The main objectives of this dissertation was: 1) to review the available evidence with respect to the period prevalence of pre-race upper respiratory tract infections (the week before a distance running event) in distance runners, the relationship between exercise and infections, and the possible health consequences of participating in sport whilst suffering from an acute infective illness; 2) to document the period prevalence of runners with an acute illness in the 7-day period prior to an endurance race; 3) to determine the period prevalence of runners who "fail" the "neck check", and would be advised not to participate in the race, 4) to determine the incidence of runners with an acute illness, and who received educational information and guidelines, and who then not start the race, 5) to determine the incidence of runners with an acute illness who chose to start the race, but do not finish the race, and 6) to determine the incidence of runners with an acute illness who chose to start the race, but develop medical complications during the race.

Background: Medical complications in pregnancy can be a significant source of stress for pregnant women and their partners. Despite this, and evidence that anxiety is very common among perinatal women, little is known about the relationship between perinatal anxiety and medical complications in pregnancy. Purpose: The purpose of this research was to conduct a systematic review of the extant literature pertaining to medical complications of pregnancy and anxiety. Specific objectives were to (a) investigate differences in anxiety experience (symptoms and/or disorder) between women experiencing a medically complicated pregnancy and women experiencing a medically uncomplicated pregnancy, and (b) investigate the nature and scope of perinatal anxiety among women whose pregnancy is fraught with medical problems. Methods: The review was guided by the PRISMA reporting process. The electronic databases MEDLINE and PsycINFO were searched to identify studies that met the study inclusion criteria. Data were extracted and presented in a narrative form including tables and figures. An adapted form of the Newcastle-Ottawa Quality Assessment Scale for case-control and prevalence studies was used to perform a quality assessment review. Results: Twelve studies met the inclusion criteria. Findings indicated that anxiety symptom severity was greater among women experiencing a medically complicated pregnancy compared to those experiencing an uncomplicated pregnancy. The prevalence studies in which symptoms of anxiety were assessed at various times during pregnancy indicate that, among women experiencing a medically high-risk pregnancy, reported symptoms were most severe at initial assessment. Though an exact estimate cannot be provided due to methodological differences, these studies reported the prevalence rates of anxiety symptoms to range from 7.8% to 46.9%. The included studies that used DSM-IV criteria concluded that the risk may be most significant for two disorders: obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD). Based on the overall quality of the available studies, the findings cannot be called as bias-free Conclusions: Women experiencing a medically complicated pregnancy appear to experience significantly more symptoms of anxiety compared to women experiencing a healthy pregnancy. / Graduate

Magister Scientiae Dentium - MSc(Dent) / Diabetes is often associated with a number of medical complications as a result of the metabolic changes taking place systemically. There is considerable evidence it is associated with oral complications including among others, gingivitis, periodontal disease, xerostomia, oral candidiasis, dental caries, periapical abscesses, lichen planus,burning mouth syndrome and an altered taste sensation (Lamster et al. 2008; Skamagas et al. 2008; Vernillo, 2003). The aim of the present study was to compare the oral health status in diabetic and non-diabetic patients with regards to their oral health problems, oral pathology and self perceived quality of life.A comparative cross-sectional study to determine the common oral complications prevalent in diabetics and non-diabetics was carried out in KwaZulu-Natal, at Prince Mshiyeni Memorial, EThekwini District, Umlazi. The study sample consisted of 150 diabetic patients and 150 non-diabetic patients attending the hospital. The oral health status was assessed clinically for each patient and recorded prior to the interview. The DMFT, plaque index and appearance of marginal gingiva were used to assess oral health status. An intra-oral examination was carried out to identify oral pathology lesions and other oral problems. Patients were then interviewed on the self perceived quality of life and the impact that diabetes has had on their lives. Plaque Index and DMFT were significantly higher among the diabetic group as opposed to the non-diabetic group. Periodontal disease was observed in more than half of the diabetic group as opposed to only 14.7% of the non-diabetic group. Except for tooth decay, the diabetic patients had more oral health problems compared to the non-diabetic group. More than half of the diabetic group reported having xerostomia compared to only 7.3% of the non-diabetic group. Altered taste sensation was also more prevalent in the diabetic group. In general, the diabetic group demonstrated a higher prevalence of oral pathology lesions and medical diabetes complications compared to the non-diabetic group.The self perceived quality of life was said to have deteriorated in 92% of diabetic subjects due to concomitant diabetic complications and 75% of this group indicated that they were not satisfied with their current quality of life.Diabetic patients were significantly less likely to perceive their quality of life as very satisfied after having adjusted for age and gender variables (OR=0.0188; CI: 0.0059-0.0594). Furthermore, diabetic patients were almost 6 times more likely to perceive themselves as “not satisfied” with their quality of life (QOL) as compared to non-diabetic patients.Individuals with diabetes exhibited poorer oral health when compared to non-diabetics.They exhibited a higher DMFT and had a significantly higher average number of missing teeth compared to the non-diabetic group. Special care needs to be given to diabetic patients because of the associated complications to improve their quality of life. A more detailed and in-depth study that utilises a diabetes-specific quality of life instrument may provide a more accurate way of determining the quality of life as well as periodontal disease in patients.

This thesis investigates long-term cognitive outcome in two cohorts of adolescents and young adults exposed to stressors during the perinatal period: one group born preterm (&lt;37 weeks of gestation and birth weight &lt;1,500 g); one group exposed to two or more courses of antenatal corticosteroids (ACS), to stimulate lung maturation in the face of threatening preterm birth. In fetal life the brain undergoes dramatic growth, and a disruption to the early establishment of functional neural networks may interrupt development in ways that are difficult to predict. Executive function refers to a set of cognitive processes that are important for purposeful regulation of thought, emotion, and behavior, and even a subtle depreciation may influence overall functioning. Study I investigated the stability of executive function development after preterm birth. Executive functions were differentiated into working memory and cognitive flexibility. Both components were highly stable from preschool age to late adolescence. In Study II, we identified subgroups within the group of children born preterm with respect to cognitive profiles at 5½ and 18 years, and identified longitudinal streams. Outcome after preterm birth was diverse, and insufficiently predicted by perinatal and family factors. Individuals performing at low levels at 5½ years were unlikely to improve over time, while a group of individuals performing at or above norm at 5½ years had improved their performance relative to term-born peers by age 18. Studies I and II pointed to the need for developmental monitoring of those at risk, prior to formal schooling. Study III investigated long-term cognitive outcome after repeat ACS treatment. The study did not provide support for the concern that repeat ACS exposure will have an adverse impact on cognitive function later in life. In sum, exposure to perinatal stressors resulted in great variation in outcome. However, for many, their rough beginnings had not left a lasting mark. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 1: Submitted.</p>