M. Tech. / It has been noted in the literature that the sensory system consists of the visual, vestibular and somatosensory systems (Guyton and Hall, 1997; Arnold and Schmitz, 1998; Murphy, 2000; Nakata and Yabe, 2001; Magee, 2002 and Gatterman, 2004). In congruence with the above authors Katz (1996), Gatterman (2004) and Murphy (2000), Morningstar, Pettibon, Schlappi, Schlapp and Ireland (2005) further stated that the postural reflexes can be subcategorised as the following: visual righting reflex, labyrinthine righting reflexes, neck righting reflexes, body on head righting reflexes and body on body righting reflexes. Each of these neurological mechanisms plays a role in balance / equilibrium. Furthermore it has been shown that spinal manipulative therapy has an effect on neurological systems. Therefore it stands to reason that spinal manipulative therapy may have an effect on balance or equilibrium.

The dimensions of the cervical spinal canal (C3 – C7) of the South African black population were measured on skeletal remains of 179 individuals (90 males and 89 females divided into age categories of 30-45; 46-60 and 61-75 years), and compared to measurements taken from CT-scans of 55 individuals divided into the same categories. There was no significant difference between measurements taken on skeletal material and CT-scans. The spinal canal is larger in males (mean = 13.96mm) than in females (mean = 13.84mm) and the Pavlov ratio is larger for females (mean = 0.89) than males (mean = 0.81). The Pavlov ratio seems to overestimate the occurrence of spinal stenosis in this population group, as almost all individuals older than 46 years are classified as stenotic according to this ratio. The shape of the cervical spinal canal was determined morphometrically by processing digital images taken of vertebrae (C3 – C7) of 60 individuals with the tps-Series of software programs and was found to be significantly different between males and females. In males the canal is congenitally triangular, whereas in females the canal assumes a more “safe”, rounded shape. The low Pavlov ratio for this population group, especially in males, can possibly be explained by these shape differences. Even slight degenerative changes affecting the spinal canal, such as osteophytosis or ossification of the posterior longitudinal ligament (OPLL), will alter the triangular-shaped male canal in such a way that the spinal cord may become compromised. Cervical vertebrae of 107 individuals were inspected for occurrence of osteophytes within the spinal canal and the incidence of OPLL. Osteophyte occurrence within the cervical spinal canal is the same for males and females and OPLL occurs frequently within this population group, especially in the cephalic region (incidence: C3 = 64.5%; C4 = 47.7%; C5 = 21%; C6 = 12.2%; C7 = 7.5%). / Dissertation (MSc (Anatomy))--University of Pretoria, 2008. / Anatomy / unrestricted

No description available.

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Technikon Natal, 1998. / The absence oftested theory has resulted in the continued variation of treatment protocols in the treatment of mechanical low back pain. This study was designed to determine the relative effectiveness of specific passive mobilization versus spinal manipulation in the treatment of uncomplicated mechanical low back pain. It was hypothesized that both spinal manipulative therapy and specific passive mobilization would be effective, but that manipulation would be significantly more effective in terms of objective and subjective findings, over the same two week treatment period / M

M.Tech.

Objetivo: Determinar si existe asociación entre el estrés y dolor cervical en los estudiantes de una universidad privada que realiza clases virtuales por medida de aislamiento social por pandemia de Covid-19. Diseño: Se realizó un estudio observacional, de corte transversal y analítico.

Cervical cancer is the fourth most common female malignancy worldwide and is substantively higher in low-income and middle-income countries. In South Africa, cervical cancer is a leading cause of mortality amongst women. The anti-cancer actions of the vitamin D and its numerous metabolites are an active field of research. The family of vitamin D metabolites regulate numerous cellular pathways which are implicated in tumorigenesis. Pre-clinical studies and clinical studies have yielded promising, although conflicting results in various cancers. Some healthy and cancerous tissue express an autocrine vitamin D metabolising system (VDMS) which is capable of tightly regulating intracellular metabolism and growth. The VDMS expresses activating and inactivating enzymes and a vitamin D receptor (VDR). At the cellular level, the VDMS can activate and inactivate vitamin D precursors and transduce signals to the nucleus to regulate various cell health genes, including cell growth, metabolism and survival. Healthy and cancerous cervical tissue express a VDMS. The anti-cancer actions of cholecalciferol, an early precursor of activated vitamin D, is poorly studied in cervical cancer. This study aimed to characterise cholecalciferol’s action on cell growth, cell death and the VDMS in a high-grade cervical cancer cell line, SiHa. SiHa cell cultures were treated with a range of cholecalciferol doses (26 nM, 104 nM, 260 nM and 2600 nM) for 72 hours. Cell count and viability were assessed by crystal violet and trypan blue assays, respectively. Cell proliferation was enumerated by Ki67 nuclear antigen and the cell cycle profile analysed by flow cytometry. Apoptotic cell death was investigated by measuring mitochondrial membrane potential (∆Ψm), phosphatidylserine (PS) externalisation, effector caspase activation and evaluation of DNA damage markers by flow cytometric analysis. The biochemical markers microtubule-associated proteins 1A/1B light chain 3B-II (LC3-II) and lactate dehydrogenase (LDH) were also measured by flow cytometry and spectrophotometric analysis to identify autophagic cell death and necrosis, respectively. In addition, brightfield microscopy and transmission electron microscopy (TEM) were respectively used to characterise morphological and ultrastructural features of apoptosis, autophagic cell death and necrosis. The VDMS in SiHa control and experimental cultures were characterised by the investigation of intracellular gene and protein expression of the cholecalciferol activating (CYP2R1 and CYP27A1) and inactivating (CYP24A1) enzymes, and the VDR. Qualitative microscopical analysis evaluated classical characteristics of cell death and semi-quantitative analysis of apoptosis was performed. Data were analysed using a one-way ANOVA and Bonferroni post-hoc test. p < 0.05 was considered statistically significant. A significant decrease in cell count and cell viability was identified in SiHa cell cultures treated with 2600 nM cholecalciferol. Furthermore, significant increase in biochemical markers of apoptosis were identified including, decreased ∆Ψm; PS exposure; terminal caspase activation; and nuclear damage at 2600 nM cholecalciferol treatment of SiHa cell cultures. Moreover, the biochemical findings were supported by brightfield microscopy and TEM, which observed classical apoptotic features viz. membrane blebbing, apoptotic bodies and nuclear fragmentation. Also, a significantly increased number of apoptotic cells were enumerated. There was no evidence of autophagic cell death and necrosis. Additionally, a significant increase in 25-hydroxylase (CYP2R1) gene and protein expression was identified in SiHa cells treated with 2600 nM cholecalciferol. Conversely, a significant decrease in 1α-hydroxylase (CYP27B1) gene and protein expression was identified in SiHa cells treated with 2600 nM cholecalciferol. Furthermore, significant increase in both 24-hydroxylase (CYP24A1) and VDR expression at gene and protein levels were observed in 2600 nM experimental SiHa cultures. In conclusion, cholecalciferol exerts growth inhibition and apoptosis in SiHa cells at 2600 nM. This is accompanied by CYP2R1 and VDR upregulation which suggests autocrine activation to calcidiol and intracellular nuclear signalling, respectively. It is therefore hypothesised that calcidiol synthesised de novo binds to VDR and induces apoptosis in SiHa cell line. / Dissertation (MSc (Chemical Pathology))--University of Pretoria, 2020. / Chemical Pathology / MSc (Chemical Pathology) / Restricted

Wits School of Public Health May 2015 / Background and objectives: Cervical cancer is a major cause of cancer-related deaths in many developing countries yet it is a preventable and treatable in early disease. Recent research has seen increasing morbidity and mortality due to cancer of the cervix attributed to the advent of the human immunodeficiency virus (HIV) epidemic worldwide. Papanicolaou smears (Pap smears) to detect cervical abnormalities are currently the best known form of early detection and prevention of invasive cervical cancer (ICC). Knowledge and awareness about cervical cancer and associated risk factors, and cervical screening is very important in determining appropriate health seeking behaviours with the aim to reduce morbidity and mortality. This study examines awareness, perceived risk and practices related to cervical cancer screening among HIV-positive women in an urban HIV clinic in Johannesburg, South Africa. This will be useful in making recommendations with regards to designing and planning of screening programmes, and addressing cervical cancer education and awareness. Materials and methods: This study analysed secondary data collected from an ongoing cervical cancer study undertaken by Right to Care in partnership with the Clinical HIV Research Unit (CHRU) among HIV-positive adult (18 years and older), female patients enrolled in the Themba Lethu Clinic HIV care and treatment programme in Johannesburg, South Africa from November 2009 to December 2012. Clinical data for all respondents was extracted from TherapyEdge-HIVTM, the electronic medical database system used for patient management at the facility. Descriptive statistics were used to summarise baseline characteristics. Models using logistic regression were developed to estimate odds ratios (OR) to further identify baseline sociodemographic factors and clinical characteristics associated with behaviours studied (awareness, perceived risk and practice related to cervical cancer and Pap smear testing) and to identify the association between these factors and the prevalence and severity of cervical disease. Awareness of the Pap smear test and the human papillomavirus (HPV) was assessed based on whether the women report knowing what a Pap smear test is, and whether they have ever heard about HPV. Perceived risk about getting cervical cancer was assessed based on how worried the study participants were about getting cervical cancer. Previous Pap screening practice was assessed using reported screening history of the study participants. In addition to this, a subanalysis was conducted to see how these responses compare to 1) the recommended practice according to the South African national cervical cancer screening guidelines based on the age of participants, and 2) the latest HIV treatment guidelines based on year of HIV diagnosis. Analysis of attrition of study participants at 12 months of study participation was conducted using different time to event analysis techniques including Kaplan Meier, Log-rank test and Cox proportional hazards model. Cox proportional hazards models were fitted to investigate associations between baseline covariate and attrition. A sub-analysis was also carried out using descriptive statistics and chi-square tests to compare the cohort of patients that were included in the study (the VICAR1 cohort) and the rest of the larger Themba Lethu Clinic (TLC) population that was not included in the study to see if there were any significant differences noted between the two groups. In addition, a sensitivity analysis of the of 12 month follow up study visit was conducted using descriptive statistics and chi-square tests to determine if there were any significant differences between study participants that came for their 12 month study visit and those that did not come for their 12 month study visit. Results: Eight hundred and fifty seven (71.30%) participants reported to be aware of Pap smear screening, with only 18.15% reporting to be aware of HPV. Of the 1192 participant who had data to ascertain perceived risk regarding cervical cancer disease, 662 (55.54%) of the women were very worried, 250 (20.97%) were somewhat worried, 280 (23.49%) were not worried about getting cervical cancer. A total of 381 (36.46%) women had adequate practice according to the national cervical cancer screening guidelines. While 304 (28.57%) had adequate practice according to the national HIV treatment guidelines. Factors associated with Pap smear screening awareness were being in the 50+ age group (aOR=4.70, 95% CI 1.63-13.55) as compared to the 18-29 age group, being of non-South African nationality (aOR=0.41, 95% CI 0.20-0.83), having a grade 10 to matric level education (aOR=2.12, 95%CI 1.28-3.52), and a tertiary level education (aOR=2.62, 95%CI 1.07-6.41) as compared to having a less than a grade 10 level education. None of the factors assessed were found to be significantly associated with awareness regarding HPV. Factors associated with perceived risk regarding cervical cancer disease were having a tertiary education (aOR=3.74, 95%CI 1.13-12.38) as compared to having less than a grade 10 level, taking snuff (aOR=0.55, 95%CI 0.33-0.92) and drinking alcohol (aOR=2.53, 95% CI 1.24- 5.17). Being in the 30-39 age group (aOR=12.23, 95%CI 4.00-37.35) as compared to being in 18-29 age group, cohabiting with a partner (aOR=0.36, 95%CI 0.17-0.75) as compared to being single, being self-employed (aOR=2.95, 95%CI 0.82-10.66) as compared to those in full time employment, and being initiated on highly active antiretroviral therapy (aOR=0.17, 95%CI 0.06-0.55) were associated with Pap smear screening practices according to the national cervical cancer guidelines. None of the factors proved to be significantly associated with the practice according to the national HIV treatment guidelines, this is mainly because the HIV treatment guidelines have stricter screening requirements for HIV positive women. Those that had a moderate to severe baseline study Pap smear at enrolment into the study were 92% less likely to have disease progression at their 12 month Pap smear screening (aOR=0.08, 95%CI 0.05-0.13) compared to those that had a negative baseline Pap smear at study enrolment. This is mostly because they would have had a treatment intervention based on their baseline study Pap screening result therefore they would mostly likely not have disease progression at a follow up screening. Only seven women enrolled in the study died of non-cervical cancer related causes during the study period. In the analysis on all-cause attrition (deceased or lost to follow up) those that are initiated on highly active antiretroviral therapy were 92% less likely to be deceased or lost to follow up than those that were not initiated on highly active antiretroviral therapy (aOR=0.08, 95% CI 0.05-0.13). The global test for the overall model showed that the proportional hazard assumption had not been violated, p=0.684. Conclusions: Results for our study showed high levels of Pap smear screening awareness amongst the study participants. However, low levels of Pap screening uptake was observed for study participants. These results and results shown in previous studies show that awareness is only the first hurdle in the challenges related to cervical cancer prevention and treatment. Adequate practice is the factor that will have the most positive influence on the disease morbidity and mortality. Rates of screening practices have been found to be worse in populations with less than 70% Pap smear screening awareness. Findings from this study and similar findings from other studies highlight that more research needs to be done into effective health education programmes to address the gaps in adequate screening practice. These efforts should not only target the clients but also the health providers as they also have an important role to play in improving awareness, knowledge and practices related to cervical cancer and Pap smear screening amongst their clients.

No description available.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Aim: To determine the intra- and inter-examiner reliability of the radiographic assessment of the cervical lordosis of asymptomatic adult males. Participants: Eighty lateral plain film radiographs of the cervical spine of asymptomatic males aged 18-45 years (taken in a previous study) were utilised for this study. However, due to the obstruction of the C7 vertebral body by the trapezius muscle, the examiners were unable to assess the CL on all 80 plain film radiographs. Three examiners took part in the study viz. Examiner One who was a qualified chiropractor with three years of clinical experience, Examiner Two who was a qualified chiropractor with six years of clinical experience and Examiner Three who was a chiropractic master’s student. Methodology: The initial set of assessments of the CL using the C1-C7 and C2-C7 modified Cobb methods was completed by Examiner One and captured on an Excel spread sheet for Round One. The procedure was then repeated for Examiners Two and Three. The process was repeated for the second set of assessments (Round Two). Each examiner was given a maximum of two weeks to complete their assessments for each round. The data was statistically analysed using SPSS 22.0 and Stata 13. Descriptive data was presented in tables as mean and standard deviation at a 95% confidence interval while intra- and inter-examiner reliability was determined using the Kappa coefficient. Results: The mean (± SD) CL values obtained by each examiner using the C1-C7 modified Cobb method for Round One was: Examiner One: 45.6˚ (± 10.4˚) (n = 70), Examiner Two: 44.0˚ (± 11.0˚) (n = 75) and Examiner Three: 43.8˚ (± 12.0˚) (n = 72). The mean (± SD) CL values obtained by each examiner using the C1-C7 modified Cobb method for Round Two was: Examiner One: 46.7˚ (± 10.7˚) (n = 72), Examiner Two: 43.3˚ (± 11.1˚) (n = 74) and Examiner Three: 43.8˚ (± 11.5˚) (n = 72). The mean (± SD) CL values obtained by each examiner using the C2-C7 modified Cobb method for Round One was: Examiner One: 15.9˚ (± 9.2˚) (n = 72), Examiner Two: 22.6˚ (± 9.7˚) (n = 75) and Examiner Three: 17.2˚ (± 9.7˚) (n = 72). The mean (± SD) CL values obtained by each examiner using the C2-C7 modified Cobb method for Round Two was: Examiner One: 16.3˚ (± 9.4˚) (n = 72), Examiner Two: 20.5˚ (± 9.0˚) (n = 74) and Examiner Three: 16.9˚ (± 9.2˚) (n = 72). The intra-examiner reliability obtained by each examiner using the C1-C7 modified Cobb method for Round One and Round Two was: Examiner One: K = 0.16, Examiner Two: K = 0.11 and Examiner Three: K = 0.16. The intra-examiner reliability obtained by each examiner using the C2-C7 modified Cobb method for Round One and Round Two was: Examiner One: K = 0.21, Examiner Two: K = 0.04, Examiner Three: K = 0.22. The inter-examiner reliability obtained by each examiner using the C1-C7 modified Cobb method for Round One and Round Two respectively was: Examiner One vs Examiner Two: K = 0.03; K = 0.09, Examiner One vs Examiner Three: K = 0.19; K = 0.15, Examiner Two vs Examiner Three: K = 0.03; K = 0.08. The inter-examiner reliability obtained by each examiner using the C2-C7 modified Cobb method for Round One and Round Two respectively was: Examiner One vs Examiner Two: K = 0.00; K = 0.01, Examiner One vs Examiner Three: K = 0.19; K = 0.11, Examiner Two vs Examiner Three: K = 0.02; K = 0.05. There was a significant difference in the intra-examiner findings for both the modified Cobb methods (p < 0.05). Using the C1-C7 modified Cobb method, there was a significant difference in the inter-examiner reliability findings between all three examiners for both rounds (p < 0.05). There was no significant difference in the inter-examiner findings of the CL using the C2-C7 modified method between Examiner One versus Examiner Two for Round One (p = 0.33) and Round Two (p = 0.23) but there was a significant difference in the findings between Examiner One versus Examiner Three (p < 0.05) and between Examiner Two versus Examiner Three (p < 0.05) for Round Two only. Conclusion: The results of this study are in agreement with those of a previous study which reported that the C1-C7 modified Cobb method over-valued the magnitude of the curve while the C2-C7 modified Cobb method under-valued the curve. A significant difference in the intra-examiner findings suggests that recall bias did not significantly affect the assessments while inter-examiner findings suggest that experience and skill of the examiners as well as assessments that require drawing of lines and measuring of angles might lead to differences in the results obtained. Further studies which would utilise a large number of digitised radiographic images from both asymptomatic and symptomatic individuals are required to confirm the findings of this study. / M