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Burger JW, Mafuze B, Brooker J, Patricios JS. Championing mental health: sport and exercise psychiatry for low- and middle-income countries using a model from South Africa. Br J Sports Med 2024; 58:519-521. [PMID: 38599682 DOI: 10.1136/bjsports-2024-108248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 04/12/2024]
Affiliation(s)
- James W Burger
- Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa
- HIV Mental Health Research Group, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Bonginkosi Mafuze
- Department of Psychiatry, School of Clinical Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Janine Brooker
- Department of Psychiatry, School of Clinical Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Alan J Flisher Centre for Public Mental Health, Cape Town, South Africa
| | - Jon S Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Burger JW, Andersen LS, Joska JA. Baseline concussion assessments can identify mental disorders: SCAT-5 and other screening tools in South African club rugby. PHYSICIAN SPORTSMED 2023; 51:472-481. [PMID: 36217827 DOI: 10.1080/00913847.2022.2134977] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/03/2022] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Although mental health screenings are not routinely conducted in rugby, the Sport Concussion Assessment Tool - Fifth Edition (SCAT-5) is widely performed and measures affective, cognitive, sleep, and physical symptoms. This study investigated the psychometric properties of the SCAT-5 to explore its potential as a mental health screening tool. METHODS During preseason for the 2021 Western Province Super League A in South Africa, clinicians conducted mental health assessments of 71 adult male rugby union players. The SCAT-5 Symptom Evaluation, Baron Depression Screener for Athletes (BDSA), Athlete Psychological Strain Questionnaire (APSQ), Center for Epidemiologic Studies-Depression (CES-D), and Generalized Anxiety Disorder-7 (GAD-7) were compared to each other and to fully structured diagnostic interviews by mental health professionals using the Mini International Neuropsychiatric Interview (MINI) 7.0.2. RESULTS Lifetime MINI-defined mental disorders were common, being identified in 33.8% (95% CI 22.79-46.17%). Only 4.29% of participants had a previous diagnosis. Exploratory Factor Analysis indicated a mental health construct of depression/anxiety being measured by the SCAT-5. The SCAT-5 had strong internal consistency (α = 0.94) and showed moderate convergent validity with the CES-D (r = 0.34; p = 0.008) and GAD-7 (r = 0.49; p < 0.0001). The area under the curve for the ability of the SCAT-5 to identify current disorders was 0.87 (p = 0.003), on par with the CES-D and GAD-7. CONCLUSION Since the SCAT-5 has the potential to identify depression and anxiety, it may allow mental health screening without the need for additional measures. Follow-up studies should further explore its discriminative ability in larger samples.
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Affiliation(s)
- James W Burger
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
| | - Lena S Andersen
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John A Joska
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
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Burger JW, Mafuze B. Getting psyched up: Developing the field of Sport and Exercise Psychiatry in South Africa. S Afr J Sports Med 2023; 35:v35i1a16352. [PMID: 38249763 PMCID: PMC10798610 DOI: 10.17159/2078-516x/2023/v35i1a16352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
Elite athletes and their entourage are exposed to intense stressors and commonly experience mental health symptoms and disorders. While there is limited literature on prevalence rates in a South African setting, initial data show that both current and retired athletes may experience these symptoms, but with low treatment rates. There is a need to improve mental health literacy and mental health care in athletes. Athletes may benefit from systematic mental health surveillance and additional screening during high-risk periods, such as injury or retirement. This commentary brings athlete mental health into focus and advocates for the inclusion of sport and exercise psychiatry into the athlete entourage and broader mental health team, in order to close the treatment gap. We provide seven recommendations for the initial way forward for sport and exercise psychiatry in South Africa.
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Affiliation(s)
- JW Burger
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town,
South Africa
| | - B Mafuze
- Department of Psychiatry and Mental Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
South Africa
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Burger JW, Bantjes J, Derman W, Whitesman S, Gomez-Ezeiza J. Associations between psychological distress and facets of mindfulness: Implications for campus-based university wellness services. J Am Coll Health 2023; 71:1074-1083. [PMID: 34242527 DOI: 10.1080/07448481.2021.1920601] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/18/2021] [Accepted: 04/18/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To investigate associations between components of psychological distress and five facets of mindfulness (i.e. observing; describing; acting with awareness; non-reactivity; non-judging). PARTICIPANTS Students from a university in South Africa (n = 174). METHODS This cross-sectional study assessed psychological distress and mindfulness using the K10 and Five Facet Mindfulness Questionnaire. Multivariate regression analysis identified associations between psychological distress and facets of mindfulness, controlling for demographics. RESULTS Prevalence of psychological distress was 56.9% (95% CI 49.2%-64.4%). Acting with awareness, non-reactivity, and non-judging predicted significantly lower psychological distress, whereas observing and describing did not. Acting with awareness was the only facet of mindfulness that consistently predicted lower levels of negative affect, fatigue, nervousness, and agitation. CONCLUSIONS Acting with awareness appears to be a key component of psychological wellbeing. To advance theory and practice, future research should consider why and how various facets of mindfulness predict lower psychological distress and its components among university students.
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Affiliation(s)
- James W Burger
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Sport and Exercise Medicine, Division of Orthopedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Division of Orthopedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- IOC Research Center, Cape Town, South Africa
| | - Simon Whitesman
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Institute for Mindfulness South Africa, Cape Town, South Africa
| | - Josu Gomez-Ezeiza
- Institute of Sport and Exercise Medicine, Division of Orthopedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- IOC Research Center, Cape Town, South Africa
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Bakkers C, van Erning FN, Rovers KP, Nienhuijs SW, Burger JW, Lemmens VE, Aalbers AG, Kok NF, Boerma D, Brandt AR, Hemmer PH, van Grevenstein WM, de Reuver PR, Tanis PJ, Tuynman JB, de Hingh IH. Long-term survival after hyperthermic intraperitoneal chemotherapy using mitomycin C or oxaliplatin in colorectal cancer patients with synchronous peritoneal metastases: A nationwide comparative study. Eur J Surg Oncol 2020; 46:1902-1907. [PMID: 32340819 DOI: 10.1016/j.ejso.2020.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/03/2020] [Accepted: 04/12/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES In the Netherlands, limited variability exists in performance of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) among centers treating colorectal peritoneal metastases (PM), except for the intraperitoneal drug administration. This offers a unique opportunity to investigate any disparities in survival between the two most frequently used HIPEC regimens worldwide: mitomycin C (MMC) and oxaliplatin. METHODS This was a comparative, population-based cohort study of all Dutch patients diagnosed with synchronous colorectal PM who underwent CRS-HIPEC between 2014 and 2017. They were retrieved from the Netherlands Cancer Registry. Main outcome was overall survival (OS). The effect of the intraperitoneal drug on OS was investigated using multivariable Cox regression analysis. RESULTS In total, 297 patients treated between 2014 and 2017 were included. Among them, 177 (59.6%) received MMC and 120 (40.4%) received oxaliplatin. Only primary tumor location was different between the two groups: more left-sided colon in the Oxaliplatin group (47.5% vs. 33.3%, respectively, p=0.048). The 1-, 2- and 3-year OS were 84.6% vs. 85.8%, 61.6% vs. 63.9% and 44.7% vs. 53.5% in patients treated with MMC and oxaliplatin, respectively. Median OS was 30.7 months in the MMC group vs. 46.6 months in the oxaliplatin group (p=0.181). In multivariable analysis, no influence of intraperitoneal drug on survival was observed (adjusted HR 0.77 [0.53-1.13]). CONCLUSIONS Long-term survival between patients treated with either MMC or oxaliplatin during CRS-HIPEC was not significantly different.
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Affiliation(s)
- C Bakkers
- Department of Surgery, Catharina Cancer Institute, Eindhoven, the Netherlands.
| | - F N van Erning
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
| | - K P Rovers
- Department of Surgery, Catharina Cancer Institute, Eindhoven, the Netherlands
| | - S W Nienhuijs
- Department of Surgery, Catharina Cancer Institute, Eindhoven, the Netherlands
| | - J W Burger
- Department of Surgery, Catharina Cancer Institute, Eindhoven, the Netherlands
| | - V E Lemmens
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
| | - A G Aalbers
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - N F Kok
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - D Boerma
- Department of Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - A R Brandt
- Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - P H Hemmer
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - W M van Grevenstein
- Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - P R de Reuver
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - P J Tanis
- Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - J B Tuynman
- Department of Surgery, Amsterdam University Medical Centers, VU Medical Center, Amsterdam, the Netherlands
| | - I H de Hingh
- Department of Surgery, Catharina Cancer Institute, Eindhoven, the Netherlands; GROW - School for Oncology and Development Biology, Maastricht University, Maastricht, the Netherlands
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Burger JW, de Villiers R, Derman W. If the shoe fits… should you just wear it? A complete calcaneal stress fracture in a female recreational runner. S Afr J Sports Med 2020; 32:v32i1a8522. [PMID: 36818973 PMCID: PMC9924611 DOI: 10.17159/2078-516x/2020/v32i1a8522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Shoe choice by runners may follow trends related to purported generalised benefits rather than following an individual risk-benefit analysis. The benefits and risks related to minimalist footwear for running has been a much debated topic. The authors report a case of a complete calcaneal stress fracture in an otherwise healthy female recreational runner in the first three weeks following her conversion from a traditional cushioned running shoe to a minimalist type of running shoe. Clinicians should be aware of the potential added bone stress with reduced cushioning and the potential risks in transitioning to new footwear.
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Affiliation(s)
- J W Burger
- Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University,
South Africa,Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town,
South Africa
| | - R de Villiers
- Winelands Radiology, Institute of Orthopaedics and Rheumatology, Stellenbosch University,
South Africa
| | - W Derman
- Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University,
South Africa,IOC Research Centre,
South Africa
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Massolt ET, van der Windt M, Korevaar TIM, Kam BLR, Burger JW, Franssen GJH, Lehmphul I, Köhrle J, Visser WE, Peeters RP. Thyroid hormone and its metabolites in relation to quality of life in patients treated for differentiated thyroid cancer. Clin Endocrinol (Oxf) 2016; 85:781-788. [PMID: 27175823 DOI: 10.1111/cen.13101] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/21/2016] [Accepted: 05/11/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Levothyroxine (LT4) is the standard of care in patients with hypothyroidism. Despite this replacement therapy, quality of life (QoL) remains impaired in a substantial amount of patients. The reasons for this are still a matter of debate. Suggested causes include lack of endogenous T3 secretion by the thyroid, changes in other thyroid hormone metabolites and interference by autoimmune processes. OBJECTIVE To investigate the association between thyroid function tests (TFTs) and QoL in patients with a history of differentiated thyroid cancer on LT4 monotherapy. These patients lack endogenous thyroidal T3 secretion in the absence of autoimmune disease. MATERIALS AND METHODS This is a cross-sectional study in 143 patients (69·2% female). Initial therapy consisted of total thyroidectomy followed by radioiodine ablation minimally one year before inclusion. We assessed health-related QoL (RAND-36), thyroid-specific QoL (ThyPRO) and fatigue with the Multidimensional Fatigue Inventory. Extensive TFTs were assessed, including 3,5-diiodo-L-thyronine (3,5-T2). RESULTS Mean age was 50·2 years and mean time since diagnosis was 8·4 years. Median TSH was 0·042 mU/l, total T4 145·0 nmol/l, free T4 25·6 pmol/l, total T3 1·93 nmol/l, reverse T3 0·53 nmol/l and 3,5-T2 0·86 nmol/l. Multiple linear regression analyses did not show any association between QoL and the different TFTs, including T4/T3 and 3,5-T2/T3 ratios reflecting peripheral metabolism. CONCLUSION We did not find any association between TFTs and QoL in athyreotic patients on LT4 monotherapy. Our data do not provide evidence that a slight increase in dose improves fatigue or well-being in hypothyroid patients on LT4 therapy.
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Affiliation(s)
- E T Massolt
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.
- Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.
| | - M van der Windt
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - T I M Korevaar
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - B L R Kam
- Department of Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - J W Burger
- Division of Surgical Oncology, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - G J H Franssen
- Division of Surgical Oncology, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - I Lehmphul
- Institute of Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Köhrle
- Institute of Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - W E Visser
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - R P Peeters
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
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Abstract
BACKGROUND Portal vein thrombosis is a rare but potentially fatal complication of splenectomy. The aim of this study was to assess the incidence, risk factors, treatment and outcome of portal vein thrombosis after splenectomy in a large series of patients. METHODS All patients who had undergone a splenectomy in the University Hospital, Rotterdam, between 1984 and 1997 were reviewed retrospectively. Splenectomy that was followed by symptomatic portal vein thrombosis was selected for analysis. Risk factors for portal vein thrombosis were sought. RESULTS Of 563 splenectomies, nine (2 per cent) were complicated by symptomatic portal vein thrombosis. All these patients had either fever or abdominal pain. Two of 16 patients with a myeloproliferative disorder developed portal vein thrombosis after splenectomy (P = 0.03), and four of 49 patients with haemolytic anaemia (P = 0.005). Treatment within 10 days after splenectomy was successful in all patients, while delayed treatment was ineffective. CONCLUSION Portal vein thrombosis should be suspected in a patient with fever or abdominal pain after splenectomy. Patients with a myeloproliferative disorder or haemolytic anaemia are at higher risk; they might benefit from early detection and could have routine Doppler ultrasonography after splenectomy.
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Affiliation(s)
- M van't Riet
- Departments of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands
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