Browsing by Author "Emsley, R."
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- ItemChanges in erythrocyte membrane fatty acids during a clinical trial of eicosapentaenoic acid (EPA) supplementation in schizophrenia(2009) Van Rensburg, S. J.; Smuts, C. M.; Hon, D.; Kidd, M.; Van Der Merwe, S.; Myburgh, C.; Oosthuizen, P.; Emsley, R.In a previously reported double-blind, placebo-controlled trial of eicosapentaenoic acid (EPA) as supplemental treatment in 40 patients with schizophrenia, we found significant improvement in symptoms as measured by the Positive and Negative Syndrome Scale (PANSS) compared to placebo (Emsley et al. 2002). Here we report changes in fatty acid composition of erythrocyte membranes in the same sample (n∈=∈16 in each group). After 12 weeks of receiving EPA, levels of several saturated and mono-unsaturated fatty acids decreased significantly while levels of n-3 fatty acids increased significantly compared to the placebo group. Increases of n-3 and n-6 fatty acids in the erythrocyte membranes were greater in subjects who improved more than 20% on overall symptoms. Changes in fatty acids correlated significantly with improvement in PANSS sub-scale scores, more so in females than in males. Docosahexaenoic acid (DHA) (22:6n-3) levels increased less than expected, suggesting a possible defect in synthesis or incorporation of DHA into membranes in schizophrenia. Improvement in dyskinesia correlated significantly with an increase in alpha-linolenic acid (18:3n-3; p∈=∈0.03), and a decrease in 20:1n-9 (p∈=∈0.005). © 2009 Springer Science+Business Media, LLC.
- ItemDisability claims on psychiatric grounds(Health & Medical Publishing Group, 1996) Emsley, R.; Coetzer, P.Recent years have seen an alarming increase in South Africa in applications for medical disability on psychiatric grounds. Psychiatric disorders now rank as the second most common indication for these applications, after musculoskeletal disorders (mainly chronic back problems). Despite its high incidence in South Africa, ischaemic heart disease features as only the third most common cause of medical disability.
- ItemHealth care discrimination against the mentally ill - A comparison of private health insurance benefits for major depressive disorder and ischaemic heart disease in South Africa(Health & Medical Publishing Group, 2004) Oosthuizen, P.; Scholtz, O.; Hugo, C.; Richards, B.; Emsley, R.[No abstract available]
- ItemNeeds-based gap analysis for service transformation in the Eastern Cape(AOSIS Publishing, 2015) Sukeri, K.; Alonso-Betancourt, O.; Emsley, R.Objectives. Part I of this research article presents a needs-based analysis for the management of schizophrenia, bipolar mood disorder and major depression for the Eastern Cape (EC) Province, South Africa. This part of the research paper focuses on quantifying human resources and bed needs for these three severe mental illnesses. Human resource expenditure is calculated for nursing staff at acute, ambulatory and medium-to-long-stay services. A further objective was to conduct a gap analysis for human resources and beds for the EC in order to assist mental health planners in the commissioning of services. Methods. Data from previous research conducted in the province, and international and national epidemiological studies were utilised to quantify the requirements for human resources (psychiatrists, medical officers/registrars, psychologists, nurses, occupational therapists and social workers) and beds for acute, medium-to-long-stay and ambulatory services at provincial and regional levels, to provide mental healthcare. The authors focused on three of the eight priority conditions set by the World Health Organization. A target coverage rate of 80% was used in all calculations. A gap analysis was conducted to demonstrate deficits and excesses, utilising available data on human resources and beds available in the province. Results. The results showed that the districts of Alfred Nzo and Ukhahlamba have no human resources or beds for the provision of mental health services. The province has a deficit of 23 psychiatrists and 243 nurses trained in psychiatry, and an oversupply of 486 other nurses. The results also clearly demonstrated an inequitable distribution of resources in the province. Conclusions. This is the first study that has provided detailed estimates of human resource and bed deficits in the EC. The study demonstrates that the areas of greatest need in terms of bed and human resource requirements are in the eastern regions of the province, which includes the former homelands of the Transkei and Ciskei. This study will assist provincial mental health planners/commissioners in developing an equitable mental health delivery programme.
- ItemThe new psychiatry(Health & Medical Publishing Group, 1993) Emsley, R.Doctors who qualified a decade or more ago are likely to be experiencing difficulties in keeping up with the changes taking place in the field of psychiatry, and may be surprised to see it assuming an increasingly imponant role in medicine. There are, of course, good reasons for the emergence of psychiatry as a major clinical specialty.
- ItemSelective serotonin reuptake inhibitors in children and adolescents(Health & Medical Publishing Group, 2006-02) Hawkridge, S.; Seedat, S.; Carey, P.; Emsley, R.; Stein, D. J.[No abstract available]
- ItemService transformation plans in the Eastern Cape informed by a needs-based gap analysis(AOSIS Publishing, 2015) Sukeri, K.; Alonso-Betancourt, O.; Emsley, R.Objectives. Part I of this research paper presented a needs and gap analysis for the management of schizophrenia, bipolar mood disorder and major depression for the Eastern Cape Province, South Africa. It identified deficits and inequitable distribution of human resources and beds in the province. In this article, Part II, the authors propose a plan for public sector mental health services to address the human resource needs in the poorer eastern regions of the province. The plan focuses on human resource training and development. Methods. Evidence-based data on staff development in mental health from low-middle income countries were utilised to develop strategies to increase staff capacity to address unmet need. A financing model with a poverty index was developed to sustain a needs-based plan. Databases searched included Pubmed, Medline, Google and Google Scholar. The key words used included: mental health, mental health training, mental health resources, mental health in low-middle-income countries, mental health policy and plans, mental health needs- based planning, primary healthcare, primary mental healthcare, mental health financing. In addition the websites of the World Health Organization and the World Psychiatric Association were searched for similar resources. Conclusions. It is feasible, with careful attention to planning and implementation of evidence-based tools, to improve public mental health service delivery in this province. Sustained political will and professional commitment will ensure successful delivery of mental health services in a resource-limited province.
- ItemThe South African Society of Psychiatrists (SASOP) treatment guidelines for psychiatric disorders(AOSIS Publishing, 2013-08) Emsley, R.; Colin, F.; Flisher, A. J.; Grobler, G.; Hawkridge, S.; Potocnik, F. C.; Seedat, S.; Stein, D. J.; Swingler, D.; Szabo, C. P.The South African Society of Psychiatrists (SASOP) Treatment Guidelines for Psychiatric Disorders have been developed in order to address the local need for guidelines in our unique clinical setting.