Browsing by Author "Moxley, Karis"

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    Body dysmorphic disorder : a diagnostic challenge in adolescence
    (AOSIS, 2018) Thungana, Yanga; Moxley, Karis; Lachman, Anusha
    Body dysmorphic disorder (BDD) is a chronic and disabling condition that is characterised by distressing preoccupations with perceived defects in one’s own appearance, which might be slight or not observable to others. It is considered to be an obsessive–compulsive spectrum disorder and is associated with depression, feelings of shame and poor quality of life. It is primarily a disorder of childhood or adolescent onset, and sub-clinical BDD symptoms begin, on average, several years before an individual’s symptoms meet full criteria for the disorder. Here we report the case of an adolescent admitted to an inpatient psychiatric unit for treatment of psychotic symptoms that were poorly responsive to standard treatments. This challenging case of BDD in an adolescent highlights the various comorbidities of the disorder, as well as the difficulties associated with BDD diagnosis.
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    Factors affecting specialist psychiatry training in South Africa : bullying during specialist psychiatric training?
    (2021) Beath, Natalie; Moxley, Karis; Subramaney, Ugasvaree; Zingela, Zukiswa; Chiliza, Bonginkosi; Joska, John; Kotzé, Carla; Seedat, Soraya, 1966-
    As many of us served as members of the Council of Psychiatrists, Colleges of Medicine of South Africa, for the triennium 2017 - 2020, we were keen to understand how workplace experiences and supervision could affect training and examination outcomes in South African (SA) centres. We conducted a cross-sectional, descriptive study of registrar trainees in psychiatry at the University of the Witwatersrand, the University of Cape Town, the University of KwaZulu-Natal, the University of Pretoria, the University of the Free State, Stellenbosch University, the University of Limpopo, and Walter Sisulu University between 1 June and 30 November 2019. We made use of an online survey that included questions on bullying/discrimination. All questions were closed-ended.
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    HPA-axis genes as potential risk variants for neurocognitive decline in trauma-exposed, HIV-positive females
    (Dove Medical Press, 2018) Jacobs, Sean; Moxley, Karis; Womersley, Jacqueline S.; Spies, Georgina; Hemmings, Sian M. J.; Seedat, Soraya
    Purpose: Previous studies have independently provided evidence for the effects of HIV infection, hypothalamic–pituitary–adrenal (HPA) axis dysfunction and early life trauma on neurocognitive impairment (NCI). This study examined the interaction between single-nucleotide polymorphisms (SNPs) of two HPA axis genes, corticotrophin-releasing hormone receptor 1 (CRHR1; rs110402, rs242924, rs7209436, and rs4792888) and corticotrophin-releasing hormone-binding protein (CRHBP; rs32897, rs10062367, and rs1053989), childhood trauma, and HIV-associated NCI. Patients and methods: The sample comprised 128 HIV-positive Xhosa females of whom 88 (69%) had a history of childhood trauma. NCI was assessed using a battery of 17 measures sensitive to the effects of HIV, and the history of childhood trauma was assessed using the validated retrospective Childhood Trauma Questionnaire-Short Form. Generalized linear regression models were used to compare allelic distribution by trauma status and global NCI. The association between genotype, childhood trauma, and cognitive scores was also evaluated using generalized linear regression models, assuming additive models for the SNPs, and ANOVA. Results: Of the seven polymorphisms assessed, only the rs10062367 variant of CRHBP was significantly associated with global NCI (P=0.034), independent of childhood trauma. This polymorphism was not significantly associated with z-scores on any specific cognitive domain. The interaction of childhood trauma and variants of CRHR1 was associated with poorer learning (rs110402) and/or recall (rs110402 and rs4792888). Conclusion: These findings suggest that CRHBP rs10062367 A allele is a possible risk variant for NCI in HIV, independent of childhood trauma. Furthermore, results show that the interaction of childhood trauma with variants of CRHR1, rs110402 and rs4792888, confer added vulnerability to NCI in HIV-infected individuals in cognitive domains that are known to be impacted by HIV. While these findings need independent replication in larger samples, it adds CRHBP and CRHR1 to the list of known genes linked to HIV- and childhood trauma-associated neurocognitive phenotypes.
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    There’s no doubt that one learns through it all : a qualitative exploration of the value surgery trainees assign to master of medicine research
    (Stellenbosch : Stellenbosch University, 2022-04) Moxley, Karis; Blitz, Julia; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
    ENGLISH SUMMARY: Background: Since 2011 The Health Professionals Council of South Africa (HPCSA) has mandated the completion of a Master of Medicine (MMed) research project for specialist registration. This has introduced several challenges for the training environment and there is concern that institutions do not adequately prepare trainees for their role as scholars. MMed research has therefore received much critical resistance and stakeholders have questioned its value as part of the specialist training curriculum. To gain a deeper understanding of the affordances, enablers, and challenges of MMed research we were interested to hear how trainees construct the meaning of value in relation to their experiences. Aim: To explore the value surgery trainees assign to their MMed research experiences. Methods: This qualitative study adopted a social constructivist epistemological perspective. We purposively sampled 9 participants who had completed their research in a single surgical division at Stellenbosch University. Data were generated via semi-structured interviews with individual participants and analysed using reflexive thematic analysis. Results and discussion: We identified four key themes: 1) resentment, relief, realisation, and prerequisite; 2) the clinician versus clinician-scientist dichotomy; 3) research exposure and leadership, and 4) “there’s no doubt one learns through it all”. MMed research is a source of trainee stress but they can recognise in hindsight research has served an important role in professional development. Through experiential and social learning, trainees develop critical appraisal skills and an improved understanding of the research process and recognise the value of scholarly competencies for evidence-based medicine. Research supervision and leadership represent key enablers in this learning process. Conclusions: Our findings suggest that MMed research offers significant educational value to specialist trainees and therefore warrants continued inclusion in the curriculum. Research supervisors play an important role in managing the research process, initiating MMed candidates into the research community, and making explicit the hidden outcomes of postgraduate research. Therefore, amongst other recommendations for health professions education, we especially recommend that future research and faculty development initiatives should focus on the professional development of MMed research supervisors.
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    Writing centres as dialogic spaces : negotiating conflicting discourses around citation and plagiarism
    (University of Stellenbosch, Department of General Linguistics, 2019) Moxley, Karis; Archer, Arlene
    Citation is fundamental in successfully constructing academic discourse. There has been much discussion concerning the considerable difficulties tertiary students experience when writing using sources, especially for those who speak English as an Additional Language. This paper interrogates the predominantly negative discourses that surround plagiarism, involving notions of honesty, integrity, punishment, trust, and deceit. These negative discourses tend to perpetuate hierarchical and impenetrable spaces in higher education. Drawing on our experiences in South African writing centres, and using key concepts from academic literacies, this paper explores ways of addressing plagiarism that can serve to empower students, including developing academic voice through citation, acknowledging “mimicry” as part of writing development, and developing critical thinking.