Category: General Interest

NHI Faces Healthcare Human Resource Emigration Challenges

Photo by Daniel Eledut on Unsplash

While the proposed National Health Insurance (NHI) could make use of existing private healthcare human resources, the necessary tax increases to fund it could drive more healthcare professionals from the country, the Professional Provident Society (PPS) has said.  Economic and other factors, such as the Durban unrest, have already caused a surge of emigrations of professionals since July last year. In addition, foreign students graduates who study critical skills in South Africa (such as nurses and GPs) will no longer have an easy route to permanent residency. 

The PPS, which counts about 30 000 healthcare professionals among its membership, pointed out the vulnerability of South Africa’s tax base – which has shrunk to only 6.9 million taxpayers, down from 7.6 million the year from the year before.

While it raised a number of concerns about the NHI, the group stated that it was broadly supportive of establishing universal healthcare in the country, and this goal could still be accomplished by using a dual public-private system. The PPS further noted that the government could benefit from the exceptional administrative capabilities and existing patient management systems.

However, NHI is dependent on strong, competitively remunerated human resources, with PPS pointing out that “South Africa has experienced a mass exodus of nurses in the 90s; we cannot risk that again. Both the government and private sector need to find a solution for South Africa and it cannot ‘import solutions’.”

“Professionals are a big proportion of healthcare delivery and the tax base. Their voices need to be considered.

“We urgently need to see the funding model, the implementation of the Health Market Inquiry (HMI) and details of how the system will work.”

The PPS said in a 2019 report that the highest risk to effective universal health cover in South Africa is losing highly skilled professionals to emigration. Healthcare professionals have a great deal of geographic freedom, and it is becoming easier to work in their trades the world over. COVID with its restrictions may have slowed emigrations by skilled professionals, but since July 2021, experts have seen a surge backed up by 18 months of pent-up demand. 

The PPS noted that research has shown “that the decision to emigrate is a complex one that is driven by various personal and societal pull and push factors.”  The NHI could be yet another push factor adding to the list of healthcare professionals’ sore points. “Healthcare worker migration from South Africa in the past has been driven by policy decisions and socio-economic and political considerations.

“In 2001, the number of nurse emigrants was roughly 20% of the total number working within the public sector in South Africa. That, together with being ranked as having the eighth-highest global number of emigrating physicians in the year 2000, created a dire situation for the sustainability of healthcare in South Africa at the time.”

Among general professionals, PPS’s research has indicated that many are considering emigration. A majority of respondents surveyed (73%) cited NHI as a potential reason for emigration, with 15% unsure and only 12% not considering leaving at all.

In addition to losses from emigration, the Department of Home Affairs has ended a 2014 waiver which allowed a quicker path to a residency permit for foreign students who acquire critical skills in South African higher learning institutions. Going forward, foreign students will no longer be able to apply for permanent residency visas without complying with the usual requirements such as providing proof of five years’ work experience. This is seen as detrimental to South Africa’s ability to attract and retain skilled professionals. This may further impact NHI implementation as the necessary skilled human resources are squeezed further as fewer foreign students may choose to study and then work in South Africa.

Source: BusinessTech

How Detrimental to Sleep is Media Use Before Bedtime?

Photo by Ketut Subiyanto from Pexels

A new study published in the Journal of Sleep Research found a complicated relationship between media use and bedtime and sleep quality and duration, with short, simple media use resulting in earlier bedtime and longer sleep duration.

Many factors contribute to sleep disturbance among young adults. Use of media is increasing rapidly, and little is known regarding its association with sleep disturbance. Previous research showed that social media use before bedtime in young adults resulted in reduced and poorer quality sleep.

The study examined how sleep might be impacted by media use – such as watching movies, television, or YouTube videos; browsing the Internet; or listening to music – before bed.

In the study, 58 adults kept a diary that recorded information related to time spent with media before bed, location of use, and multitasking. Electroencephalography captured parameters such as bedtime, total sleep time, and sleep quality. 

Media use in the hour before sleep was associated with an earlier bedtime. If the before-bed use did not involve multitasking and was conducted in bed, it was also associated with more total sleep time. A long use of media associated with later bedtime and less total sleep time.

Sleep quality, operationalised as the percent of total sleep time spent in N3 and REM sleep, was unaffected by media use before bed.

“If you are going to use media, like watching TV or listening to music, before bed, keep it a short, focused session and you are unlikely to experience any negative outcomes in your sleep that night,” said lead author Morgan Ellithorpe, PhD, of the University of Delaware.

Source: Wiley

Record Numbers of ‘Healthcare Hero’ Entries for Doctors’ Day

“She brings humanity, humility, understanding and – dare I say it – love into her practice.”

Stories of appreciation, like this one, are just the medicine South Africa’s doctors need, over 670 days into the COVID pandemic. Since March 2020, the country’s healthcare workers have been manning the frontline of this global healthcare crisis, regularly putting themselves at risk of exposure in order to help their patients. And now, many patients are giving back.

“This is why we say thank you” is the theme on the Doctors’ Day website. This dedicated website is part of an initiative called Doctors’ Day, created by EthiQal, a division of Constantia Insurance Company Limited. The initiative was launched in 2018 and is celebrated annually on 16 November. This national day is intended to raise awareness about the value that so many of the country’s doctors bring to the lives of their patients and families – and the website is the platform where stories of gratitude can be read.

“This is the fifth year that we’ve run Doctors’ Day and every year the number of stories we receive grows substantially. We’ve far surpassed the responses from last year, as more and more patients take the time to share their healthcare hero stories,” says Alex Brownlee, EthiQal Executive.

Stories of appreciation
Every year, EthiQal calls on the nation to celebrate and recognise South Africa’s doctors. Heading into the third year of the COVID pandemic, the healthcare industry deserves to be recognised more than ever for the critical role they continue to play in meeting the needs of our nation, explains Brownlee.

Of the hundreds of entries from the 2021 Doctors’ Day competition, five of the most moving stories have been selected and are featured on the website, with each winning entrant receiving R1000. EthiQal also donated R10 000 to the Healthcare Workers Care Network – a nationwide healthcare worker support network. The winning entries can be read at www.doctorsday.co.za

“Our firm belief is that doctors are national assets, and so the core of the Doctors’ Day message truly resonates with everyone who works at EthiQal. We love Doctors’ Day because it gives people an opportunity to share their sincere messages of thanks. It’s just one small way that patients can give back to their doctors. We look forward to all the new entries and heart-warming stories that we’ll receive in November,” says Brownlee.

Men in Medical Face Masks Rated as More Attractive

Source: Sammy Williams on Unsplash

Besides COVID prevention, there is an upside to wearing the ubiquitous face masks worn in many countries: they increase attractiveness, at least in men. 

A study published in Cognitive Research: Principles and Implications measured how different types of face masks changed the attractiveness of 40 male faces.

However, the researchers discovered the type of covering matters – blue medical masks were found to increase facial attractiveness more than other types of masks.

Dr. Michael Lewis, an expert in the psychology of faces, said: “Research carried out before the pandemic found medical face masks reduce attractiveness – so we wanted to test whether this had changed since face coverings became ubiquitous and understand whether the type of mask had any effect.

“Our study suggests faces are considered most attractive when covered by medical face masks. This may be because we’re used to healthcare workers wearing blue masks and now we associate these with people in caring or medical professions. At a time when we feel vulnerable, we may find the wearing of medical masks reassuring and so feel more positive towards the wearer.

“We also found faces are considered significantly more attractive when covered by cloth masks than when not covered. Some of this effect may be a result of being able to hide undesirable features in the lower part of the face—but this effect was present for both less attractive and more attractive people.”

In the study, 43 female participants were asked to rate the attractiveness of images of male faces without a mask; wearing a cloth mask; a blue medical face mask and holding a plain black book covering the area a face mask would hide. The research took place seven months after face masks became mandatory in the UK.

“The results run counter to the pre-pandemic research where it was thought masks made people think about disease and the person should be avoided,” commented Dr Lewis.

“The current research shows the pandemic has changed our psychology in how we perceive the wearers of masks. When we see someone wearing a mask we no longer think ‘that person has a disease, I need to stay away’.

“This relates to evolutionary psychology and why we select the partners we do. Disease and evidence of disease can play a big role in mate selection – previously any cues to disease would be a big turn off. Now we can observe a shift in our psychology such that face masks are no longer acting as a contamination cue.”

Next steps are to see if the reverse holds true for women’s attractiveness to men.

Source: Cardiff University

A Look Back at 2021

Photo by Olya Kobruseva on Pexels


The start of 2021 saw South African hospitals battling for resources amid a COVID surge, and planning for what would be a very controversial and drawn-out vaccination programme which would be partly paid for by the overflowing coffers of the country’s medical aid schemes. Indeed, there was a real concern that the as-yet-to-be-named Beta variant would evade vaccines, which would prove to be true – and a story which would be repeated with the Omicron variant later in the year. In China, the start of an investigation into the origins of the SARS-CoV-2 virus in Wuhan was stymied by the Chinese government denying them entry.

The middle of the year saw the Third Wave, now driven by the highly transmissible Delta variant which had ravaged India earlier in the year. Production setbacks further dogged South Africa’s vaccine programme as millions of Johnson & Johnson vaccines were deemed unfit for use. In Brazil, deaths passed half a million amid condemnation of the mishandling of the COVID pandemic by its President Jair Bolsonaro. Economic frustration, stoked by political manoeuvring around the trial of former President Jacob Zuma, saw much of the country erupt in looting and violence. This would seriously damage COVID vaccination and surveillance efforts in the affected areas, particularly KwaZulu-Natal.

Statins seemed to be losing some of their bad image as new studies revealed that they were not associated with cognitive decline, following on from a 2020 study showing many of their feared side effects were the result of the ‘nocebo’ effect. The US government initiated a probe into how a controversial drug for the treatment of Alzheimer’s disease managed to receive approval despite no evidence of benefit. Dr Zweli Mkhize stepped down as Health Minister amidst revelations about procurement irregularities relating to the Digital Vibes contract.

Towards the end of the year, South African vaccination rates fell due to a combination of factors: vaccine hesitancy, apathy and difficulty servicing remote areas. Omicron was detected in late November, immediately raising alarm due to the extremely large number of mutations it possesses. In response, countries around the world announced immediate travel bans or heightened quarantine restrictions. However, these proved futile as the highly contagious Omicron was already loose in the borders of many countries, rendering the controversial containment efforts moot.

Fortunately, early signs from Netcare showed that Omicron caused less severe disease. By year end, new effective COVID treatments were going through these stages of their final approval. Merck’s Molnupiravir (Lagevrio) had shown promise for the treatment of COVID, though later analysis with additional data showed it to be less effective than believed. Expected production for Pfizer’s nirmatrelvir (Paxlovid) was expected to increase to 80 million courses after results showed an 89% reduction of hospitalisation or death for outpatients. As the year closed, there was some good news for South Africa’s economy as travel bans were lifted – though the countries imposing them now had Omicron surges of their own to contend with.

Most Superheroes Will Age Healthily, Researchers Conclude

Spider-Man has a healthy outlook, so long as he doesn’t binge drink or smoke like his mentor, Iron Man. Source: Pixabay

Australian researchers in the Christmas edition of the British Medical Journal took a whimsical look at the ageing trajectories of Marvel superheroes based on their attributes and behaviours as seen in the films, finding them to be largely well-adjusted and likely to age healthily. 

Positive behaviours and health assets
Marvel superheroes are physically active, socially engaged, and optimistic, with high educational attainment and (with one notable exception) healthy weight, all of which have been associated with a positive ageing trajectory.

The review found that superheroes regularly engage in physical activity and exercise, both associated with healthy ageing. They often undertake high intensity interval training (HIIT), associated with improved health status in ageing men.

Even during discussions about how to stop aliens from enslaving humanity, superheroes stand regularly and pace, increasing their step count and further improving their healthy outlook.

In terms of social engagement, superheroes exhibit a high degree of social cohesion and connectedness, both linked to reduced dementia risk. People with strong social ties tend to live longer than isolated people, regardless of other risk factors such as smoking, alcohol consumption, and physical activity.

The superheroes show a positive or optimistic mindset on several occasions, as well as psychological resilience and a sense of purpose, all of which have been associated with healthy ageing.  Some have traumatic backgrounds, including Spider-Man who was orphaned, which increases his risk of substance abuse and mental health problems. However, his supportive social contacts, including positive male role models help mitigate this.

Most of the superheroes did not drink or smoke excessively, save for Iron Man and Thor, which is associated with longevity and healthy ageing. However, Thor is already thousands of years old and the researchers could not assume that modifiable personal traits would affect his life trajectory.

Negative behaviours and risk factors
Superheroes are exposed to loud noises, air pollution, and receive multiple head injuries precipitated by high risk physical activities.

Superheroes are repeatedly exposed to loud noises such as explosions, which is linked to hearing loss, which in turn is associated with an increased risk of cognitive impairment and dementia. Some of the superheroes, such as Hulk and Thor, have booming voices, potentially indicative of early sensorineural hearing loss.

During their activities, superheroes sustain multiple major head injuries, increasing their dementia risk. Involvement in high risk activities, which could increase their likelihood for life changing physical injury and disability.

Of the individual cases presented, Black Panther has probably the best health outlook, as he is extremely wealthy and intelligent, health assets that he shares in common with Iron Man. However, unlike Iron Man, he does not drink or smoke excessively, and is a vegetarian, which has well-studied benefits in healthy ageing.

On the other end of the spectrum, the Hulk was noted to have serious health concerns. Bruce Banner transforms to the Hulk when he experiences tachycardia—specifically, a heart rate of 200 beats per minute. The frequency of this occurrence suggests a predisposition to cardiac arrhythmias, possibly indicating underlying cardiac disease.

Hulk’s body mass index (BMI) is about 120 (calculated from height 213cm–243cm and weight 471kg–635kg). Although being in the overweight category might be protective, obesity is associated with a higher death rate as well as dementia, and several chronic health conditions and frailty. Hulk’s BMI also raises pragmatic concerns around future access to appropriate healthcare. Hulk’s almost constant anger (“That’s my secret Captain. I’m always angry”) might lead to increased inflammation and comorbidity in advanced old age.

Source: The British Medical Journal

Brain Surgeons versus Rocket Scientists: Who’s Brainier?

Source: Sammy Williams on Unsplash

A light-hearted research article published in the Christmas edition of the BMJ sought to see once for all who is ‘brainier’: brain surgeons versus rocket scientists.

Brain surgeons and rocket scientists are often put on a pedestal as the exemplars of intellectual endeavour. But which of them is smarter and deserves the accolade more? Or at all? A group of neurosurgeons – who were, of course, totally unbiased – decided to resolve this conundrum.

Delving into the background of the phrases, they wrote that, “The phrase ‘It’s not rocket science’ is thought to have originated in America in the 1950s when German rocket scientists were brought over to support the developing space program and design of military rockets,” a research team led by University College London neuroscientist Inga Usher explained in their new paper.

“The origin of ‘It’s not brain surgery’ is less clear. It is tempting to speculate that the pioneering techniques of the polymath and neurosurgeon Harvey Cushing captured the attention of the public and promulgated the phrase.”

Their study aimed to settle the debate once and for all, and to “provide rocket scientists and brain surgeons with evidence to support their self-assuredness in the company of the other party.” The researchers tested participants across cognitive domains such as emotional discrimination and motor control. Eschewing an overall winner, they assessed the cognitive characteristics of each specialty using a validated online test, the Great British Intelligence Test (GBIT). This test had been used to measure distinct aspects of human cognition, spanning planning and reasoning, working memory, attention, and emotion processing abilities in more than 250 000 members of the British public. Rather than being an IQ test, it is intended to more finely discriminate aspects of cognitive ability. The dataset also let the researchers benchmark both specialties against the general population.

The neurosurgeons showed significantly higher scores than the aerospace engineers in semantic problem solving (possibly attributable to their familiarity with Latin and Greek scientific terminology). Aerospace engineers showed significantly higher scores in mental manipulation and attention. Domain scores for memory, spatial problem solving, problem solving speed, and memory recall speed were similar for both groups. When each group’s scores for the six domains were compared with those in the general population, only two differences were significant: the neurosurgeons’ problem solving speed was quicker and their memory recall speed was slower. No significant difference was found between aerospace engineers and the control population in any of the domains. 

The researchers observed that, “despite the stereotypes depicted by the phrases ‘It’s not rocket science’ and ‘It’s not brain surgery’, all three groups showed a wide range of cognitive abilities. In the original GBIT, 90% of Britons scored above average on at least one aspect of intelligence, illustrating the importance of studying multiple domains that make up a concept of intelligence rather than a single measure.”

The researchers came to the conclusion that, based on the findings, in situations that do not require rapid problem solving, it might be more correct to use the phrase “It’s not brain surgery”. It is possible that both neurosurgeons and aerospace engineers are unnecessarily placed on a pedestal and that “It’s a walk in the park” or another phrase unrelated to careers might be more appropriate. Other specialties might deserve to be on that pedestal, and future work should aim to determine the most deserving profession.

On a more serious note, they also considered that fewer young people are choosing surgery or engineering as a career path, and that such pursuits are commonly seen as ‘masculine’, deterring many females at an early stage. Their results however, showed that neither field differed significantly in cognitive aspects from the general public, which should help reassure future candidates that there is no ‘requirement’ for any type of personality trait.

Source: The British Medical Journal

Great Gift Ideas for Healthcare Workers

Photo by Jess Bailey on Unsplash

If you’re stuck for gift ideas for a certain healthcare worker, or you are one yourself and looking to leave hints for someone stuck for ideas, this list could help. 

1: A Good Pair of Scrubs
This one may seem obvious, but not all scrubs are identical or of high quality, and healthcare providers can never have enough high-quality scrubs. Ones that are soft, flexible, and moisture-resistant are ideal. For the fashion-conscious healthcare worker, go for jogger style.

2: A Massage Gun
The healthcare working environment is a physically demanding one. With long shifts, sometimes up to 24 hours or even longer, much of the time is spent standing. A massage gun can work wonders for sore muscles, aches, and pains.

3: Good Moisturiser or Hand Cream
Healthcare workers wash their hands and use hand sanitiser all day long, which can cause the skin to dry out and lead to painful cracking. A good moisturiser can go a long way. However, avoid those that are heavily scented since some patients may be sensitive to the chemicals. Another great option is hydrating single-use hand masks.

4: Quick Meal Solutions
Gift cards for food delivery services like Uber Eats or Mr D are a great way for healthcare workers to get an easy meal – and can offer healthy alternatives to junk food. Cooking most likely is not at the top of their priority list either on shift or coming off of it, so this can be a practical way to be supportive and make their lives a little easier.

5: Custom Tailored Lab CoatThe long white lab coat is a symbol of office for physicians, a representation of all the long years of hard work they’ve put into their career as well as a reassuring sight for patients. A custom-tailored and embroidered white lab coat would make the perfect gift for any physician.

6: Spa DayTwo years into the pandemic with the constant threat of burnout, there’s nothing quite like having an indulgent spa day for your healthcare worker friend or family member to relax. A good massage to ease stiff muscles and a sauna session is a fantastic way to help unwind, lease the burden and de-stress.

7: Smartwatch
A smartwatch that can track health data and perform other functions can make a great gift for a healthcare worker if they don’t have one already. Smartwatches are of course convenient for checking the time, but they can also monitor activity and exercise levels and overall well-being and sync with mobile phones for calls, alerts, and many apps – some of which can warn if healthcare workers are falling ill.

8: Travel Mug
People who are on the go for their job can always use a travel mug, especially paramedics who spend long nights on shift on the road. This will keep coffee (or tea, hot chocolate, or soup) at just the right temperature for extended periods of time.

9: Compression Socks
Working in a field that requires a great deal of time spent on their feet, most healthcare workers likely know about the benefits of compression socks. They prevent muscle soreness and stiffness in the legs, and just like regular socks (and scrubs), you can never have too many.

10: Blue Light Blocking Glasses
Hours spent sitting at a computer, inputting patient charts can cause some serious eyestrain. This can purportedly be reduced by wearing blue light glasses (which can be either prescription or non-prescription) which filter out blue light, supposedly reducing strain. Evidence for the glasses are mixed, but many swear by them.

Source: MedPage Today

No Evidence of Videogame and Violence Link in the Real World

New research finds no evidence that violence increases after the release of a new video game.

Violent video games like Call of Duty are often linked by the media and public to real-life violence, although there is limited evidence to support the link. Debate on the topic generally intensifies after mass public shootings, with some commentators linking these violent acts to the perpetrators’ interests in violent video games. But different factors have been pointed out as more likely explanations, such as mental health issues and/or easy access to guns.

Before governments introduce any policies restricting access to violent video games, it is important to establish whether violent video games do indeed increase players’ violence in the real world.

Taking data from the US, Dr Agne Suziedelyte at University of London, provides evidence of the effects of violent video game releases on the violent behaviour of children. Dr Suziedelyte examined the effects of violent video games on two types of violence: aggression against other people, and destruction of objects or property.

Appearing in the Journal of Economic Behavior & Organization, the study focused on boys aged 8 to 18 years: the group most likely to play violent video games.

By using econometric methods which identify plausibly causal effects of violent video games on violence, rather than only associations, Dr Suziedelyte found no evidence that violence against other people increases after the release of a new violent video game. Parents reported, however, that children were more likely to destroy things after playing violent video games.

Dr Suziedelyte said: “Taken together, these results suggest that violent video games may agitate children, but this agitation does not translate into violence against other people — which is the type of violence which we care about most.

“A likely explanation for my results is that video game playing usually takes place at home, where opportunities to engage in violence are lower. This ‘incapacitation’ effect is especially important for violence-prone boys who may be especially attracted to violent video games.

“Therefore, policies that place restrictions on video game sales to minors are unlikely to reduce violence.

Source: City University London

Cats and Dogs Develop Myocarditis from COVID

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A new study reveals that pets can be infected with the Alpha variant of SARS-CoV-2. Due to its increased transmissibility and infectivity, this variant rapidly outcompeted pre-existing variants in England, before being replaced by the Delta variant.

The study, which was published in Veterinary Record, describes the first identification of the SARS-CoV-2 Alpha variant in domestic pets; two cats and one dog were positive on PCR test, while two additional cats and one dog displayed antibodies two to six weeks after they developed signs of cardiac disease. Many owners of these pets had themselves developed respiratory symptoms several weeks before their pets became ill and had also tested positive for COVID.  

These pets all had experienced an acute onset of cardiac disease, including severe myocarditis. Humans also have a slight risk for myocarditis from COVID, particularly in children, for whom the risk is 37 times higher than without having contracted COVID, according to the US Centers for Disease Control.

“Our study reports the first cases of cats and dogs affected by the COVID alpha variant and highlights, more than ever, the risk that companion animals can become infected with SARS-CoV-2,” said lead author Luca Ferasin, DVM, PhD, of The Ralph Veterinary Referral Centre, in the UK. “We also reported the atypical clinical manifestations characterised by severe heart abnormalities, which is a well-recognised complication in people affected by COVID but has never described in pets before. However, COVID infection in pets remains a relatively rare condition and, based on our observations, it seems that the transmission occurs from humans to pets, rather than vice versa.”

Source: Wiley