Selection policies for undergraduate medical programmes aimed at redress should be continued and further refined, along with the provision of support to ensure student success.

BackgroundChronic lifestyle diseases share similar modifiable risk factors, including hypertension, tobacco smoking, diabetes, obesity, hyperlipidaemia and physical inactivity. Metabolic syndrome refers to the cluster of risk factors that increases the risk for developing type 2 diabetes mellitus (DM) and cardiovascular disease.ObjectivesThe study aimed to assess health status and identify distinct risk-factor profiles for both chronic lifestyle diseases and metabolic syndrome in rural and urban communities in central South Africa.MethodsThe investigation formed part of the Assuring Health for All in the Free State (AHA-FS) study. During interviews by trained researchers, household socio-demographic and health information, diet, risk factors (i.e. history of hypertension and/or diabetes) and habits (e.g. smoking and inadequate physical activity levels) were determined. Adult participants underwent anthropometric evaluation, medical examination and blood sampling.ResultsThe risk-factor profile for chronic lifestyle diseases revealed that self-reported hypertension and physical inactivity were ranked the highest risk factor for the rural and urban groups respectively. The cumulative risk-factor profile showed that 40.1% of the rural and 34.4% of the urban study population had three or more risk factors for chronic lifestyle diseases. Furthermore, 52.2% of rural and 39.7% of urban participants had three or more risk factors for metabolic syndrome.ConclusionThis study confirmed that the worldwide increase in the prevalence of chronic lifestyle diseases can be attributed to a more sedentary lifestyle, especially illustrated in the urban study population, and increasing obesity. The rural study population had a higher prevalence of risk factors for metabolic syndrome.

Background: Health professional students frequently use alcohol and narcotics. The potential impact on academic performance and professional behaviour is concerning.Aim: This study aimed to determine self-reported use of alcohol, illicit substances (e.g. cannabis, lysergic acid diethylamide [LSD], magic mushroom, cocaine, crack, ecstasy, methamphetamine and heroin), prescription medication and smoking habits, correlating academic performance.Setting: Faculty of Health Sciences, University of the Free State.Methods: An observational, descriptive, cross-sectional study design was used. Information was obtained using a self-administered questionnaire, capturing demographics, self-reported academic performance, drinking and smoking habits, and substance use. Coded responses were analysed using the Remark Office OMR 8 Software System. Descriptive statistics were calculated for categorical variables.Results: Completed questionnaires comprised 171 students. A total of 78.4% of second year and 82.8% of third year students reported using alcohol. Twenty-two per cent of second year and 24.1% of third year students reported cannabis use. In the second year group, three (2.7%) students reported using magic mushroom, two (1.8%) reported cocaine, two (1.8%) reported ecstasy and one (0.9%) reported using methamphetamine. Only third year students reported using LSD or ‘crack’. Cigarette smoking was common – 31.5% and 35.1% in both groups, respectively. Smokeless tobacco devices were used by 8.5% of second year and 7.1% of third year students. Almost 40% of both groups reported that they had smoked a water pipe. Academic performance achieved was mostly 60% – 69% (38.9%) among second year students and 70% – 79% (46.6%) among third year students.Conclusion: Self-reported use of alcohol and drugs and smoking among medical students is alarming. Additional student support, early identification and referral for management and/or rehabilitation should be a priority at tertiary institutions responsible for training future healthcare professionals.

Background: Medical studies place students at risk for burnout. Resilience enables students to cope with adversity. Students’ coping skills will ensure the well-being of future healthcare professisonals.Objectives: This study investigated resilience and coping among undergraduate medical students.Setting: Undergraduate students at the University of the Free State medical school.Methods: A cross-sectional study was performed. Quantitative data regarding resilience (Connor-Davidson Resilience Scale), coping strategies (Brief COPE questionnaire) and relevant information were collected by means of an anonymous self-administered questionnaire.Results: Five hundred students (pre-clinical n = 270; clinical n = 230; approximately 62% female) participated. Most students self-reported high resilience (84.6% pre-clinical; 91.8% clinical). Mean resilience scores were 72.5 (pre-clinical) and 75.4 (clinical). Clinical students had higher resilience scores, while black, pre-clinical, first-generation and female students scored lower.Academic stress was most prominent ( 85%) and associated with lower resilience scores. Most students used adaptive coping strategies (e.g. instrumental or emotional support) associated with significantly increased resilience scores. Students who used dysfunctional strategies (e.g. substance abuse) had significantly lower resilience scores.Conclusion: Associations between resilience scores and year of study, gender, ethnicity, levels and type of stress varied. Academic pressure was a major source of stress. Adaptive coping strategies were associated with higher resilience scores.

Objectives: Obesity prevalence is increasing worldwide. In South Africa, older and urbanised African women have significantly higher rates of obesity. Limited information is available on the relationship between anthropometric parameters, adipokines and metabolic health status of African women. This study investigated the relationship between obesity, adipokines and the components of metabolic syndrome in urban African women. Methods: This study included 135 urban African women that were 26-63 years of age, identified with metabolic syndrome in the urban leg of the Assuring Health for All in the Free State (AHA-FS) study. To establish anthropometric status, the following measures were taken: body weight, height and waist circumference. Blood was drawn to determine leptin, adiponectin levels and metabolic status. Results: Adiponectin levels in obese women were significantly decreased compared to normal weight women. Leptin levels and leptin:adiponectin ratios (L:A) were increased in the obese group compared to the overweight and normal weight groups. Leptin and L:A showed strong positive correlations with body mass index and waist circumference. Adiponectin levels decreased as the number of components of metabolic syndrome increased. The L:A ratio was significantly lower in women with elevated triglycerides and significantly higher in women with elevated blood glucose levels. Adiponectin levels were significantly lower in women with elevated blood glucose. Conclusion: This study confirms the inverse relationship between adiponectin and leptin with increased body adiposity. Results indicate that waist circumference, fasting blood glucose and triglyceride levels are the metabolic syndrome components most closely associated with altered adiponectin and leptin levels and L:A in urban African women with metabolic syndrome.Normal weight kg/m 2 ) (n = 17)* Age 50.0 [47.0-52.0] Adiponectin (μg/mL) 14.4 [9.3-19.1] Leptin (ng/mL) 9.1 [5.7-14.1] L:A ratio # 0.7 [0.5-1.3] Overweight (BMI 25-29.9 kg/m 2 ) (n = 35) Age 45.0 [37.0-54.0] Adiponectin (μg/mL) 9.2 [5.0-13.2] Leptin (ng/mL) 22.0 [12.3-31.7] L:A ratio 2.2 [1.4-5.4] Obese (BMI ≥ 30 kg/m 2 ) (n = 83) Age 48.0 [41.0-56.0] Adiponectin (μg/mL) 6.4 [4.1-10.2] Leptin (ng/mL) 44.1 [31.8-75.7] L:A ratio 7.9 [3.6-11.9]