The human body best performs when it is physically active. The consequences of inactivity can bring about many health risks. The purpose of this study was to investigate the relationship between physical activity, waist circumference and medication use among South African men. Men between ages 30 and 65 years (N = 5000, ͞x = 43.2; ± 8.55) were included in this study. With the use of medication, distinction was drawn between various ethnic groups. Subjects selected for this study are members of the same medical aid. The respondents that formed part of a non-random availability population and participated voluntarily were used in this study. According to the results, it appears that out of a total of 4 954 respondents, 58.3% had the lowest incidence of physical activity, 21% were moderately active and 20.7% highly active. WC appears much higher among those that fall within the lowest incidence of physical activity group. No significant difference was observed between moderately and highly active people. There are 11 members in the high Physically Active (PA) category that has the highest WC (X =131.5). When scrutinising the different ethnic groups it is obvious that moderate to high PA is associated with a lower WC. Chronic medication (CM) use is determined on the basis of the registry for chronic medication use of the relevant medical aid. Those who participated in the assessment of waist circumference, CM and PA consisted of 4 964 respondents. In this study distinction was drawn between three medical condition influenced by exercise, namely diabetes, cholesterol and depression and hypertension. The results indicate that CM use is associated with higher WC and reduced kCal consumption. The majority of respondents (78%) do not use medication and 21.9% do. Those that do not use medication showed to have the lowest WC. However, respondents that are highly active and also use CM showed a lower MO than those that are low and moderately active. It can thus be deduced that regular physical activity is directly related to one’s health. / Thesis (MSc (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

The human body best performs when it is physically active. The consequences of inactivity can bring about many health risks. The purpose of this study was to investigate the relationship between physical activity, waist circumference and medication use among South African men. Men between ages 30 and 65 years (N = 5000, ͞x = 43.2; ± 8.55) were included in this study. With the use of medication, distinction was drawn between various ethnic groups. Subjects selected for this study are members of the same medical aid. The respondents that formed part of a non-random availability population and participated voluntarily were used in this study. According to the results, it appears that out of a total of 4 954 respondents, 58.3% had the lowest incidence of physical activity, 21% were moderately active and 20.7% highly active. WC appears much higher among those that fall within the lowest incidence of physical activity group. No significant difference was observed between moderately and highly active people. There are 11 members in the high Physically Active (PA) category that has the highest WC (X =131.5). When scrutinising the different ethnic groups it is obvious that moderate to high PA is associated with a lower WC. Chronic medication (CM) use is determined on the basis of the registry for chronic medication use of the relevant medical aid. Those who participated in the assessment of waist circumference, CM and PA consisted of 4 964 respondents. In this study distinction was drawn between three medical condition influenced by exercise, namely diabetes, cholesterol and depression and hypertension. The results indicate that CM use is associated with higher WC and reduced kCal consumption. The majority of respondents (78%) do not use medication and 21.9% do. Those that do not use medication showed to have the lowest WC. However, respondents that are highly active and also use CM showed a lower MO than those that are low and moderately active. It can thus be deduced that regular physical activity is directly related to one’s health. / Thesis (MSc (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

In the latter part of the 20th century chronic diseases, especially cardio vascular-related diseases (CVDs) and Type 2 diabetes mellitus (DM) seemed to have emerged as substantial problems. This can be seen in the prevalence and the cost of CVDs in South Africa and worldwide. It was predicted that by the year 2030 more people would be dying from CVDs than from Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/Aids). The reasons for the occurrence of CVDs are linked to biological (i.e. hypertension, hyperlipidemia, obesity, insulin resistance, etc), psychological (i.e. emotional stress), and behavioural or lifestyle risk factors. It is known that physical exercise can aid in the treatment of CVDs. Institutions such as the American College of Sports Medicine (ACSM) recommended an exercise frequency of three times per week for 20 minutes. According to literature, a third of patients in exercise studies do not comply with their exercise protocol, and after three to six months, 50 percent will drop out of organised training groups. Less than a third of South Africans complied with exercising 30 minutes a day on most days of the week. Thus, there has been much interest among health-care providers to manage exercise compliance. Exercise compliance is a complex construct, and thus in the present study the role that behavioural patterns play was also investigated via psychological behavioural models. The major objectives of the study were the following: <ul> <li> Firstly, to determine if exercise compliance or non-compliance had an influence on shifts measured in the clinical parameters (i.e. blood pressure, blood lipid levels, blood glucose levels, body mass index, body fat percentage and cardiac risk percentage) over time.</li> <li> Secondly, to determine whether there were any correlation between the psychological behavioural models and the exercise compliance of the members over the course of the Best Med/Access Health-Disease Management Programme (BM/AH-DM Programme).</li></ul> In the present study, a retrospective data analysis was done on data collected from Best Med Medical Aid members (n = 400) who participated in a chronic disease management programme for three and a half years. The inclusion criteria for participation on the programme were the presence of one or more of the following CVDs namely: hypercholesterolemia, hypertension and DM. The members’ clinical parameters (height, body weight, body fat percentage, blood pressure, finger-prick non-fasting (random) blood cholesterol level, finger-prick non-fasting (random) blood glucose, sub-maximal V02 fitness test) were measured every three months. After a baseline assessment was done, an exercise programme was given to each member and a norm of exercising twice a week was prescribed. If members adhered to the norm they were considered compliant and if they did not adhere to the norm, they were considered as being non-compliant. Their exercise compliance, and relevant clinical parameters were measured over 30 months, although data analysis was only a reflection of the first 12 months’ data. At the beginning of the BM/AH-DM Programme the members’ Level of Readiness (LOR) to make a lifestyle change was measured via a questionnaire and by the end of the programme they completed an Implicit Theory Scale (ITS) questionnaire. Descriptive statistics (means, standard deviation) were used to determine the entire groups’ compliance, and to divide the group into compliant and noncompliant groups. The T-test or the Mann-Whitney Test (an equivalent nonparametric technique) was applied to determine significant differences between groups. Thus did the clinical parameters measured over time (baseline to 3 months, baseline to 6 months and baseline to 12 months), change more in the compliant than in the non-compliant group? And were there correlations between psychological questionnaires answers and the two exercise groups? The results indicated that the group’s exercise compliance trend decreased drastically over time. Statistical significant decreases were demonstrated in systolic (p = 0.007) and diastolic (p = 0.012) blood pressure, BMI (p = 0.072 and p = 0.0003), cardiac risk percentage (p = 0.003), and body weight (p = 0.003 and p = 0.0000). All of these decreases were seen in the exercise compliant group. There were no statistical correlations between the psychological questionnaires and the exercise groups. Limitations were the quality of the clinical data, the exercise compliance data that deteriorated over time, and the LOR and ITS questionnaires was neither valid nor reliable tools in making predictions regarding exercise behaviour/compliance. For future research it is recommended that measurements of blood pressure and cholesterol be done more thoroughly, and dietary fat intake must be monitored. A valid and reliable cardiac risk tool, LOR and ITS questionnaires must be designed. AFRIKAANS : Die voorkoms en kosteïmplikasies van kroniese siektetoestande in Suid–Afrika en wêreldwyd, het in die laaste gedeelte van die 20ste eeu ‘n wesenlike probleem geword. Kardiovaskulêre (KVS) siektes en tipe 2 diabetes mellitus (DM) is veral voorbeelde van sulke siektetoestande. Daar is voorspel dat in die jaar 2030, meer mense wêreldwyd aan KVS sal doodgaan, as aan Menslike Immuniteitsgebrekvirus/Verworwe Immuniteitsgebreksindroom (MIV/Vigs). Die risikofaktore wat met die oorsake van KVS geassosieer word, is die volgende: <ul> <li> Biologiese (met inbegrip van hipertensie, insulienweerstandigheid, hoë bloedcholesteroltellings, ens)</li> <li> Sielkundige (bv emosionele spanning) • Risikofaktore wat verband hou met lewenstyl.</li></ul> Literatuur bevestig dat fisiese oefening help om KVS en diabetes mellitus te behandel. Die American College of Sports Medicine (ACSM) het ‘n oefenriglyn van drie maal per week vir 20 minute lank as ‘n minimumfrekwensie daargestel. Volgens literatuur oefen ‘n derde van pasiënte wat deelneem aan oefeningnavorsingsstudies nie volgens die riglyne wat gestel word nie en binne die eerste drie tot ses maande sal 50% van die pasiënte ophou oefen. Navorsing wat op die Suid-Afrikaanse bevolking gedoen is, toon dat minder as ‘n derde 30 minute lank op meeste dae van die week oefen. Dus is die belangstelling van gesondheidsterapeute rakende die bestuur van gereelde oefeningdeelname geprikkel. Gereelde oefeningdeelname sluit ook die rol van gedragspatrone in en dus is sielkundige gedragsmodelle gebruik om dit ook in die huidige studie te ondersoek. Copyright / Dissertation (MA)--University of Pretoria, 2009 / Biokinetics, Sport and Leisure Sciences / unrestricted

Chronic, noncommunicable diseases such as chronic fatigue syndrome (also known as myalgic encephalomyelitis) are rapidly becoming a worldwide epidemic that profoundly affects public health and productivity. Chronic fatigue syndrome (CFS) is characterised by severe and debilitating fatigue and although its etiology is still unknown, recent studies have found considerable evidence that mitochondrial dysfunction and oxidative stress might be responsible for the underlying energy deficit in these patients. Adenine and pyridine nucleotides could be used as potential biomarkers for energy related disorders such as chronic fatigue syndrome because of their various functions in the energy and redox pathways. The first part of this study focussed on developing a liquid chromatography electrosprayionisation tandem mass spectrometry (LC-ESI-MS/MS) method for the quantification of these nucleotides in blood samples. Due to the instability of nucleotides in biological matrices it was also necessary to find a suitable extraction method that would be able to stop enzymatic activity via protein precipitation. Out of the four extraction methods investigated during this study, deproteinisation of whole blood samples with perchloric acid produced the highest nucleotide abundances. Although nucleotide standards were found to be stable in perchloric acid, nucleotide levels in blood samples were not stabilised by addition of perchloric acid. The second part of this study consisted of measuring the nucleotide levels in blood samples of controls and possible CFS patients in order to test the proof of concept of the new LCESI- MS/MS method. Despite changes in the nucleotide levels due to perchloric acid and problems with nucleotide instability, it was still possible to distinguish between the two groups based on the results obtained with the new LC-ESI-MS/MS method. The newly developed LC-ESI-MS/MS method proved to be reliable and adequate for nucleotide quantification in whole blood samples, thus the aim of this study was achieved. / MSc (Biochemistry), North-West University, Potchefstroom Campus, 2014

Asthma is a chronic disease of the airways and affects many people regardless of their age, gender, race and socioeconomic status. Since asthma is recognised as one of the major causes of morbidity and mortality in people and especially in South Africa, the prescribing patterns, prevalence and medication cost of asthma in South Africa are saliently important and need to be investigated. A non-experimental, quantitative retrospective drug utilisation review was conducted on medicine claims data of a pharmaceutical benefit management company in a section of the private health care sector of South Africa. The study period was divided into four annual time periods (1 January 2008 to 31 December 2008, 1 January 2009 to 31 December 2009, 1 January 2010 to 31 December 2010 and 1 January 2011 to 31 December 2011). The prescribing patterns and cost of asthma medication were investigated and stratified according to province, age and gender. Patients were included if the prescriptions which were provided by the health care practitioners matched the Chronic Disease List (CDL) of South Africa and the International Classification of Disease (ICD-10) coding for asthma and chronic obstructive pulmonary disease (COPD). Data analysis was conducted by means of the SAS 9.3® computer package. Asthma patients were divided according to different age groups (there were five different age groups for this study), gender and geographical areas of South Africa. The study indicated a steady increase in the prevalence of asthma patients from 0.82% (n = 7949) in 2008 to 1.18% (n = 15 423) in 2009 and reached a minimum of 0.79% (n = 8554) in 2011. Analysis of the prevalence regarding geographical areas in South Africa suggested that Gauteng had the highest number [n = 17 696, (0.85%)] of asthma patients throughout the study period, followed by KwaZulu Natal [n = 8 628, 1.16%)] and the Western Cape [(n = 8513, 0.97%) (p < 0.05)]. The prevalence of asthma in female patients [0.89% (n = 26 588)] was higher than in their male counterparts [0.79% (n = 19 244)] (p > 0.05). The results showed that asthma was not as common chronic disease in children. The total number of asthma patients younger than 7 years represented 0.64% (n = 2 909). It was found that patients over 65 years of age showed the highest prevalence of the five age groups [1.94% (n = 13 403) (p < 0.05)]. The average number of asthma prescriptions per patient per year was 8.28 (95% CI, 8.16- 8.40) and 5.15 (95% CI, 5.06-5.23) in 2008 and 2011, respectively. The number of asthma items per prescription varied from 1.55 (95% CI, 1.55-1.56) in 2008 to 1.40 (95% CI, 1.39- 1.40) in 2011. Medication from the MIMS® pharmacological group (anti-asthmatics and bronchodilators) was used to identify asthma medication. The top three asthma medication with the highest prevalence in the study period were the anti-inflammatory inhaler of fluticasone (n = 39 721) followed by the single item combination product of budesonide/ formoterol (n = 25 121) and salbutamol (n = 24 296). The influence of COPD on asthma treatment and the costimplication thereof were investigated. Medication from the MIMS® pharmacological group (anti-asthmatics and bronchodilators) was used to identify COPD medication. This study also showed that COPD had an influence in the economic burden of the South African asthma population. The cost of medication is responsible for the single largest direct cost involved in the economic burden of asthma. This study showed that asthma represented 0.88% of the direct medication cost in the study (excluding hospitalisation and indirect cost). The average cost per prescription and average cost per asthma item both increased throughout the study period. The prescribing patterns for the different medication used in the treatment of asthma were investigated and recommendations for further research in this field of study were made. / MPharm (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Chronic, noncommunicable diseases such as chronic fatigue syndrome (also known as myalgic encephalomyelitis) are rapidly becoming a worldwide epidemic that profoundly affects public health and productivity. Chronic fatigue syndrome (CFS) is characterised by severe and debilitating fatigue and although its etiology is still unknown, recent studies have found considerable evidence that mitochondrial dysfunction and oxidative stress might be responsible for the underlying energy deficit in these patients. Adenine and pyridine nucleotides could be used as potential biomarkers for energy related disorders such as chronic fatigue syndrome because of their various functions in the energy and redox pathways. The first part of this study focussed on developing a liquid chromatography electrosprayionisation tandem mass spectrometry (LC-ESI-MS/MS) method for the quantification of these nucleotides in blood samples. Due to the instability of nucleotides in biological matrices it was also necessary to find a suitable extraction method that would be able to stop enzymatic activity via protein precipitation. Out of the four extraction methods investigated during this study, deproteinisation of whole blood samples with perchloric acid produced the highest nucleotide abundances. Although nucleotide standards were found to be stable in perchloric acid, nucleotide levels in blood samples were not stabilised by addition of perchloric acid. The second part of this study consisted of measuring the nucleotide levels in blood samples of controls and possible CFS patients in order to test the proof of concept of the new LCESI- MS/MS method. Despite changes in the nucleotide levels due to perchloric acid and problems with nucleotide instability, it was still possible to distinguish between the two groups based on the results obtained with the new LC-ESI-MS/MS method. The newly developed LC-ESI-MS/MS method proved to be reliable and adequate for nucleotide quantification in whole blood samples, thus the aim of this study was achieved. / MSc (Biochemistry), North-West University, Potchefstroom Campus, 2014

Asthma is a chronic disease of the airways and affects many people regardless of their age, gender, race and socioeconomic status. Since asthma is recognised as one of the major causes of morbidity and mortality in people and especially in South Africa, the prescribing patterns, prevalence and medication cost of asthma in South Africa are saliently important and need to be investigated. A non-experimental, quantitative retrospective drug utilisation review was conducted on medicine claims data of a pharmaceutical benefit management company in a section of the private health care sector of South Africa. The study period was divided into four annual time periods (1 January 2008 to 31 December 2008, 1 January 2009 to 31 December 2009, 1 January 2010 to 31 December 2010 and 1 January 2011 to 31 December 2011). The prescribing patterns and cost of asthma medication were investigated and stratified according to province, age and gender. Patients were included if the prescriptions which were provided by the health care practitioners matched the Chronic Disease List (CDL) of South Africa and the International Classification of Disease (ICD-10) coding for asthma and chronic obstructive pulmonary disease (COPD). Data analysis was conducted by means of the SAS 9.3® computer package. Asthma patients were divided according to different age groups (there were five different age groups for this study), gender and geographical areas of South Africa. The study indicated a steady increase in the prevalence of asthma patients from 0.82% (n = 7949) in 2008 to 1.18% (n = 15 423) in 2009 and reached a minimum of 0.79% (n = 8554) in 2011. Analysis of the prevalence regarding geographical areas in South Africa suggested that Gauteng had the highest number [n = 17 696, (0.85%)] of asthma patients throughout the study period, followed by KwaZulu Natal [n = 8 628, 1.16%)] and the Western Cape [(n = 8513, 0.97%) (p < 0.05)]. The prevalence of asthma in female patients [0.89% (n = 26 588)] was higher than in their male counterparts [0.79% (n = 19 244)] (p > 0.05). The results showed that asthma was not as common chronic disease in children. The total number of asthma patients younger than 7 years represented 0.64% (n = 2 909). It was found that patients over 65 years of age showed the highest prevalence of the five age groups [1.94% (n = 13 403) (p < 0.05)]. The average number of asthma prescriptions per patient per year was 8.28 (95% CI, 8.16- 8.40) and 5.15 (95% CI, 5.06-5.23) in 2008 and 2011, respectively. The number of asthma items per prescription varied from 1.55 (95% CI, 1.55-1.56) in 2008 to 1.40 (95% CI, 1.39- 1.40) in 2011. Medication from the MIMS® pharmacological group (anti-asthmatics and bronchodilators) was used to identify asthma medication. The top three asthma medication with the highest prevalence in the study period were the anti-inflammatory inhaler of fluticasone (n = 39 721) followed by the single item combination product of budesonide/ formoterol (n = 25 121) and salbutamol (n = 24 296). The influence of COPD on asthma treatment and the costimplication thereof were investigated. Medication from the MIMS® pharmacological group (anti-asthmatics and bronchodilators) was used to identify COPD medication. This study also showed that COPD had an influence in the economic burden of the South African asthma population. The cost of medication is responsible for the single largest direct cost involved in the economic burden of asthma. This study showed that asthma represented 0.88% of the direct medication cost in the study (excluding hospitalisation and indirect cost). The average cost per prescription and average cost per asthma item both increased throughout the study period. The prescribing patterns for the different medication used in the treatment of asthma were investigated and recommendations for further research in this field of study were made. / MPharm (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

The research endeavoured to voice the told and untold stories of adolescents living with HIV undergoing continual disease management at the Kalafong Hospital Paediatric HIV Clinic. Through the telling of their stories the adolescents had the opportunity to make sense of their illness experiences. Some of the participating adolescents had limited opportunities to discuss their experiences with friends or family members. The research was completed within the qualitative social constructionist narrative approach. Six adolescents from the clinic participated voluntarily in the research. The participants attended the clinic regularly for disease management and were on ART. The study explored the experiences of the adolescents by means of two semi-structured individual interviews. Expressive art in the form of drawings and poetry were used to aid storytelling. Through collaborative exploration of the adolescents‟ stories, it became possible to co-construct the meanings that they attached to their experiences of HIV, which informs their identity. The interview transcripts were analysed, re-storied, and placed within a narrative framework of understanding, based on the three-dimensional space approach by Clandinin and Connelly (2000). The framework of understanding aided the researcher to look at the different contexts, identities, and social significant aspects found in the adolescents‟ stories. Multiple identities were constructed in their stories such as patient, scholar, friend, family, and athlete identities. These were constructed based on their experiences in the family and cultural, school and social, and medical contexts. The adolescents attributed different meanings to their stories of living with HIV such as that of normality, sameness, realism, and difference. The unique and similar aspects that were found in the adolescents‟ stories were identified and discussed with reference to various concepts such as disclosure, adherence, and ART. It was found that status disclosure was done by staff at the clinic and it occurred during young adolescence. All the adolescents, except one who was not aware of her status, showed insight into the chronic nature of their disease. Five adolescents‟ statuses have not been disclosed to anyone outside the families. In only one instance, the family was not aware of his status. Most adolescents assumed primary responsibility for ART. They expressed conflicting ideas about the role of ART. Some adolescents had to cope with side effects, the possibility of accidental status disclosure and non-adherence, and fears of rejection. The research, employing a narrative approach, endeavours to contribute to create a holistic understanding of HIV/AIDS in the context of health care. Lack of communication and impersonal staff interactions with patients were identified as barriers to disease management. The research recommends that the clinic should provide ongoing support to the adolescents with regards to disclosure of their status to friends, family, and partners, and adherence to medication. The social significant aspects found in the adolescents‟ stories will be disseminated to the staff at the clinic. This will assist the multi-disciplinary team to gain a better understanding of the reality of the adolescent and how these experiences inform their identity. / Dissertation (MA)--University of Pretoria, 2010. / Psychology / unrestricted