone]

Title: Chronic pain assessment and management

in a central hospital

No. of students: 2

Type: Interpretive

Summary:

The multi-disciplinary Pain Referral Clinic at Groote Schuur manages patients referred from medical specialists in different disciplines, who are unable to manage the pain in their own discipline. The patients often experience pain as part of a complex syndrome and many are long-term attendees at the pain clinic. At Groote Schuur Hospital there is no recent data on how patients experience management of their chronic pain.

In this SSM the students will summarise current thinking in chronic pain pathophysiology and the management options for chronic pain, and then perform an analysis of the chronic pain clinic’s patients satisfaction of their management, at Groote Schuur Hospital. This will be written up as a formal report together with recommendations and a literature review. There is potential for this to be submitted as a report to a local medical journal.
Module no: 08
Contact: Dr Janieke Van Nugteren

[e-mail]

Tel: [phone]

Title: Orthopaedic pain in a central hospital’s

outpatient clinic

No. of students: 2

Type: Interpretive

Summary:

There is no recent data on the incidence of orthopaedic pain in the population of Cape Town. Pain accounts for much of the symptomatology in orthopaedics. Operative solutions do not exist for much of the pain, and even when surgery is a treatment option, waiting lists can result in long delays.

In this SSM the students will review the physiology of pain, summarise current pain management options for orthopaedic pain and perform an analysis of the incidence of pain as a symptom and current pain assessment and treatment in patients presenting to the orthopaedic OPD, at Groote Schuur Hospital. Students will be introduced to assessment tools for pain evaluation and then use these tools to audit pain experienced by patients presenting to the orthopaedic OPD. This will be written up as a formal report together with recommendations and a literature review. There is potential for this to be submitted as a report to a local medical journal

.

HEALTH AND REHABILITATION SCIENCES – AHS2054S

Module no: 09
Contact: Associate Professor Sinegugu Duma

[e-mail]

Number of students: 4

Type: Literature Review

Title: Gender-based violence as public health issue.

Summary:

Gender-based violence is associated with various physical, mental, and reproductive health problems. It is reported that women who present to health care settings with trauma and injuries are often victims of intimate-partner violence. Unfortunately the health practitioners do not always know how to manage the victims of intimate partner violence when they present for health care. The purpose of this module is to introduce the students to gender-based violence as a public health issue. In this case study based module, the student will review the provided case study and conduct literature review to address the following:

1. 
   Distinguish the features of intimate partner violence.
   
2. 
   Discuss the effects of intimate partner violence on health.
   
3. 
   Describe the barriers to screening for intimate partner violence.
   
4. 
   Describe principles of effective screening for intimate-partner violence.
   

A written report, with a minimum of 2000 word count shall be submitted at the end of the module. Opportunities for the discussion of the case study and literature review with convenor will be provided per appointment where necessary
SURGERY – CHM2001S
Module no: 10 (Plastic Surgery)

Contact: Dr Kevin Adams

Email: [e-mail]

Phone: [phone]

Title: Surgery for Transgender patients at GSH

Number of students: 2

Type: Data capturing and analysis

Summary: A transgender person may have a male body but feel inside that they are female, or vice versa. They experience a deep incongruence between their physiological gender and their basic internal sense of gender self (or core gender identity). They may choose hormone treatment and/or surgery to address this or simply live their lives according to their preferred sense of their ‘gender’. Unfortunately, attempts to access care in the public sector often result in humiliation, up to 6 years on surgical waiting lists and sometimes being routed via the private sector at major expense, and with no guarantee of an outcome. Furthermore, many transgender persons continue to battle the medical prejudice and ignorance of the healthcare professionals they come into contact with.

The Dept of Psychiatry and Mental Health, UCT, runs one of only two public sector transgender clinics in South Africa. This GSH clinic consists of a multi-disciplinary team that offers a comprehensive service to transgender persons. It uses the services of a dedicated clinical psychologist, psychiatrist, clinical social worker, endocrinologist, plastic surgeon, gynaecologist, family physician and has links with the main referral NGO’s – the Triangle Project and Gender DynamiX. The transgender clinic has been offering a service for several years, however, the database for the surgical services have not been systematically captured and/or analysed.

The tasks for this SSM include the following:

• 
  Reviewing the clinic’s retrospective records, and capturing the Surgery dept data (incl. surgical waiting lists) into a comprehensive data set.
  
• 
  Reviewing existing literature on TG patients and access to surgery in low-to-middle income countries
  
• 
  Writing up a research report