Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban University of Technology, 2010. / The aim of this study was to determine the prevalence of and risk factors for neck pain in the white population in the greater Durban area. The rational for this study was that there have been few epidemiological studies done on neck pain and even less when concerning different population groups. Discrepancies between population groups have been found in various pain related studies. The present epidemiological study eliminated any possible variables between population groups by studying only the white population in a specific geographical area (Durban). Therefore, physicians treating people with neck pain should use the risk factors that were established in this and other studies and integrate them in their treatment protocol. The study was conducted at three shopping centres around Durban that were randomly selected. Each shopping centre was grouped by the socio-economic status of the surrounding suburbs. There were 900 participants surveyed at three shopping centres by means of a questionnaire. The data were then statistically analysed using SPSS version 15. It was found that the overall prevalence of neck pain was 45%. The participants in this study that had neck pain were more likely to be females that were married or previously married, had a job that caused their heads to turn or to work with their arms above their heads. Lifestyle factors included one or a combination of the following: lead a stressful lifestyle, were emotional, had perceived bad posture, had previously experienced neck or head trauma, slept in awkward positions, watched television, required glasses and did not play squash.

The main experimental work of this thesis has been a cross-sectional study of the prevalence of refractive error and its biometric correlates in Middle Eastern adults. In addition dynamic accommodative responses and twenty-four hour axial length fluctuations were investigated in young myopic adults. The prevalence of myopia in 3000 Middle Eastern adults (age range 17-40 years) was similar to previously reported levels of myopia in the West. Myopia was associated with a higher level of education, occupations with a high nearwork demand and positive family history of myopia; all of which have been identified as risk factors for myopia development and progression Diurnal variations in axial length (AL) of similar magnitude to those previously reported in emmetropes were observed in myopes recruited in the current thesis. However, the pattern of the diurnal variation in AL was significantly different between early-onset myopes (EOMs) and late-onset myopes (LOMs). There were no significant differences between EOMs and LOMs in the dynamic accommodative response to a sinusoidally oscillating target. The accommodative phase lag was increased following 30 minute adaptation to myopic defocus using +2.00 D lens. However, intense prolonged (30 minute) nearwork was found to have no effect on accommodative gain or phase lag. A number of recommendations for further work on the prevalence of refractive error in the Middle East are suggested along with further research on diurnal AL variations and dynamic accommodative responses in EOMs and LOMs.

Objectives. To investigate diabetes prevalence, incidence, mortality trends, the effects of hyperglycaemia and blood pressure, diabetes and hypertension treatment, and the effect of screening detection on total and cardiovascular disease (CVD), myocardial infarction (MI) and stroke incidence. Study population and methods. Between 1972 and 2001 all patients with diabetes, some detected clinically and some by case-finding procedures (screening), were entered in a diabetes register at Laxå Primary Health Care Center in Sweden. The register included information on medical treatment and laboratory data as well as information on mortality and morbidity from National Registers. The register was supplemented with five non-diabetic subjects, matched to each diabetes patients by age, sex, and year of detection. Results. During the study period 776 new diabetes cases was found, 36 type 1 diabetes mellitus and 740 type 2 diabetes mellitus. Age standardised incidence and prevalence rates for type 1 and type 2 diabetes did not increase over time. Diabetic patients had 17% higher mortality rate than non-diabetic persons, 22% in women and 13% in men. The corresponding over-mortality in CVD was 33%, 41% in women and 27% in men. CVD mortality decreased across time in non-diabetic subjects and in diabetic men but not in diabetic women. Results regarding coronary heart disease (CHD) were similar. CVD incidence increased with fasting blood glucose (FBG), body mass index (BMI), mean arterial blood pressure (MABP), and decreased with metformin treatment and sulfonylurea. Myocardial infarction incidence increased with FBG, BMI and MABP, and decreased with metformin treatment. Stroke incidence increased with MABP. There was no difference in prognoses between those detected by screening or clinically. Conclusions. Diabetes prevalence and incidence did not change over time. The over-mortality according to diabetes was moderate. CVD and MI during follow up were negatively affected by hypertension and hyperglycaemia, and positively by pharmacological diabetic treatment. For stroke no pharmacological protective effect was seen. Screening did not improve prognosis.

Many patients suffer from dermatological diseases throughout the world. Literature about this problem is emphasizing that it is getting worse. Factors such as poor hygiene, poverty and diseases such as HIV/AIDS, have increased the prevalence of dermatological diseases in developing countries such as Namibia. Understanding the different dermatological diseases and studying their prevalence will aid in ensuring patients better quality of life. The aim of the study was to investigate the prevalence and medicinal treatment patterns of dermatological diseases in the private healthcare sector of Namibia, with special reference to Windhoek. The research methodology was divided into two sections, namely a literature analysis and an empirical study. The literature analysis has been done to ensure knowledge about dermatological conditions before the empirical study was started. The empirical study was divided into two phases and data were collected from the community pharmacy environment (Phase 1) and a dermatologist (Phase 2). A total number of 507 patients participated in this study. In the community pharmacy environment, data were gathered from dermatological prescriptions of general practitioners (Phase 1A) and from pharmacist-initiated therapy prescriptions (Phase 1B). The data collected from the dermatologist (Phase 2), were collected from patients files at the dermatologist‘s practise. Phase 1A indicated that urticaria (n=36) had the highest prevalence followed by eczema (n=28) and contact dermatitis (n=28). 49% of the patients that participated in this phase were seeking treatment for the same condition the second time. In Phase 1B, contact dermatitis (n=15) showed the highest prevalence with eczema (n=14) and urticaria (n=8) second and third respectively. 77% of the patients participating in this phase of the research study did not have a family history of the same dermatological diseases. Phase 2 indicated that the highest prevalence of dermatological diseases was acne vulgaris (n=30) and melasma (n=19). The treatment duration that occurred most often in this phase was 180 days. Over all, the data indicated that eczema was the dermatological disease with the highest incidence of 11.2% (n=57). Other diseases that played a significant part were acne vulgaris (10.5%), urticaria (9.0%), contact dermatitis (8.6%) and melasma (7.1%). Rare dermatological diseases such as Kaposi sarcoma showed relatively high prevalence (n=9). It was concluded that this could be due to the fact that the dermatologist consulted, had been the only dermatologist claiming directly from the government medical aid, and that most of the patients diagnosed with Kaposi sarcoma during this research study were government employees. Many dermatological diseases were not specifically defined or diagnosed, but still treated with topical corticosteroids which may suggest that the term eczema is undefined and easily used by different healthcare practitioners for dry-skin related conditions. It is concluded in this research study that the three most prevalent dermatological diseases in the private healthcare sector of Namibia are eczema, acne vulgaris and urticaria. These conditions are not considered to be life-threatening, but they do have a significant effect on the quality of life of patients. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Major changes that emphasise the importance of a balanced work and family life have occurred within organisations. Inability to manage this integration between the work and home domains can affect the performance of organisations and the wellbeing of their employees. In order to measure work-home interaction and wellbeing, it is important to use valid, equivalent and reliable instruments. However, there is a lack of empirical research when investigating work-home interaction, burnout and work engagement in the earthmoving equipment industry in South Africa. Furthermore, the earthmoving equipment industry is a multicultural environment and construct equivalence across subgroups therefore becomes important when measuring work-home interaction, burnout and work engagement across different cultural or language groups. It also seems relevant to consider differences in the work-home interaction and work wellness levels between important demographic groups in the earthmoving equipment industry. It appears as if burnout and engagement can be seen as part of the total wellness continuum; and that job characteristics may be related to burnout and engagement through negative and positive work-home interaction. However, little information was found that included these factors in a structural model for the earthmoving equipment industry. The objectives of this research were to test the psychometric properties of the Survey Work- Home Interaction - Nijmegen (SWING), the Maslach Burnout Inventory - General Survey (MBI-GS) and the Utrecht Work Engagement Scale (UWES); to determine if various demographic groups differ with regard to work-home interaction and wellbeing; and to test a structural model that includes job characteristics, work-home interaction and wellbeing for employees in the earthmoving industry. A cross-sectional survey design was used. Random samples (n = 528) were taken from employees in the earthmoving equipment industry in Gauteng, the Limpopo Province, Mpumalanga, the Northern Cape, the Western Cape, the Eastern Cape, Kwa-Zulu Natal and the North West Province. Structural equation modelling confirmed a four-factor model of work-home interaction which measures negative work-home interference, positive work-home interference, negative homework interference and positive home-work interference. This factor structure was equivalent across language, ethnicity, gender, education, marital status and parental status. All four factors were reliable. The participants reported more negative WHI than negative HWI, and more positive HWI than positive WHI. It was found that statistically significant differences that are based on age, gender, language, ethnicity, a partner's contribution to household income and the different business units exist between the demographic groups. The results confirmed a four-factor structure of burnout (exhaustion, cognitive weariness, cynicism and professional efficacy) and a two-factor structure of work engagement (including vigour and dedication). These structures were equivalent across language and education groups, and all scales were reliable. SEM analyses supported a two-factor structure for the wellness construct, consisting of burnout (exhaustion, cognitive weariness and cynicism) and engagement (vigour, dedication and professional efficacy), which was equivalent for the language and education groups. Statistically significant differences that are based on age, gender, language and the different business units were found between the demographic groups. Structural equation modelling showed that job demands are associated with negative WHI and consequently with burnout, providing support for a full-mediation effect of negative WHI. Job resources were associated with negative WHI and consequently with burnout, providing support for partial mediation of negative WHI between job resources and burnout. Job resources were also associated with positive WHI and consequently with engagement, providing support for partial mediation of positive WHI between job resources and engagement. Recommendations for the organisation and future research were made. / Thesis (Ph.D. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2007.

Background: Hip and groin pain is common in ice hockey and particular in goaltenders, because their movement patterns make them particularly vulnerable. "Skate to the post-technique” (SMS-technique) is a relatively new technique that the goaltenders uses and no studies have been published where the SMS-technique is studied and the hypothesis is that the hip is subjected to high stresses which can lead to hip and/or groin pain. Purpose: The purpose of this study was to investigate the prevalence of hip/groin pain in male ice hockey goaltenders of elite level in Sweden and if factors such as age, level of SMS-technique use and prevention training can be linked with the pain. The study also examines whether the goalies are concerned of injuring the hip and/or groin. Method: Descriptive and comparative cross-sectional study consisted of an online survey in which 57 % of 94 goaltenders participated. Results: A total of 63 % responded that they have pain in the hip/groin every month or more frequently. Over half of the goaltenders follow a specific training program and a significant difference in pain incidence was seen between them and those who do not follow a training program, p = 0.01. Most responded that they are more or less worried of getting hurt in the hip/groin. No significant difference in the occurrence of pain could be observed at different degrees of using SMS-technique. Conclusion: Many goaltenders have hip/groin pain and those who have pain are more often following a specific exercise program to prevent injuries in the hip and/or groin. / Bakgrund: Höft och ljumsksmärta är vanligt inom ishockey och främst hos målvakterna eftersom deras rörelsemönster gör dem extra utsatta. ”Skridsko mot stolpe-tekniken” (SMS-tekniken) är en relativt ny teknik som målvakter använder och inga studier har i nuläget publicerats där den studerats och hypotesen är att höften utsätts för stora påfrestningar vilket kan leda till höft/ljumsksmärta. Syfte: Syftet med studien var att undersöka prevalensen av höft/ljumsksmärta hos manliga ishockeymålvakter på elitnivå i Sverige samt om faktorer som grad av SMS-teknikanvändande och förebyggande träning kunde kopplas samman med den smärtan samt om målvakterna var oroliga för att skada sig. Metod: Deskriptiv och komparativ tvärsnittsstudie som bestod av en webbaserad enkät som distribuerades till 94 målvakter och där 57 % deltog. Resultat: Totalt 63 % hade ont i höft/ljumske varje månad eller oftare. Över hälften av målvakterna följde ett specifikt träningsprogram och en signifikant skillnad i smärtprevalens kunde ses mellan dem och de som inte följde ett träningsprogram, p=0,01. De flesta var mer eller mindre oroliga för att skada sig i höft/ljumske. Ingen signifikant skillnad i smärtförekomst kunde ses vid olika grader av SMS-teknikanvändande. Konklusion: Många målvakter hade höft/ljumsksmärta och de som hade ont följde i högre grad ett specifikt träningsprogram för att förebygga skador.

Résumé : Problématique : Une augmentation importante de la prévalence du diabète a été observée au Nouveau-Brunswick au cours de la dernière décennie. Sachant que le diabète est associé à des complications de santé nombreuses et à des coûts élevés infligés au système de soins de santé, il devient important d’identifier les facteurs pouvant expliquer l’augmentation de la prévalence du diabète. L’étude a pour objectif de décrire l’évolution de ces facteurs afin de prioriser les interventions en lien avec cette maladie. Méthodes : Une revue critique de la littérature a permis l’identification de l’ensemble des facteurs pouvant expliquer l’augmentation de la prévalence du diabète. Des données administratives disponibles au Nouveau-Brunswick et des données tirées d’enquêtes de Statistique Canada ont été utilisées afin de décrire l’évolution de plusieurs des facteurs tirés de la revue critique de la littérature. Résultats : Une augmentation de 120% de la prévalence du diabète de type 2 au Nouveau-Brunswick a été observée entre 2001 et 2014. Cette augmentation pourrait être explicable par l’ensemble des cinq catégories de facteurs pouvant expliquer une augmentation de la prévalence dont plusieurs facteurs de risque individuels (dont l’obésité, le prédiabète et l’hypertension), de facteurs de risque environnementaux (dont l’urbanisation), de l’évolution de la maladie (exprimée par une diminution du taux de mortalité et une augmentation de l’incidence), de l’effet de détection (augmentation du nombre de personnes testées, diminution de la valeur d’HbA1c et de l’âge à la détection) et d’un effet du changement dans l’environnement (exprimé par un effet de période et de cohorte). Conclusion: L’augmentation de la prévalence du diabète notée au Nouveau-Brunswick pourrait s’expliquer par plusieurs facteurs de risque individuels, environnementaux, de l’évolution de la maladie, de l’effet de détection et d’un effet du changement dans l’environnement. Cette étude permettra de guider les actions sur le diabète au Nouveau-Brunswick et d’inspirer les autres provinces et pays à identifier les facteurs pouvant contribuer à l’augmentation de la prévalence du diabète grâce à la liste de l’ensemble des facteurs potentiellement explicatifs. / Abstract : Background: A major increase in the prevalence of diabetes in New Brunswick was observed over the last decade. Because diabetes is associated with many health complications and increases healthcare system costs, it is important to identify factors that could explain the increase in prevalence of diabetes in New Brunswick to help government prioritize interventions to reduce the burden of diabetes. The objective of this study is to describe factors potentially involved in the increase in prevalence of diabetes. Methods: A critical review of the literature was used to identify a list of factors that could explain an increase in prevalence of diabetes. Administrative data available in New Brunswick from 2001 to 2014 and data from Statistics Canada were used to conduct a repeated cross sectional descriptive study. Results: A 120% increase in the prevalence of type 2 diabetes was observed in New Brunswick between 2001 and 2014. The increase in prevalence of diabetes could be explained by an increase in the prevalence of many individual risk factors (such as obesity, hypertension and rediabetes), environmental risk factors (like urbanization), the evolution of the disease (expressed by an increase in incidence rate and a decrease in mortality rate), a detection effect (observed by an increase in number of people tested and a decrease in HbA1c values and age at detection) and environmental changes (with a period and cohort effect). Conclusion: The major increase in prevalence of diabetes in New Brunswick could be explained by many individual risk factors, environmental risk factor, the evolution of the disease, the detection effect and an environmental change. The comprehensive overview of factors presented will help guide actions about diabetes in New Brunswick and will inspire others jurisdictions to identify factors that could explain the increase in their country or province.

L’amusie congénitale est un trouble neurogénétique qui se caractérise par une inhabileté à acquérir des habiletés musicales de base, telles que la perception musicale et la reconnaissance musicale normales, malgré une audition, un développement du langage et une intelligence normaux (Ayotte, Peretz & Hyde, 2002). Récemment, une éude d’aggrégation familiale a démontré que 39% des membres de familles d’individus amusiques démontrent le trouble, comparativement à 3% des membres de familles d’individus normaux (Peretz et al., 2007). Cette conclusion est intéressante puisqu’elle démontre une prévalence de l’amusie congénitale dans la population normale. Kalmus et Fry (1980) ont évalué cette prévalence à 4%, en utilisant le Distorted Tunes Test (DTT). Par contre, ce test présente certaines lacunes méthodologiques et statistiques, telles un effet plafond important, ainsi que l’usage de mélodies folkloriques, désavantageant les amusiques puisque ceux-ci ne peuvent pas assimiler ces mélodies correctement. L’étude présente visait à réévaluer la prévalence de l’amusie congénitale en utilisant un test en ligne récemment validé par Peretz et ses collègues (2008). Mille cent participants, d’un échantillon homogène, ont complété le test en ligne. Les résultats démontrent une prévalence globale de 11.6%, ainsi que quatre profiles de performance distincts: pitch deafness (1.5%), pitch memory amusia (3.2%), pitch perception amusia (3.3%), et beat deafness (3.3%). La variabilité des résultats obtenus avec le test en ligne démontre l’existence de quatre types d’amusies avec chacune une prévalence individuelle, indiquant une hétérogénéité dans l’expression de l’amusie congénitale qui devra être explorée ultérieurement. / Congenital amusia is a heritable disorder in which subjects fail to acquire basic musical abilities, such as normal music perception and music-recognition abilities, despite normal hearing, normal language abilities, and normal intelligence (Ayotte, Peretz & Hyde, 2002). Recently, a family-aggregation study showed that 39% of first-degree relatives in amusic families express the disorder, compared to 3% in control families (Peretz et al., 2007). This latter finding is interesting in that it illustrates a prevalence of the disorder in non-amusic families. Kalmus and Fry (1980) evaluated the prevalence of congenital amusia at 4%, using the Distorted Tunes Test (DTT). However, this test presents some methodological and statistical problems, such as a strong ceiling effect, as well as the use of folkloric tunes, which disadvantages the amusic participants since they cannot assimilate these melodies correctly. The present study aimed at re-evaluating the presence of congenital amusia, using a recently validated online test by Peretz and colleagues (2008). One thousand one hundred participants, from a homogeneous sample, completed the online test. Results showed a global prevalence of 11.6%, with four distinct patterns of performance emerging: pitch deafness (1.5%), pitch memory amusia (3.2%), pitch perception amusia (3.3%), and beat deafness (3.3%). The variability in the results obtained with the online test brings evidence of at least four types of amusias with individual prevalences, indicating a heterogeneity in congenital amusia that needs to be further explored in later studies.

Abdominal Aortic Aneurysm (AAA) is a disease that mainly affects elderly men, and ruptured AAA (rAAA) is associated with a mortality of > 80%. AAA seldom gives any symptoms prior to rupture. The aims of this thesis were to investigate different aspects of how to affect mortality from rAAA. In Study I, we identified 849 patients treated for rAAA during 1987-2004, and studied the 30-day survival after surgery, depending on whether they came directly to the treating hospital (one-stop) or were transferred via another hospital (two-stop). A two-stop referral pattern resulted in a 27% lower population-based survival rate for patients 65-74 years of age. However, the consequences would be small even if a one-stop referral pattern could be generally accomplished, due to the huge over-all mortality related to rAAA, hence an argument to find and treat AAA before rupture, e.g. by screening. In Study II, we examined the AAA-prevalence and the risk factors for AAA among 70-year-old men. The screening-detected AAA-prevalence was 2.3%, thus less than half the predicted. The most important risk factor was smoking. In Study III, we compared the screening-detected AAA-prevalence, the attendance rate, and the rate of opportunistic detection of AAA, between almost 8000 65- and 6000 70-year-old men. There was no difference in the screening-detected prevalence; probably due to the fact that almost 40% of the AAAs among the 70-year-old were already known prior to screening, compared to roughly 25% in the 65-year-old. The attendance rate was higher among the 65-year-old men, 85.7% compared 84.0% in the 70-year-old. Thus, there is no benefit of screening for AAA among 70- instead of 65-year-old men. In Study IV, a cost-effectiveness analysis, we found that screening for AAA still appears to be cost-effective, despite profound changes in disease pattern and AAA-management. In conclusion, we found that mortality from rAAA is not affected in any substantial way by different referral patterns and hence centralisation of services for AAA/rAAA is not a solution. A better alternative is to prevent rupture through early detection by screening. Screening 65-year-old men for AAA still appears to be cost-effective, despite profound changes in disease pattern and AAA-management during the last decade. Screening 70- instead of 65-year-old men will not increase the efficacy of screening.

INTRODUCTION La production biologique contribue de façon significative aux défis du développement durable. Les infections à Mycobacterium avium sous-espèce paratuberculosis (MAP), Neospora caninum (NC), au virus de la diarrhée virale bovine (BVD) et au virus de la rhinotrachéite infectieuse bovine (IBR) sont bien reconnues pour affecter de manière significative la production dans les élevages laitiers. Il n’existe toutefois aucune donnée sur l’importance de ces pathogènes dans les troupeaux biologiques. HYPOTHESE Ces quatre pathogènes sont présents dans les troupeaux laitiers biologiques, mais leur prévalence est moindre par rapport à l’élevage conventionnel. OBJECTIFS Estimer les séroprévalences de NC, MAP, BVD, IBR dans les troupeaux laitiers biologiques québécois. MÉTHODOLOGIE Dans la province du Québec, 60 troupeaux laitiers biologiques ont été sélectionnés aléatoirement. Un échantillon sanguin a été prélevé sur 30 vaches adultes, pour l’évaluation de NC et MAP, et sur 5 animaux plus de 6 mois non vaccinés, pour l’évaluation de BVD et IBR. Une détection d’anticorps par ELISA, pour NC et MAP, et par séroneutralisation pour BVD et IBR a été réalisée sur les sérums obtenus. Un questionnaire a été rempli par chaque éleveur. RÉSULTATS La séroprévalence individuelle de NC et MAP, avec un intervalle de confiance de 95%, étaient de 4.1% (3.2%-5.2%) et 0.8% respectivement (0.0%-1.3%). La séroprévalence de troupeau de NC, MAP, BVD, IBR, si au moins un animal est positif dans un troupeau étaient de 50.8%, 20.3%, 37.3%, 31.0% respectivement. Ces séroprévalences étaient de 30.5%, 3.4%, 28.8% et 18.9%, respectivement, si au moins deux animaux sont positifs. La taille du troupeau a un effet significatif sur le statut de BVD (p=0.02) et il y a une bonne corrélation entre le statut BVD et IBR (Kappa-0.54). DISCUSSION/CONCLUSION La séroprévalence individuelle de NC, MAP, IBR semblent être moindre dans les troupeaux laitiers biologiques comparativement au conventionnel. Il ne semble pas y avoir de grandes différences entre la séroprévalence du BVD des troupeaux biologiques et celle des conventionnels. / INTRODUCTION Organic herds are important component of sustainable development. Mycobacterium avium subspecies paratuberculosis (MAP), Neospora caninum (NC), bovine viral diarrhoea (BVD) virus and infectious bovine rhinotracheitis (IBR) virus infections are well known to have major impact on dairy production. However, there are actually no data on the prevalence of these pathogens in organic dairy herds. HYPOTHESIS These four pathogens are present among cattle organic herds but their prevalence is less than among conventional cattle herds. OBJECTIVE To evaluate the seroprevalence of NC, MAP, BVD, IBR in cattle organic herds in Québec province. METHODOLOGY In the province of Québec, 60 organic herds were randomly sampled. Thirty adult cows, to estimate NC and MAP, and 5 unvaccinated animals more than 6 months old, for BVD and IBR, were bled. An ELISA test, for NC and MAP, and seroneutralisation test for BVD and IBR were used to analyse the serum. A questionnaire was filled in by farmers. RESULTS Individual prevalence of NC and MAP (IC=95%) were 4.1% (3.2%-5.2%) and 0.8% (0.0%-1.3%) respectively. Herd level prevalence of NC, MAP, BVD, IBR, based on a herd-test cut point of 1 positive animal, were 50.8%, 20.3%, 37.3%, and 31.0% respectively. Based on a herd-test cut point of 2 positive animals, these prevalence were 30.5%, 3.4%, 28.8% and 18.9% respectively. Herd size was significantly associated with BVD herd prevalence (p=0.02).... There was a good correlation between herd prevalence of BVD and herd prevalence of IBR (Kappa=0.54). DISCUSSION/CONCLUSION Prevalence of NC, MAP, and IBR seem to be less among cattle organic herds than in cattle conventional herds. It seems that there is no difference between prevalence of BVD among organic herds and conventional herds.