In Australia, colorectal cancer (CRC) is the most common registrable cancer affecting both men and women, and the third most common cause of cancer deaths. Clinical data from randomised, controlled trials indicate that population-based screening utilising the faecal occult blood test (FOBT) can reduce mortality from this disease. However, high adherence rates with repeated testing are required to secure these outcomes. This study examines repeat adherence with FOBT screening in a rural community two years after a first screening round was conducted. Patients, aged 50 to 74 years, registered with four local general practices were mailed a FOBT kit with a letter of invitation from their general practitioner. Following the intervention, 119 telephone interviews were conducted with adherers and non-adherers to examine knowledge and attitudes related to screening. Compliance with screening was recorded and compared with first round-data. Participation in the screening program was modest. Of the 3,406 participants eligible for both screening rounds, 34.1% and 34.7% participated in rounds 1 and 2, respectively. A majority of participants (56.8%) did not adhere to either screening, a quarter (25.7%) participated in both rounds, and 17.5% participated in one of the two rounds. First-round adherence was the strongest predictor of second-round adherence (OR=16.29; 95% CI: 13.58, 19.53) with 75.2% of first-round adherers completing a FOBT in round 2. Females were also more likely to adhere in both rounds, although the difference between females and males decreased across rounds. Knowledge and attitudes differed between adherers and non-adherers and are discussed within the context of the major findings. Results from this trial indicate that achieving high levels of compliance in a national screening program will be challenging. Strategies to increase repeat adherence are suggested.

>Magister Scientiae - MSc / Informal settlements are often implicated in surface water pollution with faecal matter. In most instances faecal pollution in the associated surface waters persists despite improvements in sewage removal infrastructure. This study evaluates the importance of investigating the water quality of the Plankenbrug River before it reaches Khayamnandi settlement by comparing water quality in spring and in winter upstream (Pre-Khayamnandi) and downstream (Post- Khayamnandi) from the settlement. In this study, faecal indicator bacteria (Escherichia coli and total coliforms) were enumerated using Chromocult agar. E. coli was further characterized with analytical profiling index (API) and haemolysis assays. Both Pre- and Post-Khayamnandi were not significantly different from each other for both total coliforms and E. coli in winter. Pre-Khayamnandi had between 105 and 108 cfu/100 ml for total coliforms while Post-Khayamnandi had total coliform colony count between 106 and 107 cfu/100 ml. E. coli also exhibited a similar pattern with slightly higher counts at Post-Khayamnandi with colony counts from 104 to 107 and 105 to 107 cfu/100 ml. Spring microbial count demonstrated a significant difference to winter counts within each test site (p ≤ 0.01) and across the two sites (p ≤ 0.05). Both total coliforms and E. coli were 102 fold higher at Post-Khayamnandi than at Pre-Khayamnandi in spring. The API assay demonstrated significant difference (p ≤ 0.05) between the two test sites. Pre- Khayamnandi predominantly had two different profiles while Post-Khayamnandi had three. These profiles represented five distinct E. coli biotypes. Sorbitol and sucrose tests within the API assay demonstrated significant differences (p ≤ 0.05) between the two test sites. The prevalence of sorbitol fermenters at Pre-Khayamnandi was 100% while at Post-Khayamnandi it was 73%. Pre-Khayamnandi also demonstrated a significantly higher prevalence of sucrose fermenters than Post-Khayamnandi at 100% and 59% respectively. These differences indicated dissimilar sources of faecal contamination around these sites. Differences in the distributions of sorbitol and sucrose fermenting biotypes demonstrate different toxicity potentials across these two test sites. The haemolysis assay demonstrated that 9% of isolates were haemolytic with reference to both known α- and β-haemolyitic streptococci at Post-Khayamnandi. At Pre-Khayamnandi there was a higher percentage of α- and β-haemolyitic species, 29% and 28%, respectively. Post- Khayamnandi and Pre-Khayamnandi were significantly different from each other with reference to both α- and β-haemolysis (p ≤ 0.05). These haemolytic activities also demonstrate different toxicity potentials across the two sites. In conclusion Khayamnandi contributes to an already heavy faecal load in the Plankenbrug River. Thus remedial measures to maintain high surface water quality of Plankenbrug River should be directed upstream from the Khayamnandi settlement as well as within the settlement equally. This study recommends integration of microbial loads with programs such as the National Microbial Monitoring Program of South Africa to drive prioritization process in directing reclaiming of water quality, inter alia.

O presente estudo teve como objetivo avaliar o efeito de níveis crescentes de inclusão de polpa cítrica na dieta de equinos, através da avaliação da palatabilidade, digestibilidade aparente e características físico-químicas das fezes. As dietas foram compostas por 60% da energia proveniente do volumoso (feno de Coast Cross) e 40% do concentrado, com níveis crescentes de inclusão de polpa cítrica (0, 7, 14, 21 e 28%). Para a realização do experimento, foram realizados dois testes. O primeiro ensaio consistiu na determinação da palatabilidade dos concentrados, através do teste de preferência. Para isso foram utilizados 15 equinos, por um período de 10 dias, totalizando 150 observações, em delineamento inteiramente casualizado. As variáveis observadas foram primeira ação, primeira escolha e razão de ingestão. Para a realização do ensaio de digestibilidade e características físico-químicas das fezes, foram utilizados cinco equinos, em delineamento quadrado latino 5x5. Avaliou-se a digestibilidade aparente dos nutrientes e as características de cor, consistência, pH, concentração e relação entre ácidos graxos de cadeia curta e capacidade tamponante a pH 5 e a pH 6, das fezes. Observou-se efeito da inclusão da polpa cítrica (P<0,001) sobre a primeira ação, sendo que 66,91% dos animais cheiraram os concentrados, enquanto 33,09% comeram, e também para a primeira escolha (P<0,001),onde os tratamentos 0, 7 e 14% apresentaram maior preferência. Para a razão de ingestão, também houve diferença (P<0,001) entre os tratamentos, sendo que o concentrado controle o mais consumido. Não foi observado efeito (P>0,05) dos níveis de inclusão de polpa cítrica sobre a digestibilidade aparente dos nutrientes. Para as características das fe zes não houve efeito de tratamento (P>0,05) na consistência e cor. A coloração se manteve esverdeada, e a consistência foi classificada como normal (escore 3).Não houve efeito de tratamento (P>0,05) para o pH, concentração e relação entre ácidos graxos de cadeia curta e capacidade tamponante das fezes. O valor médio observado de pH foi de 6,62, e a capacidade tamponante a pH 5 e pH 6 foi de 16,53 e 5,13 mmol/L, respectivamente. Os cavalos têm a capacidade de identificar a presença da polpa cítrica nos concentrados, e preferem concentrados sem a inclusão. A adição de polpa cítrica em até 28% não afeta negativamente a digestibilidade dos concentrados e as características físico-químicas das fezes, sendo uma alternativa de ingrediente na formulação de dietas para equinos. / The purpose of this study was to evaluate the citrus pulp inclusion in horses diet, through evaluation of palatability, apparent digestibility and feces physicochemical characteristics. The diets were composed of 60% of the energy from roughage (Coast Cross hay) and 40% from concentrate with increasing levels of citrus pulp (0, 7, 14, 21 and 28%).To perform the experiment, there were two distinct tests. The first experiment consisted in determining the concentrates palatability. Fifteen horses were used, for a 10-day period, totaling 150 observations, in a randomized design. The variables were first action, first choice and intake rate. For the digestibility test and feces physicochemical characteristics, five horses were used in 5x5 Latin square design. Were evaluated the nutrients digestibility and the feces characteristics of color, consistency, pH, concentration and relation between short-chain fatty acids, and buffering capacity at pH 5 and pH 6. There was an effect of the citrus pulp inclusion (P<0.001) on the first action, 66.91% of the animals smelled the concentrates, while 33.09% ate. For the first choice there was also significant difference (P<0.001) and 0, 7 and 14% treatments had a higher preference. For the intake rate there were differences (P<0.001) between treatments, being the control concentrate the most consumed. There was no effect (P>0.05)of the citrus pulp levels on nutrient digestibility. For feces characteristics there were no treatment effect (P>0.05) in consistency and color. The color remained green, and consistency were classified as normal (score 3). There was no treatment effect (P>0.05) for pH, concentration and relation between short-chain fatty acids, and buffering capacity of the feces, the mean pH value observed was 6.62, and the buffering capacity at 5 and 6 was 16.53 and 5.13 mmol / L respectively. Horses have the ability to identify the citrus pulp presence in concentrates, but they prefer the concentrates without citrus pulp inclusion. Addition of citrus pulp does not adversely affect the concentrates digestibility or the feces physicochemical characteristics, being an alternative ingredient in the horses diets formulation.

The overall aim of this thesis was to study epidemiological and clinical changes in the natural history of Crohn’s disease, its phenotype, the need for surgery and pharmacological therapy over time, as well as the role of faecal calprotectin as a biomarker of pathophysiology and disease course. An increased incidence and prevalence of Crohn’s disease was seen in the period 1963-2010. The proportion of patients with non-stricturing, non-penetrating disease behaviour at diagnosis increased, suggesting that either patients with Crohn’s disease are diagnosed earlier in their disease course today or that the Crohn’s disease phenotype is changing. A decrease in complicated disease behaviour, an increased use of immunomodulators, and a reduced frequency of surgical procedures five years after Crohn’s diagnosis was observed. The decrease in surgery at five years seemed to be explained mainly by a decrease in early surgery within three months from diagnosis, likely reflecting an increased proportion of patients with non-stricturing, non-penetrating disease. This suggests that the introduction of new treatment alternatives alone does not explain the reduction in surgery rates, and an increasing proportion of patients with uncomplicated disease at diagnosis may also play an important role. Subclinical mucosal inflammation, mirrored by increased NFkB activity and increased neutrophil activity (i.e. FC and MPO expression), was observed in healthy twin siblings in both discordant monozygotic and discordant dizygotic twin pairs with IBD. These findings strongly support the hypothesis of an ongoing subclinical mucosal inflammation at the molecular level in healthy first-degree relatives of IBD patients. Baseline FC as well as consecutive FC measurements predict relapse in IBD. The doubling of FC value increased the risk of relapse by 101% in the following three months. This increased risk attenuates with time by 20% for every three month period since the sample was obtained.

Anal acoustic reflectometry (AAR) is a technique that is currently under investigation for the assessment of faecal incontinence. It uses reflected sounds waves to measure cross sectional area at different pressures leading to a profile of the anal canal, and in particular the high pressure zone of the anal sphincters. The cross sectional area from the high pressure zone is then plotted on a graph to give seven characteristic parameters. AAR has been shown to be reproducible and reliable, able to distinguish between continence and incontinence, correlate with the severity of incontinence and able to discriminate between the three patterns of incontinence (urge, passive and mixed). Opening pressure has been shown to be an independent predictor of success with peripheral nerve evaluation, the trial period before sacral nerve stimulation. This thesis aimed to validate AAR against manometry and explore its physiological and clinical potential. A retrospective analysis of 265 patients who had undergone AAR was undertaken in order to develop a surrogate marker for anal canal length. The surrogate marker did find the expected difference between men and women but this was not clinically significant. Furthermore, the surrogate marker was unable to differentiate between incontinence and continence. A technical limitation (Gibbs phenomenon) of AAR was subsequently shown to explain this unexpected result. Prior manometry could possibly interfere with the interpretation of AAR, and therefore a prospective randomised cohort study of 30 patients was conducted to assess two orders of data collection. Reassuringly it does not matter which one of these investigations is undertaken first. In order to test the hypothesis that the greater the challenge to the anal sphincter, the greater the response, the effect of two rates of anal canal stretch was investigated in a prospective randomised cohort study of 50 patients with faecal incontinence. No difference was found between normal or fast rates of AAR. This study has validated a faster method of AAR that can be used alongside manometry in any order. A pudendal nerve block was used to investigate whether AAR assesses primarily internal or external sphincter function in a prospective cohort study of 15 patients using both AAR and manometry. Bilateral pudendal nerve block reduced the function of the external anal sphincter but had no effect on the internal sphincter using both techniques. This study suggests that AAR at rest is predominately an investigation of the internal anal sphincter. A prospective study of 30 patients with faecal incontinence was carried out to establish if AAR can predict the outcome from posterior tibial nerve stimulation. Posterior tibial nerve stimulation improved rectal sensation, manometry squeeze pressures, quality of life, severity of incontinence and was more effective for patients with urge incontinence. A variety of demographic, clinical and physiological measures were unable to predict the success of posterior tibial nerve stimulation. The results presented in this thesis suggest that the full clinical potential of AAR has yet to be realised and it will be necessary to compare it with high resolution anal manometry in the future. Progress in this field would be greatly facilitated by establishing the normal values for this technique and the development of a robust AAR assessment of the external anal sphincter.

No description available.

Capturing and holding of white rhinoceros (Ceratotherium simum) for the reintroduction to new reserves or breeding in zoos often involves a risk of mortality. Non-invasive techniques to monitor the stress experienced by these animals may guide the selection of management techniques that reduce risks to animal well-being. The aim of the study was to evaluate the biological relevance of a developed technique to monitor stress hormone metabolites in faecal samples of wild-caught and captive-bred white rhinoceros. Faecal corticosterone concentrations were measured via radioimmunoassay (125I RIA), in seven white rhinoceros (3 males and 4 females), at three sites, before and after an adrenocorticotropic hormone (ACTH) challenge test and control saline injection. Administration of ACTH resulted in a significant increase in faecal corticosterone concentrations (up to 350% above pre-ACTH baseline) within 1-2 days of injection, returning to baseline 4 days post-injection. It was found that individual baseline corticosterone concentrations fluctuate naturally and vary between individual animals, suggesting that an adequate baseline period of faecal sampling is needed in order to accurately assess responses to ACTH stimulation. Furthermore, the technique proved sensitive enough to detect elevations in faecal corticosterone concentrations due to environmental stressors. Data of faecal corticoid concentrations were correlated with gastrointestinal transit (GIT) times before and after ACTH and saline treatment by using art glitter as a digestive marker. This showed that gut passage times correlated to the ACTH-induced time to peak. Overall the results confirm that measurements of faecal corticosterone metabolites with the validated 125I RIA is a useful diagnostic tool to monitor adrenocortical activity in white rhinoceros. This study can therefore provide a methodology for examining chronically heightened adrenal activity in these animals and consequently be used to inform management strategies that aim to improve the welfare of white rhinoceros in captivity. / Dissertation (MSc)--University of Pretoria, 2011. / Anatomy and Physiology / unrestricted

In the year 2000, 170 countries decided to stand together and solve some primary and common global problems like poor health, water, and sanitation. Obtaining access to safe drinking water is every individual’s right. The UN defines safe drinking water as “the water required for each personal or domestic use must be safe, therefore free from micro-organisms, chemical substances and radiological hazards that constitute a threat to a person's health” (UNDESA, 2014). This thesis focuses on identifying the number of people who potentially receive spring water from a piped source in rural mountainous areas. There are three significant steps and data requirements which are necessary to meet this study’s objective. These are to: 1) obtain data classifying the various sources of drinking water in each country by specifying the percentage of population served by a particular water in rural and urban areas, 2) determine the number of countries which are undeveloped or developing, and 3) identify specific countries which are defined as mountainous (and thus likely to have spring fed piped water systems) based on elevation and slope in order to estimate the number of people living in mountainous areas. Results show that 183.54 (million) people were estimated to receive piped water from the springs in mountainous areas. Approximately, 34% of the population is from the Eastern Asia and South-Eastern Asia regions, and 33% reside in the Latin America and Caribbean Islands. These were followed by Western Asia and North Africa Regions with 15% and Central Asia and Southern Asia Regions with 14% of their population estimated to receive piped spring water.

This study focused on analysing the diet composition of nestlings of different age during two breeding seasons in rural environment of agricultural farm near Veselí nad Lužnicí, South Bohemia. Feeding behaviour and habitat selection by parents was also monitored. Population decline of the species as a consequence of low invertebrates rate in nestlings diet and disappearing of important habitats are discussed. Most of studies on feeding behaviour in the Czech Republic focused only on feeding frequency. Two commonly used methods for diet determination, neck- collars and faecal analysis, were compared. The feeding frequency of male and female were also determined. Coleoptera (Scarebeidae) were the most often determined group in samples of feacals, while Diptera (Tipulidae) were the most often determined group in samples from ligatures. The differences between diet of younger and older nestling were assessed. While diet of young nestlings contained Diptera, Coleoptera dominated in diet of older nestlings. The vegetable food, mainly seeds of Poaceae, dominated in diet of older nestlings. Amount of food increased along age gradient (samples of older nestlings were heavier). Different effect of animal proportion in the nestling diet was determined. Increase in animal proportion in the dietof young nestlings caused...

Wetlands are considered a last line of defence against poor water quality. Despite the natural capabilities of wetlands to remove a variety of contaminants from surface water, the track record for wetland conservation leaves much to be desired. In the northern parts of the City of Tshwane, 84% of wetlands have been degraded. When viewed against the poor bacteriological quality of river water in the study area, the lack of wetland conservation efforts is of particular concern. Given the large number of wetlands in the Tshwane area in need of rehabilitation, this study aimed to devise a methodology to prioritise these wetlands for rehabilitation. No blueprint for such a prioritisation process exists, as studies are adapted to take into account the availability of data and the unique requirements of the study area. The methodology for this study is based on the prioritisation of a specific river basin, based on expected maximum faecal bacterial load originating from various sources of pollution. Four river basins were compared with each other in a series of screening processes. Screening was done on a landscape level using a Geographic Information System (GIS) to generate various composite layers as part of the screening process. The screening processes relied on the application of several weighted criteria. Weights for criteria are based on scientific literature. Weights are also allocated in line with the “worst case scenario”, as the study is in essence an assessment of the various pollution sources and their maximum possible contribution to deteriorating surface water quality. A Simple Additive Weighting technique was used to assess the total pollution loads and total numbers of users at risk from contaminated surface water in each of the river basins. It is important to note that the objective is to only rate the pollution sources, whilst exact pollution loads were not calculated. Diffuse, areal and point sources of pollution were rated using the estimated contributions to faecal coliform loads. The river basin with the highest score was selected for the selection of candidate wetlands for rehabilitation purposes. The Apies River Basin scored highest for most of the criteria, with the exception of the number of households at risk from contaminated surface water. Despite the 0.60 weight allocated to households at risk, the extent of pollution sources in this river basin allowed it to be singled out as the basin in which a wetland for rehabilitation is most urgent in order to attenuate bacterial load. Two wetlands were short listed, based on their high need for rehabilitation, their hydrogeomorphic location (valley bottom with a channel), and given that they are larger than 1ha in size and within a minimum distance from the households at risk. Site level assessments are required for a final selection between the two, taking into account the nature of the current disturbances, the possibility of risk due to back-flooding, the projected costs associated with rehabilitation, the nature of the vegetation associated with the wetlands and the general conservation value of each of the wetlands.