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Poor sleep quality, low physical activity and low-to-moderate diet quality in South African first-year medical students
Borresen, Jill; Celie, Bert; Laubscher, R.; Bac, Martin; Wood, Paola Silvia; Camacho, Tanya Chantelle de Sousa; Nolte, Kim; Schwellnus, Marianne; Schwellnus, Martin Peter (South african Medical Association, 2025-03)
BACKGROUND : The personal health behaviours and lifestyle habits of health professionals influence their counselling practices related to non-communicable diseases (NCDs). There is limited evidence on the prevalence of modifiable NCD risk factors among medical students in South Africa (SA). Objectives. To determine the prevalence of modifiable behavioural and metabolic NCD risk factors in first-year medical students at a SA university. METHODS : This cross-sectional observational study included 256 first-year students. Participants completed five online questionnaires regarding lifestyle behaviours (physical activity, dietary habits, smoking, alcohol consumption and sleep quality). NCD-related metabolic markers including body composition, blood pressure, total cholesterol and random glucose concentrations, were measured. The prevalence of risk factors was calculated using internationally accepted criteria, and sex differences were reported using one-way ANOVA or χ2 test (p<0.05). RESULTS : The prevalence of poor sleep quality was 79.7%, followed by low-to-moderate diet quality (66.8%), low levels of physical activity (64.1%), overweight/obesity (26.2%), current/past smoking (13.3%) and harmful use of alcohol (12.5%). Most (88.3%) participants had two or more NCD-related risk factors. The prevalence of multiple NCD risk factors differed significantly between male and female participants, with more male participants having ≥2. CONCLUSIONS : This study found that first-year medical students at a South African university have a high prevalence of lifestyle-related risk factors, specifically poor sleep quality, low levels of physical activity and low-to-moderate diet quality. Sleep hygiene, regular activity and good nutrition should be promoted, and interventions focusing on nutrition, smoking cessation and alcohol consumption could be targeted by sex.
External factors affecting the efficacy of the Albertina Sisulu executive leadership programme in health fellowship in South Africa : a 360° qualitative assessment
Van der Berg-Cloete, S.E. (Sophy); Tosh, Cheryl A.; Buch, Eric (South African Medical Association, 2025-09)
BACKGROUND : In South Africa (SA), concerns have been expressed that the leadership is not ready for the implementation of National Health Insurance (NHI). The health minister has therefore advocated leadership development and training to equip leaders with the skills to perform optimally. The Albertina Sisulu Executive Leadership Programme in Health (ASELPH) Fellowship, a postgraduate qualification offered in SA, was developed for this purpose and was proven to improve the leadership skills of executive leaders. OBJECTIVES : To identify the various factors influencing the efficacy of the ASELPH Fellowship. Methods. A quasi-experimental study design was used to determine the factors affecting the ASELPH Fellowship. Data were collected from healthcare leaders (n=42) by means of a questionnaire before and after training. It included post-training and retrospective assessments from their assessors and their module daily assessments and reflective essays. Descriptive analysis and thematic content analysis were used for the qualitative reflections. The perceptions of participants, including students and assessors, regarding external barriers to implementing their newfound skills and competencies were assessed. RESULTS : Participants found it difficult to implement their training owing to a lack of leadership skills and knowledge, shortage of human and financial resources, political pressure, poor governance and policy implementation. Despite these barriers, participants who attended the course were still able to improve their leadership skills and performance in the workplace. CONCLUSION : Leadership training and development programmes such as the ASELPH Fellowship bode well for the future implementation of public health because much-needed leadership skills are injected into the currently beleaguered public health system
Does it matter where you know them from? Race-ethnicity and the impact of social domain on intergroup contact
Kelly, Monique D.A.; Arendse, Danille Elize (Sage, 2025-12)
Previous research generally suggests that increased racial-ethnic intergroup contact can reduce prejudice. Most studies, however, have examined the effects of contact within one social domain, that is, the specific context in which contact occurs. Thus, the question of how the social domain shapes the strength and direction of the contact–prejudice relationship remains underexplored. Utilizing data from a self-administered online survey (N = 637), this exploratory study examines the effects of intergroup contact on neighbor acceptance across different social domains (family, friends, work, social media, school, neighborhood, community), paying particular attention to differences by respondent and hypothetical neighbor race-ethnicity. Findings reveal that not all domains of intergroup contact are significantly associated with neighbor acceptance and that the positive effects of intergroup contact vary by racial-ethnic group. We also find evidence that intergroup contact can reduce neighbor acceptance for same race-ethnic individuals among minority respondents. This study nuances conceptualizations of context in assessing the effectiveness of contact in reducing prejudice.
Guidelines for designing and conducting Delphi consensus studies : an expert consensus Delphi study
Hohmann, Erik; Beaufils, Philippe; Beiderbeck, Daniel; Chahla, Jorge; Geeslin, Andrew; Hasan, Samer; Humphrey-Murto, Susan; Hurley, Eoghan; Laprade, Robert F.; Martetschlager, Frank; Matache, Bogdan; Moatshe, Gilbert; Monllau, Juan Carlos; Murray, Iain; Niederberger, Marlen; Ruetschi, Urs; Shang, Zhida; Weber, Stephen; Wong, Ivan; Perry, Nicholas P.J. (Elsevier, 2025-10)
PURPOSE : To conduct a Delphi project to develop guidelines for the design and execution of Delphi studies within medical and surgical specialties. METHODS : Open-ended questions in round 1 and open-ended and semi-open questions in round 2 were answered. The results of the first 2 rounds were used to develop a Likert-style questionnaire for round 3. The level of agreement and consensus was defined as 80%. Consensus was further categorized into specific percentage ranges for clarity: 100% unanimous consensus, 90% to 99% very strong consensus, and 80% to 89% consensus. RESULTS : Consensus was achieved for 35 of 63 items (56%). Unanimous agreement was reached for 4 items (6.3%), while very strong consensus was established for 12 items (19%). Consensus was reached for an additional 19 items (30.1%), and the panel remained undecided on 7 items (11.1%). CONCLUSIONS : Unanimous agreement was reached for iteration, the ability to establish treatment guidelines, a proven track record of panel members, and the requirement for at least 1 steering committee member to be a Delphi expert. Very strong consensus was reached on several key requirements: a clear definition of consensus, controlled feedback between rounds, precise definitions of expert and expertise, and the need for panel members to show experience through publications and clinical practice. Criteria for panel selection should ensure diversity and specialization, with steering committee members being content experts and a minimum of 20 to 30 panel members for broader topics. Regional experts should provide consensus on specific topics only. The steering committee should develop questions, with open-ended questions in round 1 and both types in round 2. Limiting the process to 3 rounds is advisable, aiming for at least 80% consensus in the final round. LEVEL OF EVIDENCE : Level V, expert opinion.
Illness is common in trail runners during training : a prospective cohort study
Janse van Rensburg, Dina Christina; Jansen van Rensburg; Audrey; Boer, Pieter Henk; Serero, Precious; Botha, Tanita; Schoeman, Marlene; Viljoen, Carel Thomas (Elsevier, 2026)
OBJECTIVES : Trail runners often experience illness during event preparation. We aimed to prospectively determine prevalence, incidence, clinical characteristics, severity (time-loss, burden) and associated illness risk factors amongst South African male and female recreational trail runners of different ages over a 30-week training period. DESIGN : Prospective cohort. METHODS : Illness and training data from 152 trail runners (120 males, 32 females) were collected every 14 days over 30 weeks using the updated OSTRC-H questionnaire. Illness prevalence (%), incidence (I: per 1000 trail running exposure-days), incidence ratio (IR), severity [% time-loss; illness burden (IB: days lost/1000 trail running exposure-days)], and associated risk factors are reported. RESULTS : Over 30 weeks, 52 % of runners reported illness, with a mean two-week all-illness prevalence of 10.1 %. The overall illness incidence was 7.2 (95 % CI: 5.7–9.2). The winter-to-summer IR was 1.6 (p = 0.022). Illness incidence in females (I = 9.7) was higher than in males (I = 6.6), with a female:male IR of 1.5 (p < 0.05). Most illnesses affected the respiratory (64.3 %), digestive (15.9 %) and musculoskeletal (5.7 %) systems. Moderate illness severity (8–28 days time-loss) occurred in 29.3 % of runners. The overall IB was 43.2 days lost. BMI ≥ 25 kg/m2 was associated with illness, but no significant illness risk factors were identified via Poisson regression. CONCLUSIONS : During a 30-week training period, 52 % of runners reported illness, with a higher incidence in females. The respiratory tract accounted for > 60 % of illnesses. One in three trail runners experienced > one week time-loss. A higher BMI > 25 kg/m2 was associated with illness. Further research is needed to identify risk factors and develop prevention strategies. PRACTICAL IMPLICATIONS • Prioritise respiratory health monitoring • Screen for high-risk profiles early • Tailor strategies for females and higher-BMI runners • Inform trail running guidelines HIGHLIGHTS • Trail runners show an illness prevalence of 10.1% during training. • Females experience significantly higher illness incidence than males. • Illness mainly affects the respiratory system of trail runners during training. • Approximately one-third of trail runners suffer from moderate to severe illness, resulting in > 8 days of time-loss in a 30-week training period. • Trail runners with a higher BMI (> 25 kg/m2) are more susceptible to illness.