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The viral marketing offers answers for the structuring and disseminating fast and large-scale information in favor of content, products, and their brands. Sustained by the growth of technological users, social networks and mobile technology, video viewing, posts, and sharing, it has become an everyday action. Thus, the organizations started to produce commercial videos and dissemination them in the social networks, where consumer users share what they identify themselves with. Lister (2018) highlights that a video that is socially shared generates 1.200% more shares than the text and images combined. Video is a trend in terms of online communication, as millions of dollars are spent on these efforts to persuade and generate an impact on their audiences target monthly (Lister, 2018). However, most of the studies about video sharing are related to consumer content, not firm generated content. In this sense, the central objective of this study is to identify the antecedents of commercial video sharing and its impact on the consumers' attitudes. The videos that were mostly seen on YouTube in 2017 and the top of mind brands were selected as the research's corpus. A total of 368 questionnaires were collected, preceded by the viewing of the videos that were selected. The results reveal significant impacts of the entertainment value and utility value with the intention of sharing videos, but the social value has no significant impact. In this sense, this study contributed by identifying content and persuasion strategies for firms in order to earn media from sharing of commercial videos, which every day more represent a larger share in the organizations' communication budget.

Childhood hypertension drives hypertension in later life; hence, assessing blood pressure in children is an important measure to determine current and future cardiovascular health. There is, however, a paucity of childhood blood pressure data, particularly for sub-Saharan Africa. This study explores blood pressure and associations with age, sex, socioeconomic status, physical activity, fitness, and cardiovascular risk markers. In the 'Disease, Activity and Schoolchildren's Health' (DASH) study, a cross-sectional analysis was conducted in disadvantaged neighbourhoods in the Eastern Cape province of South Africa. Assessments included blood pressure, accelerometer-measured physical activity, physical fitness, and cardiovascular risk markers. The study consisted of 785 children (383 boys, 402 girls, M = 12.4+/-0.9 years). Overall, 18% of the children were classified as hypertensive, while 20% were either overweight/obese, and almost four out of ten children did not meet global daily physical activity recommendations. Hypertensive children were more likely to be overweight/obese, chi(2) (2,785) = 14.42, p < 0.01, but only if they did not meet physical activity recommendations, chi(2) (2,295) = 11.93, p < 0.01. Considering the moderating effect which sufficient activity has on the relationship between hypertension and body weight, more emphasis should be placed on early primary health intervention and education strategies.

Background: Physical inactivity and low cardiorespiratory fitness (CRF) are independent cardiovascular risk factors among children, but have rarely been investigated concurrently in sub-Saharan Africa. The purpose of this study was to compare physical activity (PA) and CRF of primary schoolchildren living in Côte d'Ivoire (CI), South Africa (ZA), and Tanzania (TZ), to test sex- and age-related differences, and to examine whether PA and CRF are associated with each other.Methods: Baseline data from an ongoing cluster-randomized controlled trial were used, including 499 children from CI (Taabo, 49% girls, M = 8.0 ± 1.6 years), 1,074 children from ZA (Gqeberha, 49% girls, M = 8.3 ± 1.4 years), and 593 children from TZ (Ifakara, 51% girls, M = 9.4 ± 1.7 years). PA was assessed by accelerometry and CRF by a 20 m shuttle-run test. The data were analyzed using multi-/univariate analyses of variance and mixed linear models.Results: Most children met recommendations put forward by the World Health Organization for moderate-to-vigorous PA (MVPA) and achieved high CRF scores. In CI, 89.6% of the children met MVPA recommendations (boys: 91.7%, girls: 87.4%), whereas this rate was 76.9% in ZA (boys: 91.0%, girls: 62.4%), and 93.8% in TZ (boys: 95.5%, girls: 92.0%). Children from TZ had the highest CRF and MVPA levels, followed by children from CI and ZA. Boys had higher MVPA levels than girls, whereas girls engaged in more sedentary behavior. Sex differences were strongest in ZA. Sedentary behavior and MVPA were higher among older schoolchildren compared to their younger peers. Higher MVPA, but not sedentary behavior, was associated with better CRF.Conclusions: In all three settings, higher levels of MVPA were associated with higher CRF scores. Nevertheless, children living in the most urbanized setting (such as observed in ZA) were physically less active and had lower CRF than peers living in more rural areas (such as observed in CI and TZ). Particularly for girls, urbanization might increase the risk for insufficient MVPA, which may have negative effects on their CRF, thus negatively influencing health and well-being at later age.

Management of the cavus foot is a difficult task for the foot and ankle surgeon. Tendon transfers have been a longstanding accepted treatment for the flexible cavus foot. Performing tendon transfers requires an in-depth understanding of the patient's medical history, factors leading to the development of deformity, as well as the deforming forces contributing to the deformity. Evaluation of the patient for rigid, progressive, and/or spastic deformities is critical to avoid postoperative complications. Educating the patient on postoperative rehabilitation, potential complications, and postoperative expectations is essential to ensure appropriate surgical outcomes.

Childhood stunting can have negative long-term consequences on cognitive development, academic achievement, and economic productivity later in life. We determined the prevalence of stunting and examined whether stunting and associated risk factors (low dietary diversity, insufficient hemoglobin, food insecurity, and soil-transmitted helminth (STH) infections) are associated with academic achievement and cognitive function among South African children living in marginalized communities. A cross-sectional sample of 1277 children (aged 5–12 years) was analyzed. Stunting was defined according to 2007 WHO growth references. Cognitive functioning was measured with the computerized Flanker task and academic performance via school grades. Blood and stool samples were collected to obtain hemoglobin level and STH infection. Dietary diversity was assessed by a food frequency questionnaire. Associations were examined via mixed linear regression (with school class as a random intercept). Nine percent of the children were stunted (95% CI: 7.6–10.8%). Low dietary diversity (β = 0.13, p = 0.004), food insecurity (β = −0.12, p = 0.034), and stunting (β = −0.13, p = 0.031) were associated with poorer end of the year results among girls. No such associations were found among boys. No significant associations were found for socioeconomic status and hemoglobin levels. The prevalence of stunting and STH infections were low in the present sample. Risk factors seem differently associated with girls’ and boys’ academic achievement. Promoting nutrition may help to promote academic achievement among girls living in low- and middle-income countries.

The coexistence of multiple cardiovascular risk factors has been reported in school-aged children from the age of nine years, but most evidence stems from high-income countries. This cross-sectional study aimed at describing the cardiovascular health risk, physical activity (PA) behavior and cardiorespiratory fitness (CRF) levels of South African primary schoolchildren, and at examining the associations between PA/CRF and a composite measure of cardiovascular risk. Cross-sectional data from 832 primary schoolchildren (grade 1–4) were analyzed. Total cholesterol/HDL ratio, triglycerides, systolic/diastolic blood pressure, body fat, and glycated hemoglobin were assessed as cardiovascular risk markers. Data were analyzed via mixed linear regressions and analyses of covariance. Overall, 24.2% of the participants did not meet current PA standards. Higher CRF/PA were associated with lower body fat and lower clustered cardiovascular risk (p &lt, 0.05). When categorizing children into CRF/PA quartiles, a lower clustered cardiovascular risk gradient was found in children with higher CRF (p &lt, 0.05) or PA (p &lt, 0.05). Our data shows that higher CRF/PA is associated with lower clustered cardiovascular risk already from a young age. Given that clustered cardiovascular risk present during childhood can track into adulthood, we advocate for PA participation and a healthy weight from a young age onwards.

(1) Background: Early childhood malnutrition may result in increased fat mass (FM) among school-aged children in low- and middle-income countries (LMICs). We explored whether South African children with shorter stature have greater overall and abdominal FM compared to normal stature children. (2) Methods: Baseline assessments of body composition and weight were determined among school-aged children enrolled in a randomized controlled trial in Port Elizabeth, South Africa, using bioelectrical impedance analysis. Multiple linear regression models tested associations of children’s height and degree of stunting with FM, fat free mass (FFM), truncal fat mass (TrFM), and truncal fat free mass (TrFFM) overall and by sex. (3) Results: A total of 1287 children (619 girls, 668 boys) were assessed at baseline. Reduced child height was associated with higher FM and lower FFM and TrFFM, but these associations were reversed with increases in height. Girls classified as mildly or moderately/severely stunted had higher FM and TrFM but lower FFM and TrFFM, while no association was found for boys. (4) Conclusions: Our study suggests that efforts to reduce the non-communicable disease burden in LMICs should target growth-impaired children who may have greater overall FM and greater abdominal FM.

Background Cardiovascular fitness has been associated with both executive function and academic achievement in multiple cohort studies including children and adolescents. However, research is scarce among children from low- and middle-income countries. Hence, this paper focuses on South African primary schoolchildren living in marginalized areas and examines if academic achievement and inhibitory control can be explained by children’s age, socioeconomic status, soil-transmitted helminth infections, food insecurity, stunting, grip strength, and cardiorespiratory fitness. Methods The sample of this cross-sectional study consisted of 1277 children (48% girls, mean age: 8.3 years). Data were assessed via questionnaires, stool samples, anthropometric measurements, 20 m shuttle run test, grip strength test, Flanker task, and school grades. Data were analysed with mixed linear regression models with random intercepts for school classes, separately for boys and girls. Results Higher socioeconomic status was most closely associated with academic achievement among boys (p p p p p Conclusions Academic performance has been shown to be compromised in schoolchildren living in marginalised areas, compared to schoolchildren in less disadvantaged parts of South Africa. The present study suggests that cardiorespiratory fitness and grip strength are two potentially modifiable factors that are associated with children’s academic achievement and cognitive performance, and that should be targeted in future school-based interventions.

This research investigates a method for performing manual classification of the terrain in imagery from the on-board camera of an unmanned aerial vehicle, to develop classifiers for systematic terrain classification. Drone images were captured across rural County Donegal in Ireland, and software was developed to manually label the terrain in these images, labelled in a lattice of 30 x30-pixel tiles. This dataset was used to train both a classic computer vision model and a Convolutional Neural Net model to classify the type of terrain under the UAV. The accuracy of the computer vision approach to the classification was compared to that of a Convolutional Neural Network trained using the Semantic Segmentation approach. The Convolutional Neural Network classifier was found to be the most accurate approach, achieving an fl score of 0.95.

Background/AimPhysical inactivity (PIA) is a growing global health problem and evidence suggests that PIA is a key driver for cardiovascular and chronic diseases. Recent data from South Africa revealed that only about half of the children achieved recommended daily physical activity (PA) levels. Assessing the intensity of PA in children from low socioeconomic communities in low-income and middle-income countries is important to estimate the extent of cardiovascular risk and overall impact on health.MethodsWe conducted a cross-sectional survey in eight quintile 3 primary schools in disadvantaged communities in the Port Elizabeth region, South Africa. Children aged 10–15 years were subjected to PA, blood pressure, cholesterol, blood glucose and skinfold thickness assessments. Cardiovascular risk markers were converted into standardised z-scores and summed, to obtain a clustered cardiovascular risk score.ResultsOverall, 650 children had complete data records. 40.8% of the children did not meet recommended PA levels (ie, logged ConclusionsCRF and objectively assessed PA are closely linked with children’s clustered cardiovascular risk. Given that 4 out of 10 South African schoolchildren from marginalised communities do not meet international PA recommendations, efforts should be made to ensure that promoting a physically active lifestyle is recognised as an important educational goal in primary schools.Trial registration numbersISRCTN68411960 and H14-HEA-HMS-002.

Die Anzahl an geriatrischen Patienten mit Frakturen steigt. Ziel der Behandlung von Sprunggelenkfrakturen in diesem Patientengut ist es, eine moglichst uneingeschrankte Autonomie und Lebensqualitat der Patienten sicherzustellen. Dazu gilt es, die Komplikationen und Einschrankungen nach einer Sprunggelenkfraktur zu minimieren. Entscheidend fur den weiteren Verlauf ist die initiale Behandlung. Die Ergebnisse werden zwar wesentlich durch das Weichteilmanagement, die Reposition und die sichere Osteosynthese bestimmt, aber erst die Optimierung des Behandlungsprozesses im Sinne des geriatrischen Komanagements sowie die Sicherstellung der postoperativen Mobilisation und der weiteren Versorgung fuhren zu einem zufriedenstellenden Ergebnis. Hier liegen die Vorteile einer interdisziplinaren Zusammenarbeit von Unfallchirurgen und Geriatern auf der Hand.

Verletzungen der Peronealsehnen sind selten und werden oft ubersehen. Typische Pathologien sind Tendinitis, Ruptur und Luxation. Begleitverletzungen sind Frakturen. Sie sind oft mit Instabilitaten am oberen Sprunggelenk (OSG) und Ruckfusfehlstellungen vergesellschaftet. Daher sollten diese Pathologien ausgeschlossen bzw. in der Therapie berucksichtigt werden. Zur Diagnostik ist die klinische Untersuchung entscheidend. Ultraschalluntersuchungen sind sehr hilfreich. Das MRT erscheint prinzipiell gut geeignet. Das wahre Ausmas der Sehnenpathologie wird aber nicht selten erst intraoperativ ersichtlich. Knocherne Begleitverletzungen und Deformitaten werden rontgenologisch und mit der CT beurteilt. Auch wenn zu Beginn der Therapie in der Regel konservativ vorgegangen wird, ist gerade bei Rupturen eine Progredienz eher wahrscheinlich. Daher sollte der richtige Zeitpunkt fur eine operative Therapie nicht versaumt werden. Hier kommen Nahttechniken und Ersatzverfahren zum Einsatz. Luxationen sind die Domane der operativen Therapie und erfolgen in Abhangigkeit von der zugrunde liegenden Anatomie/Pathologie. Die Ergebnisse der konservativen Therapie sind auch hier ernuchternd. Die akute Tendinitis hingegen ist einer konservativen Therapie in der Regel gut zuganglich, wenn sie nicht das Resultat einer groben Fehlstellung ist. Die Rehabilitation nach der operativen Versorgung ist anspruchsvoll und gerade nach der operativen Therapie von Peronealsehnenrupturen langwierig. Die zu erwartenden Ergebnisse erscheinen vielversprechend.

Hypertension and overweight are growing public health concerns in school-aged children. We examined whether cardiorespiratory fitness and sport participation contribute to the prevention of hypertension and overweight. We conducted a cluster-randomized controlled trial with 853 children aged 8–13 years in eight primary schools in Port Elizabeth, South Africa. Cardiorespiratory fitness, sport participation, body mass index, and blood pressure were assessed at baseline and after a physical activity intervention, which took place at two time-points (July–September 2015 and February–April 2016) for 10 weeks each. Mixed logistic regressions were employed to analyze the data. At baseline, 18.8% of the children were classified as overweight/obese and 13.5% as hypertensive. High cardiorespiratory fitness and high sport participation were negatively associated with overweight/obesity, while high sport participation was associated with lower risk for hypertension. Longitudinally, normal weight children who initially had higher cardiorespiratory fitness showed less decrease in this variable, while those who participated in the physical activity intervention were less likely to become overweight/obese. High cardiorespiratory fitness and sport participation are linked with children’s weight status. Children who are fit and participate regularly in sport outside school hours are less likely to be hypertensive. Our findings highlight the importance of regular extracurricular physical activity and maintaining cardiorespiratory fitness levels.

Background: Information about the relationships between physical fitness, body composition and nutrition has increased in recent years; however, little is known about physical fitness and the coexistence of under-/overnutrition among children living in disadvantaged areas. Objectives: To determine the physical fitness status and its association with body composition, growth and selected socio- demographics in primary schoolchildren from disadvantaged communities in the Nelson Mandela Bay region. Methods: Nine hundred and sixty-five children (49% girls, M=9.5 years) participated in this cross-sectional study. Height and weight were measured to establish body mass index, and height-for-age z-scores. Physical fitness was assessed using tests from the Eurofit Physical Fitness test battery (flexibility, upper/lower body muscular strength and cardiorespiratory fitness). Between- group differences and cross-sectional associations were examined with univariate (Chi2-tests, analyses of variance) and multivariate methods (mixed linear/logistic regression). Results: Most children had normal weight (76.7%), while 4.5% were underweight and 18.7% were overweight/obese. Underweight children and children with stunted growth (11.5%) had lower average upper body strength (p

Background In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d’Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both. Methods Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1–4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation. Discussion The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent. Trial registration The study was registered on August 9, 2018, with ISRCTN. 10.1186/ISRCTN29534081.

It is typically assumed that for species to persist in working landscapes, they must either persist alongside agricultural pressures (i.e. land-sharing) or become restricted to remnant patches of natural habitat (i.e land-sparing). However, a third possibility is that species survive in stable ecological refuges that then supply the surrounding matrix with immigrants. In this study, we examined the potential for refuge-colonisation dynamics across two Key Biodiversity Areas dominated by commercial farmland in South Africa. We combined six years of remote sensing and two years of field surveys to examine mountains and rocky outcrops as ecological refuges using butterflies as indicators of environmental change. Vegetation on mountains and outcrops had higher and less variable productivity and moisture retention than the matrix, even across exceptionally wet and dry years. Moreover, butterflies in the matrix were a nested subset of species from the mountains and outcrops, and there was little evidence that species with certain traits were limited to either habitat. This suggests that species can retreat to ecological refuges during harsh conditions and recolonise the surrounding matrix once conditions improve. Ecological refuges can, therefore, unify land-sharing and land-sparing because their targeted protection would support the persistence of species throughout wider landscapes.

OBJECTIVES: To evaluate the effect of a 20-week school-based physical activity intervention program on academic performance and selective attention among disadvantaged South African primary school children. DESIGN: Cluster randomized control trial. METHODS: The study cohort included 663 children from eight primary schools, aged 8-13 years. Data assessment took place between February 2015 and May 2016 following the implementation of a 20-week school-based physical activity program. The d2 test was employed to assess selective attention, while the averaged end-of-year school results (math, life skills, home language, and additional language) were used as an indicator of academic performance. Physical fitness was assessed using the 20-m shuttle run test (VO2 max) and grip strength tests. We controlled for cluster effects, baseline scores in selective attention or academic performance, and potential confounders, such as children's age, gender, socioeconomic status, self-reported physical activity (as determined by a pre-tested questionnaire), body mass index, hemoglobin (as a proxy for anemia, as measured by blood sampling), and soil-transmitted helminth infections (as assessed by the Kato-Katz technique). RESULTS: Our multivariate analysis suggested that the physical activity intervention had a positive effect on academic performance (p = 0.032), while no effect was found on selective attention (concentration performance; p = 0.469; error percentage; p = 0.237). After controlling for potential confounders, the physical activity condition contributed to the maintenance of academic performance, whereas a decrease was observed in learners in the control condition. Furthermore, physically active and fit children tend to have better concentration performance (CP) than their less fit peers (self-reported activity; p0.021). CONCLUSION: A 20-week physical activity intervention contributes to the maintenance of academic performance among socioeconomically deprived school children in South Africa. School administrators should ensure that their school staff implements physical activity lessons, which are a compulsory component of the school by the curriculum.

Transition from secondary to tertiary education presents unique challenges for first-year nursing students. First year nursing students have to adapt to the unique challenges of clinical practice environments, as their education and training incorporates an almost equal amount of time for class attendance and clinical practice placement. The aim of the study was to explore and describe the experiences of first-year nursing students regarding their teaching-learning environment in the comprehensive four-year diploma programme. A qualitative, explorative, descriptive and contextual approach was used. Fourteen second-year students from two Nursing College campuses were purposively selected for the study. Semi-structured individual interviews were conducted. Participants were asked to reflect on their experiences of the first year of the nursing programme. Interview sessions were audio-recorded and transcribed verbatim by the researcher. The researcher and independent coder later used Tesch’s method of data analysis to analyse and code the transcribed data The findings indicated that the majority of their experiences concerning the teaching-learning environment in the first year of study were negative. These negative experiences related to challenges in the classroom and at the clinical practice environments in relation to their nurse educators and clinical staff members; management challenges were related to lack of resources at the campuses and the reportedly poor communication between campus managers and the students. Nurse educators and professional nurses in clinical practice environments should aim at optimising the teaching-learning environment of first-year nursing students in order to improve student retention and graduation thereby increasing the number of professional nurses in the country.

Any product development process must start with a thorough analysis of the customer needs that the product is aimed at satisfying. This, however, is a challenging task, as customer needs tend to vary over time. As future is uncertain, a significant degree of uncertainty is attached to the anticipation of the future customer needs. This issue is especially relevant to manufacturers of aircraft, as extensive development costs and long product life cycles require a solid decision basis when initiating a new aircraft development program. Therefore, this paper is targeted at supporting the anticipation of future customer needs under uncertainty by proposing an approach to the derivation of robust design requirements through the consideration of alternative future scenarios. The approach is composed of several methodical steps that comprise the building of multiple scenarios, a scenario-specific analysis of the target market and customers, a description of distinct Concepts of Operations, and eventually a derivation of design requirements to form the aircraft specification. The paper ultimately portrays a case study that demonstrates the applicability and allows further evaluation of the proposed approach.

Background Low- and middle-income countries are facing a dual disease burden with infectious diseases (e.g., gastrointestinal tract infections) and non-communicable diseases (e.g., diabetes) being common. For instance, chronic parasite infections lead to altered immune regulatory networks, anemia, malnutrition, and diarrhea with an associated shift in the gut microbiome. These can all be pathways of potential relevance for insulin resistance and diabetes. The aim of this study was to investigate the association between common gastrointestinal tract infections and glycemia in children from non-fee paying schools in South Africa. Methodology We conducted a cross-sectional survey among 9- to 14-year-old school children in Port Elizabeth. Stool and urine samples were collected to assess infection status with parasitic worms (e.g., Ascaris lumbricoides, Enterobius vermicularis, and Trichuris trichiura), intestinal protozoa (e.g., Cryptosporidium parvum and Giardia intestinalis), and the bacterium Helicobacter pylori. Glycated hemoglobin (HbA1c) was measured in finger prick derived capillary blood. All children at schools with a high prevalence of helminth infections and only infected children at the schools with low infection rates were treated with albendazole. The association of anthelmintic treatment with changes in HbA1c 6 months after the drug intervention was also investigated. Findings A high prevalence of 71.8% of prediabetes was measured in this group of children, with only 27.8% having HbA1c in the normal range. H. pylori was the predominant infectious agent and showed an independent positive association with HbA1c in a multivariable regression analysis (β = 0.040, 95% confidence interval (CI) 0.006–0.073, p, Author summary Parasitic worms (e.g., pinworm, roundworm, and whipworm), intestinal protozoa (e.g., Cryptosporidium parvum and Giardia intestinalis), and the bacterium Helicobacter pylori persist at high rates in the gastrointestinal tract of people from low- and middle-income countries. These infectious agents are increasingly paralleled by high rates of non-communicable diseases, such as diabetes. We studied the association of glycemia, measured as HbA1c with common gastrointestinal tract infections among school children aged 9–14 years from disadvantaged neighborhoods in Port Elizabeth, South Africa. Our goal was to deepen the understanding of whether specific gastrointestinal tract infections might be early life determinants of elevated HbA1c levels that might lead to diabetes. We found that the bacterium H. pylori was very common among our group of children with a positive association with hyperglycemia. None of the other infectious agents showed such an association. Additional, longitudinal studies are needed to determine whether there is causality for the observed association between H. pylori and hyperglycemia. The integration of biomarkers will allow studying mediating mechanisms.

Background. Footscan technology allows for assessment of injury risk and walking mechanics, yet there is a dearth of normative datapertaining to the normal, injury-free foot in a South African (SA) context.Objective. To generate normative tables from plantar pressure prole data gathered from students at an SA university.Methods. e RS Footscan (RSscan, Belgium) system was used to measure the plantar pressure values of the foot. Ten anatomical landmarksof the foot were analysed: the hallux, lateral toes, ve metatarsal heads, midfoot, and medial and lateral heel. ese ten areas were groupedinto one of three regions: forefoot, midfoot and heel. A total of 180 participants were subdivided as follows: gender (males, n=90; females,n=90); race (black, n=60; white, n=60; coloured, n=60). Each race group comprised 30 males and 30 females.Results. Of the ten individual plantar pressure areas, the second and third metatarsal heads demonstrated the highest mean peak plantarpressure values. Of the three regions, the heel region was ascribed with the largest plantar pressure values. Black females, coloured malesand coloured females yielded the highest pressure values, especially under the midfoot region of the foot. Black and white males and whitefemales exhibited the lowest pressure under the foot, especially under the midfoot region.Conclusion. e plantar pressure prole data generated in this study could serve to provide clinicians with a frame of reference whenevaluating participants within the age range of 18 - 30 years.

People from low- and middle-income countries still face challenges stemming from parasitic infections. Additionally, non-communicable diseases (NCDs) and their risk factors are rapidly increasing, which puts South African children at an elevated risk of a dual disease burden, with negative consequences for child development and wellbeing. Contrastingly, regular physical activity (PA) is associated with decreased cardiovascular disease (CVD) risk. Therefore, the objective of this study was to examine whether PA is associated with the double infection-CVD phenotype burden in South African schoolchildren. 801 children (402 boys, 399 girls; mean age 9.5 years) from eight schools from disadvantaged neighbourhoods were included. Data assessment took place between February and March 2015 in Port Elizabeth, South Africa. Children who achieved PA recommendations (physically active on 6-7 days/week for at least 60 min), who were active, but below recommended standards (2-5 physically active days/week), or who were insufficiently active on almost all days (0-1 physically active days/week) were compared with regard to systolic and diastolic blood pressure, body mass index (BMI), percent body fat, and infection with soil-transmitted helminths. Moderate and high self-reported PA levels were associated with lower BMI, lower body fat, and lower risk of being hypertensive. Conversely, children with high self-reported PA were more likely to be infected with soil-transmitted helminths than peers with low PA levels. Promoting PA in disadvantaged areas is worthwhile to prevent NCD later in life, but should be combined with regular anthelminthic treatment to comprehensively improve children's health and wellbeing.

The relationship between health-related quality of life (HRQoL), physical activity (PA), and cardiorespiratory fitness (CRF) among disadvantaged communities in low- and middle-income countries is poorly understood. In South Africa, children from socioeconomically deprived households are at an elevated risk of sedentary lifestyles and poor HRQoL. We examined whether higher self-reported PA and higher CRF levels are associated with better HRQoL in South African schoolchildren from disadvantaged neighbourhoods. Overall, 832 children aged 8–12 years participated in this cross-sectional study. HRQoL was assessed through five dimensions of the KIDSCREEN-27 tool. Self-reported PA was measured using a single item of the Health-Behaviour of School-Aged Children test, and CRF with the 20-m shuttle run test. Higher self-reported PA was significantly and positively related to HRQoL. Significant, but small group differences existed across all dimensions of HRQoL between low and high self-reported PA. No significant associations were observed between CRF levels and HRQoL. Schoolchildren reporting PA of at least 60 min on at least 6 days a week (the recommended minimum) report higher HRQoL than their peers with lower PA levels.

Background Albendazole is one of two standard drugs for the control of soil-transmitted helminthiasis. Methods A total of 149 schoolchildren from Port Elizabeth, South Africa, were examined for soil-transmitted helminth infections using duplicate Kato-Katz thick smears before and 2 weeks after administration of albendazole (400 mg). Results Trichuris trichiura was the predominant soil-transmitted helminth species (prevalence 60.4%), followed by Ascaris lumbricoides (47.7%). While albendazole was highly efficacious against A. lumbricoides (cure rate [CR] 97.2%; egg reduction rate [ERR] 94.3%), it lacked efficacy against T. trichiura (CR 1.1%; ERR 46.0%). Conclusions Our study confirms low efficacy of single dose albendazole against T. trichiura. There is a need for safe and efficacious drugs against T. trichiura.

Obesity-related conditions impose a considerable and growing burden on low- and middle-income countries, including South Africa. We aimed to assess the effect of twice a 10-week multidimensional, school-based physical activity intervention on children&rsquo, s health in Port Elizabeth, South Africa. A cluster-randomised controlled trial was implemented from February 2015 to May 2016 in grade 4 classes in eight disadvantaged primary schools. Interventions consisted of physical education lessons, moving-to-music classes, in-class activity breaks and school infrastructure enhancement to promote physical activity. Primary outcomes included cardiorespiratory fitness, body mass index (BMI) and skinfold thickness. Explanatory variables were socioeconomic status, self-reported physical activity, stunting, anaemia and parasite infections. Complete data were available from 746 children. A significantly lower increase in the mean BMI Z-score (estimate of difference in mean change: &minus, 0.17, 95% confidence interval (CI): &minus, 0.24 to &minus, 0.09, p &lt, 0.001) and reduced increase in the mean skinfold thickness (difference in mean change: &minus, 1.06, 95% CI: &minus, 1.83 to &minus, 0.29, p = 0.007) was observed in intervention schools. No significant group difference occurred in the mean change of cardiorespiratory fitness (p &gt, 0.05). These findings show that a multidimensional, school-based physical activity intervention can reduce the increase in specific cardiovascular risk factors. However, a longer and more intensive intervention might be necessary to improve cardiorespiratory fitness.

Zusammenfassung Es wird uber den seltenen Fall eines extraskelettalen myxoiden Chondrosarkoms am Fus berichtet. Die betroffene Patientin stellte sich wegen einer an Grose langsam zunehmenden nicht schmerzhaften Schwellung im 4. Intermetatarsalraum unter der Primardiagnose eines Ganglions zur Excision vor. Histologisch konnte eine extraskelettale Manifestation eins myxoiden Chondrosarkoms beschrieben werden. Anhand der Literatur wird auf die Besonderheiten dieser seltenen Neubildung eingegangen. Da bei extraskelettalen Chondrosarkomen mit einer Rezidivrate von bis zu 50% gerechnet werden muss und sie zudem meist weder strahlensensibel noch einer Chemotherapie zugangig sind, muss die primare Resektion den Tumor komplett entfernen. Eine konsequente Nachsorge in Zusammenarbeit mit einem onkologischen Zentrum sollte gewahrleistet sein. In der uberwiegenden Zahl der Falle sind tumorose Neubildungen am Fus benigner Natur. Dennoch sollten Resektionen nach Moglichkeit den Prozess en bloc entfernen, um die Therapiechancen bei uberraschend bosartigen Befunden nicht zu mindern.

Zusammenfassung Die Lapidusarthrodese ermoglicht die korrigierende Stabilisierung des ersten Strahls bei mittel – bis schwergradiger Hallux valgus Fehlstellung. Auch wenn der Begriff der Instabilitat des ersten tarsometatarsalgelenks (TMT I) in der Literatur noch nicht eindeutig und reproduzierbar definiert werden konnte, erscheint deren Berucksichtigung fur die Korrektur des Hallux valgus bedeutsam. Die Einfuhrung der winkelstabilen Plattenosteosynthese hat zu einer fruheren Belastbarkeit der Arthrodese bei gleichzeitiger Verringerung der Pseudarthroserate gefuhrt. Es werden die modernen Techniken der Durchfuhrung dieser Operation sowie die Ergebnisse und Komplikation eines konsekutiven Patientengutes einer spezialisierten Fachklinik vorgestellt.

Background As traditional lifestyle and diets change with social and economic development, disadvantaged communities in low- and middle-income countries increasingly face a double burden of communicable and non-communicable diseases. We studied the relationship between physical fitness and infections with soil-transmitted helminths (STHs), intestinal protozoa and Helicobacter pylori among schoolchildren in Port Elizabeth, South Africa. Methods We conducted a cross-sectional survey among 1009 children, aged 9 to 12 years, from eight primary schools in socioeconomically disadvantaged neighbourhoods of Port Elizabeth. Physical fitness was determined using field-deployable tests of the Eurofit fitness test battery. Stool samples were analysed with the Kato-Katz thick smear technique to diagnose STHs and with rapid diagnostic tests (RDTs) to detect intestinal protozoa and H. pylori infections. Haemoglobin (Hb) levels were assessed and anthropometric indicators determined. Results Complete data were available for 934 children (92 %). In two schools, high STH prevalences were found (Ascaris lumbricoides 60 and 72 %; Trichuris trichiura 65 % each). For boys and girls co-infected with A. lumbricoides and T. trichiura (n = 155) the maximal oxygen uptake (VO2 max) was estimated to be 50.1 and 47.2 ml kg-1 min-1, compared to 51.5 and 47.4 ml kg-1 min-1 for their non-infected peers (n = 278), respectively. On average, children without helminth infections had greater body mass (P = 0.011), height (P = 0.009) and a higher body mass index (P = 0.024) and were less often stunted (P = 0.006), but not significantly less wasted compared to their peers with a single or dual species infection. Among 9-year-old boys, a negative correlation between helminth infections and VO2 max, grip strength and standing broad jump distance was observed (P = 0.038). The overall mean Hb level was 122.2 g l-1. In the two schools with the highest prevalence of STHs the Hb means were 119.7 and 120.5 g l-1, respectively. Conclusions Intestinal parasite infections appear to have a small but significant negative effect on the physical fitness of infected children, as expressed by their maximal oxygen uptake. We observed a clear impact on anthropometric indicators. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1761-5) contains supplementary material, which is available to authorized users.

In the context of an increasing congestion of air traffic flows worldwide, a high-capacity turboprop transport aircraft was designed at the Institute of Aircraft Design of Technical University of Munich that is specifically aimed at serving short- and mid-range routes. Within the scope of research on the concept, this paper presents a parametric aircraft design tool that was created at the institute to support comprehensive analyses and design iterations of large turboprop aircraft. Through a modular approach, the tool covers a broad range of design-related disciplines including aerodynamics, mass prediction, and propulsion and performance modeling. The tool was employed to examine the institute’s turboprop concept. It revealed critical design features and drivers of the concept. During multiple design loops, parameter variations were carried out, and the aircraft was redesigned until the top-level aircraft requirements and certification constraints were met. Finally, mission performance and fuel efficiency of the revised concept were evaluated with the tool.

In the face of global climate change and steadily increasing energy prices, various private and public stakeholders of the commercial aviation industry have proclaimed ambitious goals aimed at reducing the global fuel consumption and thus mitigating the future environmental impact of aviation. From today’s viewpoint, these goals can only be reached if substantial technological progress is achieved in the various fields of air transportation. Here, the progress in aircraft technologies represents one major enabler. Estimating the impact of nextgeneration aircraft types on the future fuel demand of the global commercial air transport fleet, and analyzing the remaining carbon-emissions reduction gap relative to aviation’s climate goals, are the objectives of this paper. To handle the uncertainty about the future technological progress that affects the global fleet performance, multiple technologyimprovement scenarios are investigated. A numerical model of the global air transport fleet is employed to quantify the fleet-wide fuel demand and carbon-emissions reduction impact and conduct sensitivity analyses. The results obtained clearly indicate that the climate goals of the mid-term future cannot be reached solely by integrating next-generation aircraft types into the fleet. Further measures such as the use of biofuels will equally be required.

The AutoR-project takes a holistic approach to reduce the cost of heliostat fields: Wireless control and energy supply enables to use smaller heliostats which need less steel per mirror area (but usually have high wiring cost). A low cost but high efficient drive system is chosen which reduces energy consumption to a minimum amount and leads to low cost for PV cell and energy storage. The usual boundary layer wind tunnels tests for heliostats are proven regarding energy spectra to avoid oversizing of steel structure and drives or failures because of underestimations of the loads. The concepts for wireless control and energy supply, the wind tunnel investigations and the first rim drive heliostat prototype are presented. © 2015 The Authors. Published by Elsevier Ltd.

Background Socioeconomically deprived children are at increased risk of ill-health associated with sedentary behavior, malnutrition, and helminth infection. The resulting reduced physical fitness, growth retardation, and impaired cognitive abilities may impede children’s capacity to pay attention. The present study examines how socioeconomic status (SES), parasitic worm infections, stunting, food insecurity, and physical fitness are associated with selective attention and academic achievement in school-aged children. Methodology The study cohort included 835 children, aged 8–12 years, from eight primary schools in socioeconomically disadvantaged neighborhoods of Port Elizabeth, South Africa. The d2-test was utilized to assess selective attention. This is a paper and pencil letter-cancellation test consisting of randomly mixed letters d and p with one to four single and/or double quotation marks either over and/or under each letter. Children were invited to mark only the letters d that have double quotation marks. Cardiorespiratory fitness was assessed via the 20 m shuttle run test and muscle strength using the grip strength test. The Kato-Katz thick smear technique was employed to detect helminth eggs in stool samples. SES and food insecurity were determined with a pre-tested questionnaire, while end of year school results were used as an indicator of academic achievement. Principal findings Children infected with soil-transmitted helminths had lower selective attention, lower school grades (academic achievement scores), and lower grip strength (all p, Author summary Children growing up in challenging environments, such as townships in South Africa, are at an increased risk of ill-health associated with sedentary behavior, poor nutrition, growth retardation, and infections with parasitic worms. Negative factors such as limited educational resources, insufficient health care and safety are exacerbating the effects of poverty and, taken together, might cause developmental delays and school failure. A total of 835 school children aged 8–12 years were examined for soil-transmitted helminth infection, physical fitness, selective attention, stunting, household socioeconomic conditions, and food security. Furthermore, children’s academic achievement scores were utilized as a proxy for academic achievement. The multivariate analyses showed that low selective attention was associated with soil-transmitted helminth infection and low shuttle run performance, whereas higher academic achievement was observed in children without soil-transmitted helminth infection and with higher shuttle run performance. Our study suggests that soil-transmitted helminths and low physical fitness hinder children from realizing their full potential.

Frakturen und insbesondere Luxationsfrakturen des Chopart-und Lisfranc-Gelenkes sind insgesamt seltene Verletzungen. In etwa der Halfte der Falle entstehen diese schweren Verletzungen des Fuses bei Polytraumatisierten im Rahmen eines Hochrasanztraumas beim Verkehrsunfall. Aufgrund der Verbesserungen der aktiven und passiven Sicherheitssysteme im Fahrzeug werden schwerste Thorax-und Abdominaltraumata sowie Extremitatenverletzungen uberlebt. Da eine erhebliche Intrusion der Fahrgastzelle auftritt, wird ein hoher Anteil der kinetischen Energie auf den Fusubertragen. Beim Sturz aus groser Hohe fuhrt das Vielfache der Erdbeschleunigung zu schweren Zertrummerungen und Luxationen des Fusskeletts. Gerade beim Polytraumatisierten ist in der Behandlungskaskade dringlicher Versorgungen die Wiederherstellung eines voll gebrauchsfahigen Fuses ein nicht zu vernachlassigendes Ziel. Dies nicht zuletzt, um spatere rekonstruktiv-korrigierende Eingriffe mit nur teilweise befriedigendem Erfolg zu vermeiden. Fusverletzungen sollten daher nicht am Rande des Interesses stehen, sondern verlangen obligatorisch eine detaillierte Diagnostik. In das Therapiekonzept fliest neben dem radiologisch erhobenen Befund ebenso die Beurteilung des Lokalzustandes der Extremitat ein: Durchblutung, Innervation, Weichteilmantel, Knochendefekte etc. Die “Hannover fracture scale” und der MES (mangled extremity severity)-Score sind wichtige Entscheidungshilfen zur Frage der primaren Amputation. Ein Kompartmentsyndrom mus notfallmasig dekomprimiert werden, die definitive Oteosynthese nach Konsolidierung der Weichteile sekundar erfolgen. Die Osteosyntheseverfahren selbst sollen eine fruhzeitige Belastung des Fuses gestatten bei gleichzeitigem Erhalt der Mobilitat der Fusgelenke. Genaue Kenntnisse des Operateurs in der Anatomie des Fuses sowie der Technik der Operationsverfahren sind notwendige Voraussetzungen zur Wiederherstellung eines belastungsfahigen Fuses.

This paper presents the conceptual design of a high-capacity turboprop-driven transport aircraft for short- and medium-range operation. It also depicts the iterative procedure and results of the design process as well as the design methods involved. The aircraft design is based on a market analysis that reveals that the short- and mid-haul markets represent a major fraction of the air transport sector. With two passenger decks and one cargo deck, the turboprop aircraft is intended to operate with a maximum capacity of 420 seats and five tons of cargo over a travel distance of 3,000 km. The design enables operations at airports with underdeveloped infrastructure. Thus, it is especially suitable for fast growing markets in emerging countries. The use of four turboprop engines, each delivering a take-off power of 9.5 MW, enables more energy efficient flight operations on short routes than conventional aircraft types.

A large number and valuable, academic literature on shadow banking has developed since the 2007/8 financial crisis but with different conclusions on the essential factors at work. In the rapidly evolving literature, especially from the United States of America, reviews have been done on the fundamental reasons for the existence of shadow banking, the functioning of shadow banking institutions and activities, the reasoning behind the drive to regulate shadow banking and the impact of financial sector reform efforts on shadow banking credit intermediation.Limited research has, however, been done on the prevalence, the importance and the risks of shadow banking to the financial systems of emerging economies. This thesis contributes to the discussion and on whether shadow banking activities and/or institutions contribute to systemic risk so as to necessitate the need to be regulated in order to maintain stability in the financial markets. Testing the hypothesis that shadow banking leads to increased risks for the formal banking sector will play a significant role to understand potential risks that may arise within financial systems and enable the development of policy and regulatory responses. These are currently unresolved empirical issues. The research focuses on empirical evidence about the presence of shadow banking in South Africa and its impact on the stability in financial markets, emphasizing both microeconomic and macroeconomic perspectives for which there is little empirical evidence in extant literature.

Following complex foot injuries (incidence up to 52%) in the multiply-injured patient the ultimate goal remains the same as for all significant foot injuries: the restoration of a painless, stable and plantigrade foot to avoid corrective procedures with moderate results. In the case of a complex trauma of the foot (5 point-score)--e.g. a crush injury--primary amputation in the multiply-injured patient (PTS 3-4) is indicated. Limb salvage (PTS 1-2) depends on the intraoperative aspect during the second look (within 24-48 hours after injury): the debridement has to be radical, the selection of amputation level should be at the most distal point compatible with tissue viability and wound healing. A free tissue transfer should be done early if necessary. Single lesions presenting with a compartment syndrome need an immediate dorsal fasciotomy, in the case of a multiply-injured patient as soon as possible. Open fractures are reduced following radical debridement and temporarily stabilized with K-wires and/or tibiotarsal transfixation with an external fixateur until the definitive ORIF. Dislocation-fractures of the talus type 3 and 4 according to Hawkins' classification need open reduction and internal fixation by screws (titan). Open fractures of the calcaneus are stabilized temporarily by a medial external fixateur after debridement until the definitive treatment. If there is a compartment syndrome an immediate dermatofasciotomy is essential. Like closed, calcanear fractures in multiply-injured patients dislocation-fractures of the Chopart's joint need immediate open reduction only if it is an open fracture or associated with a compartment syndrome. The incidence of a compartment syndrome in the case of dislocation fractures of the Lisfranc's joint is high and therefore a dorsal dermatofasciotomy without delay is critical. Open reduction and internal fixation are achieved either by 1.8 mm K-wires or 3.5 mm cortical screws. To avoid further soft tissue damage a delayed primary closure can be necessary and a temporary tibio-tarsal transfixation is useful. Despite the life-threatening injuries of the multiply-injured patient one must insist on an exact diagnosis of the foot trauma (radiographs in 3 standard projections: exact lateral, dorso-plantar, 45 degrees oblique) if long-term disability due to articular incongruities and complex derangement of the arc geometry of the foot is to be avoided.

Long product life cycles paired with a high degree of uncertainty about the state of the long-term future make the product development process very challenging in the aviation industry. Future customer needs and environmental constraints must be anticipated, which severely increases the risk of failure when developing a new product. This paper presents a scenario-based approach to product development with the goal to better handle uncertainty and mitigate the risks. By exemplarily exploring the potentials of a more personalized air transport system, three alternative future scenarios in 2050 are created. The subsequent derivation of high-level requirements reveals a clear individualization trend of the mobility needs of future customers. Two key customer groups are determined: elderly people whose travel plans are merely motivated by leisure activities, and businesspersons who require a flexible and reliable air transport system with reasonable trip costs. Concepts of operations that were specifically developed for each scenario to meet the respective market constraints and customer needs expose a high potential of a more automated transport system that is able to seamlessly combine several transport modes without the traveler’s interference.

Reconstructive osteotomies for the treatment of Hallux valgus are among the most prevalent procedures in foot and ankle surgery.The combination of biodegradable materials with an innovative method for fixation by application of ultrasonic energy facilitates a new bonding method for fractures or osteotomies. As clinical experience is still limited, the aim of this study was to assess the safety and performance of the SonicPin system for fixation of Austin/Chevron osteotomies.Chevron osteotomy was performed on 30 patients for the treatment of Hallux valgus. The used SonicPins were made from polylactide and are selectively melted into the cancellous bone structure during insertion by ultrasonic energy. Patients were followed for one year, which included X-ray and MRI examinations as well as evaluation of life quality by EQ-5D (EuroQol).The MRI after three months showed adequate bone healing in all cases and no signs of foreign body reactions, which was again confirmed by MRI 12 months postoperatively. The bony healing after 12 months was uneventful without any signs of foreign body reactions.In summary, based on the low complication rate and the significant improvement in health related quality of life (EQ-5D) reported in this study, fixation of an Austin/Chevron osteotomy with a SonicPin for treatment of Hallux valgus can be considered to be safe and efficient over the short term.Level of Clinical Evidence:Therapeutic Level III.

In the face of ambitious mitigation policies of the environmental impact of the civil air transport industry, this paper proposes an integrated technique for the assessment of future aircraft technologies in order to determine the impact at fleet-wide level these technologies actually have. With the help of scenario planning methods, three different future scenarios are developed, defining alternative growth rates of the air transport market. The core of the proposed technique is a fleet system dynamics model that is able to dynamically calculate the time and market-specific fleet size, composition, and age distribution, taking the scenario-specific market growth rates as input data. Preliminary results of the study presented reveal the major future aircraft sales markets, as well as the market size for future aircraft generations such as the A320neo/B737max aircraft. In addition, fleet-level performance calculations quantify the increase in fuel efficiency that is required to reach the system-wide CO2 emission targets set by the Air Transport Action Group.

Fractures of the talus are uncommon, counting for only about three thousandths of all fractures and 3% regarding the foot skeleton.1 Within this small entity, 10–15% peripheral talar fractures occur. Yet they are of major importance because of the frequency of complications and the resulting long-term disability when initial treatment is delayed or improper.2 Timely diagnosis and early treatment as well as minimally invasive techniques have improved the overall results. Still these injuries represent a demanding challenge concerning proper diagnosis, decision making, and surgical approach even for the experienced foot surgeon dealing with trauma cases.3,4

According to Fick, the three-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the ankle-foot unit: the upper ankle joint, the posterior lower ankle joint and the anterior lower ankle joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction as well as in selective foot arthrodeses.

Increased health risks associated with physical inactivity in the Black population have been reported in recent years. Black women, suffering the highest levels of inactivity, overweight and obesity, are at greatest risk of developing chronic diseases of lifestyle. This explorativedescriptive study investigated the physical activity patterns and health status of two generations of Black professional women, reflecting pre-democracy and post-democracy age groups. Quantitative measures were used, including the ActiGraph GT1M accelerometer, the Global Physical Activity Questionnaire and the Health-Promoting Lifestyle Profile. Sample groups comprised teachers, nurses, social workers and public sector managers. Participants aged between 35 and 45 years were allocated to the older generation group (n = 111), whilst those aged between 18 and 21 years (students in the mentioned professional fields) were allocated to the younger generation group (n = 69). The results indicated that these women displayed lower levels of health-promoting behavioural practices than expected, significantly lower levels of physical activity and significantly higher levels of overweight and obesity than the South African norms. The observation that the younger group appeared to be replicating the patterns of the older women is a cause of concern. Greater compliance to health-promoting behaviours was expected in this group owing to participants’ professional involvement in health, education and social development fields. Wide-ranging initiatives are necessary to promote physical activity and health amongst the Black female population in South Africa.Opsomming Gedurende die afgelope jare het navorsing onder die Swart bevolking ʼn toename in gesondheidsrisiko’s wat met fisieke onaktiwiteit geassosieer is, getoon. Swart vroue, wat die hoogste vlakke van onaktiwiteit, oorgewig en obesiteit toon, blyk ook die grootste risiko te loop om leefstylverwante chroniese siektes te ontwikkel. Hierdie ondersoekendbeskrywende studie het die fisieke aktiwiteitspatrone en gesondheidstatus van twee generasies van Swart professionele vroue ondersoek. Die tweegenerasiesteekproef verteenwoordig voor- en na-demokrasie-ouderdomsgroepe. Kwantitatiewe meetinstrumente, naamlik die ActiGraph GT1M versnellingsmeter, Globale Fisieke Aktiwiteitsvraelys en die Gesondheidsbevorderende Leefstylprofiel is gebruik. Die steekproef het onderwysers, verpleegkundiges, maatskaplike werkers en bestuurders in die openbare sektor ingesluit. Deelnemers tussen 35 en 45 jaar is aan die ouergenerasie-toetsgroep toegewys (n = 111), terwyl dié tussen 18 en 21 jaar (studente in bogenoemde studierigtings) aan die jongergenerasietoetsgroep toegewys is (n = 69). Die resultate het gewys dat die Swart professionele vroue laer as verwagte gesondheidsbevorderende gedrag, betekenisvol laer vlakke van fisieke aktiwiteit en betekenisvol hoër vlakke van oorgewig en obesiteit toon as die Suid-Afrikaanse norme. Die waarneming dat die jonger groep dieselfde gedragspatrone as die ouer vroue getoon het, is ʼn bron van kommer. ʼn Groter nakoming van gesondheidsbevorderende gedrag is onder die jonger groep vroue verwag, aangesien hulle hul opleiding in die professionele sektor van gesondheid, onderwys en maatskaplike werk ontvang. ʼn Holistiese benadering is nodig om fisieke aktiwiteit en gesondheid onder Swart Suid-Afrikaanse vrouens te bevorder.

Objective. To compile an injury profile of 46 fast bowlers aged 11 - 18 years, and to identify the associated risk factors for injury during one academy cricket season. Methods. The fast bowlers selected were tested and observed for one academy cricket season (March - November). Subjects were grouped into injury classifications (uninjured=S1; injured but able to play=S2; injured and unable to play=S3). Anthropometrical and postural data for the subjects were collected preseason (T1). Physical fitness screenings were conducted and the relationship between fitness and occurrence of injuries was assessed. Additional factors such as bowling techniques and bowling workload were assessed. A regression analysis was conducted to analyse the relationship between bowling workload and weeks incapacitated. Results. Fifteen per cent of the subjects remained injury free for the duration of the season. The incidence of serious injury (S3) showed a statistical and moderate, practical significant increase (V=0.23, df≥2) throughout the data collection period (4% at T1 - 30% at T3 (post-season)). The most common injuries were to the knee (41%) and lower back (37%), occurring from mid-season (T2) to T3. The nature of the injuries was predominantly strains (39%) and ‘other' (39%), with the highest reported incidence during the period T1 - T3. Sprains followed, with an overall incidence of 14%. Subjects were incapacitated approximately 1 out of every 7 weeks of play. The S1 and S2 bowlers performed consistently better than the S3 bowlers in all the fitness variables tested. Bowling workload presented a statistically significant (p South African Journal of Sports Medicine Vol. 20 (4) 2008: pp. 115-118

Projects that fail, for whatever reason, can impact negatively on society, organisations, and other stakeholders. A number of researchers have identified various critical success factors (CSFs) that can influence the outcome and success of a project. This research therefore aims to determine the CSFs that influence various success measures of small- to medium-sized projects at a South African mining company, Exxaro Resources’ Grootegeluk Coal Mine. Other objectives of this research include determining the extent of the impacts of these CSFs on the different success measures of a project. The investigation suggests that there are correlations among CSFs, and that certain factors impact the outcome of projects far more than others. This research finds that the single most important CSF for small- to medium-sized projects is the selection of a competent project manager. The competent project manager is characterised by a group of interrelated CSF factors: good leadership, commitment, and learning from past experiences. Based on the research results, other CSFs are discussed and explored in order for recommendations to be made on how this mining company, and possibly other organisations, can achieve greater project success.

Thalidomide was administered to 83 patients with myelodysplastic syndrome (MDS), starting at 100 mg by mouth daily and increasing to 400 mg as tolerated. Thirty-two patients stopped therapy before 12 weeks (minimum period for response evaluation), and 51 completed 12 weeks of therapy. International Working Group response criteria for MDS were used to evaluate responses. Intent-to-treat (ITT) analysis classified all off-study patients as nonresponders. Off-study patients belonged to a higher risk category (P =.002) and had a higher percentage of blasts in their pretherapy bone marrow than patients who completed 12 weeks of therapy (P =.003). No cytogenetic or complete responses were seen, but 16 patients showed hematologic improvement, with 10 previously transfusion-dependent patients becoming transfusion independent. Responders had lower pretherapy blasts (P =.016), a lower duration of pretherapy platelet transfusions (P =.013), and higher pretherapy platelets (P =.003). Among responders, 9 had refractory anemia (RA); 5 had RA with ringed sideroblasts; and 2 had RA with excess blasts. By ITT analysis, 19% of patients (16 of 83) responded, and when only evaluable patients were analyzed, 31% (16 of 51) responded. It was concluded that thalidomide, as a single agent, is effective in improving cytopenias of some MDS patients, especially those who present without excess blasts. (Blood. 2001;98:958-965)