Day: December 12, 2025

Categories : PaediatricsTags :

Rise in ADHD Diagnoses can Leave Parents Confused About ‘Typical’ Behaviour for Kids

On By ModernMedia

Children have higher energy levels than adults – but what is ‘typical’ behaviour?

Photo by Annie Spratt on Unsplash

Parents of children who fidget, daydream, and enjoy running and jumping should not automatically be concerned about ADHD.

This is the argument of a team of experts, comprised of a paediatrician, social worker and occupational therapist. They say it is important to attempt to alleviate confusion among parents around what is ‘typical’, and when children need professional help for developmental or behavioural differences.

Based on extensive evidence, their new book Developmental and Behavioral Complexities in Children highlights how the prevalence of ADHD, autism spectrum disorder, and some other developmental and behavioural diagnoses has increased – although they suggest it is not clear if this is because more people are aware of the conditions, screening has improved, changes in the diagnostic criteria have occurred, and/or if there is a genuine increase in the population. The increase in public awareness can sometimes lead to parents and caregivers questioning whether their child’s behaviour is different from others.

Jo-Ann Blaymore Bier, a retired developmental-behavioural paediatrician from Boston Children’s Hospital, occupational therapist Theresa A. Johnson, and Ellen Mullane who is a social worker, also say that opinions can differ among professionals which adds to the uncertainty for people who have children.

“The field of child development is not always a ‘black and white’ science,” they add.

“The way that children behave varies under different conditions and settings. Professionals may have varying thresholds for recommending intervention.

For example, they say: “Being energetic does not necessarily mean that a child has ADHD. Most children enjoy movement, and young children have limited attention spans.

Based on latest research and clinical experience, the experts offer strategies to manage problematic behaviours and examine the evidence behind available treatments.

The book is intended for advanced level students and professionals working in the field of child development, but may also be beneficial for parents and other caregivers who may have concerns. The book also answers questions that caregivers often ask such as is it my child’s personality or something more serious?

The authors, who have helped thousands of children, document a range of ‘typical’ behaviours as well as those likely to be symptoms of specific diagnoses, including autism, ADHD, and oppositional defiant disorder.

In the book, they emphasise that no one demonstrates what others consider acceptable behaviour all the time, and that all children are ‘wired’ differently.

ADHD is the most common childhood neuro-behavioural disorder, with some data sources indicating that about a million more children and adolescents in the US were diagnosed with ADHD in 2022 compared to 2016.

Increased awareness, changes in diagnostic criteria and in social norms are among many factors which the authors of Developmental and Behavioral Complexities in Children suggest may have contributed to the rise in cases.

However, no single specific medical test exists for ADHD. Clinicians make an assessment based on the child’s clinical presentation and on information from people who have observed the child’s behaviour.

For instance, children who are more energetic than their peers but also ‘function in group activities’ may not necessarily have ADHD,  according to the authors.

Autism spectrum disorder (ASD) is also on the rise and is examined in detail in the book. The authors say the ASD diagnosis may have become even more complex – instead of easier – to understand.

The term ‘neurodiversity’ has also become increasingly used. In the book, the authors say: “Accepting and encouraging individuality can be positive goals. But if an individual’s differences are having a negative impact on their functioning, providing supports to improve their quality of life can be beneficial.”

Source: Taylor & Francis

Categories : Antibiotics Mental HealthTags :

A Common Antibiotic may Reduce Schizophrenia Risk in Young People

On By ModernMedia
Photo by Danilo Alvesd on Unsplash

A commonly prescribed antibiotic could help reduce the risk of some young people developing schizophrenia, new research suggests. Experts found that patients of adolescent mental health services who were treated with the antibiotic doxycycline were significantly less likely to go on to develop schizophrenia in adulthood compared with patients treated with other antibiotics.

The researchers say that the findings highlight the potential to repurpose an existing, widely used medication as a preventive intervention for severe mental illness.

Lower risk

Schizophrenia is a severe mental disorder that typically emerges in early adulthood and is often associated with hallucinations and delusional beliefs.

To better understand potential ways of preventing the condition, researchers from the University of Edinburgh, in collaboration with the University of Oulu and University College Dublin, applied advanced statistical modelling to large-scale healthcare register data from Finland.

The team analysed data from more than 56 000 adolescents attending mental health services who had been prescribed antibiotics. They found that those treated with doxycycline had a 30–35% lower risk of developing schizophrenia than peers who received other antibiotics.

The researchers hypothesised that the protective effect could be linked to doxycycline’s impact on inflammation and brain development.

Reduce inflammation

Doxycycline is a broad-spectrum antibiotic commonly used to treat infections and acne. Previous studies suggest it can reduce inflammation in brain cells and influence synaptic pruning – a natural process where the brain refines its neural connections. Excessive pruning has been associated with the development of schizophrenia.

Further analyses showed that the lower risk wasn’t simply because the young people may have been treated for acne rather than having infections, and was unlikely to be explained by other hidden differences between the groups.

The study is published in the American Journal of Psychiatry. It involved researchers from the University of Edinburgh, the University of Oulu, University College Dublin, and St John of God Hospitaller Services Group, and was funded by the Health Research Board.

As many as half of the people who develop schizophrenia had previously attended child and adolescent mental health services for other mental health problems. At present, though, we don’t have any interventions that are known to reduce the risk of going on to develop schizophrenia in these young people. That makes these findings exciting.

Because the study was observational in nature and not a randomised controlled trial, it means we can’t draw firm conclusions on causality, but this is an important signal to further investigate the protective effect of doxycycline and other anti-inflammatory treatments in adolescent psychiatry patients as a way to potentially reduce the risk of developing severe mental illness in adulthood.

 Professor Ian Kelleher, Professor of Child and Adolescent Psychiatry at the University of Edinburgh

Source: University of Edinburgh

Categories : Healthcare Politics and RegulationsTags :

EDITORIAL | What has Actually Happened on NHI This Year?

On By ModernMedia

By Spotlight

It is not a stretch to say that the NHI Act has been one of the most controversial pieces of legislation in post-apartheid South Africa.

Since President Cyril Ramaphosa signed it into law in May 2024, just two weeks ahead of the national and provincial elections, at least nine different court cases have been launched against the Act, or specific provisions in the Act. None of those cases have made it through the courts and it seems likely some might be combined. 

In one preliminary to the bigger court battles, the North Gauteng High Court in Pretoria ordered Ramaphosa to provide the record of his decision to sign the act, but the President is challenging that order. 

A subtext to the torrent of court cases is the sense that it is only through litigation that the NHI Act might be scrapped, or that some of the most controversial provisions in it might be repealed. The alternative to litigation, political compromise, for now seems dead in the water. There was some hope for such compromise around a year ago when Business Unity South Africa and several healthcare worker groups pushed government for a change in course – but while the Presidency seemed open to considering changes, the health minister did not, and eventually the ANC, and government with it, decided to buckle down behind their current NHI plans. 

The door to political compromise could of course reopen should the balance of political power in the country change – as it will surely do after the 2029 elections, if not earlier. 

To the courts then 

There has been much media coverage of the various court cases challenging the NHI Act. Understandably, a lot of the public statements were aimed at drumming up public support for the various points of view. In the end, the courts will hopefully look past the rhetoric and politicking and judge the cases on their merits. 

This is why in recent months Spotlight put substantial resources into combing through seemingly endless court papers and chatting to a variety of lawyers in an attempt to sift the wheat from the chaff. As with many other court cases we’ve reported on, we suspect the various NHI-related cases will in the end turn on just a few key legal questions. In a special two-part series, we tried to pin down what these key legal questions are likely to be – you can see part 1 here and part 2 here. (Thank you to the three lawyers we quote in the article, as well as those who shared their views, but opted not to be named and quoted.) 

In our view, this crystallisation of the legal case against the NHI Act, and/or specific provisions in the Act, is the most notable NHI-related development this year. After all, a major ruling against the Act could make much else moot. 

Other NHI developments 

Meanwhile, the Department of Health is moving ahead on the assumption that NHI will be implemented as envisaged in the Act. The first formal step towards setting out the proposed governance structure and processes of the NHI Fund is underway with draft regulations that were published in the Government Gazette in March. Amongst others, the regulations provide for the appointment of the board of the NHI Fund, the fund’s chief executive officer, and for a benefits advisory committee and a healthcare benefits pricing committee. In the background here is the fact that, until the NHI Fund has been established as a public entity, it cannot be awarded a budget by parliament. 

One source of funding for NHI could be the phasing out of medical scheme tax credits. This is according to a presentation by the National Health Department’s NHI lead, Dr Nicholas Crisp, who was addressing the Standing Committee on Appropriations in the National Assembly. The presentation notes that medical scheme tax credits could raise as much as R34bn for the NHI Fund by 2027/28. At the moment, eligible beneficiaries receive medical scheme tax credits to the value of R364 per month for the primary member, R364 for the first dependant, and R246 for each additional dependant. The rough idea is that tax credits would first be phased out for high-income earners. This would eventually be followed by the state scrapping medical scheme subsidies to civil servants. 

But Finance Minister Enoch Godongwana seems unconvinced. He told BusinessDay: “It’s actually an attack on the middle class”. 

And indeed, the proposed scrapping of medical aid subsidies has added fuel to suggestions that government is intentionally undermining the viability of private healthcare in South Africa. A set of recommendations on how to better regulate the country’s private healthcare sector remains largely unimplemented six years after being published. Government did publish draft regulations for tariff determination in the private sector in February, but, as we recently reported, those draft regulations have now been withdrawn. In fact, those draft regulations were so poorly thought out that one wonders whether they were a serious attempt at addressing the issue in the first place. 

According to Crisp’s presentation, NHI could take “10, 15 or more” years to implement. There is some welcome realism in this. Rather absurdly, Section 57 of the NHI Act still states that it will be introduced in two phases, between 2023 and 2026, and between 2026 and 2028. 

Several experts have suggested to Spotlight that, mainly for financial reasons, NHI is essentially dead in the water and that the more serious people in the government and the ANC know this. Few are however willing to say this publicly. Others, like Crisp and Health Minister Dr Aaron Motsoaledi, would of course beg to differ, and mean it. 

Not the only solution 

One thing that should not get lost in all this is that things really do need to change. Apart from being extremely unequal, much of the healthcare system in South Africa is deeply dysfunctional. But Motsoaledi is wrong when he suggests that the specific system set out in the NHI Act is the only possible solution. As we’ve previously argued, there are other viable paths to universal health coverage, even if the current set of leaders in the ANC refuses to seriously consider them. 

One of the great tragedies of NHI is that for all the noise, we have never really had an informed public debate about the policy options and the reasons for going with one set of health reforms rather than another. There were few things as depressing as watching members of parliament’s portfolio committee for health reducing someone’s nuanced and constructive feedback on the Bill to a simple question of whether someone is for or against NHI. The ANC of course had a majority in parliament prior to the 2024 elections, so maybe there was a sense that they did not need to listen and do the hard work of engaging and bringing people along with them. 

Either way, it now seems likely that in 2026, the courts will have to make one or more landmark rulings that will determine the future of NHI. We have some idea of what the key issues will be on which those cases will turn, but as to how the courts will decide, your guess is as good as ours. 

Republished from Spotlight under a Creative Commons licence.

Read the original article.

Categories : Obstetrics & Gynaecology Substance UseTags :

Effectiveness of Common Treatments for Opioid Use Disorder in Mothers and Infants

On By ModernMedia
Photo by Alina Matveycheva

Over the last 20 years, substance use-related deaths have more than doubled for women of reproductive age. Overdose deaths are now a leading cause of maternal mortality in the US, and in some states, the leading cause.

Still, substantial gaps remain in understanding how different treatment approaches influence the short- and long-term health of mothers and infants, as well as their broader economic impacts over time.  

New research published this month in the journal JAMA Pediatrics found that while established medications for opioid use disorder in mothers – buprenorphine and methadone – are both superior and cost saving compared to alternative treatment pathways (naltrexone, medication-assisted withdrawal or no treatment), buprenorphine produced the greatest health gains and cost savings for mothers and infants.

Using a mathematical simulation model, the study projected the health and cost outcomes for pregnant individuals with opioid use disorder and their infants over their lifetime. The economic model captured how treatment decisions during pregnancy can have lasting health and economic consequences, such as risks of preterm birth, that extend from infancy through adulthood and drive substantial downstream health effects and costs. Outpatient buprenorphine emerged as the optimal treatment in most scenarios tested (58%-100%) and in nearly every lifetime scenario that incorporated both mother and infant trajectories (99%). In other words, across thousands of simulations, buprenorphine consistently produced the best health outcomes and lower costs compared to alternative strategies. 

The study, led by Ashley Leech, PhD, assistant professor of Health Policy at Vanderbilt University Medical Center, and Stephen Patrick, MD, MPH, O. Wayne Rollins Distinguished Professor of Health Policy and chair of the Department of Health Policy and Management at Emory University, is among the first to compare the short- and long-term health benefits and costs of opioid use disorder treatment for mothers and infants, examining outcomes during pregnancy, postpartum and beyond the infant’s first year of life using simulation modeling.

Existing studies have not examined outcomes beyond the infant’s first year of life. The study used a hypothetical treatment group modeled on known demographic and other social factors to estimate differences in outcomes and cost savings over time for each treatment and population group. The paper found that, although neonatal opioid withdrawal syndrome (NOWS) has received much of the clinical attention as a marker of poor infant health after opioid exposure during pregnancy, preterm birth and low birth weight carry greater morbidity and mortality and played a more significant role in shaping long-term infant outcomes. Notably, buprenorphine, despite its direct association with NOWS, was protective against these critical outcomes. 

“Nationwide, we have seen a significant growth of pregnant women with opioid use disorder, but there have not been comprehensive models that evaluate trade-offs of different medications and strategies,” said Patrick. “This study evaluated the trade-offs we face as clinicians – How will medications affect moms and babies? With the evidence we have available, what can we expect years from now? Bottom line, we found that buprenorphine treatment in pregnancy was cost saving and improved outcomes for mothers with opioid use disorder and their babies.”

The researchers emphasised, however, that patient-centred care and patient choice remain essential to sustaining treatment. “While we found that buprenorphine yielded the greatest health gains and was cost saving across all model variations, methadone could still be a viable option for mothers, and at the individual level, it might work better for some,” said Leech, the lead author of the study. “Buprenorphine shows clear benefits for long-term infant outcomes, but it can be more difficult for patients to start and stay on this treatment because, as a partial agonist, it may not feel as strong to those dependent on drugs like heroin or fentanyl. Methadone, by contrast, is often easier for patients to initiate and sustain.

“This is an opportunity to make sure buprenorphine works as well as possible – by ensuring pregnant individuals receive effective doses across trimesters (since they often need higher and increasing amounts for effectiveness compared to nonpregnant patients) and by removing unnecessary Medicaid restrictions.”

The study estimated substantial cost savings to public insurance programmes like Medicaid, finding that treating pregnant individuals this year could save roughly $4 billion in infant-related lifetime costs alone.  

“Medicaid is the largest payer for pregnant individuals and those with substance use disorders. Our research shows that treatment is not only effective but also has the potential to generate significant savings for Medicaid, benefiting both mothers and their children’s long-term health,” Leech said.

Source: Vanderbilt University Medical Center

Categories : General Interest Implants and ProsthesesTags :

Össur South Africa Launches 2026 ‘What’s Your Epic?’ Campaign

On By ModernMedia

Movement is a Right, not a Privilege

Inspiring South Africa to Support Mobility, Inclusion and the Power of Possibility

Össur South Africa‘s Team 1: Rentia Retief & Travis Warwick-Oliver

Össur South Africa is proud to announce the launch of the 2026 ‘What’s Your Epic?’ campaign, an initiative that champions one simple truth: everyone deserves the freedom to move. As the world turns its attention to the Cape Epic from 15 – 22 March 2026, Össur is once again harnessing this global stage to drive awareness, spark action, and rally support for mobility access across South Africa.

Following the success of last year’s inaugural campaign, Össur South Africa has entered three amputee teams into the 2026 Cape Epic, one of the world’s most iconic and demanding mountain biking events. These six remarkable riders embody grit, courage, and the unbreakable belief that mobility transforms lives. Their mission is bigger than the race: to unlock meaningful support and funding for three exceptional non-profit organisations: Jumping Kids, Zimele and Rejuvenate SA.

“Movement is a fundamental right, not a privilege reserved for the few,” says Blignaut Knoetze, Managing Director of Össur South Africa. “Whether you’re an elite athlete, a child receiving their first prosthetic or an adult rebuilding independence; mobility unlocks dignity, participation, and potential. ‘What’s Your Epic?’ is our call to South Africa to stand with us in supporting organisations who make this freedom possible.”

The 2026 campaign aims to raise funds and awareness for four organisations driving mobility access and inclusion:

  • Jumping Kids: Providing quality prostheses, education access, and sport opportunities to children living with limb loss, giving them the tools to build confident, successful futures.
  • Rejuvenate SA: Founded on the belief that movement is a basic human right, Rejuvenate SA supplies mobility aids to those who cannot afford them, restoring dignity and independence.
  • Zimele: Meaning “independence” in Xhosa, Zimele supports adults with physical disabilities to regain control over their lives, reintegrate into society and build economic self-sufficiency.

Together, these six athletes across three teams are redefining what’s possible.

  • Team 1: Rentia Retief & Travis Warwick-Oliver

Rentia (33, Somerset West), an artist and amputee athlete, who survived a cycling accident in 2023. Her journey is a testament to courage and the belief that mobility is a right every person deserves. Partnering with her is Travis (32, Durban), founder of Rejuvenate SA, adaptive athlete, and two-time UTMB finisher who has transformed his own amputation into a mission to help others move freely and live without limitations.

  • Team 2: Mhlengi Gwala & Kean Dry

Mhlengi (34, Durban), an international para-triathlete and multiple African champion who continues to defy all odds after a 2018 attack that led to the amputation of his right leg. Riding alongside him is Kean (30, Cape Town), a dedicated endurance athlete and community motivator whose story of resilience inspires thousands to believe that adversity does not define possibility.

  • Team 3: Brian Style & Rudi Joubert

Brian (40, Springs), a passionate cyclist who has rebuilt his life through mountain biking, uses sport as a platform for giving back. He rides with Rudi (42, Secunda), a determined amputee athlete known for his positivity, teamwork, and commitment to raising funds for mobility solutions.

“These riders are not just racing, they are raising their voices for those who cannot and shining a spotlight on organisations that restore dignity, independence, and hope,” says Knoetze. Össur South Africa is inviting the public, corporates, partners, and communities to be part of this extraordinary movement. Whether through donations, corporate partnerships, fundraising initiatives, or simply sharing the message, every contribution helps someone stand, walk, run, play, work, or dream again.

“‘What’s Your Epic?’ is about pushing boundaries; not just on the bike, but in society,” adds Knoetze. “When we support mobility, we support access. We support inclusion. We support futures. We are asking South Africa to back our riders, our NPOs, and the belief that everyone deserves the freedom to move.”

Donate, fundraise, or get involved as an individual and/ or company. Your support can help someone take their first step, return to work, join a sport, or believe in possibility again.
Össur Donations, ABSA Bank, Account number: 4123 215 542, Branch code: 632005
Reference: company name and contact number

Please contact Amelda Potgieter (apotgieter@ossur.com) for more information and/ or Section 18A certificates.

This is more than a race. It’s a movement. What’s your Epic?