The purpose of this study was to examine whether perceived neighbourhood characteristics and personal characteristics in 2007/2008 predicted health-related outcomes: steps taken per day, life-space mobility, physical function, body mass index (BMI), and body composition-related health benefits in 2010/2011 among community-dwelling older adults. The total sample consisted of 341 men and women above the age of 62 years. Steps per day were measured using pedometers for a 3-day period and the change score was reported as a binary outcome: increased steps and decreased steps. Life-space mobility was assessed using the Life-Space Assessment and the outcome was the life-space score as a continuous variable. Physical function was assessed using the Late Life Function and Disability Instrument. The outcome was the total score as a continuous variable. BMI was assessed using the index of the participants’ self-reported weight divided by the height squared. Body composition-related health benefits were assessed using the participants’ BMI refined by the participants’ self-assessed waist circumference. The independent variable was the perception of the neighbourhood environment assessed using select items of the Neighbourhood Environment Walkability Scale in four categories: presence and maintenance of sidewalks; aesthetics; walkability safety; and traffic safety. Demographic and health information (sex, age, self-rated health, physical function limitations, number of chronic conditions and body mass index) were also collected. Regression analysis showed that although more positive perceptions of neighbourhood characteristics such as walkability safety, traffic safety and sidewalks were associated with health-related outcomes, overall, the perceived neighbourhood environment was not a strong predictor of health-related outcomes among community-dwelling older adults. These outcomes were mostly predicted by demographic and health status variables (i.e. chronic conditions, self-rated health, body mass index, physical function limitations). Initiatives targeted at the neighbourhood environment should consider the health-related outcome of interest (i.e. walking, mobility, physical function or obesity), the specific age group (i.e. old age or very old age and oldest old age), and the importance of demographic and health variables in shaping the relationship between the neighbourhood environment and these outcomes.

Thesis (M.Sc. (Menslike Bewegingskunde))--North-West University, Potchefstroom Campus, 2008.

Chronic diseases of lifestyle (CDLs) are on the increase in South Africa and appears to be increasing the financial burden on the economy. Biokinetics is a health profession addressing CDL, with exercise as the treatment modality. The scope of practice includes the prevention and treatment of CDL. Biokinetics as a profession has been registered with the Health Professions Council of South Africa (HPCSA), previously the South African Medical and Dental Council (SAMDC), since 1983. In this period of 25 years, the profession has only been practising in the private health care sector of South Africa. There have been no investigations to determine the market demand for this health profession. Therefore the purpose of this investigation is to determine the potential market demand for biokinetics in the private health care sector of South Africa. This investigation will take into account the potential market demand based on the patients that can be treated for CDL by biokinetics, and not the number of persons that are at risk of developing CDL. For this investigation secondary data from a pharmaceutical benefit management company (PBM) were analysed to determine the prevalence of chronic diseases in the private health care sector based on chronic medication usage in 2007. These numbers were linked to the postal codes that made it possible to determine the medication usage at municipality level. Telephonic interviews provided information about the average number of patients treated per biokineticist per month, while the number of biokineticists with active practice numbers were obtained from the Board of Health Care Funders (BHF). The results indicate that about 56% (911,212 out of 1,600,000) of the subscribers managed by the PBM were treated with medication for CDL. The prevalence of non-steroid anti-inflammatory medication (20.8%) gave an indication of medication prescribed mostly for chronic musculo-skeletal injuries. Cardiovascular diseases (13.1%), bronchodilators (10.95%) and hypertension (9.8%) were the most prevalent chronic diseases treated with medication. In 2007, the profession consisted of 284 biokinetic practices with 625 actively practicing biokineticists. The majority of the practices were located in Gauteng (130) with 63 in the Western Cape. The sub-sample of 50 biokineticists indicated that an average of 100 patients can realistically be treated by one biokineticist per month. The potential market demand calculated from these figures indicate that 9,112 biokineticists are needed in the private health care sector. These numbers indicate that in 2007, only an estimated 6.2% of CDL could potentially be treated by the number of registered biokineticists. The conclusion that can be drawn from this study is that there is an immense potential market for biokinetics in the private health care sector. This study has only investigated the diseased persons and has not taken into account those who are at risk of developing a chronic disease of lifestyle, which are also treated by biokinetics intervention with exercise as modality. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2010.

Background Physical inactivity causes obesity, a condition which is related to insulin resistance, hypertension, diabetes mellitus, dyslipidemia and the metabolic syndrome (MS). MS is the collective description of lifestyle diseases associated with significant morbidity and premature mortality. MS has recently been observed in youth, and if left untreated could lead to cardiovascular diseases. Regular physical activity (PA) and exercise training appear to modify the independent risk factors for MS and cardiovascular diseases, and has a positive effect on waist circumference, blood pressure, body fat percentage, insulin sensitivity and arterial compliance. Aims The aim of this study was to determine the relationship between body composition and selective markers of the MS, and the extent to which a PA intervention programme will influence selective markers of the MS, body composition and markers of vascular function in black adolescents. Methods Grade 9 classes from two high schools, in a low socio-economic status area near Potchefstroom, participated as the experimental and control group respectively. The experimental group consisted of 194 participants and the control group of 57 participants. The experimental group participated in a 10-week P A intervention. Body mass index, stature, body mass, waist-hip ratio, waist circumference, hip circumference, body fat percentage, fasting serum insulin, fasting plasma glucose, plasma leptin, homeostasis model assessment of insulin resistance (HOMA-IR), systolic blood pressure (SBP), diastolic blood pressure (DBP), Windkessel arterial compliance (Cw), total peripheral resistance, Tannerstage and habitual physical activity were measured. The data were analysed by means of descriptive statistics, Mann-Whitney U-tests, analysis of covariance (ANCOVA), Pearson's correlation analyses and multiple regression models. HOMA-IR and leptin were log transformed before analyses because of the skewed distribution. The Statistica for Windows and SAS computer programmes were used to analyse the data according to the above-mentioned aims of the study. Results and conclusions Firstly, a significant positive association was found between body fat percentage and both SBP (p=O.02) and HOMA-IR (p=O.02) respectively. Girls with a high body fat percentage had higher SBP (p=O.004), DBP (p=O.03), plasma insulin (p=O.004) and HOMA-IR (p=O.004) than girls with normal body fat percentage. Secondly, a 10-week PA intervention led to a significant decrease in SBP (p=O.000061), a trend of decreasing HOMA-IR, and a trend of increasing Cw in black adolescents. Lastly, no significant differences were found in body composition and vascular function variables for the normal-and over-fat group in this study after the 10-week PA intervention. In conclusion, the results of this study showed firstly, that there was a positive association between body fat percentage and SBP and HOMA-IR respectively; and secondly, that PA had a positive effect on some MS markers, namely: SBP and HOMA-IR. Further research regarding PA intervention's influence on the MS in black adolescents should be conducted, as there is clearly a shortage of literature that focuses on this research theme within this South African ethnic group. / Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2010.

Thesis (M.Sc. (Menslike Bewegingskunde))--North-West University, Potchefstroom Campus, 2008.

Chronic diseases of lifestyle (CDLs) are on the increase in South Africa and appears to be increasing the financial burden on the economy. Biokinetics is a health profession addressing CDL, with exercise as the treatment modality. The scope of practice includes the prevention and treatment of CDL. Biokinetics as a profession has been registered with the Health Professions Council of South Africa (HPCSA), previously the South African Medical and Dental Council (SAMDC), since 1983. In this period of 25 years, the profession has only been practising in the private health care sector of South Africa. There have been no investigations to determine the market demand for this health profession. Therefore the purpose of this investigation is to determine the potential market demand for biokinetics in the private health care sector of South Africa. This investigation will take into account the potential market demand based on the patients that can be treated for CDL by biokinetics, and not the number of persons that are at risk of developing CDL. For this investigation secondary data from a pharmaceutical benefit management company (PBM) were analysed to determine the prevalence of chronic diseases in the private health care sector based on chronic medication usage in 2007. These numbers were linked to the postal codes that made it possible to determine the medication usage at municipality level. Telephonic interviews provided information about the average number of patients treated per biokineticist per month, while the number of biokineticists with active practice numbers were obtained from the Board of Health Care Funders (BHF). The results indicate that about 56% (911,212 out of 1,600,000) of the subscribers managed by the PBM were treated with medication for CDL. The prevalence of non-steroid anti-inflammatory medication (20.8%) gave an indication of medication prescribed mostly for chronic musculo-skeletal injuries. Cardiovascular diseases (13.1%), bronchodilators (10.95%) and hypertension (9.8%) were the most prevalent chronic diseases treated with medication. In 2007, the profession consisted of 284 biokinetic practices with 625 actively practicing biokineticists. The majority of the practices were located in Gauteng (130) with 63 in the Western Cape. The sub-sample of 50 biokineticists indicated that an average of 100 patients can realistically be treated by one biokineticist per month. The potential market demand calculated from these figures indicate that 9,112 biokineticists are needed in the private health care sector. These numbers indicate that in 2007, only an estimated 6.2% of CDL could potentially be treated by the number of registered biokineticists. The conclusion that can be drawn from this study is that there is an immense potential market for biokinetics in the private health care sector. This study has only investigated the diseased persons and has not taken into account those who are at risk of developing a chronic disease of lifestyle, which are also treated by biokinetics intervention with exercise as modality. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2010.

Background Physical inactivity causes obesity, a condition which is related to insulin resistance, hypertension, diabetes mellitus, dyslipidemia and the metabolic syndrome (MS). MS is the collective description of lifestyle diseases associated with significant morbidity and premature mortality. MS has recently been observed in youth, and if left untreated could lead to cardiovascular diseases. Regular physical activity (PA) and exercise training appear to modify the independent risk factors for MS and cardiovascular diseases, and has a positive effect on waist circumference, blood pressure, body fat percentage, insulin sensitivity and arterial compliance. Aims The aim of this study was to determine the relationship between body composition and selective markers of the MS, and the extent to which a PA intervention programme will influence selective markers of the MS, body composition and markers of vascular function in black adolescents. Methods Grade 9 classes from two high schools, in a low socio-economic status area near Potchefstroom, participated as the experimental and control group respectively. The experimental group consisted of 194 participants and the control group of 57 participants. The experimental group participated in a 10-week P A intervention. Body mass index, stature, body mass, waist-hip ratio, waist circumference, hip circumference, body fat percentage, fasting serum insulin, fasting plasma glucose, plasma leptin, homeostasis model assessment of insulin resistance (HOMA-IR), systolic blood pressure (SBP), diastolic blood pressure (DBP), Windkessel arterial compliance (Cw), total peripheral resistance, Tannerstage and habitual physical activity were measured. The data were analysed by means of descriptive statistics, Mann-Whitney U-tests, analysis of covariance (ANCOVA), Pearson's correlation analyses and multiple regression models. HOMA-IR and leptin were log transformed before analyses because of the skewed distribution. The Statistica for Windows and SAS computer programmes were used to analyse the data according to the above-mentioned aims of the study. Results and conclusions Firstly, a significant positive association was found between body fat percentage and both SBP (p=O.02) and HOMA-IR (p=O.02) respectively. Girls with a high body fat percentage had higher SBP (p=O.004), DBP (p=O.03), plasma insulin (p=O.004) and HOMA-IR (p=O.004) than girls with normal body fat percentage. Secondly, a 10-week PA intervention led to a significant decrease in SBP (p=O.000061), a trend of decreasing HOMA-IR, and a trend of increasing Cw in black adolescents. Lastly, no significant differences were found in body composition and vascular function variables for the normal-and over-fat group in this study after the 10-week PA intervention. In conclusion, the results of this study showed firstly, that there was a positive association between body fat percentage and SBP and HOMA-IR respectively; and secondly, that PA had a positive effect on some MS markers, namely: SBP and HOMA-IR. Further research regarding PA intervention's influence on the MS in black adolescents should be conducted, as there is clearly a shortage of literature that focuses on this research theme within this South African ethnic group. / Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2010.

With amateur athleticism on the rise in Canada, older Masters athletes have been promoted as exemplars of “successful aging” in governmental population health campaigns that encourage all seniors to be physically active. This study investigates the life experiences of a group of ‘successfully aging’ Masters athletes to better situate their circumstances against the backdrop of a discourse of health responsibilization enacted by the state in its efforts to improve the health of aging citizens. Data were obtained from 15 in-depth interviews with Masters athletes age 60 and over. The findings revealed Masters athletes to have had exceptional life-long involvement in athleticism with intense physical training debuting early in adult life with several participants having been high-ranking amateur athletes prior to their involvement in Masters athleticism. Belonging for the most part to a high socioeconomic status, these participants were able to afford the costs associated with participation in high calibre athletic training and events. While these athletes might be held as exemplars of successful aging, they did not perceive themselves as such nor are their lifestyles and athletic achievements typical of the older seniors population that is targeted by state funded population health promotion efforts. This study offers insight into the socially constructed nature of successful aging under neoliberalism. It highlights a trend whereby health and aging are responsibilized as successful personal endeavours rather than as the outcomes of determinants largely outside the control of any one individual. / Graduate / 0340 / 0615 / mcgowanb@uvic.ca

Background & Objectives: Participation in cognitive, social and physical activity (PA) may play a role in prevention of cognitive decline in older adults. Literature supporting the benefits of healthy lifestyle behaviours, especially PA, on cognition continues to accumulate. Moreover, a strong association between gait and cognitive health is increasingly being recognized. Yet, a firm understanding of the individual differences and between-person effects of PA on cognition and gait of older adults is lacking. Thus, the primary objective of the main study was to distinguish the within- and between-person sources of variation in PA on cognition in a group of inactive older adults. Study 2 examined the within- and between-person effects of a) PA on gait and b) gait on cognition. Study 3 examined the social cognitive predictors of walking. Methods: The between- and within-person of PA on cognition were examined in a single-group longitudinal design. Participants (n=159) were enrolled in a four-month supervised walking program and provided with materials and coaching to promote the adoption of behaviours to enhance and maintain their cognitive health. Group participants walked at least 3 times per week at a brisk intensity and were encouraged to get 150 minutes of moderate-to-vigorous PA per week. At baseline, participants completed measures of social cognitive predictors of walking. Assessments of cognition, diet, fitness, gait, PA and other health behaviours occurred at baseline, and at 6, 9, 12, and 16 weeks follow-up. Results and Discussion: Multilevel models revealed significant: 1) within-person effects of PA on select measures of executive functioning and 2) consistent between-group effects of cognitive activity, but not other lifestyle behaviours, on cognition. Study 2 revealed consistent significant 1) within-person effects of PA on gait velocity and stride time variability during dual task walking, 2) between-person effects of PA on gait velocity during both dual task and normal walking, and 3) between-person effects of gait velocity and stride time variability on cognition during both normal and dual task walking. Significant within-person effects of gait on cognition were limited. In study 3, self-monitoring emerged as a significant predictor of change in walking. Conclusion: Distinct patterns of within- and between-person effects on the PA, cognition and gait were observed. Further work will need to continue to clearly elucidate the within- and between-person sources of variation in relations between PA, gait and cognition using well-designed longitudinal and experimental designs. / Graduate / 0633 / 0623 / kkowalsk@uvic.ca

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