The Maslach Burnout Inventory is not a measure of burnout.

For decades, the Maslach Burnout Inventory (MBI) has been regarded as the "gold standard" for the assessment of burnout. The present paper demonstrates that the MBI fails to measure the construct it is purported to measure. On a deeper level, the problems affecting the MBI question the very idea of burnout.

Methodological challenges in a study on falls in an older population of Cape Town, South Africa.

Background: Falls are a major cause of disability, morbidity and mortality in older persons, but have been under researched in developing countries.

Objective: To describe challenges encountered in a community-based study on falls in a multi-ethnic population aged ≥65 years in a low-income setting.

Methods: The study was conducted in four stages: A pilot study (n=105) to establish a sample size for the survey.

Risk factors for falls in older adults in a South African Urban Community.

Background: Studies on falls in older adults have mainly been conducted in high income countries. Scant, if any, information exists on risk factors for falls in the older population of sub-Saharan African countries.

Methods: A cross-sectional survey and a 12-month follow-up study were conducted to determine risk factors for falls in a representative multi-ethnic sample of 837 randomly selected ambulant community-dwelling subjects aged ≥65 years in three suburbs of Cape Town, South Africa.

Prevalence of Falls in an Urban Community-Dwelling Older Population of Cape Town, South Africa.

Objective: Falls are a major cause of disability and mortality in older adults. Studies on falls in this population have mainly been conducted in high income countries, and scant attention has been given to the problem in low and middle income countries, including South Africa. The aim of the study was to establish a rate for falls in older adults in South Africa.

Early clinical predictors of a severely abnormal amplitude-integrated electroencephalogram at 48 hours in cooled neonates.

Aim: There is a need to identify infants with hypoxic ischaemic encephalopathy who have a poor outcome despite therapeutic hypothermia. A severely abnormal amplitude-integrated electroencephalogram at 48 h predicts death or disability. Our aim was to determine whether clinical assessment at age 3-5 h predicts a severely abnormal amplitude-integrated electroencephalogram at 48 h or death in cooled infants.

Early clinical signs in neonates with hypoxic ischemic encephalopathy predict an abnormal amplitude-integrated electroencephalogram at age 6 hours.

Background: An early clinical score predicting an abnormal amplitude-integrated electroencephalogram (aEEG) or moderate-severe hypoxic ischemic encephalopathy (HIE) may allow rapid triage of infants for therapeutic hypothermia. We aimed to determine if early clinical examination could predict either an abnormal aEEG at age 6 hours or moderate-severe HIE presenting within 72 hours of birth.

Methods: Sixty infants ≥ 36 weeks gestational age were prospectively enrolled following suspected intrapartum hypoxia and signs of encephalopathy.

Defining hypoxic ischemic encephalopathy in newborn infants: benchmarking in a South African population.

Objectives: There are few population-based studies of hypoxic ischemic encephalopathy (HIE) in sub-Saharan Africa, and the published criteria that are used to define and grade HIE are too variable for meaningful comparisons between studies and populations. Our objectives were (1) to investigate how the incidence of HIE in our region varies with different criteria for intrapartum hypoxia and (2) to determine how encephalopathy severity varies with different grading systems.

Method: We reviewed the records of infants with a diagnosis of HIE born between September 2008 and March 2009 in public facilities in the Southern Cape Peninsula, South Africa.

Can a new paediatric sub-specialty improve child health in South Africa?

Compared with other middle-income countries, child health in South Africa is in a poor state, and should be addressed by focusing on the health care needs of all children across a system or region. Paediatricians have had little effect on this situation, partly because their training is not aligned with South African needs. The proposed re-engineering of primary health care will be limited by the skewed distribution of staff and the lack of suitable skills.

Diagnostic accuracy of clinical signs used to identify electrolyte disturbances in children with diarrhoea.

Background: No studies have assessed the diagnostic accuracy of clinical signs of electrolyte disturbances in children with dehydrating diarrhoea.

Aims: To assess the diagnostic accuracy and reliability of clinical signs previously reported to be associated with plasma sodium and potassium disturbances in children.

Methods: A cross-sectional analytical study of 476 children aged 6 weeks to 2 years, admitted to a rehydration unit in Cape Town, South Africa.

Can lay health workers increase the uptake of childhood immunisation? Systematic review and typology.

Objectives: Lay health workers (LHWs) are used in many settings to increase immunisation uptake among children. However, little is known about the effectiveness of these interventions. The objective of this review was to assess the effects of LHW interventions on childhood immunisation uptake.

Therapeutic impact of routine electrolyte testing in childhood diarrhoea.

Aim: To report on the management of plasma sodium and potassium disturbances, identified by routine electrolyte testing in children.

Methods: A prospective cohort study of patients admitted to the Diarrhoea Rehydration Unit of Red Cross Children's Hospital, Cape Town, South Africa. The patients were 530 children aged 6 weeks to 2 years with a primary diagnosis of diarrhoea.

Does chair type influence outcome in the timed "Up and Go" test in older persons?

Objective: To test the effects of the use of a collapsible, portable chair (chair B), as opposed to a 'standard' chair (chair A), on the outcome of the timed "Up and Go" (TUG) test.

Design: Cross-sectional.

Setting: Multipurpose senior centres.

WITHDRAWN: Conjugate vaccines for preventing Haemophilus influenzae type B infections.

Background: Haemophilus influenzae (H. influenzae) is an important cause of meningitis and pneumonia in children. Vaccine cost is a significant barrier to use in low income countries.

WITHDRAWN: Chest radiograph in acute respiratory infections.

Background: Chest radiography is widely used during the management of acute lower respiratory infections, but the benefits are unknown.

Objectives: To assess the effects of chest radiography on clinical outcome in acute lower respiratory infections.

Search Strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 1), MEDLINE (1950 to January 2007) and EMBASE (January 1976 to February 2007).

Review: optical micrometer resolution scanning for non-invasive grading of precancer in the human uterine cervix.

Management of cervical precancer is archetypal for other cancer prevention programmes but has to consider diagnostic and logistic challenges. Numerous optical tools are emerging for non-destructive near real-time early diagnosis of precancerous lesions of the cervix. Non-destructive, real-time imaging modalities have reached pre-commercial status, but high resolution mapping tools are not yet introduced in clinical settings.

WITHDRAWN: Symptomatic treatment of the cough in whooping cough.

Background: Whooping cough is an important cause of childhood morbidity and mortality. There are 20 to 40 million cases of whooping cough annually world-wide, 90% of which occur in developing countries, resulting in an estimated 200 to 300,000 fatalities each year. Much of the morbidity is due to the effects of the paroxysmal cough.

Chest radiograph in acute respiratory infections.

Background: Chest radiography is widely used during the management of acute lower respiratory infections, but the benefits are unknown.

Objectives: To assess the effects of chest radiography on clinical outcome in acute lower respiratory infections.

Search Strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 1), MEDLINE (1950 to January 2007) and EMBASE (January 1976 to February 2007).

Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial.

Background: Childhood asthma is common in Cape Town, a province of South Africa, but is underdiagnosed by general practitioners. Medications are often prescribed inappropriately, and care is episodic. The objective of this study is to assess the impact of educational outreach to general practitioners on asthma symptoms of children in their practice.

Conjugate vaccines for preventing Haemophilus influenzae type B infections.

Background: Haemophilus influenzae (H. influenzae) is an important cause of meningitis and pneumonia in children. Vaccine cost is a significant barrier to use in low income countries.