Music in the learning area Arts and Culture and the subject Music fight for survival in rural South Africa. Neither more experienced educators nor new generalist teachers were trained to teach the four art forms of Arts and Culture. Courses for Arts and Culture as learning area at universities are scarce and the courses that do exist mostly cater for students who already have a background in music. Other courses again only cover two or three art forms and do not follow the actual school curriculum for Arts and Culture. This then leaves the educator unprepared to deal with the realities of the learning area. Many principals and educators regard Arts and Culture as a filler subject for educators who do not have enough lessons on their timetables. The lack of knowledge amongst educators, a curriculum with no logical progression and scarcity of resources have resulted in learners who are inadequately prepared for and not interested to continue with Music as subject in grade 10 to 12 which in turn leads to fewer music students at universities and fewer music educators. This thesis aimed to pinpoint some of the challenges in Music and suggest possible solutions to start a remedial process to get Music back into schools. Educators, principals and subject advisors were consulted regarding the challenges they are experiencing in music and suggestions and possible solutions were sought from literature and experts in the field of music. The finding has been that similar challenges are experienced throughout South Africa and these challenges are amplified in rural areas. The present situation where untrained educators have to teach a specialist area like music as part of Arts and Culture can only be improved with an ongoing process of intensive workshops and mentoring programmes for in-service educators by subject advisors who are qualified in music and music experts who have an in-depth knowledge of the school curriculum. It will also be advisable for the Department of Basic Education to appoint more subject advisors and also appoint them according to their specialization area/s so that they are capable of assisting educators effectively. / Thesis (DMus)--University of Pretoria, 2011. / Music / unrestricted

MEDCS / Department of Curriculum Studies and Education Management

Thesis (M.Sc. (Physiology)) -- University of Limpopo, 2019 / Background Type 2 diabetes mellitus (T2DM) is an increasing challenge globally, and is estimated to affect 439 million adults by 2030. This estimate is linked to an unhealthy lifestyle with characteristics such as low physical activity (PA) and high plasma glucose levels (PGLs). Studies associating PA with insulin resistance and diabetes among adults and adolescents have been conducted widely in developed countries. Such studies are scanty among rural populations, especially in Africa. Assessment of the burden of diabetes and associated lifestyle risk factors in developing countries is essential in order to encourage appropriate intervention strategies to counter the increasing prevalence. Aim and objectives The aim of this study was to investigate the relationship between PA and T2DM among rural young adults aged 22 to 30 years in Ellisras area in Limpopo Province, South Africa Methods A total of 713 young adults (349 males and 364 females) who have been part of the Ellisras Longitudinal Study participated in the current study. Physical activity data was collected using a validated questionnaire. After an overnight fast, participants provided fasting venous blood samples for determination of plasma glucose and insulin. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance. Anthropometric measurements (waist circumference and height) were performed using standard procedures. Linear and logistic regressions were used to assess the relationship between PA, pre-diabetes, insulin resistance and T2DM; and the odds of having T2DM with low PA levels. Results The prevalence of physical inactivity was 67.3 and 71.0% for males and females, respectively. That of pre-diabetes was between 45.7% and 50.2%. The prevalence of diabetes was 9.6% for males and 10.1% for females while for insulin resistance was 22.9% for males and 29.3% for females. Linear regression found a significant relationship (p<0.05) between physical activity and blood glucose (ß =5.715; 95% CI 4.545; 6.885), waist circumference (ß = 37.572; 95% CI 25.970; 49.174) and waist-toheight ratio (ß = 0.192; 95% CI 0.087; 0.296). Logistic regression found a significant (p<0.05) relationship between low physical activity and T2DM (Odds ratio = 2.890; 95% CI 1.715; 4.870) and insulin resistance (Odds ratio = 1.819; 95% CI 1.266; 2.614). Conclusion Physical activity is low in this population, and is independently associated with T2DM and insulin resistance. KEY WORDS Type 2 diabetes mellitus; pre-diabetes; insulin resistance; physical activity; young adults; rural South African population. / Vrije University, Amsterdam, The Netherlands, and the University of Limpopo

Thesis (M. Sc. (Physiology)) --University of Limpopo, 2019 / Introduction: There is an increased trend in the prevalence of hypertension in children and adolescents in African countries. There are complications in diagnosing hypertension in children and adolescents due to the variation of blood pressure (BP) values with age, gender and height. The progression of the health transition with non-communicable diseases (NCDs) adds significantly to the disease burden, despite infectious diseases and undernutrition remaining persistent in both low and middle-income countries. Metabolic syndrome (MetS) is a global problem associated with the clustering of several cardiovascular risk factors. South African evidence suggests an upsurge of NCDs amidst the existence of communicable diseases (CDs) such as HIV/AIDS and tuberculosis. Moreover, NCDs and CDs in the country are influenced by socio-demographic factors; and thus tend to be more prominent in certain segments of the population. Aim and Objectives: The aim of this study was to perform blood pressure to height ratio and to determine lifestyle risk factors associated with metabolic syndrome among the Ellisras rural population aged 6-30 years, who are part of the ELS. Methods and materials: The current study is based on secondary data analysis of the Ellisras Longitudinal Study (ELS) and was conducted in two phases. Phase 1 included data analysis of all the participants in the ELS. This sample included a total number of 9002 children and adolescents (4678 boys and 4324 girls), aged 6-17 years. Parents or guardians provided written informed consent. Phase 2 consisted of biochemical analysis from a subsample of participants in the ELS. The subsample included 624 participants (306 males and 318 females) aged 18-30 years at the time the study was conducted. All participants underwent a series of anthropometric measurements (waist circumference and height) according to the standard of the International Society for the Advancement of Kinanthropometry (ISAK). The waist circumference (WC) measurements were taken to the nearest 0.1 cm, using a soft measuring tape. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Metabolic syndrome risk factors included total cholesterol (TCHOL), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), elevated fasting blood glucose (FBG), elevated blood pressure (BP) and high waist circumference (WC). A dietary intake questionnaire was also administered to each participant and self‑administered questionnaire was used to collect data on lifestyle factors, including smoking and alcohol intake. Dietary intake variables used in the linear regression method were log transformed prior to analysis because of their skewed distribution. Receiver-operating characteristic (ROC) curve was used to assess the accuracy of BPHR to screen children with prehypertension and hypertension. The optimal systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) cut-off points for hypertension were determined. Sensitivity/specificity, positive predictive values and negative predictive values were calculated. Results: The optimal thresholds for defining prehypertension was 0.77 in children aged 6-10 years and 0.73 in adolescents aged between 11 and 17 years for systolic BPHR and 0.55 in children and 0.53 in adolescents for diastolic BPHR, respectively. The corresponding values for hypertension stage 1 were 0.76 and 0.73 for SBPHR and 0.50 and 0.58 for DBPHR, respectively. The BPHR is an accurate tool for screening elevated BP in Ellisras children aged 6-17 years. This can help to prevent the misclassification of children and adolescent hypertension. Furthermore, this tool can be used to screen children before the development of prehypertension and hypertension. Moreover, it can be used to manage hypertension in Ellisras children, ultimately reducing the risks of developing hypertension and associated cardiovascular disease in adulthood. Overall, the prevalence of metS was 23.1% (8.6% males and 36.8% females). Females appeared to have higher mean values for WC, FBG, TCHOL and LDL-C than males (82.14, 5.62, 4.62 and 2.97, respectively). The only significant gender difference observed was on WC (p<0.001). Males on the other hand had higher mean values for HDL-C, TG, SBP and DBP than females (1.20, 1.06, 125.91 and 71.44, respectively). The only significant difference observed in this case was on SBP (p<0.001). No significant age group differences were observed in all the metabolic risk factors with the exception of DBP where the older (25-30 years) participants presented with high SBP than the younger age group (18-24 years) (70.96 mmHg vs 68.78 mmHg, p<0.05). While, majority of females had significantly high WC, elevated total cholesterol and LDL-C, and reduced HDL-C; majority of males had elevated BP, SBP and DBP. No significant age and gender differences were observed on dietary intake. However, according to the linear regression analysis, no association between log total energy, log added sugar, log SFA and log MUFA with metabolic risk factors. There was a low and negative significant association between log fibre with SBP and DBP (β:-0.004, p=0.003 and β:-0.004, p=0.046), respectively, crude. After adjusting for the potential confounding factors, log fibre was also associated with FBG (β:-0.028, p=0.046). Log PUFAs was inversely associated with FBG, HDL-C and SBP crude. Log trans fatty acids was inversely associated with WC, HDL-C and SBP crude. Both log PUFAs and log trans fatty acids were not associated with any metabolic risk factors after adjusting for potential cofounding factors. Log protein was inversely associated with SBP both crude and adjusted for potential cofounding factors. On predicting the actual risk using the logistic regression analysis, participants who had high dietary energy intake were significantly less likely to present with larger WC, low HDL-C and high LDL-C (OR: 0.250 95%CI [0.161;0.389], OR: 0.306 95%CI [0.220;0.425] and OR: 0.583 95%CI [0.418;0.812], respectively), but more likely to presents with elevated FBG, high TCHOL, high TG and hypertension (OR: 1.01 95%CI [0.735;1.386], OR: 1.039 95%CI [0.575;1.337], OR: 1.186 95%CI [0.695;2.023], OR: 5.205 95%CI [3.156;8.585], respectively) crude. After adjusting for age, gender, smoking and alcohol status, high energy intake was more likely to increase two times high the large WC and elevated FBG among study participants (OR: 2.766 95%CI [0.863;3.477] and OR: 2.227 95%CI [1.051;3.328], respectively). Furthermore, low dietary fibre intake was nearly four times more likely to increase the low HDL-C, crude (OR: 3.864 95%CI [1.067;13.988]) crude. Those participants who consumed high trans fats were more likely to present with high FBG (OR:1.424 95%CI [0.985;2.060]), but less likely to present with LDL-C (OR: 0.540 95%CI [0.321;0.906]) crude. However, after adding potential cofounding factors, participants with high fatty acid were less likely to present with high FBG (OR: 0.672 95%CI [0.441;1.023]). Conclusions: MetS is prevalent in young adults in Ellisras and is differentiated by age and gender with more females at an increased rate by virtue of their body size status, reduced HDL-C, elevated FBG and high LDL-C and the diet they consume that is in most cases high energy, more carbohydrates, high added sugar and SFA. Therefore, identifying groups that are at an increased risk and those that are in their early stages of MetS will help improve and prevent the increase of the metS in the future. These results have high policy implications. KEY CONCEPTS Metabolic syndrome; risk factors; blood pressure; blood pressure to height ratio; cardiovascular disease; dietary intake; rural South African.

Thesis (M.Sc. (Physiology)) -- University of Limpopo, 2016 / Cardiovascular diseases (CVDs) are major public health problems nowadays in Africa. From prospective studies, it is also known that risk factors for CVDs start early in life and increase morbidity and mortality in sub-Saharan African adults. Mostly the risk factors of CVDs are malnutrition and hypertension. Economic development in South Africa leads to lifestyle changes that contribute to a high prevalence of high blood pressure (BP) and malnutrition. However, little is known about the relationship of anthropometric indicators and BP in children from the developing countries. Therefore the aim of this study was to determine the association between anthropometrics indicators and BP among rural children in Ellisras area of Limpopo province, South Africa. All 1961 children (n=1029 boys, n=932 girls) aged 5-12 years underwent anthropometric and BP measurements using standard procedure. Receiver operating characteristics (ROC) curve was used to assess the ability of anthropometric indicators to discriminate children with high BP. ROC was used to determine the area under curve (AUC), cut-off value, sensitivity and specificity for underweight in children for each age and gender. Linear regression was used to assess the relationship between anthropometric indicators and BP. ROC curve showed that height (AUC = 0.700, 95%Cl 0.581 to 0.818), SH (AUC= 0.690, 95%Cl 0.573 to 0.786) and SH/H (AUC=0.670, 95% 0.533 to 0.807) can significantly (P<0.05) identify Ellisras children with hypertension. AUC for neck circumference (NC) (0.698), mid upper arm circumference (MUAC) (0.677) and body mass index (BMI) (0.636) for boys were statistically significant (P<0.05) for high systolic blood pressure (SBP), while in girls AUC of BMI was not significant (P>0.05) for high diastolic blood pressure (DBP). The regression analysis showed a positive significant (P<0.05) association of SBP with NC (β=0.764, 95%CI 0.475 to 1.052) and MUAC (β=1.286, 95% Cl 0.990 to 1.581) for unadjusted and adjusted age and gender. NC (β=0.628 95% Cl 0.303 to 0.953) and MUAC (β=1.351 95% CI 1.004 to 1.697) showed a significant association with SBP. However, MUAC had a significant association with DBP for both unadjusted and adjusted age and gender. Sitting height (SH) was significantly associated with SBP (β = 0.134, 95% Cl 0.210 to 0.416) and DBP (β = 0.088, 95% Cl 0.086 to 0.259) for unadjusted. After adjusted for age and gender, SH was significantly associated with both SBP (β = 0.161, 95% Cl 0.220 to 0.532) and DBP (β = 0.101, 95% Cl 0.066 to 0.329). There was a positive significant association between BP and anthropometric indicators in this population study, though the association of DBP and NC disappeared after adjustments for age and gender. Furthermore, there is a positive significant association between DBP and SBP with the components of height amongst Ellisras rural children. NC and MUAC are the simplest techniques with good interrater reliability and could be used to screen underweight in children. / Vrije University, Amsterdam, The netherlands University of Limpopo National Research Foundation (NRF)