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This study aims to determine the project management maturity level of four organisations in the Lesotho Water Sector. It assesses its influence on perceived project success by undertaking case studies in these organisations. It, therefore, contributes to the limited literature on project management maturity in the water sector in Africa. The results indicated that the average project management maturity was 2, with one organisation at a maturity level of 3. A total of 53% of executed projects were perceived as successful. The study found that high-maturity-level organisations tend to execute projects more successfully. Additional factors that may lead to project failure in this sector were identified. [ABSTRACT FROM AUTHOR]

A notion exists that organisations with higher levels of project management maturity execute projects more effectively and efficiently and so have a higher probability of achieving project success. This paper reports on a single case study that measured the project management maturity of four project management knowledge areas, and also investigated the impact of project management maturity on perceived project success in a mining operation. The study found that project management maturity plays a pivotal role in achieving project management deliverables. However, project management maturity alone is not sufficient to guarantee project success. [ABSTRACT FROM AUTHOR]

Spirituality is a general term used to refer to one's belief system and lived expression. It is a broad term and has been used to formulate different forms of spiritual expression. In the Christian context spirituality is defined as a life based on biblical faith that originates from a trust in and personal relationship with Christ. Pseudo-Christian groups especially False Christ cults presume, based on the claim of the leader being "Christ", that they are Christian and therefore their spirituality is also Christian. This study investigates the spirituality of False Christ cults compared to Christian spirituality to find the resemblances and differences and found them lacking since the presence of the persona of a so-called "Christ" inevitably changes the essential faith aspect of Christian spirituality namely faith in the redemptive work of Christ. Salvation through Christ is replaced with some manmade religious system of the "modern-day Christ". [ABSTRACT FROM AUTHOR]

The Greek word pharmakeia and its related meanings in the Christian Bible, more specifically in Revelation 18:23, formed the basis for the belief that it is directly related to the measures of and medical interventions used to address the Covid-19 pandemic in which big pharma played a major role. This study will investigate the word pharmakeia in the passages of the Bible with the view to understand the context in which it is used as well as its meaning to determine its relevance today. Although the word pharmacy and pharmaceutical products are derived from the word pharmakeia they cannot explicitly be linked in the text of the Bible to refer to big pharma. This, however, does not mean that the word and its variants do not carry implicit applications that can be to the detriment of Christian believers today. The word pharmakeia in the Bible is related to occult and pagan worship practices. Although these practices do not refer to pharmaceuticals only, they included practices that involved conscience-altering drugs and narcotics containing poisonous elements. These practices were always related to the magic realm which made participants susceptible to the influence of the demonic world. Similarly, one can conclude that policymakers and influential role players during the pandemic through magical maneuvers of mass media propaganda proverbially “cast a spell” on the world’s population causing humans to act uniformly across the world as if they had been captured. [ABSTRACT FROM AUTHOR]

This paper explores whether organisations in a developing country have become more mature over time in their project management practices, and compares the current state to findings from a similar study conducted in 2010. It thus contributes to the scant literature on project management maturity in developing countries. Six hundred responses to a project management maturity questionnaire were used to investigate the perceived project management success of 9 389 projects. The results indicated that the perceived average project management maturity dropped from the 2010 value of 2.88 to 2.64 in 2020. Despite this, most of the projects surveyed were still perceived as successful. [ABSTRACT FROM AUTHOR]

Much has been written about the Gloriavale Christian Community in New Zealand. This secluded community since its inception in 1969 has grown into a strong self-sustaining farming and business community. Their claim to be a true Christian community is based on their application of the same principles as the early Christian church. This claim of being Christian has been met with mixed views and as of late, with the surfacing of more allegations of unjust actions within the community, a general belief has been established that the culture of the community is exploitative. This study looked at the functioning of the early Christian church and compared the community of Gloriavale to that. The study showed disparities between the two and found that Gloriavale cannot be equated to the early Christian church mainly because of its belief to live in isolation from society which not only jeopardizes sound oversight from the broader Christian community over their teaching and practices but also creates a breeding ground for a controlling and inhibiting culture. This community is therefore a false representation of the early Christian church. [ABSTRACT FROM AUTHOR]

Reintegration of former pseudo-Christian cult members into society is a multi-layered endeavour. This article utilizes research conducted on cults, their dynamics and impact on members, and the findings of psychologists concerning the behaviour of cult members. It draws on personal research in dealing with former cult members for many years in an attempt to provide guidelines on how former pseudo-Christian cult members can be reintegrated into society. Different aspects are considered, especially the twisted Bible message that forms the basis of such cults. Also, how personality and value systems used to entrap members can be rightfully used to break the hold of the cult and assist in the reintegration process. The article points out that membership in a cult can result in disorders similar to addictive disorders. Knowing what areas the proselyting and controlling strategy of cults focused on is very valuable in undoing the hold of the cult culture on former members and re-establishing the Christian faith as part of reintegrating former members back into society. [ABSTRACT FROM AUTHOR]

Social justice has filled the globe and its agenda and push on humanity have become evident. This ‘justice’ does not portray the justice of the Bible yet many Christians have fallen prey to this worldly justice, believing it to equate to biblical justice and therefore it is necessary to submit to its tenets. As a result, a modified gospel to accommodate the social justice agenda has been created. Unfortunately, this ‘justice’ presented as the modern redeemer of the inequalities of humanity is flawed and nothing more than a creation of the reprobate mind of sinful mankind that can never attain harmony and equality set out as its goals. This article points out that its agenda has infiltrated the church and led to some movements to redefine and reinterpret central biblical doctrine to accommodate the tenets of social justice. It further points out that the church has the calling to expose and oppose the misleading meaning that is approved by social justice and to continue to preach the undiluted gospel of Jesus Christ the only justifier. [ABSTRACT FROM AUTHOR]

Sound claws are essential for beef cattle, given the marked influence they have on functional longevity and subsequent performance. The aim of this study was to evaluate morphological and physiological claw characteristics of Bonsmara SA beef cattle in the major bioregions of South Africa. Normal claws of 89 Bonsmara stud animals were collected from three bioregions in which Bonsmara cattle are farmed, namely Mesic Highveld Grassland, Eastern Kalahari Bushveld and Central Bushveld bioregions. Most of these claws were from Bonsmara bulls that were slaughtered after completion of a standardized intensive feeding test and a few were from older cows. Lateral toe length (LL), medial toe length (ML), claw circumference, colour coding and tensile strength (TS) were determined on the fore and hind claws and mineral composition only on the fore claws. Multifactorial analysis of variance (ANOVA) models indicated that bioregion, moisture content, calcium (Ca), selenium (Se) and claw position (fore versus hind claws) had a significant effect (P <0.05) on TS. It is clear that environmental factors need to be considered in the evaluation of claw quality. This research serves as a benchmark for claw traits in the Bonsmara breed. Recording of claw and conformation traits is essential for genetic improvement. [ABSTRACT FROM AUTHOR]

This paper identifies the essential support functions of project management offices (PMO) for various organisational project management maturity (OPMM) levels. A case study of a South African petrochemical company compares a PMO within the company with a small projects department that is not supported by a PMO. OPMM development drivers and essential PMO support functions are identified for both structures. It is proposed that the requirements of essential PMO support functions depend on the OPMM level, but are also affected by business needs. The highest OPMM level is not required for every organisation, as the optimum OPMM level depends on the specific business' requirements. [ABSTRACT FROM AUTHOR]

Currently, many organisations experience challenges as a result of uncertainty, fast-changing environments, globalisation, and increasingly complex work tasks. In order to adapt to these challenges, a shift in leadership style may be needed. Traditionally, leadership has been seen as a vertical relationship (top-down influence). For a number of decades, this vertical leadership model has been the principal one in the leadership field; but lately, shared and balanced leadership have gained importance, especially in the project management literature. This theoretical study highlights some differences between 'leadership' and 'management', and explores current trends in the leadership literature. It especially focuses on vertical, shared, and balanced leadership in project management, and identifies future opportunities for research. [ABSTRACT FROM AUTHOR]

It is widely accepted that project leaders should adapt their behaviour to meet the unique leadership demands of a variety of situations. Recently, vertical, shared, and horizontal styles of leadership have gained prominence, especially in the project management literature. Several factors are believed to play a role in determining an appropriate balance between these leadership styles. This theoretical study explores the influence of project types, the stage in the project life cycle, organisational project management maturity, and the level of trust and collaboration between project team members on the appropriate balance of leadership styles in projects. This paper presents a conceptual framework of these factors, while empirical results will be reported on in the sequel to this paper. [ABSTRACT FROM AUTHOR]

Project sponsors play significant roles at the stage gates of project life cycle models (PLCMs). However, research on the roles that sponsors play at stage gates, and the attributes required of the sponsor, are sparse. This study investigated the roles played by government and municipal sponsors at the PLCM stage gates of a water utility, and identified the attributes that the sponsor should have as well as the challenges they face. A case study approach was employed, and semi-structured interviews were conducted with relevant stakeholders. The findings could assist the senior management of water utilities, national government departments, and municipalities when appointing suitable project sponsors. [ABSTRACT FROM AUTHOR]

Background: Multiple long-term conditions (MLTCs; commonly referred to as multimorbidity) are highly prevalent among people admitted to hospital and are therefore of critical importance to hospital-based healthcare systems. To date, most research on MLTCs has been conducted in primary care or the general population with comparatively little work undertaken in the hospital setting., Purpose: To describe the rationale and content of ADMISSION: a four-year UK Research and Innovation and National Institute of Health and Care Research funded interdisciplinary programme that seeks, in partnership with public contributors, to transform care for people living with MLTCs admitted to hospital., Research Design: Based across five UK academic centres, ADMISSION combines expertise in clinical medicine, epidemiology, informatics, computing, biostatistics, social science, genetics and care pathway mapping to examine patterns of conditions, mechanisms, consequences and pathways of care for people with MLTCs admitted to hospital., Data Collection: The programme uses routinely collected electronic health record data from large UK teaching hospitals, population-based cohort data from UK Biobank and routinely collected blood samples from The Scottish Health Research Register and Biobank (SHARE). These approaches are complemented by focused qualitative work exploring the perspectives of healthcare professionals and the lived experience of people with MLTCs admitted to hospital., Conclusion: ADMISSION will provide the necessary foundations to develop novel ways to prevent and treat MLTCs and their consequences in people admitted to hospital and to improve care systems and the quality of care for this underserved group., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: ES reports funding support from HDRUK, MRC, Wellcome Trust, NIHR, Alpha 1 Foundation, EPSRC and British Lung Foundation. SG reports funding support from HDRUK, MRC and NIHR. MDW reports consulting fees from Rejuvenate Biomed. In addition to the support all authors acknowledge from the ADMISSION research collaborative, MDW, JGB, SJH, MO, CP, SJR, SMR, , RC and AAS also acknowledge support from the National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre based at Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Newcastle University. SHa, MSi and DC are supported by the National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre. JMSW is funded by a NIHR Research Professorship (NIHR301614). RC also receives support as part of a generous donation made by the McArdle family to Newcastle University for research that will benefit the lives of older people in the UK. MDW, SP and JS acknowledge support from the NIHR Newcastle HealthTech Research Centre. SJR holds an NIHR Clinical Lectureship, funded by Health Education England (HEE) and NIHR. The other authors have no conflicts of interest to declare., (© The Author(s) 2025.)

Background: PROTECT ( Platform Randomised evaluation of clinical Outcomes using novel TEChnologies to optimise antimicrobial Therapy) has brought together a team of researchers to design a platform trial to rapidly evaluate and adopt into care multiple diagnostic technologies, bringing immediate benefit to patients. Rapid diagnostic tests will be used to identify patients at risk of deterioration from severe infection, before they become critically unwell. The platform will assess their comparative clinical effectiveness and cost-effectiveness relative to current standard of care. Preliminary work, conducted under a Health Technology Assessment Application Acceleration Award, provided key evidence to optimise the design of the PROTECT platform., Methods: Qualitative methods which involved consulting key stakeholders in the field of serious infection addressed the key priorities. A high-level care pathway analysis focusing on serious infection in secondary care, captured the points of contact, actions, decisions, and potential outcomes associated with a patient's care., Results: Two use cases of rapid diagnostic tests for serious infection were identified; (1) in acute emergency medicine to decide on antimicrobial initiation and/or escalation of care, and (2) in hospitalised patients to monitor treatment response. The "ideal" test should be rapid, point-of-care, cheap to procure, have capacity for high usability, and ability to be performed and interpreted by all staff. Facilitators to the adoption of infection diagnostic tests is their clinical need, and the main potential barrier is poor change management and behavioural change., Conclusions: Any new test should provide robust evidence of its clinical effectiveness and have the potential to accelerate ruling in or out serious infection which benefits the clinical pathway for patients, clinicians, and hospitals as a whole, to be considered for adoption as a new standard of care., Competing Interests: No competing interests were disclosed., (Copyright: © 2025 Naseem R et al.)

A scoping review methodological framework formed the basis of this review. A search of two electronic databases captured relevant literature published from 2013. 1184 articles were screened, 200 of which met inclusion criteria. Included studies were categorised as tests for either respiratory infections OR pulmonary exacerbations. Data were extracted to ascertain test type, sample type, and indication of use for each test type. For infection, culture is the most common testing method, particularly for bacterial infections, whereas PCR is utilised more for the diagnosis of viral infections. Spirometry tests, indicating lung function, facilitate respiratory infection diagnoses. There is no clear definition of what an exacerbation is in persons with CF. A clinical checklist with risk criteria can determine if a patient is experiencing an exacerbation event, however the diagnosis is clinician-led and will vary between individuals. Fuchs criteria are one of the most frequently used tests to assess signs and symptoms of exacerbation in persons with CF. This scoping review highlights the development of home monitoring tests to facilitate earlier and easier diagnoses, and the identification of novel biomarkers for indication of infections/exacerbations as areas of current research and development. Research is particularly prevalent regarding exhaled breath condensate and volatile organic compounds as an alternative sampling/biomarker respectively for infection diagnosis. Whilst there are a wide range of tests available for diagnosing respiratory infections and/or exacerbations, these are typically used clinically in combination to ensure a rapid, accurate diagnosis which will ultimately benefit both the patient and clinician., Competing Interests: Declaration of competing interest Raasti Naseem, Nicola Howe, Cameron Williams, Sara Pretorius and Kile Green received funding for this work as part of a wider study from LifeArc (http://www.lifearc.org) and collaborating organisations through the CFAMR Syndicate (https://cfamr.org.uk/) and declare no conflicts of interest. The NIHR had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript., (Copyright © 2024 [The Author]. Published by Elsevier B.V. All rights reserved.)

Background: Antibiotic choice for complicated appendicitis should be based on both microbiological effectiveness as well as ease of administration and cost especially in lower resourced settings. Data is limited on comparative morbidity outcomes for antibiotics with similar microbiological spectrum of activity. Incidence and morbidity of surgical site infection after appendectomy for complicated appendicitis was assessed after protocol change from triple antibiotic (ampicillin, gentamycin, and metronidazole) regimen to single agent (amoxycillin/clavulanic acid)., Methods: Surgical site infection (SSI) rate, relook surgery rate and length of hospital stay were retrospectively compared in patients treated for acute appendicitis preceding (2014, 2015; "triple-therapy, TT") and following (2017, 2018; "single agent, SA") antibiotic protocol change., Results: The rate of complicated appendicitis was similar between groups; 72.6% in TT and 66% in SA (p = 0.239). Significantly, SSI occurred in 22.7% of the SA group compared to 13.3% in TT group (OR 1.920, 95% CI 1.000-3.689, p = 0.048). Use of laparoscopy increased from 31% in TT to 89% in SA, but with subgroup analysis this was not associated with increased SSI (17.3% in open and 20.6% in laparoscopic; OR 0.841, 95% CI 0.409-1.728, p = 0.637). Relook rate (OR 1.444, 95% CI 0.595-3.507, p = 0.093) length of hospital stay (U = 6859, z = -1.163, p = 0.245), and ICU admission (U = 7683, z = 0.634 p = 0.522) were equivocal. Neither group had mortalities., Conclusions: Despite increased SSI with SA, overall morbidity relating to ICU admission, relook rate and length of hospital stay was similar in both groups. More prospective research is required to confirm equivalent overall morbidity and that single agent therapy is more cost-effective with acceptable clinical outcomes., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The mathematical method which will achieve the most accurate and precise age-at-death estimate from the adult skeleton is often debated. Some research promotes Bayesian analysis, which is widely considered better suited to the data construct of adult age-at-death distributions. Other research indicates that methods with less mathematical complexity produce equally accurate and precise age-at-death estimates. One of the advantages of Bayesian analysis is the ability to systematically combine multiple indicators, which is reported to improve the age-at-death estimate. Few comparisons exist between Bayesian analysis and less complex mathematical models when considering multiple skeletal indicators. This study aims to evaluate the performance of a Bayesian approach compared to a phase-based averaging method and linear regression analysis using multiple skeletal indicators. The three combination methods were constructed from age-at-death data collected from 330 adult skeletons contained in the Raymond A Dart and Pretoria Bone Collections in South Africa. These methods were tested and compared using a hold-out sample of 30 skeletons. As is frequently reported in literature, a balance between accuracy and precision was difficult to obtain from the three selected methods. However, the averaging and regression analysis methods outperformed the Bayesian approach in both accuracy and precision. Nevertheless, each method may be suited to its own unique situation-averaging to inform first impressions, multiple linear regression to achieve statistically defensible accuracies and precisions and Bayesian analysis to allow for cases where category adjustments or missing indicators are necessary., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Tufts Center for the Study of Drug Development (Tufts CSDD) collected data on trial design elements and clinical trial performance outcomes from 187 protocols provided by 20 companies. 10 design variables were tested for correlations with 11 performance variables, and regression models of each performance variable were tested. Results: Many significant correlations were found (p < .01, p < .05). The number of countries and the number of sites were each positively correlated with amendment frequency, longer screening and study duration as well as study participant dropout rates. The number of internal reviews prior to protocol finalization was also positively correlated with these same performance outcomes. In regression modeling, scientific and operational design characteristics were significant predictors of cycle time, enrollment and retention outcomes, and amendment frequency, even when controlling for phase and therapeutic area. These predictors included the number of endpoints, eligibility criteria, procedures per visit, number of countries, and investigative sites. The results of this analysis suggest practical considerations for optimizing protocol performance., (© 2021. The Drug Information Association, Inc.)

Background: The use of mobile technologies for data capture and transmission has the potential to streamline clinical trials, but researchers lack methods for collecting, processing, and interpreting data from these tools., Objectives: To assess the performance of a technical platform for collecting and transmitting data from six mobile technologies in the clinic and at home, to apply methods for comparing them to clinical standard devices, and to measure their usability, including how willing subjects were to use them on a regular basis., Methods: In part 1 of the study, conducted over 3 weeks in the clinic, we tested two device pairs (mobile vs. clinical standard blood pressure monitor and mobile vs. clinical standard spirometer) on 25 healthy volunteers. In part 2 of the study, conducted over 3 days both in the clinic and at home, we tested the same two device pairs as in part 1, plus four additional pairs (mobile vs. clinical standard pulse oximeter, glucose meter, weight scale, and activity monitor), on 22 healthy volunteers., Results: Data collection reliability was 98.1% in part 1 of the study and 95.8% in part 2 (the percentages exclude the wearable activity monitor, which collects data continuously). In part 1, 20 of 1,049 overall expected measurements were missing (1.9%), and in part 2, 45 of 1,083 were missing (4.2%). The most common reason for missing data was a single malfunctioning spirometer (13 of 20 total missed readings) in part 1, and that the subject did not take the measurement (22 of 45 total missed readings) in part 2. Also in part 2, a higher proportion of at-home measurements than in-clinic readings were missing (12.6 vs. 2.7%). The data from this experimental study were unable to establish repeatability or agreement for every mobile technology; only the pulse oximeter demonstrated repeatability, and only the weight scale demonstrated agreement with the clinical standard device. Most mobile technologies received high "willingness to use" ratings from the patients on the questionnaires., Conclusions: This study demonstrated that the wireless data transmission and processing platform was dependable. It also identified three critical areas of study for advancing the use of mobile technologies in clinical research: (1) if a mobile technology captures more than one type of endpoint (such as blood pressure and pulse), repeatability and agreement may need to be established for each endpoint to be included in a clinical trial; (2) researchers need to develop criteria for excluding invalid device readings (to be identified by algorithms in real time) for the population studied using ranges based on accumulated subject data and established norms; and (3) careful examination of a mobile technology's performance (reliability, repeatability, and agreement with accepted reference devices) during pilot testing is essential, even for medical devices approved by regulators., Competing Interests: C.R., T.W., M.K., T.S., and S.P. are employed by PAREXEL International. N.A., N.B., A.T., C.E., S.K., and L.H. are employed by Sanofi-Aventis Recherche & Développement. The authors have no other conflicts of interest to declare., (Copyright © 2018 by S. Karger AG, Basel.)

Although guidelines for facial approximations, including those for the eye, are in use in South Africa, limited data on African populations exist to confirm its validity. As precise placement of the eyes in facial approximations is of importance for facial recognition, this study tested established guidelines by measuring specific instrumental dimensions. Forty-nine cadavers from the Sefako Makgatho Health Sciences University and the University of Pretoria were dissected to determine the position of the canthi and the size and position of the eyeball in the orbit. Thirty cone beam computer tomography scans and 30 computer tomography scans from the Oral and Dental and Steve Biko Hospitals respectively were used to determine the size of the eyeball. Results from this study were compared to the published guidelines. The most prominent discrepancies included a more rectangular shape of the orbit, an oval shaped eyeball and a different position of the canthi. In African faces, the medial canthus was found to be located higher than the lateral canthus. The distance between the endocanthion and superior orbital margin was 17.7mm and the exocanthion and superior orbital margin 19.5mm. Inter-population differences may have an effect on facial approximations and its accuracy as is often demonstrated in practice. The findings of this study should be taken into consideration when designing population specific guidelines for reconstruction of the eye in South Africans of African ancestry., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Optimal maternal body composition during pregnancy is a public health priority due to its implications on maternal health and infant development. We therefore aimed to conduct a systematic review of randomised, controlled trials, and case-control and cohort studies using lifestyle interventions to improve body composition in developing countries. Of the 1 708 articles that were searched, seven studies, representing three countries (Brazil, Iran and Argentina), were included in the review. Two articles suggested that intervention with physical activity during pregnancy may significantly reduce maternal weight gain, and five studies were scored as being of poor quality. This systematic review highlights the lack of research within developing countries on lifestyle interventions for the management of excessive weight gain during pregnancy. Similar reviews from developed countries demonstrate the efficacy of such interventions, which should be confirmed using well-designed studies with appropriate intervention methods in resource-limited environments.

Background: Tufts Center for the Study of Drug Development (Tufts CSDD), in collaboration with 15 pharmaceutical companies and contract research organizations, gathered data on substantial global protocol amendments to better understand how to manage and to reduce the significant unplanned expense and delays associated with major changes to finalized protocol designs., Methods: Data from 836 phase I-IIB/IV protocols were analyzed to understand amendment prevalence. Impact assessments were based on data from 136 randomly selected amendments. Data from 52 protocols were analyzed to derive estimates of the direct cost to implement amendments., Results: Tufts CSDD found that 57% of protocols had at least one substantial amendment, and nearly half (45%) of these amendments were deemed "avoidable." Phase II and III protocols had a mean number of 2.2 and 2.3 global amendments, respectively. Protocols with one or more global amendments tended to be larger in scope, with longer patient recruitment durations and overall study durations compared with those without a global amendment. Protocols with at least one substantial amendment had fewer actual screened and enrolled patients relative to the original baseline plan than did those protocols without an amendment. The median direct cost to implement a substantial amendment was US$141,000 for a phase II protocol and $535,000 for a phase III protocol., Conclusions: The study findings provide insights into optimizing development planning, protocol design, and clinical trial management practices.

This review aimed to provide an overview of the current research on the psychological impact of overactive bladder. A systematic search yielded 32 papers. It was found that people with overactive bladder tended to have greater levels of depression, anxiety and embarrassment/shame; difficulties with social life; impact on sleep and sexual relationships; and a lower quality of life than people without overactive bladder. A psychological impact on family members was also found. Psychological health should be considered an important aspect of managing overactive bladder and further research is required to determine how best to provide psychological care and support in this area., (© The Author(s) 2014.)

Beyond changing dietary patterns, there is a paucity of data to fully explain the high prevalence of obesity and hypertension in urban African populations. The aim of this study was to determine whether other environmental factors (including sleep duration, smoking and physical activity) are related to body anthropometry and blood pressure (BP). Data were collected on 1311 subjects, attending two primary health care clinics in Soweto, South Africa. Questionnaires were used to obtain data on education, employment, exercise, smoking and sleep duration. Anthropometric and BP measurements were taken. Subjects comprised 862 women (mean age 41 ± 16 years and mean BMI 29.9 ± 9.2 kg/m²) and 449 men (38 ± 14 years and 24.8 ± 8.3 kg/m²). In females, ANOVA showed that former smokers had a higher BMI (p<0.001) than current smokers, while exposure to second hand smoking was associated with a lower BMI (p<0.001) in both genders. Regression analyses demonstrated that longer sleep duration was associated with a lower BMI (p<0.05) in older females only, and not in males, whilst in males napping during the day for > 30 minutes was related to a lower BMI (β = -0.04, p<0.01) and waist circumference (β = -0.03, p<0.001). Within males, napping for >30 minutes/day was related to lower systolic (β = -0.02, p<0.05) and lower diastolic BP (β = -0.02, p = 0.05). Longer night time sleep duration was associated with higher diastolic (β = 0.005, p<0.01) and systolic BP (β = 0.003, p<0.05) in females. No health benefits were noted for physical activity. These data suggest that environmental factors rarely collected in African populations are related, in gender-specific ways, to body anthropometry and blood pressure. Further research is required to fully elucidate these associations and how they might be translated into public health programs to combat high levels of obesity and hypertension.