The purpose of this paper is the development of a model to investigate possible causal relationships among some of the commonly reported risk factors for the development of osteoporosis and consequential hip fracture. Comparison of hip fracture incidence between women of primarily European descent, referred to in the literature as Caucasians, and Japanese women is made. Studies report the incidence of hip fractures among Japanese women is lower than among Caucasian women. Numerous factors related to the development of osteoporosis are significantly different between Japan and the United States. The model helps explain the interrelationships among the variables involved in this observed geographical variation in hip fracture incidence. / Department of Anthropology

Thesis (Ph. D.)--University of Oklahoma. / Bibliography: leaves 162-169.

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: While there has been several studies that have been conducted targeting university students at state owned universities in South Africa, specifically on the impact of HIV/AIDS epidemic, no extensive study was conducted to establish what informs adoption of high risk sexual behaviour among university students in the context of HIV, STI and unplanned pregnancy epidemics at any of the state owned South African universities, let alone private universities. In order to address this identified gap in the body of knowledge, a cross-sectional study underpinned by the ‘social norms’ theory was undertaken at a private university in the Gauteng Province, South Africa to establish why undergraduate students engage in high risk sexual behaviour that puts them at risk of contracting HIV, STIs and unplanned pregnancy. Quantitative data was collected from 342 students through a questionnaire and qualitative data was collected from 38 students through the focus group discussions. Findings revealed that early sexual debut, intergenerational sex, multiple and concurrent partners, unprotected sex, sex under the influence of alcohol and illegal drugs and transactional sex constitute high risk sexual behaviour. The study concluded that peer pressure, independence, financial needs, drug and alcohol abuse, fear of being an outcast, need to identify with modernity, lack of individual perception of risk, campus culture and sexual partner influence are the factors influencing the adoption of high risk sexual behaviour on campus. Based on the findings and conclusions, recommendations are provided for the development of an HIV prevention programme on campus that is aimed at mitigating the negative consequences of the HIV/AIDS, STIs and unplanned pregnancy epidemics. / AFRIKAANSE OPSOMMING: Die literatuur toon aan dat daar alhoewel daar wel studies onderneem is ten einde die impak van die MIV epidemie onder studente aan openbare universiteite te bepaal onderneem is, daar nog steeds baie min kennis in hierdie verband bestaan. Die faktore wat ‘n rol vervul in hoërisiko seksuele gedrag onder studente aan hierdie universiteit is grootliks onbekend. Ten einde hierdie gaping te probeer oorbrug is hierdie studie onderneem aan ‘n privaat universiteit in Gauteng provinsie in Suid-Afrika. Die doel van die studie was om vas te stel wat voorgraadse studente motiveer om hoë seksuele gedrag te beoefen, wetende dat hulle hulleself blootstel aan MIV-infeksie en onbeplande swangerskappe. ‘n Steekproef van 342 student is in die studie gebruik en ‘n vraelys is deur hulle voltooi. ‘n Verdere 38 student het deelgeneem aan ‘n fokusgroepbespreking. Resultate toon aan dat studente dikwels meer as een seksuele maat het; dat seks beoefen word terwyl studente onder die invloed van alkohol is; dat seks dikwels onbeskermend plaasvind en dat alle hierdie faktore bydraend is tot hoë blootstelling aan MIV-infeksie. Die studie het verder gevind dat groepsdruk, finansiële probleme, dwelm- en alkoholmisbruik en groepsdruk verdere bydraende faktore tot hoë-risiko gedrag onder studente is. Resultate van die studie is gebruik om aanbevelings te maak vir die ontwikkeling van ‘n MIV-voorkomingsprogram wat daarop gerig is om die oordrag MIV en onbeplande swangerskappe aan die universiteit ( wat in die studie ondersoek is ) te bekamp.

Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2016. / Cardiovascular diseases (CVD) are the leading cause of global mortality, of which over 75% occurred in low- and middle-income countries such as South Africa. The lipid profile, specifically decreased levels of high density lipoprotein cholesterol (HDL-C), elevated triglyceride levels and the presence of small-dense low density lipoprotein (sdLDL) has been reported associated with CVD. An increased number of sdLDL is also common in metabolic syndrome (MetS), visceral obesity and diabetes mellitus, the last a known risk factor for CVD. The modification of low density lipoprotein (LDL) size, or number of sdLDL particles, has been reported to significantly reduce CVD risk, but not conclusively so and needs further investigation. In this regard, sdLDL particles are seldom estimated routinely for clinical use because of financial and other limitations. Currently, an alternative approach for estimating sdLDL is to use equations derived from routine lipid measures, as has been proposed by several groups. However, there is a need for extensive evaluation of this equation across different ethnic and disease groups, especially since reports showed an inadequate performance of the equation in a Korean population. The aim of this study was to assess the performance of a recently proposed equation for the estimation of sdLDL in healthy and diabetic mixed ancestry South Africans. Furthermore, we also investigated the role of sdLDL as a cardiometabolic risk factor, as measured against known risk factors such as the glycemic and lipid profiles.

Submitted in fulfillment of the requirements for Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, 2017. / Background: Ice hockey is a fast paced team sport, played on an ice surface in an enclosed arena. As a result of the high contact, aggressive nature of the sport, players are susceptible to injury. Ice hockey is not a popular sport in South Africa and the environment is unique in comparison to international ice hockey countries. The playing surfaces and ice rink arenas differ across South Africa, which may affect the risk of injury in this population. Protective equipment is not easily accessible to ice hockey players in South Africa and therefore they may be at a higher risk of injury. Participation in ice hockey is developing in South Africa; however there is a paucity in the literature relating to injuries in the South African context. This study aimed to determine a profile of ice hockey injuries in South African players. Methodology: This study was a quantitative, descriptive study that used a self-administered questionnaire. The questionnaire was administered to 187 ice hockey players (141 male and 46 female) who were registered with the South African Ice Hockey Association. Players were required to sign the letter of information and informed consent form, following which, questionnaires were distributed to the participants who met the study criteria. The researcher was present to supervise and collect all forms and completed questionnaires directly after completion. The questionnaire contained sections on demographics, injuries sustained over the previous season as well as the use of protective equipment. The results were analysed using SPSS version 24 and a p value of < 0.05 was considered statistically significant. Results: The response rate met the minimum requirement of 138 males and 45 females. Of the 187 participants, 110 (58.8%) of the participants sustained at least one injury due to ice hockey. Age was considered to be a risk factor in this study as those participants in the youngest age group of 18-27 were at a higher risk of all injuries (χ2 p-value < 0.0001). Although gender was not a risk factor for the total number of injuries, female players in this study were at a greater risk of head and knee injuries (χ2 p-value = 0.0196 and χ2 p-value = 0.0046 respectively). The most severe injury affected the head (10.2%, n = 19) and overall the knee was the most commonly affected area of injury (n = 30). The majority of the injuries were sustained during a game and resulted from contact with another player. The results of this study showed that the use of protective equipment does not prevent all injuries in ice hockey. The type of facial protection worn was a risk factor for facial injuries and the lack of a mouthguard was a risk factor for head injuries. Conclusion: The aim of this study was to determine a profile of ice hockey injuries in South African players. The South African demographic profile of ice hockey players showed similarities to international profiles with respect to age, gender, BMI and player position. The profile of injuries in this study was similar to international injury profiles in terms of site, type, severity, onset and mechanism of injury and regarding the majority of injuries being sustained during a game. Ice hockey players in the younger age groups were at a higher risk of injury both in South Africa and internationally. Females were at a higher risk of head injuries in comparison to males which is congruent with international literature. In South Africa, and internationally, the use of full facial protection and a mouthguard was shown to decrease the risk of facial and head injuries respectively. The South African demographic profile differed from international findings in terms of experience level, total hours of training per week and number of games played in a season. The injury profile of South African ice hockey players showed that this population is at a higher risk of muscular injuries than international players. Larger ice surfaces and flexible boards and glass did not reduce the risk of injury in South African ice hockey players in the same way as it has internationally. / M

Ce travail a pour objectifs de déterminer la prévalence des maladies coronariennes (MC) au Liban, de décrire le profil des personnes qui en souffrent, d'explorer la tendance de l'hypertension artérielle (HTA), du diabète et de la dyslipidémie à se regrouper chez les mêmes individus, et enfin d'évaluer le contrôle de l'HTA. Une étude transversale fut menée au niveau national. Un échantillon de 1515 individus fut choisi. Des données sur les caractéristiques sociodémographiques, sur les facteurs de risque (FDR) les plus importants de la MC et l'histoire médicale des participants furent collectées. Le clustering des FDR biologiques (FDRbio) fut examiné par la méthode du ratio de cas observés sur les cas attendus. Notre travail a révélé une MC prématurée avec une prévalence de 13.4%, a confirmé la pertinence des FDR classiques dans la population libanaise, a montré que les FDRbio se regroupent plus fréquemment qu'attendu et a révélé un contrôle insuffisant de l'HTA. / This thesis aimed to determine the prevalence of coronary heart diseases (CHD) in Lebanon, to describe the profile of people who suffer from it, to explore the tendency of hypertension, diabetes, and dyslipidemia to cluster in the same individuals beyond what could be attributed to chance, and finally to evaluate the control of high blood pressure. A national cross-sectional study was conducted by choosing a sample of 1515 individuals. We collected data on sociodemographic characteristics of the participants, their medical history and the most important risk factors (RFs) for CHD. The clustering of biological RFs (bioRFs) was assessed using the observed to expected ratio method. Our work revealed premature CHD with a prevalence of 13.4%, confirmed the relevance of classic RFs of CHD and their applicability to the Lebanese population, showed that bioRFs cluster more often than expected, and revealed an insufficient control of hypertension.

Helicobacter pylori (H. pylori) is a microaerophilic, Gram-negative motile curved rod that inhabits the gastric mucosa of the human stomach. The organism chronically infects billions of people worldwide and is one of the most genetically diverse of bacterial species. Infection with the organism potentially induces chronic gastritis and peptic ulcer disease. In addition, H. pylori plays a role in the etiology of gastric cancer and gastric MALT lymphoma. The risk of infection is increased in those living in the developing world, which has been ascribed to precarious hygiene standards, crowded households, and deficient sanitation common in this part of the world. Thus, the aim of this study was to identify the risk factors in the transmission of H. pylori in our environment, i.e. in Nkonkobe Municipality in the Eastern Cape Province, South Africa. Faecal samples were collected from 356 apparently healthy subjects, consisting of 168 males and 188 females aged from 3 months to 60 years (Mean = 31 years). A standardized questionnaire was applied, it described demographic characteristics including age, sex, household hygiene, socioeconomic status, area of residence, duration of stay in the area, sharing bath water, sharing tooth brush, habit of sucking thumb, medication currently being taken or medication taken within the past three months, source of water, type of toilet used, education and occupation. A sandwich-type enzyme immunoassay amplification technology (Amplified IDEIA TM Hp StAR TM , Oxoid, UK) was used to analyze the faecal samples for the detection of H. pylori antigens using monoclonal antibodies specific for H. pylori antigens. To assess the possibility of faecal oral route with tap water as an intermediary link, PCR targeting the ureC (glmM), a highly conserved gene in H. pylori ii was carried out to detect H. pylori DNA in faecal samples of already positive samples by HpSA test as well as in direct tap water used by the H. pylori positive subjects. QIAamp DNA stool mini kit was used to extract DNA from faecal samples. Tap water samples were then obtained using sterile bottles from areas inhabited by H. pylori positive subjects as determined by HpSA test and PCR. DNA extraction from water samples was done using UltraCleanTM Water DNA Isolation Kit (0.22μm) according to the manufacturer’s instructions. PCR with primers specific for H. pylori glmM gene was carried out with both positive and negative controls incorporated. Fisher’s exact test was used to assess the univariate association between H. pylori infection and the possible risk factors. Odds ratio (OR) and the corresponding 95 percent confidence interval (CI) were calculated to measure the strength of association using EPI INFO 3.41 package. P values of < .05 were required for significance. The precision rate of the diagnostic tests used was also determined. H. pylori antigen was detected in 316 of the 356 subjects giving an overall prevalence of 88.8 percent. Prevalence increased with age from 75.9 percent in children < 12 years age to 100 percent in the age group from 13 years to 24 years, also 100 percent prevalence of H. pylori was recorded in young adults aged 25-47 years and subjects aged 60 years (P < .05). H. pylori prevalence was higher in females than in males. Of 188 females who participated in the study, H. pylori antigen was detected in 172 (91.5 percent) versus 144 (85.7 percent) of 168 males (P > .05). Interestingly, H pylori antigen was detected more often (100 percent) in the high socioeconomic group than in those of low socioeconomic group (85.9 percent). Sixteen (66.7 percent) of twenty four faecal samples that had previously tested positive for the organism by HpSA test were confirmed positive by PCR. However none of the treated tap water samples tested positive for the organism by PCR. The present iii study revealed a high prevalence of H. pylori in faecal samples of asymptomatic individuals in the Nkonkobe Municipality, an indication of active infection. The obtained results also revealed that direct treated tap water might not be playing a crucial role in the oral transmission of H. pylori in the studied population.

As the leading cause of death in the United States, coronary heart disease (CHD) is a growing public health problem, despite the fact that many risk factors for the disease are preventable, especially if addressed early in life. The purpose of the current study was to examine the effects of loss-framed versus gain-framed versus information-only health messages on both intention to attend and actual attendance at an appointment to get screened for CHD risk factors (i.e., hypertension, diabetes, and dyslipidemia). It was hypothesized that a population of young adults would be more likely to view screening for CHD risk factors as a low-risk, health-affirming behavior as opposed to a risky, illness-detecting behavior and would thus be more strongly influenced by gain-framed messages than loss-framed messages. Additional goals included the exploration of the extensively researched individual health beliefs of perceived threat (as defined by the health belief model) and health locus of control as they relate to message frames. One hundred forty-three undergraduate students were randomly assigned to either the loss-framed, gain-framed, or information-only control conditions. Framing manipulation checks revealed that participants failed to discern differences in the tone and emphasis of the experimental pamphlets. As a result, no tests of framing effects could be conducted. Sixteen (11.2%) of the 143 participants who participated in Part 1 of the experiment participated in Part 2 (i.e., attended a risk factor screening appointment). Multiple regression analysis revealed risk index, age, and powerful others health locus of control as significant predictors of screening intention. Gender was the only demographic or health related variable that was significantly related to screening outcome, such that women were more likely to get screened than men. Limitations and recommendations are discussed.

INTRODUCTION AND AIM Black South Africans are experiencing an increase in the prevalence of cardiovascular disease (CVD). Fibrinogen functionality, including total and gamma prime (y’) fibrinogen concentration, as well as fibrin network structure, play an important role in CVD development and events. Several genetic and environmental factors influence fibrinogen functionality, and in turn, known CVD risk factors associated with total and y’ fibrinogen concentration have also been associated with altered fibrin clot structure. However, the main body of evidence regarding the role of fibrinogen functionality in CVD is based on studies conducted in white ethnicities and/or in vitro. The main aim of this study was, therefore, to determine the relationship between fibrinogen functionality and CVD in black South Africans in a plasma setting. Since there is greater genetic diversity in Africans than in non-black ethnicities, it was also our objective to investigate the influence of genetic polymorphisms in determining fibrinogen synthesis and plasma clot properties, and to determine possible gene-environment interactions altering clot properties. PARTICIPANTS AND METHODS The South African arm of the Prospective Urban and Rural Epidemiology (PURE) study included 2010 apparently healthy black men and women between the ages of 35 and 65 years, residing in rural or urban settlements. Blood samples were collected from the participants during a 12-week period in 2005. The following variables were analysed: total and y’ fibrinogen concentration, CVD risk factors and genetic polymorphisms in the fibrinogen and Factor XIII genes as well as turbidimetric analysis of clot formation and lysis (expressed as clot lysis time (CLT)). RESULTS Increased plasma levels of both total (largest contribution of 33%) and y’ fibrinogen were associated with increased fibre diameter while y’/total fibrinogen ratio had the opposite effect. The rate of lateral aggregation of fibrin fibres (slope) increased with an increase in total fibrinogen concentration, but not fibrinogen y’. Increasing fibrinogen y’ concentration was associated with longer CLTs and was the largest contributor to its variance (12%). Increased total and y’ fibrinogen were significantly associated with increased waist circumference, body mass index, C-reactive protein (CRP), glycosylated haemoglobin, metabolic syndrome (MetS) and low high-density lipoprotein (HDL) cholesterol levels. Furthermore, the association of fibrinogen y’ with these CVD risk factors was independent of total fibrinogen levels. C-reactive protein was the largest contributor to variance in fibrinogen y’ levels and y’/total fibrinogen ratio (apart from total fibrinogen). We observed significant associations between single nucleotide polymorphisms (SNPs) at rs1049636 and rs2070011 loci and increased total and y’ fibrinogen levels, respectively. Only SNP rs1800787 was associated with clot properties (increased maximum absorbance). Significant gene-environment interactions were observed between SNPs rs2227385, rs1800787, rs1800788, rs4220 and rs5985 and total and/or y’ fibrinogen levels in determining clot properties. The CVD risk factors age, MetS, CRP, HDL-cholesterol and homocysteine associated significantly with clot properties, independent of total and/or y’ fibrinogen plasma concentration. CONCLUSION The results of this thesis provide several novel insights relevant to this research field. Plasma y’ fibrinogen concentration and y’ ratio were found to be associated with altered clot properties in a plasma setting, and are also influenced by CVD risk factors other than fibrinogen. The associations between SNPs, total and y’ fibrinogen and clot properties differ somewhat from evidence reported in white populations. Significant gene-environment interactions between SNPs and total and y’ fibrinogen in determining clot properties existed and had opposing effects, i.e. both prothrombotic and antithrombotic, suggesting that the influence of genetic factors on fibrinogen should focus not only on concentration, but also on functionality. Cardiovascular disease risk factors also influence clot properties in vivo, through mechanisms independent of total and/or y’ fibrinogen concentration. / PhD (Nutrition), North-West University, Potchefstroom Campusm, 2015

The Road Freight Industry accounts for 1 to 5 percent of most countries GDP (AECOM International Development, 2011). According to e-Natis there was 321 056 Trucks (Heavy load Vehicle GVM > 3500 kg) in South Africa by November 2009 (Arrive Alive, 2009). This relative big industry, according to the statistics, influences most other industries value chains. Vehicles are driven by trucks drivers, making driving trucks their living. These drivers have their own lifestyles and ways that they go about. This study focusses on the risk factors of truck drivers’ lifestyles, especially long-distance truck drivers. This mini-dissertation draws attention to the limited research done on lifestyle risk factors and occupational hazards of long-distance truck drivers in South Africa. Most of the legislation regulating road transport is old and outdated, and any existing legislation is not being enforced. The goal of the study is to draw closer attention to the impact of certain lifestyle risk factors, social behaviours and occupational stressors on the lives of long-distance truck drivers, their close families and communities. The research was based on a comprehensive literature review as well as an empirical investigation done in the Gauteng province. A total of 150 long-distance truck drivers participated in the empirical investigation, by completing anonymous questionnaires. It is the researcher’s hope that this mini-dissertation will aid the betterment of long-distance truck drivers’ lives, general health and to make South African roads safer for all road users. / MBA, North-West University, Potchefstroom Campus, 2015