Opinions of medical students at the University of Cape Town on emigration, conscription and compulsory community service

A study was conducted to determine emigration intentions of medical students at the University of Cape Town. Students from 1st to 5th year completed a self-administered questionnaire. A response rate of 86% was achieved. Over half the students (54%) were considering emigration. The most frequently selected motivating factors were moral dissatisfaction with the present government and career opportunities abroad. Men who were eligible for military conscription rated this factor as an important deterrent to remaining in South Africa, and 81% stated objections to national service. However, 71% would be less likely to emigrate were an alternative national service (ANS) instituted. Should a compulsory community service be implemented, 41% of those eligible would be more inclined to emigrate. Recommendations include the implementation of ANS; a re-evaluation of the compulsory community service proposal; and further investigation of emigration trends and of ways to curb emigration. Suggestions offered are a reappraisal of both selection criteria and medical education; and the provision of incentives for doctors to work in rural areas

Updated European Consensus Statement on diagnosis and treatment of adult ADHD

Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness. Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated. Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated? Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD. (c) 2018 The Author(s). Published by Elsevier Masson SAS.Peer reviewe

Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit/hyperactivity disorder: study protocol for a randomized controlled trial

Background: The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently needed. Bright light therapy (BLT) improves day– night rhythm and is an emerging therapy for major depression. Exercise intervention (EI) reduces obesity and improves depressive symptoms. To date, no randomized controlled trial (RCT) has been performed to establish feasibility and efficacy of these interventions targeting the prevention of co-morbid depression and obesity in ADHD. We hypothesize that the two manualized interventions in combination with mobile health-based monitoring and reinforcement will result in less depressive symptoms and obesity compared to treatment as usual in adolescents and young adults with ADHD. Methods: This trial is a prospective, pilot phase-IIa, parallel-group RCT with three arms (two add-on treatment groups [BLT, EI] and one treatment as usual [TAU] control group). The primary outcome variable is change in the Inventory of Depressive Symptomatology total score (observer-blinded assessment) between baseline and ten weeks of intervention. This variable is analyzed with a mixed model for repeated measures approach investigating the treatment effect with respect to all three groups. A total of 330 participants with ADHD, aged 14 – < 30 years, will be screened at the four study centers. To establish effect sizes, the sample size was planned at the liberal significance level of α = 0.10 (two-sided) and the power of 1-β = 80% in order to find medium effects. Secondary outcomes measures including change in obesity, ADHD symptoms, general psychopathology, health-related quality of life, neurocognitive function, chronotype, and physical fitness are explored after the end of the intervention and at the 12-week follow-up. This is the first pilot RCT on the use of BLT and EI in combination with mobile health-based monitoring and reinforcement targeting the prevention of co-morbid depression and obesity in adolescents and young adults with ADHD. If at least medium effects can be established with regard to the prevention of depressive symptoms and obesity, a larger scale confirmatory phase-III trial may be warranted.The trial is funded by the EU Framework Programme for Research and Innovation, Horizon 2020 (Project no. 667302). Funding period: January 2016–December 2020. This funding source had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data, or decision to submit results. Some local funds additionally contributed to carry out this study, especially for the preparation of the interventions: FBO research activity is by the Spanish Ministry of Economy and Competitiveness – MINECO (RYC-2011-09011) and by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Unit of Excellence on Exercise and Health (UCEES)

The Full Range of Benefits of Telemedicine in a Developing Country: The Example of South Africa

This presentation was given by at the Med-e-tel 2005 Conference in Luxembourg on April 6th, 2005.Effects and Benefits of eHealth: Lessons Learned in Four Continents; Tele Medicine's (TM) benefits in developed countries are well known. But Public Service TM in developing countries provides these gains and also other most important advantages, which are much less familiar. The latter will be described, with reference to existing South African TM programmes.Tele Medicine Research Centre, Medical Research Council of South Africa, Cape Town, South Africa

A critical comparison of three methods for measuring dental models.

A critical comparison of three methods for measuring distances between various fiducial points on orthodontic plaster casts is presented. The first method consisted of using a vernier caliper by which direct measurements (Dv) of the distances were recorded. The second method consisted of measuring the same casts using a reflex metrograph (Dm), where the co-ordinates of the points relative to two axes were recorded and the distances between various points were calculated. In the third method, reflection holograms of the casts were made, and the same distances were measured on the holographic images (Dh) using the reflex metrograph. The Wilcoxon sign rank test indicated no significant differences (p greater than 0.1) between measurements made by the various techniques. The means of the different distances scored varied within less than 0.5 mm (Dv-Dh), 0.5mm (Dv-Dm) and 0.2mm Dm-Dh). This study indicated that holograms can provide sufficiently accurate representations of orthodontic study models. Their retention as case records may solve the problem of the storage of orthodontic plaster casts.Articl

A Teledermatology Network for Underserved Areas of South Africa

This presentation was given at the Med-e-tel 2005 Conference in Luxembourg on April 7th, 2005.eHealth and Developing Countries (1): This paper will describe an ongoing study examining the feasibility of and satisfaction with a telemedicine network that aims to enhance delivery of dermatological care in relatively remote areas of South Africa using a simple store-and-forward telemedicine system. In addition, issues of sustainability of such a teledermatology network will be discussed.University of Washington, USA; University of Cape Town, RSA, South Africa; and Medical Research Council of South Africa, Pretoria, South Afric