Dissertations / Theses: 'Urban cohorts'

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Ng, Michael Kwok Keung. "The Urban Cohorts." Thesis, Royal Holloway, University of London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.504816.

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This thesis examines the Urban cohorts, part of the Rome garrison under the Roman Empire, and explores the genesis of the corps as well as their history and role throughout successive dynasties. Chapter 1 describes the Urban prefecture and the creation of the permanent Urban prefecture, as one of the Augustan reforms related to the Urban cohorts. As a whole, this work will encompass the history of the Urban cohorts from their inception under Augustus to their disappearance/probable demise in the early 4th century under Constantine the Great in chapters 2 and 4-7. Chapter 3, follows chapter 2 (the Augustan and Tiberian Urban cohorts) with a discussion on the organisation ofthe corps. Chapter 8 examines the creation and deployment of two Urban cohorts from Rome to the provinces (Gaul and Africa). A discussion of the recruitment patterns and role of the Urban cohorts follows this chapter and examines the recruitment of the Urban cohorts before and after the Severan period when major changes took place in the Rome garrison during the 3rd century. Throughout the thesis, 'there will be a re-examination of previous arguments about the corps as well as are-appraisal of their role within the city of Rome and the role they may have played within Imperial politics. The evidence comprises both epigraphic and literary materials and have been used to elucidate matters of organisation and the role ofthe Urban cohorts. The thesis will contain an epigraphic commentary that updates the existing corpus of epigraphic material and a short section on the equipment of the Urban cohorts.

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Ikehara, Elizabeth Slack. "A Comparison of Socio-Political Attitudes of Older Urban Women: The 1910-1924 Cohorts." PDXScholar, 1991. https://pdxscholar.library.pdx.edu/open_access_etds/1342.

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The central theme of this study is that because of the changing life styles and the macro-events which occurred after World War I these years were a watershed. The women born in the three five-year cohorts from 1910 through 1924 were at different stages of maturity and awareness as particular economic and political events occurred. The social and political climates were different for each of these cohorts of women. Therefore there would be discernible differences in attitudes and opinions among the cohorts. A literature review indicated three models for the formation of social attitudes and political opinions. The "Personality Types" is based on the premise that attitudes formed early in life remain fixed. The "Aging/Conservative" model considers that attitudes become increasingly conservative as the person ages. This study, however, was based on the "Historical Change" model. Beliefs and attitudes may change in response to personal experiences throughout the life course. Four research questions were developed. 1. How have macro-events affected the life experiences of women in these cohorts? 2. How have social pressures affected their experiencing of employment, matrimony, and motherhood? 3. How do the opinions of women in these three cohorts with regard to social and political issues differ and change? 4. Can differences of opinions among the women of the three cohorts be traced to dissimilarities in life experiences? Census data literature was researched to provide background documentation on technological and demographic changes in the United States during the 20th century. Questions for cohort comparisons were selected from the National Opinion Research Council Surveys of 1972 through 1989. These considered individual and family demographics, labor force participation, social attitudes, and political orientation. For the 2,814 respondents analysis was done by five-year cohorts to determine differences and by six-year periods to point out trends. Both ANOVA and Chi-square were used to verify statistical significance. Focus group sessions, with 41 participants, met at senior centers and housing units in the Portland metropolitan area. A questionnaire completed by each participant confirmed that the focus group demographics corresponded to those of the national sample. Individual life experience time lines provided material for opening the discussion. Other discussion topics were based on differences noted among the three cohorts in the NORC data analysis. These were in the areas of education, work experience, family life patterns, political orientation, and attitudes toward societal changes. A brief finding for each research question follows. 1. NORC data indicated that each successive cohort held increasingly liberal sociopolitical opinions, and that women of all three cohorts became less conservative over the years. The focus group participants related these changes to specific macro-events in their life experiences. 2. Focus group discussions disclosed that the 1910-1914 cohort realized later in life that societal pressure had limited their educational achievement. Women of the 1915-19 cohort came to understand that their acceptance of the homemaker role was somewhat based on societal expectations. The 1920-24 cohort were aware that discrimination in the work arena was based on societal norms of the time. 3. Analysis of both NORC data and opinions expressed in the focus groups indicated that each successive cohort was increasingly broadminded and tolerant. 4. The women participating in the focus groups exhibited an awareness of the differential effects of life experiences. They specified the effects of macro-events (chiefly the Great Depression), education, mobility, and workforce participation. This research has tentatively confirmed that a generational watershed occurred for women born before World War I and those born after. As the women of the 1910 through 1924 cohorts matured they experienced differing social and political climates. This resulted in cohort differences. Further investigation may reveal more precise cohort boundaries for the 1910 through 1924 years. It should be remembered also that cohort boundaries for men may not coincide with those of women.

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Sun, Yilin. "Lifecycle Stage, Automobility Cohort and Travel: Probing into Structural Change in Urban Travel." 京都大学 (Kyoto University), 2009. http://hdl.handle.net/2433/85387.

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The mobility of urban residents has been expanding over time. Kitamura and susilo (2005) have shown that this expansion stems more from structural change (i.e. change in the relationship between travel behavior and demographic factors), than from change in demographic and socio-economic characteristics (for example, attributes of the individuals and households, such as, more women employed, the household size shrinking, and the resident population aging) of urban residents. Urry (2005) went to conjecture that this structural change is due to increasingly prevailing automobility, i.e., conversion of social and economic system and way of life to adapt to the ownership and use of the automobile. In this study, this conjecture is explored by examining automobility characteristics across lifecycle stages and across automobility cohorts over time. The level of automobility is operationally defined in this study in terms of: automobile ownership, total auto travel time, modal split, and the fraction of trip attraction in traditional central city in the study area. The Kyoto-Osaka-Kobe (Keihanshin) metropolitan area of Japan is the study area of this effort. Intra-household interaction has dominant influences on household members' activity and travel, and also it is closely associated with lifecycle stage. Lifecycle stage factor is introduced into the analytical scope of this study and regarded as a main factor through this research. Nine stages of household lifecycle are formulated according to the classification scheme of the family lifecycle stage. The classification scheme utilizes the criteria, which generally are age and marital status of household head, presence and age of children of head, presence of other relatives and non-relatives. On the other side, changing the built environment affects urban residents' travel behavior to a large extent. This study explores how automobility characteristics and travel activity behavior changed across lifecycle stages within different residential areas over time using statistical analyses. The results confirm that the residence area rather than lifecycle stage is a significant explainer for automobile ownership and automobile use. It further suggests that even within each lifecycle stage, change in the automobile use over time is suppressed in commercial and mixed commercial/residential areas. However, the fraction of automobile trips for suburbs, unurbanized areas, and autonomous areas increased over time in the range of 0 to 4 times depending on the lifecycle stage. Younger childless couple stage and all adults' stage are more auto-oriented in suburbs, unurbanized area, and autonomous areas, and this trend becomes stronger as automobility progresses. No significant differences were observed in the numbers of trips for households of the same lifecycle stage across different residential areas, suggesting that similarly active lifestyles exist. The results suggest that household members' age is also a strong explainer for the fraction of auto trips and total auto travel time, through a four variable ANOVA analysis, including lifecycle stage, residence area, time, and age effect. It has been pointed out that the elderly of these days behave differently than the elderly grew up with the automobile and have been using it ever since their habit forming ages. Thus another important factor introduced into this research is automobility cohort which is defined by grouping individuals who turn 20 years old during the time period indicated. Each time period is chosen with respect to the level of automobility. The following five cohorts are developed for the study area and used in the analysis: pre-war (up to 1945), pre-motorization (1946-1960), initial growth (1961-1970), mass-ownership (1971-1980), and multi-car ownership (1980-). Using the repeated cross-sectional data of Kyoto-Osaka-Kobe metropolitan area in 1970, 1980, 1990, and 2000, this study has attempted to offer a possible explanation of the increases in automobility characteristics by examining automobility characteristics of automobility cohorts. In addition, time effects and age effects are introduced into the analysis as in standard cohort analysis. It focused on statistical age-period-cohort analysis using the popular multiple classification APC model. The identifiability problem attendant with the use of APC model was discussed with repeated cross-sectional data. An interesting finding is shown that pre-war and pre-motorization cohorts show little, roughly 6%, increase on the fraction of auto trips and nearly unchanged on total auto travel time over 1970 through 2000, although their household automobile ownership has increased more than 2 times. Initial growth, mass-ownership, and multi-car ownership cohorts show a great growth of automobile ownership, the fraction of auto trips, and auto travel time from 1970 to 2000, but a little surprising result is that mass-ownership cohorts, not multi-car ownership cohorts, show the largest increases to rely on auto use over 1970 through 2000. The above results confirm that each cohort having certain automobility traits that are unique, especially in terms of auto use. The standard age-period-cohort analysis confirms that automobility cohort effect do exist, unfortunately, automobility cohort effect is not an important explainer for automobility characteristics, while time effect plays an important part in automobile ownership choice, and age effect mainly determines automobile use. An attempt at APC-RA model illustrate that residence area rather than time effect have the strongest impact on automobile ownership, and age effect is still a significant explainer for the fraction of auto trips and auto travel time. This result is different with the results of age-period-cohort analysis, which further emphasize that residence area is a significant explainer for household automobile ownership in the Kyoto-Osaka-Kobe metropolitan area from 1970 to 2000. Significant changes in demographic and socio-economic characteristics of urban resident have taken place over the past several decades. Most notable are: aging of the population and resulting increases in retired, non-employed individuals; decreasing household size caused by increasing fractions of single individuals and couples with fewer children; increased labor force participation by women; general increased in income; and increasing auto ownership and auto dependence. The overall effects on travel of these changes are complex and future trends are not immediately obvious, partly because some of the changes have opposite, cancelling effects on travel, and partly because these changes themselves are not independent but closely linked to each other. Prevailing tendencies in travel, however, have been expansion—urban residents' travel has continuously expanded over time in terms of total travel time (or distance), auto use, energy consumption, and the spatial extension of their action space. Will these trends continue into the future? Or will the trend change due to the aging of the urban population? Or are there other factors at work? If so, what are the magnitudes of demographic effects relative to theirs? The focus of this study is on auto travel. The analysis examines how auto travel has changed over time with changing demographics, residential location, and metropolitan structure. Simultaneous equations model systems are developed at the household level, with auto ownership, fraction of auto trips and total auto travel time as its dependent (or endogenous) variables. Their automobility characteristics are characterized and behavioral distinction identified through examination of the models' coefficient estimates. Using the repeated household travel survey results, the stability over time of the simultaneous equation system is statistically examined, and thereby the effects of demographics changes are separated from those of structural change. Using the results, it is shown how much of the change in urban auto travel is due to changes in demographics and how much is due to structural change. The statistical analyses have offered strong evidence that urban residents' auto use have been expanding. The results have further indicated that this expansion has been caused primarily by changes in the structural relationships even mixed changes in demographic factors have had opposite, cancelling effects on auto travel. In addition, the resultant model system is applied in a scenario analysis to forecast possible changes in future auto travel that will follow hypothetical demographic changes in the metropolitan area. To face the coming global energy crisis and air pollution issues, the above results with the findings of this study would suggest that significantly more sustainable behavior for society would be possible with more compact built environments that facilitate non-motorized and public transit travel. Unfortunately, it takes time, money, resources, and the political will to change the built environment and initial steps that educate the public such as voluntary travel behavior change may be necessary first steps on the move to more sustainable travel. As a suggestion for future works, more statistical analysis on interaction effects of three variables or four variables ANOVA analysis, including lifecycle stage, residence area, time, and age effects, need to be considered. Also, the interaction effects of age-period-cohort analysis need us to pay more attention on the future work. The simultaneous equations model system is developed as an attempt to explore how much of the change in urban travel is due to changes in demographics and how much is due to structural change, more endogenous variable could be considered in the future research, such as, residential location, commute distance, and commute trip mode choice.
Kyoto University (京都大学)
0048
新制・課程博士
博士(工学)
甲第14925号
工博第3152号
新制||工||1473(附属図書館)
27363
UT51-2009-M839
京都大学大学院工学研究科都市社会工学専攻
(主査)教授藤井聡, 准教授吉井稔雄, 准教授宇野伸宏
学位規則第4条第1項該当

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Ampleman, Matthew D. "Inhalation and dietary exposure to PCBS in urban and rural cohorts via congener-specific airborne PCB measurements." Thesis, University of Iowa, 2014. https://ir.uiowa.edu/etd/1532.

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Polychlorinated biphenyls (PCBs) are a group of 209 persistent organic pollutants, whose documented carcinogenic, neurological and respiratory toxicities are expansive and growing. Existing inhalation estimates demonstrate ubiquitous exposure to World Health Organization (WHO) indicator PCBs and limited other PCB congeners in North America and Europe. However, inhalation exposure estimates of most lower-chlorinated congeners are lacking, and continuing release of PCBs from urban areas demands location-specific assessments of PCB exposure in ambient air and contaminated environments. Using paired indoor and outdoor airborne PCB measurements and activity questionnaires from the AESOP Study, we assess congener-specific exposure rates for adolescent children and their mothers in East Chicago, Indiana and Columbus Junction, Iowa. Our cohorts of 129 (EC) and 135 (CJ) and our detection of 202 individual congeners and coelutions allows unprecedented quantification of congener-specific inhalation exposure, which we compare to dietary exposure using Total Diet Survey PCB concentrations. ∑PCB inhalation is greater for children than for their mothers in both locations, and is greater for East Chicago mothers and children than for Columbus Junction mothers and children, respectively. Schools attended by AESOP Study children have higher indoor PCB concentrations than do homes, and contribute to more than half of children's inhalation PCB exposure. Inhalation of the potentially neurotoxic congeners PCB 11, 40/41/71, and 51 was apparent among individuals at each location. Additional, congener-specific and biological inferences are possible via comparison with sera-based PCB concentrations for these cohorts.

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Koh, Wen Xin. "Polychlorinated biphenyls and their hydroxylated metabolites in human serum from urban and rural cohorts in the United States." Diss., University of Iowa, 2015. https://ir.uiowa.edu/etd/5793.

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In this dissertation, concentrations of 209 polychlorinated biphenyl (PCB) congeners and 64 hydroxylated PCB (OH-PCB) congeners were determined in 97 adolescents and 86 mothers living in East Chicago, Indiana and Columbus Junction, Iowa. Sera of the participants were collected between April 2010 and March 2011. PCBs and OH-PCBs in human sera were extracted, separated and quantified using gas chromatography tandem mass spectrometry (GC-MS/MS). A quality control protocol was established to ensure data quality during extraction and analysis processes and to affirm the data were representative, accurate, reproducible and precise. Total PCB concentrations in 164 participants’ sera ranged from 0.021 – 4.683 ng/g fresh weight (f.w.). Associations between the concentration of total 209 PCBs, along with the concentration of an additional 30 individual PCB congeners, and socio-demographic characteristics (age, gender, ethnicity and community of residence), body mass index and breastfeeding history were examined. Total PCB concentrations were significantly higher in older mothers and significantly lower in mothers who experienced longer breastfeeding duration. Columbus Junction adolescents had significantly higher total PCB concentrations than East Chicago adolescents. Associations were also found to be congener-specific. Lower-chlorinated congeners were significantly associated with environmental factors such as community of residence. Host factors such as age, gender, body mass index and breastfeeding history were significantly associated with higher-chlorinated PCBs. Non-Aroclor PCBs, PCBs that were not found in Aroclor commercial mixtures, were measured in sera of the participants. Concentration of total non-Aroclor PCBs among 175 participants ranged from none-detected to 0.288 ng/g f.w. Their concentrations were found to account for an average of 10% (up to 50%) of the overall concentration of total 209 PCBs in human serum. Moreover, an average of 50% of these concentrations may be due to exposure of paint pigments. PCBs 11, 14, 35 and 209 were the major dominating and most frequently detected non-Aroclor PCB congeners in the samples. Adolescents had significantly lower concentrations of total non-Aroclor PCBs than mothers regardless of their community of residence. In addition, total non-Aroclor PCBs were significantly higher in Columbus Junction community. Among the 64 OH-PCB congeners, 58 of them were detected in serum of 159 participants and ranged from 0.017 – 0.324 ng/g f.w. Total OH-PCB concentrations were significantly lower in adolescents in both communities. Lower-chlorinated OH-PCBs were found to be less frequently detected in serum. Besides that, a few rarely reported OH-PCBs (4, 4’-diOH-PCB 202, 4’-OH-PCB 208, 4-OH-PCB 163, and 3’-OH-PCB 65) were measured an highly detected in the samples. Apart from that, 3’-OH-PCB 65 was discovered for the first time in human serum. Evidence showed possible direct environmental exposure of this congener instead be the result of regular PCB metabolism. Furthermore, concentrations of 4-OH-PCB 107 and 4-OH-PCB 187 in human serum changed significantly over 3-year evaluations. The research findings of this dissertation indicate the importance of congener-specific PCB analysis to examine their association with different host and environmental factors. Results of these studies further emphasize the importance of assessing potential toxicity of non-Aroclor PCBs and their adverse health effects to the general population. Thus, studies have significant implications for future human risk assessment.

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Redaelli, Davide. "I veterani delle milizie urbane in Italia e nelle province di lingua latina. Indagine storico-epigrafica." Doctoral thesis, Università degli studi di Trieste, 2015. http://hdl.handle.net/10077/11103.

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2013/2014
Le coorti pretorie, le coorti urbane e gli equites singulares Augusti costituivano i corpi d'élite dell'esercito romano per via di un reclutamento selezionato e di un trattamento privilegiato rispetto alle altre unità. Lo studio si propone di indagare il fenomeno del veteranato di queste tre formazioni in un arco di tempo che va da Augusto all'ascesa di Diocleziano e in uno spazio che copre l'Italia, con l'esclusione di Roma e del suo suburbio fino al X miglio, e le province di lingua latina. L'indagine si basa sull'esame della documentazione epigrafica nella quale lo status di veterano di uno o più personaggi menzionati nel testo è sicuro e l'appartenenza ad uno dei tre corpi analizzati è certa o molto probabile. Il lavoro si divide in due parti: nella prima vi è un commento ad ogni singola testimonianza, nella seconda vengono svolte considerazioni di carattere generale sui veterani delle milizie urbane. Tali considerazioni scaturiscono da una visione complessiva della documentazione. Si vuole tentare in questo modo di rispondere a interrogativi riguardanti i rapporti sociali e l'integrazione di questi veterani nelle comunità scelte come residenza dopo il congedo, la loro partecipazione alla vita civica e le attività economiche cui si dedicavano. Una particolare attenzione è rivolta a riconoscere quanti veterani decidevano di rientrare in patria o di stabilirsi in località diverse da quelle natie e le motivazioni che guidavano tale scelta, la loro provenienza e la loro estrazione sociale.
Due to a preferential treatment and special recruitment among the military units, praetorian guard, urban cohorts and equites singulares Augusti were the élite troops of ancient roman army. This research aims to investigate the social and material life of the veterans of this élite troops, in a period of time included between Augustan age and Diocletian rise. It also considers a territory including Italy, except Rome and its suburbs until the tenth mile, and latin speaking provinces. This work is based on an epigraphic documentation in wich the veteran status of one or more subjects is proven and the belonging to one of the three élite corps is certain or probable. The research is divided into two parts. In the first part an analysis and a description is made for each documentary source. In the second part, general considerations are expressed about the veterans of urban militias. These considerations stem from an accurate documentation overview. The purpose is to answer questions regarding the integration and social relations between veterans and the community chosen to live with after the disbandment or, for example, the activities and the role of a veteran in civic and economical life. Specific attention is also paid to the territorial origin, social background and about the choice, made by a veteran, to return home or settle elsewhere after the service.
XXVII Ciclo
1986

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Murray, Elaina, Kate E. Beatty, Louise H. Flick, Michael Elliot, Lisa V. John, Vetta Thompson-Sanders, Allison King, et al. "Maximizing Retention in an Urban Prospective Cohort Study." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6857.

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BACKGROUND: Retaining participants in multi-year prospective cohort studies presents challenges, especially in urban settings. Early identification of participants at risk for attrition may enhance retention. We examine the validity of two risk for loss-to-follow-up assessments and early retention efforts in one Primary Sampling Unit during the National Children’s Study pilot. Our goal was to identify cases requiring additional attention. Retention challenges included high poverty, frequent moves, lack of spousal support, and mistrust of research. METHODS: Recruitment ended in 2012 and research activities shifted to retention. Data collectors (DC) completed subjective risk assignments (low, medium, high) based on knowledge of participants. Descriptive statistics compared risk assessments to socio-demographic characteristics, responses regarding participation, and missed appointments 11 months after risk assessment. RESULTS: We recruited approximately 100 participants. Higher perceived risk was associated with greater likelihood for mothers to be minorities, younger, and have lower education and income (X2=15.362, p<.01; X2=12.118, p<.05; X2=9.947. p<.01; and X2= 7.720, p<.05 respectively). Participants with income below federal poverty placed higher values on receiving incentives (X2= 6.011 p<.05). African American or “other” race participants placed a higher value on feeling comfortable with the interviewers than White respondents (X2=12.539 p<.01). Risk assignment and race were associated with number of missed appointments (X2=8.698 p<.01; X2 =4.307, p<.05). CONCLUSION: Results suggest DCs’ subjective assessment of risk predicts number of missed appointments. Future research might consider strategies to improve African American and “other” race participants’ comfort with interviewers. The ethics of dollar amounts for incentives among low-income participants remain a concern.

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Jones, Laura Louise. "Determinants of pubertal development in an urban South African cohort." Thesis, Loughborough University, 2008. https://dspace.lboro.ac.uk/2134/11602.

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Age at the initiation of puberty and at menarche are key maturational indicators. They reflect health both within and between populations; in that a declining average age is associated with improving health, nutrition, and socio-economic conditions. Knowledge of the timing of pubertal development and menarche is important as earlier development within a population, in particular, has been linked with an increased risk of negative sequelae including overweight and obesity, development of risk factors for non-communicable diseases such as hypertension and insulin resistance, and engagement in risk behaviours such as early sexual debut and substance abuse. The main aims of this study were to investigate the timing of, and the early life factors (such as body composition and growth velocities) associated with pubertal development and age at menarche in Black and White urban South African adolescents. Mixed-longitudinal data (n = 401) from the Birth to Twenty (Bt20) birth-cohort study, initiated in 1990 and set in SowetoJohannesburg, South Africa were used. Median age at the initation of puberty and at menarche was derived by fitting logistic curves to cumulative frequency plots. Logistic regression models were constructed to examine the early life predictors of the timing of puberty and menarche. Data were also collected from adolescents and Bt20 staff (n = 72) using focus groups to explore views on the pubertal development questionnaire used in the Bt20 study. Median age at the initiation of genitalia development was 10.4 years (95% Cl = 8.4, 12.4) for Black boys and 9.8 years (95% Cl = 9.4, 10.2) for White boys. Median age for the initiation of pubic hair development for Black males was 10.8 years (95% Cl = 9.6, 12.0) compared to White males, which was 10.2 years (95% Cl = 8.4, 12.0). Median age at the initiation of breast development in Black females was 10.1 years (95% Cl = 9.3, 10.9) compared to White females which was 10.2 years (95% Cl = 8.2, 12.2). Median age for the initiation of pubic hair was 10.3 years (95% Cl = 9.3, 11.3) and 10.5 years (95% Cl = 8.7, 12.3) for Black and White girls, respectively. Results from logistic regression showed that a greater weight and height velocity in late childhood significantly increased the odds of achieving early breasU genitalia development. Furthermore, a low socio-economic status (SES) index at 9/10 years significantly reduced the odds of achieving early breasUgenitalia development. A greater weight, height, body mass index (BM I), and growth rate during infancy and childhood significantly increased the odds of achieving early pubic hair development. Median age at menarche for Black females was 12.4 years (95% Cl = 12.2, 12.6) and 12.5 . years (95% Cl = 11.7,13.3) for White females. Average menarcheal age for Black girls has declined by 0.56 years per decade and 0.32 years for White girls in South Africa, when comparing the current study findings with those from previous studies. Results from logistic regression showed that being taller, fatter and heavier in late childhood significantly increased the odds of achieving earlier menarche. The focus groups provided a range of opinions relating to the Bt20 pubertal development questionnaire and procedure. The majority of views were positive and included the ease of understanding and completion of the tool. Negative views revolved around the language used and privacy issues. These qualitative results provided a unique insight into the way in which pubertal development data are assessed and how these methods can potentially be improved to enhance the reliability and accuracy of pubertal development data collection. The results from this study provide the most recent estimates of age at the. initiation of puberty and age at menarche for urban Black and White South African adolescents. This is particularly important given the social, nutritional, and economic transition currently occurring in this country as these key maturity indicators reflect population health. This study has also added to our knowledge of the factors that are associated with pubertal development, showing that proximate rather than distal factors are the most sensitive indicators in this urban transitioning environment. In addition, the results from the focus groups provided a unique insight into how pubertal development data are assessed and how these methods could be improved. The negative health outcomes which have been associated with earlier pubertal development and age at menarche are major public health concerns, particularly in the South African context given the HIV/AIDS epidemic and rising levels of obesity. This study highlights the need for renewed research and resources for intervention strategies and policy programmes which target appropriate sex and obesity education in urban South African children.

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Tapia, Villarreal Irving. "Urban form, demography and daily mobility forecasts : comparative analysis France-Mexico." Thesis, Paris 1, 2014. http://www.theses.fr/2014PA010040/document.

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Dans le cadre du protocole de Kyoto, la France s’est engagée à diviser par quatre ses émissions de gaz à effet de serre (GES) de 1990 à l'horizon 2050. Le Mexique a pour objectif d’atteindre une réduction de 50% en 2050 par rapport à l’année 2000. En vue du poids croissant du secteur des transport dans les villes d’environ 1 million d’habitants dans le total des émissions de CO2, nous souhaitons vérifier dans quelles mesures les expériences observées dans le Nord (plafonnement de la mobilité, diffusion de nouvelles technologies sur les véhicules) peuvent se répéter dans le Sud. Nous nous sommes pour cela appuyé sur des études de cas en France (Paris et Lille) et au Mexique (Juarez et Puebla). Le premier objectif de cette thèse a été d’identifier les déterminants de la mobilité urbaine. Le deuxième objectif a été d’appliquer le modèle âge-cohorte pour la prévision de la demande de transport, afin de prendre en compte l’évolution de la structure de la population (vieillissement) et les changements de comportement. Finalement, nous avons développé des diagnostics des émissions de GES. En France, nous avons observé des tendances vers une réduction des émissions de GES due à la baisse de la mobilité et aux nouvelles technologies, mais qui est encore loin d'être suffisante pour atteindre les objectifs fixés. Les études de cas du Mexique montrent l’incapacité à inverser la tendance à l'augmentation des émissions de GES ; par conséquent les objectifs de réduction seront difficilement atteints. Le cas du Mexique peut nous donner un aperçu des tendances dans les pays émergents, qui sont très loin d'atteindre un développement durable et resteront face à un grand défi dans le futur
In the context of the Kyoto Protocol, France has set Greenhouse Gas (GHG) emission reduction targets of 75% below 1990 levels by 2050. More recently, Mexico has set the objective to achieve a 50% reduction by 2050 with respect to the base year 2000. Since the transport sector in urban areas with approximately 1 million inhabitants accounts for most CO2 emissions and will continue to increase its share, we wanted to determine to what extent the experiences observed in cities from developed countries (peak travel, dissemination of new vehicle technologies) may be repeated in urban areas from developing nations. For this purpose, we focus on case studies in France (Paris and Lille) and Mexico (Juarez and Puebla). The first objective of this thesis was to identify the determinants of mobility on each urban region. The second objective was to apply the age-cohort model for the development of long-term travel demand forecasts in order to take into account changes in the population structure (ageing) and in travel behaviour. The last objective was to develop GHG emissions assessments from observed travel demand. The decline in mobility and the dissemination of new vehicle technologies in France led to a reduction in GHG emissions. However, these changes are not sufficient to achieve the GHG reduction targets. The case studies in Mexico show the inability to reverse the trend towards the increase of GHG emissions; therefore the reduction targets will be hardly achieved. The case of Mexico give us an overview of trends in emerging countries, which are very far from achieving sustainable development and will face a major challenge in the coming decades

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Zhang, Zhe. "Cohort Differences in the Gender Division of Household Labor in Urban China." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1376916003.

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Zaman, Syed Mohd Akramuz. "Cohort study of the effect of measles on childhood morbidity in urban Bangladesh." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299774.

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Talbert, Kevin M. "AN EDUCATIONAL CRITICISM OF THE NARRATIVE CURRICULUM OF AN URBAN TEACHING COHORT PROGRAM." Miami University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=miami1342803252.

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Le, Clercq Louis Stephanus. "Molecular characterization of full genome hepatitis b virus sequences from an urban hospital cohort in Pretoria, South Africa." Diss., University of Pretoria, 2014. http://hdl.handle.net/2263/43142.

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Hepatitis B Virus (HBV) is a DNA virus and belongs to the genus Orthohepadnavirus of the Hepadnaviridae family which represents one of two animal viruses with a DNA genome which replicates by reverse transcription of a viral RNA intermediate. Nucleotide variation led to further sub-classification into 8 genotypes (A to H). The reverse transcription step within its life cycle is prone to the introduction of errors and recombination when dually infected. This leads to a viral quasispecies which forms during the course of infection with many minor population variants; such variants can however only be detected by means of ultra-deep sequencing. A recent study in the Department of Medical Virology (UP) by Mayaphi et al. identified a number of the specimens that partitioned away from the typical subgenotype A1 clades with high bootstrap values and longer branch lengths. Thus, the main objective of the current study was to characterize the full genome of all variants for the outliers observed in the aforementioned study, inclusive of potential recombination, dual infection and minor populations. Twenty samples were selected from a previous cohort for purposes of the present study. The viral DNA was extracted and amplified by PCR according to the methods described by Günther et al. with modified primer sets. Nineteen of the samples were successfully amplified and 15 of these were sequenced. Specimens were sequenced by NGS on the Illumina MiSeq™ sequencer and sequence data used to reconstruct the viral quasispecies of each specimen. Further analyses of the reconstructed variants included molecular characterization as well as phylogenetic analysis and screening for recombination and drug resistance mutations. Full genome coverage was obtained for twelve of the fifteen samples and full genome variants reconstructed, generating nearly 40 full genomes. Phylogenetic analysis showed that the majority of the samples are of genotype A, more specifically of subgenotype A1, differing by less than 4% from known sequences. The phylogenetic analysis revealed a similar clade of outliers, where four samples clustered together with significant bootstrap support (75%) and a fifth sample partitioned separate from, yet close to, this clade, away from the typical African A1 clade. This clade was assigned to genogroup III. Three samples were of the Asian A1 clade (genogroup I) with remaining specimens grouping within genotype D and E. The variants showed low diversity within each specimen with some differing at but a few positions across the genome while even the most diverse quasispecies differed by less than a percentage (32 positions). Several unique and atypical positional variations were observed amongst study samples of which some were present in but one of the variants for that sample. Twenty-six lead to shared amino acid changes. Some observed changes, such as A1762T/G1764A and G1896A, could explain the serological patterns such as HBeAg negativity while others, such as C2002T, were previously implicated in disease progression and severity. Sample N199 presented a longer branch length and revealed short regions within the genome that display evidence of recombination between HBV/A1 and HBV/A2. The results illustrate the utility of NGS technology in characterizing viral variants.
Dissertation (MSc)--University of Pretoria, 2014.
lk2014
Medical Virology
MSc
Unrestricted

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Guillaud, Lucas. "Militaria à Lugdunum : étude de l'armement et de l'équipement militaire d'époque romaine à Lyon (1er s. av.-IVe s. apr. J.-C.)." Thesis, Lyon, 2017. http://www.theses.fr/2017LYSE2024/document.

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En tant que colonie romaine, capitale administrative de la province de Lyonnaise, la ville de Lugdunum tisse depuis ses origines des liens étroits avec l’exercitus romanus. Impliquée directement, et à plusieurs reprises, dans des conflits militaires de grande ampleur, elle est la seule ville de Gaule à avoir accueilli une cohorte urbaine, dont l’existence est attestée par les sources écrites comme par les inscriptions funéraires. Face à ces témoignages, et à défaut de découvertes récentes, l’archéologie, jusqu’ici peu prise en compte, apparaît comme une source complémentaire de poids pour comprendre les modalités de la présence et de l’occupation militaire de Lugdunum. Le développement récent de l’archéologie programmée et préventive a favorisé la collecte d’un mobilier toujours plus abondant. Parmi les ensembles d’instrumentum recueillis, certains objets, appelés militaria, relèvent de la sphère militaire. Le travail exposé au sein de cette thèse se propose donc de traiter de la question de la présence militaire romaine à Lugdunum à travers le prisme de ces artefacts archéologiques. L’étude proposée s’appuie sur un corpus de de 496 fragments pour 337 objets, répartis sur quarante sites disséminés sur le territoire de la colonie romaine et ses abords proches. Chaque artefact fait l’objet d’une étude exhaustive selon les catégories fonctionnelles en usage (armement offensif et défensif, ceintures/baudrier, harnachement, autres). Une discussion d’ordre technologique, typologique et chronologique est proposée pour chacun d’eux, sur la base des comparaisons observées à l’échelle du monde romain. A l’appui des données collectées, une discussion d’ordre quantitative, spatiale et contextuelle est engagée ainsi qu’une réflexion sur une éventuelle production artisanale de certaines catégories d’armement et d’équipement militaire à Lugdunum. Les résultats de l’étude servent de point d’appui pour un discours élargi sur la présence militaire romaine à Lyon entre le Ier et le IVe s. apr. J.-C. La confrontation des données archéologiques, historiques et épigraphiques permet de proposer plusieurs hypothèses sur la nature de l’occupation militaire de Lugdunum, sur son évolution et sa densité mais aussi son intégration au tissu urbain de la colonie de droit romain
As a roman colony and administrative capital of the Gaul Lyonnaise province, the city of Lugdunum entwines, since its origins, direct links with the exercitus romanus. This city was entangled directly and often in major military conflicts. Furthermore, it was the only settlement in Gaul to welcome a roman cohort, whose existence is confirmed by written sources such as funerary inscriptions. Taking into account these evidences, and lacking of recent findings, Archeology, lightly valued till now, appears as a great important source to understand the procedures of the military presence and occupation in Lugdunum. Recentdevelopments in both rescue and voluntary Archeology, favored the assemblage of a great number of collections. Among the gathered sets of instrumentum, certain objects arise mainly from the military sphere, the militaria.The work set out at the center of this thesis enables to approach the interpretation of the roman military presence in Lugdunum through the perspective of these archeological artifacts. The present study relies on a militaria corpus of 496 fragments to 337 objects, diffused over forty sites, scattered on the territory of the roman colony and its outskirts. Each artifact wassubjected to a thorough research, according to the classifications in use: defensive and offensive armament, belts, straps, harness and others. A technological, typological and chronological analysis is proposed for each one of them, based on the fieldwork observed at the scale of the roman world. After analyzing the data collected, conclusions about space, context and quantity can be established, as well as the notion of a possible craft-related production of certain types of military weaponry and equipment in Lugdunum.The results of this study provide a support for a broader discussion, as it concerns the roman military occupation in Lyon between the 1st century BC and the 4th century AD. The combination of the archaeological, historical and epigraphical data allows several hypothesis on the nature of the military establishment in Lugdunum, but also on its evolution, density andits role on the urban network of the colony of roman law

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Willey, Barbara Annouscha. "Household socio-economic status, social support and infant and child growth in urban South Africa : a cohort study from 1990." Thesis, Loughborough University, 2007. https://dspace.lboro.ac.uk/2134/35399.

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The rapid political, economic and social changes experienced by South Africans from 1991, combined with socio-economic inequalities ingrained in South African society at this time, made the early 1990s a unique and well-suited period to investigate child growth inequalities. Furthermore, recent estimates of low birth weight and stunting (≤ 3 years), showing prevalence of 15% (Chen et aI., 2006) and 25.5% (Labadarios, 1999) respectively, indicate that poor intrauterine and postnatal growth patterns continue to represent considerable public health issues in this setting. This study aimed to investigate associations of birth measures of household SES and social support with infant/child growth in urban South Africa. Anthropometric, demographic, socioeconomic and social support data for quantitative analyses were obtained from the 1990 Bt20 cohort (n=3275).

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Bertin, Mélanie. "Impact des inégalités sociales et de la pollution atmosphérique sur le risque d'issues défavorable de grossesse dans la cohorte mère-enfant PELAGIE : rôle du contexte urbain-rural." Thesis, Rennes 1, 2015. http://www.theses.fr/2015REN1B010/document.

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La grossesse est une période sensible et déterminante pour le développement de l’enfant et l’état de santé à l’âge adulte. L'adaptation biologique et physiologique de l'organisme face à des « stresseurs » physiques et psychosociaux au cours de cette période peut ainsi exercer ses effets à l'âge adulte (et possiblement sur plusieurs générations). Cette toxicité différée suppose intrinsèquement la nécessité d’étudier les conséquences des expositions environnementales au cours de la vie foetale et ce suivant une approche holistique intégrant autant les facteurs de risque à des niveaux micro (caractéristiques individuelles) et macro (expositions physiques externes et contexte psycho-social). Etant donné l’hétérogénéité du territoire breton dans lequel s’inscrit ce travail de thèse, nous avons cherché à explorer l’impact des inégalités sociales et de l’environnement physique (pollution atmosphérique) sur l’issue de la grossesse (croissance foetale et risque de prématurité) indépendamment chez des femmes enceintes résidant dans des zones urbaines et rurales. Ce travail s’est appuyé sur les données issues de la cohorte bretonne mère-enfant PELAGIE, qui a inclus 3421 femmes enceintes entre 2002- 2006. Les paramètres anthropométriques et l’âge gestationnel à la naissance ont été renseignés à l’accouchement par le personnel médical. Le contexte urbain et rural breton a été caractérisé à partir de la définition des unités urbaines de l’INSEE. Les concentrations annuelles de pollution atmosphérique (dioxyde d’azote (NO2)) ont été modélisées à une échelle de 100 m à partir d’un modèle de "land-use regression" développé à l’échelle européenne. Enfin, le niveau socio-économique des IRIS a été estimé à l’aide d’un indice de désavantage social - construit à partir des données du recensement de l’INSEE et dont la validité et l’adaptabilité à des territoires à la fois urbains et ruraux a été examinée au préalable. Nos résultats suggèrent une influence délétère d’un contexte de vie socioéconomique défavorable sur la croissance intra-utérine, spécifiquement chez les femmes résidant en milieu rural. Nous avons également observé une augmentation du risque de prématurité associée à des niveaux > 16.4 μg.m-3 de NO2 dans l’air, à l’inverse, uniquement chez les femmes résidant dans des zones urbaines. Les associations entre l’exposition à la pollution atmosphérique et les marqueurs de la croissance intra-utérine, bien que sexe-spécifiques, ne semblent en revanche pas varier sensiblement suivant le gradient urbain-rural. Ce travail confirme la nécessité d’évaluer l’influence des inégalités sociales et environnementales sur le développement intra-utérin et de considérer l’importance et le rôle du contexte de vie, notamment urbain-rural, dans la formation de ces inégalités
Pregnancy is a sensitive and critical period for the development of the child and the health of adults-to-be. The biological and physiological adaptation of the body dealing physical and psychosocial stressors during this period may exert its effects in adulthood (and possibly over several generations). This delayed toxicity presupposes intrinsically the need to study the effects of exposure to environmental risk factors during fetal life using a holistic approach involving risk factors at both the micro (individual characteristics) and the macro level (physical and psycho-social context). Given the heterogeneity of the Breton territory in which this work was conducted, we explored whether the impact of social inequalities and the physical environment (air pollution) on birth outcomes (fetal growth and the risk of prematurity) could be modified according to an urban or rural place of residence. This work was based on data collected as part of the Breton mother-child cohort PELAGIE, which had included 3421 pregnant women between 2002- 2006. The anthropometric parameters and gestational age at birth were measured by medical personnel at delivery. We defined urban and rural areas according to the definition of “urban units” from the National Census Bureau (INSEE). The annual concentrations of air pollution (nitrogen dioxide (NO2)) were estimated using a land-use regression modeled at a 100 m scale and developed as part of an European project. Finally, neighbourhood deprivation was estimated using a composite index developed at census blocks level and whose use was legitimated over both urban and rural areas. Neighbourhood deprivation was associated with an increased risk of infants with fetal growth restriction, only for women living in rural areas. We also observed an increased risk of preterm birth associated with NO2 concentrations > 16.4 μg.m-3, only among women residing in urban areas. The associations between air pollution and fetal growth, although sex-specific, did not seem on the other hand, to vary significantly according to the urban-rural spectrum. This work confirms the need to explore the influence of both social and environmental inequalities on intrauterine development, and to assess the role of place-based factors, such as the urban-rural context, in shaping these inequalities

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Hoebel, Svelka. "Metabolic syndrome marker cut-off points and target organ damage revisited in an urban South African cohort : the SABPA study / Svelka Hoebel." Thesis, North-West University, 2012. http://hdl.handle.net/10394/8483.

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Objectives: The aim of this study was to determine the prevalence of MetS among different African populations using the new Joint Statement Criteria. Hereafter we aimed to determine whether waist or neck circumference is the best predictor of MetS risk after ethnic, gender and age-specific cut-points were developed. Lastly, we aimed to determine whether afore-mentioned cut-point can predict albumin:creatinine ratio as a marker of target organ damage. Methods: The study sample (N=409) comprised of urban African (men, N=101; women, N=99) and Caucasian (men, N=101; women, N=108) teachers from the Dr. Kenneth Kaunda Education district in the North-West Province, South Africa. Participants were aged between 25 and 65 years. Anthropometric measurements, albumin:creatinine ratio and other markers of the metabolic syndrome (MetS) (systolic and diastolic blood pressure [SBP and DBP], glucose, triglycerides [TG] and high density lipoprotein [HDL]) were determined. Results: Africans (65 and 63 % for men and women) and Caucasian men (73%) showed high prevalence of MetS; ROC analysis determined neck circumference (NC) cut-points of 39 and 35 cm for young and older African men, 32 and 35 cm for young and older African women, 40 and 41 cm for Caucasian men and 34 and 33 cm for Caucasian women. This NC cut-point can be used to determine metabolic syndrome risk in all groups, except in African women; ROC developed waist circumference (WC) cut-points were 91 cm for all African male groups, 84, 81 and 84 cm for young, older and total group of African women. Suggested WC cut-points for Caucasian men were 93 cm for the young group and 97 cm for older as well as total Caucasian male groups, while cut-points for Caucasian women were 87 cm, 79 cm and 84 cm for young, older and total Caucasian women. These WC cut-points were good measures of metabolic syndrome risk in all groups; neither cut-point of WC nor NC could increase the risk of albumin:creatinine ratio. Conclusion: African women as a group present with few MetS risk factors and glucose is associated with renal function risk in Africans; NC cut-points may be used as an additional anthropometric marker to predict the metabolic syndrome in a South African cohort, but not in African women; WC cutpoints demonstrated to be good predictors of the metabolic syndrome in the same South African cohort, especially among men; WC would seem to be the best measure of MetS risk in all African populations, although NC can also be used for this purpose in all African populations, except in African women.
Thesis (PhD (Human Movement Science))--North-West University, Potchefstroom Campus, 2012

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Egbujie, Bonaventure Amandi. "Relationship between socio-economic status and cardiovascular disease in black South Africans living in a rural and an urban community." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/3989.

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Magister Public Health - MPH
Introduction: In recent years, cardiovascular disease (CVD) has emerged as a leading cause of death in developing countries. It is important to identify and target people who are at risk,given that a third of all deaths are expected to be due to CVD by 2020. Studies have shown socio-economic patterning in the prevalence of risk factors for CVD, including obesity,smoking and lipid profile. In developed countries, the association between socio-economic status (SES) and CVD risk factors is negative, with a higher prevalence of CVD risk factors among people of lower SES. However, findings from studies in developing countries on this including South Africa has been inconsistent. In addition, there is scant information on differences in socio-economic patterning of CVD risk factors between urban and rural areas in South Africa.Aim: To examine the association between SES indicators and CVD risk factors among an adult population cohort of Black South Africans living in a rural and urban community.Study design: Quantitative cross-sectional analytical study of baseline data of a populationbased cohort of 2000 Black South African men and women aged 30-70 years who are part of the Cape Town arm of the Prospective Urban and Rural Epidemiology (PURE) Study. The study cohort has been established in Mount Frere, Eastern Cape (rural) and Langa, Cape Town(urban) since 2009 and the current work is secondary analysis of the baseline study data.Data collection/synthesis: SES indicators including income, employment status, marital status and completed education were gleaned from the baseline data of the PURE Cape Town study for all study participants. Then CVD risk factors including obesity, hypertension, selfreported diabetes, consumption of tobacco and alcohol consumption were also determined for the same participants. Data analysis: Data was analysed using SPSS version 20 for Windows. Descriptive statistics including frequency counts, percentages, mean and standard deviations (where normal distribution) and median and interquartile range (where non-normal) were used to summarise data on SES and CVD risk factors. This was performed separately for rural and urban study participants. Analytical statistics was used to examine associations between SES indicators and CVD risk factors with risk factors as both dichotomous and multi-level categorical variables. Kendall’s τ rank correlation coefficient was obtained to assess the relationship between the three indicators of SES. Prevalence rates reported with 95% confidence intervals was determined for risk factors across categories of SES indicators. P-values for trends in CVD risk factors were obtained by treating the SES indicators as categorical variables in logistic regression analyses. Multiple logistic regression analysis to estimate independent effects of the different SES indicators on risk factors was performed. In all analyses, P-values < 0.05 were regarded as significant.Results: There was a significant difference in the socioeconomic and CVD risk factors profile of urban and rural participants. Except for hypertension and tobacco use with insignificant higher prevalence in the urban location, all CVD risk factors were significantly higher in urban than rural participants. Some CVD risk factors (hypertension and diabetes) were positively associated with high SES (income) and some others (tobacco use) were negatively associated with employment status. Highest income earners had the highest risk of hypertension (AOR= 2.4, 95% CI 1.5-3.9) and diabetes (AOR= 2.2, 95% CI 1.2-4.1) after adjusting for age, sex and other SES variables. Marital status however showed the most consistent association across all CVD risk factors; widowed participants had a high risk of hypertension (OR=2.1, 95% CI 1.2-3.7) and diabetes (OR=2.0, 95% CI 1.1-3.7), but had the lowest risk of tobacco (OR=0.3, 95% CI 0.14-0.66) and alcohol use (OR=0.3, 95% CI 0.15-0.72). The distribution of CVD risk factors by SES gradient showed inconsistent patterning and difference between the urban and rural participants.Conclusion: In this cohort of adult Black South Africans, high income earning and widowed marital status were associated with higher hypertension and diabetes prevalence, while unemployment was associated with higher tobacco use.Recommendations: CVD risk reduction interventions that recognise the differential susceptibility of individuals in different SES group need to be designed and implemented.Widows and widowers should be given focussed attention in health screening as they may have increased vulnerability to diseases especially CVDs. There is however need for more research to establish the pathway through which SES factors predispose or protect individuals from CVDs.

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Kuepper, Rebecca, Os Jim Van, Roselind Lieb, Hans-Ulrich Wittchen, and Cécile Henquet. "Do cannabis and urbanicity co-participate in causing psychosis? Evidence from a 10-year follow-up cohort study." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-103747.

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Background: Cannabis use is considered a component cause of psychotic illness, interacting with genetic and other environmental risk factors. Little is known, however, about these putative interactions. The present study investigated whether an urban environment plays a role in moderating the effects of adolescent cannabis use on psychosis risk. Method: Prospective data (n=1923, aged 14–24 years at baseline) from the longitudinal population-based German Early Developmental Stages of Psychopathology cohort study were analysed. Urbanicity was assessed at baseline and defined as living in the city of Munich (1562 persons per km2; 4061 individuals per square mile) or in the rural surroundings (213 persons per km2; 553 individuals per square mile). Cannabis use and psychotic symptoms were assessed three times over a 10-year follow-up period using the Munich version of the Composite International Diagnostic Interview. Results: Analyses revealed a significant interaction between cannabis and urbanicity [10.9% adjusted difference in risk, 95% confidence interval (CI) 3.2–18.6, p=0.005]. The effect of cannabis use on follow-up incident psychotic symptoms was much stronger in individuals who grew up in an urban environment (adjusted risk difference 6.8%, 95% CI 1.0–12.5, p=0.021) compared with individuals from rural surroundings (adjusted risk difference −4.1%, 95% CI −9.8 to 1.6, p=0.159). The statistical interaction was compatible with substantial underlying biological synergism. Conclusions: Exposure to environmental influences associated with urban upbringing may increase vulnerability to the psychotomimetic effects of cannabis use later in life.

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Reid-Brown, Carolyn A. L. "Project-Based Learning: Investigating Self-Directed Learning Readiness Skills And Content Knowledge Retention In An Urban Jamaican High School Eighth Grade Integrated Science Cohort." FIU Digital Commons, 2017. http://digitalcommons.fiu.edu/etd/3388.

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Self-directed learning (SDL) readiness skills and the command and/or retention of content knowledge have been identified as key factors for success in post-secondary settings. The Government of Jamaica (GOJ) has stated that two in three Jamaican secondary school graduates lack the requisite content knowledge and self-directed learning skills needed for advancement in the work space and in postsecondary education (Vision 2030 Jamaica National Development Plan, 2009). This dissertation examined the efficacy of project-based learning (PBL) as a method of instruction for improving SDL readiness skills and content knowledge retention. More specifically, the phenomenon was explored within the context of a developing country – in this case – Jamaica. The difference in SDL readiness skills and content knowledge retention was investigated among 8th grade students in an urban high school under PBL conditions (N = 30) and under Traditional Direct Instruction (N=35) using a quasi-experimental design. Data on students’ SDL readiness skills, knowledge comprehension and content knowledge retention were collected using validated instruments. Scores on all three measures were recorded pre-intervention and post-intervention with a follow-up on content knowledge retention. One way repeated measures mixed ANOVAs were run. Results showed that on SDL readiness skills, the difference over time for the PBL group was significantly different from the difference over time for the TDI/control group (pp

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21

Kuepper, Rebecca, Os Jim Van, Roselind Lieb, Hans-Ulrich Wittchen, and Cécile Henquet. "Do cannabis and urbanicity co-participate in causing psychosis? Evidence from a 10-year follow-up cohort study." Cambridge University Press, 2011. https://tud.qucosa.de/id/qucosa%3A26468.

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Background: Cannabis use is considered a component cause of psychotic illness, interacting with genetic and other environmental risk factors. Little is known, however, about these putative interactions. The present study investigated whether an urban environment plays a role in moderating the effects of adolescent cannabis use on psychosis risk. Method: Prospective data (n=1923, aged 14–24 years at baseline) from the longitudinal population-based German Early Developmental Stages of Psychopathology cohort study were analysed. Urbanicity was assessed at baseline and defined as living in the city of Munich (1562 persons per km2; 4061 individuals per square mile) or in the rural surroundings (213 persons per km2; 553 individuals per square mile). Cannabis use and psychotic symptoms were assessed three times over a 10-year follow-up period using the Munich version of the Composite International Diagnostic Interview. Results: Analyses revealed a significant interaction between cannabis and urbanicity [10.9% adjusted difference in risk, 95% confidence interval (CI) 3.2–18.6, p=0.005]. The effect of cannabis use on follow-up incident psychotic symptoms was much stronger in individuals who grew up in an urban environment (adjusted risk difference 6.8%, 95% CI 1.0–12.5, p=0.021) compared with individuals from rural surroundings (adjusted risk difference −4.1%, 95% CI −9.8 to 1.6, p=0.159). The statistical interaction was compatible with substantial underlying biological synergism. Conclusions: Exposure to environmental influences associated with urban upbringing may increase vulnerability to the psychotomimetic effects of cannabis use later in life.

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22

Nganawara, Didier. "L'accès des migrants au premier emploi en milieu urbain : une étude démographique appliquée à la ville de Bangui." Paris 1, 2005. http://www.theses.fr/2005PA010534.

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Notre étude a pour objectifs l'examen de la dynamique du risque d'accès au premier emploi et l'apport d'une contribution à la recherche sur les déterminants de ce risque en milieu urbain banguissois. Les données proviennent d'une enquête biographique sur les hommes âgés de 25 à 54 ans au moment de l'enquête en 2001 à Bangui. La technique d'estimation par la régression semi-paramétrique de Cox est utilisée pour évaluer les effets des facteurs déterminants de l'accès au premier emploi à Bangui. Les résultats indiquent que les migrants accèdent très rapidement à leur premier emploi à Bangui voire dans le salariat formel par rapport aux non-migrants. La crise conjoncturelle de l'emploi concernerait exclusivement l'accès au salariat formel à Bangui. Les jeunes, qu'ils soient migrants ou non, sont systématiquement défavorisés par rapport à leurs aînés : une entrée tardive sur le marché de l'emploi, moindre accès aux emplois du secteur formel, plus souvent indépendants dans le secteur formel ou apprentis et salariés dans l'informel. De façon générale, la génération, le statut migratoire, la scolarisation, l'appartenance ethnique et la conjoncture économique semblent déterminer largement l'accélération de l'accès et le type d'activité à occuper lors du premier emploi. La scolarisation apparaît comme un facteur déterminant de l'accès au premier emploi salarié dans le secteur formel à Bangui, quel que soit le statut migratoire.

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Tavares, Aline da Silva. "Prevalência e incidência de infecção pelo vírus da dengue em uma comunidade urbana: Um estudo de coorte." reponame:Repositório Institucional da FIOCRUZ, 2014. https://www.arca.fiocruz.br/handle/icict/10303.

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Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
A dengue é uma doença febril aguda transmitida pela picada do mosquito Aedes aegypti. Em torno de 40% da população mundial vive em áreas tropicais e subtropicais sob risco de infecção e desenvolvimento da doença. No Brasil, a dengue é uma doença de grande impacto para a saúde pública. Entretanto, poucos estudos de coorte prospectiva foram realizados para estimar a incidência de infecções e para identificar grupos populacionais de maior risco para infecção. Identificar grupos de risco pode ajudar a orientar os programas de prevenção e controle da dengue, de modo a reduzir a carga da doença. Este estudo teve como objetivos determinar a soroprevalência e a densidade de incidência e fatores demográficos e socioeconômicos associados à infecção pelo vírus da dengue em uma comunidade urbana. Um estudo de coorte foi realizado nas comunidades de São Marcos e Pau da Lima, bairros periféricos de Salvador-BA que apresentam infra-estrutura sanitária deficiente. Foram incluídos 2.323 participantes com idade ≥5 anos, residentes em domicílios selecionados aleatoriamente na comunidade. A coorte foi recrutada entre janeiro e junho de 2010 e o seguimento se deu após um ano, entre janeiro e maio de 2011. Em 2010, durante visitas domiciliares, os moradores dos domicílios selecionados que aceitaram participar do estudo assinaram o Termo de Consentimento Livre e Esclarecido e foram entrevistados para obtenção de dados demográficos e socioeconômicos. Amostras de sangue foram coletadas, transportadas no mesmo dia para a FIOCRUZ e, após centrifugação, alíquotas de soro foram congeladas a -20°C. Este procedimento foi repetido durante o seguimento da coorte em 2011. O teste utilizado para detectar anticorpos específicos contra dengue nas amostras de soro foi o ELISA IgG indireto. Medidas de tendência central, de dispersão e frequências foram utilizadas para descrever as características demográficas e socioeconômicas da população. A soroprevalência e a soroincidência foram calculadas de acordo com essas características. IC de 95% foram calculados para os indicadores de prevalência e de incidência. Dos 2.323 participantes testados no estudo de base em 2010, 2.036 (87,6%; IC 95%: 86,2 - 88,9) foram soropositivos para a presença de anticorpos IgG contra a dengue. A soroprevalência de dengue foi semelhante entre homens e mulheres. A análise da soroprevalência estratificada por faixa etária mostrou que quanto maior a idade dos indivíduos maior a soroprevalência de dengue (10 a 15 anos RP=1,75 [IC 95% 1,50 - 2,04] e maiores de 15 anos 2,19 [IC 95% 1,90 - 2,52]). Indivíduos de cor parda e branca apresentaram menor soroprevalência do que a cor preta. Aqueles com maior renda per capita e maior escolaridade apresentaram maior soroprevalência. Dos 240 membros da coorte que tiveram as amostras negativas para a presença de anticorpos IgG contra a dengue, 116 apresentaram uma infecção primária inaparente durante o seguimento, o que corresponde a uma incidência de 53,9 (IC 95%: 44,7-64,4) infecções primárias 8 inaparentes por 100 pessoas-ano. Os resultados apresentados mostram que a dengue apresenta uma intensa transmissão em comunidades urbanas pobres do Brasil. A urgente necessidade de estratégias alternativas para controle da dengue no Brasil faz-se necessário, a exemplo de vacinas.
Dengue fever is an acute febrile disease transmitted by the mosquito Aedes aegypti. Around 40% of the world population lives in tropical and subtropical areas at risk of infection and disease development. In Brazil, dengue is a disease of great impact on public health. However, few prospective cohort studies have been conducted to estimate the incidence of infections and to identify population groups at higher risk for infection. The identification of risk groups can help guide prevention programs and dengue control in order to reduce the burden of disease. This study aimed to determine the prevalence and incidence density and socioeconomic and demographic factors associated with dengue virus infection in an urban community. A cohort study was conducted in the communities of San Marcos and Pau da Lima, outskirts of Salvador-BA who have poor health infrastructure. About 2,323 participants aged ≥ 5 years, residents in households randomly selected in the community were included. The cohort was recruited between January and June 2010 and follow-up occurred after one year, between January and May 2011. In 2010, during home visits, residents of selected households agreed to participate and signed a consent form Informed and were interviewed to collect demographic and socioeconomic data. Blood samples were collected, transported the same day to FIOCRUZ and, after centrifugation, serum aliquots were frozen at -20°C. This procedure was repeated during follow-up of the cohort in 2011. Test used to detect specific antibodies in serum samples from dengue was IgG ELISA indirect. Absolute and relative frequencies were used to describe the demographic and socioeconomic characteristics of the population. The seroprevalence and seroincidence were calculated according to these characteristics by means of chi-square or Fisher's exact test. 95% CI were calculated for indicators of prevalence and incidence density. Of the 2,323 participants tested at baseline in 2010, 2,036 (87.6%, 95% CI: 86.2 to 88.9) were positive for the presence of IgG antibodies against dengue. The seroprevalence of dengue was similar between men and women. The analysis of seroprevalence by age group showed that the older individuals of higher seroprevalence of dengue (10 to 15 years PR = 1.75 [95% CI 1.50 to 2.04] and over 15 years 2, 19 [95% CI 1.90 to 2.52]). The brown and white individuals had a lower prevalence than black subjects. Higher income per capita and higher education showed a higher seroprevalence. Of the 240 members of the cohort who had negative samples for the presence of IgG antibodies against dengue fever, 116 had a silent primary infection during follow-up, corresponding to an incidence of 53.9 (95% CI: 44.7 to 64 4) inapparent primary infections per 100 person-years. The results show that dengue has an intense transmission in urban poor communities in Brazil. The urgent need for alternative strategies for dengue control in Brazil it is necessary, like vaccines.

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Samus, Joseph Nicholas. "Preparing for the Next Generation of Senior Population: An Analysis of Changes in Senior Travel Behavior over the Last Two Decades." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4574.

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Over the past several decades, the senior age group has become the fastest growing segment of the population in the United States (Warner, 2011). This study seeks to contribute to the ongoing discussion of the impacts that the increases in senior travel will have on the future transportation systems and planning efforts. The main objective of this research is to conduct an explorative analysis of the changes in senior travel behavior over the past two decades and discuss the implications of these changes to transportation planning in the future. This thesis seeks to further understanding of this topic by providing a detailed analysis and consideration of relevant contexts through a review of previous studies and the author's background in the field of transportation. Results indicate significant changes in travel behaviors and make-up of the senior population. Over the three (1990, 2001, and 2009) survey periods, senior travel changed as a result of increased activity and a need to maintain their typical way of life well into older age. As the baby boom generation continues to out travel each previous generation, there is no evidence to assume that as they reach retirement age that trend will end. Seniors today are remaining active and working well into their older age and the age group has continued to increasingly contribute to total travel. These increases will be echoed by the baby boom generation and must be considered by traffic forecasters, researcher and policy makers in the future.

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Shange, Nkosinathi. "Investigating the determinants of use of healthcare services by South African adults with non-communicable diseases: An analysis of the prospective urban rural epidemiological (pure) study cohort." University of Western Cape, 2020. http://hdl.handle.net/11394/8048.

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Master of Public Health - MPH
Non-communicable diseases (NCDs) are the leading cause of death globally, affecting a significant proportion of the economically active population, the majority of these occurring in low- and middle-income countries (LMICs). In South Africa, over 40% of deaths are attributable to NCDs. The use of healthcare services by individuals who have NCDs is putatively high but has yet, not been adequately quantified. Furthermore, there is a paucity of research data on factors that influence healthcare services use among those experiencing NCDs in South Africa.

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Magalhães, Alexandre Pedro Tavares da Fonseca. "How distances to Urban Green Spaces and Open Sport Spaces can influence physical activity in teenagers of Porto Community. The Epiteen (Epidemiological Health Investigation of Teenagers in Porto) Cohort." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/55455.

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Carneiro, Cristina Maria da Silva Moreira. "Association between Urban Green Spaces and Symptoms of Depression in 17 years old adolescents in the city of Porto. The EPIteen (Epidemiological Health Investigation of teenagers in Porto) Cohort." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2011. http://hdl.handle.net/10216/63770.

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Magalhães, Alexandre Pedro Tavares da Fonseca. "How distances to Urban Green Spaces and Open Sport Spaces can influence physical activity in teenagers of Porto Community. The Epiteen (Epidemiological Health Investigation of Teenagers in Porto) Cohort." Dissertação, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/55455.

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Carneiro, Cristina Maria da Silva Moreira. "Association between Urban Green Spaces and Symptoms of Depression in 17 years old adolescents in the city of Porto. The EPIteen (Epidemiological Health Investigation of teenagers in Porto) Cohort." Dissertação, Faculdade de Medicina da Universidade do Porto, 2011. http://hdl.handle.net/10216/63770.

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Dwarkanath, Pratibha. "The relationship of maternal micronutrient intakes of Vitamin B12, vitamin B6, folate and calcium on intrauterine growth retardation and birth weight : a prospective cohort study of urban South Indian pregnant women." Thesis, Curtin University, 2011. http://hdl.handle.net/20.500.11937/1497.

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The period of intrauterine growth and development is one of the most vulnerable periods in the human life cycle. The weight of the infant at birth is a powerful predictor of infant growth and survival, and is dependent on maternal health and nutrition during pregnancy. Prevention of low birth weight (LBW; <2500 g), which affects nearly 30% of infants born in India, is a public health priority. Low birth weight includes infants born prematurely (<37 weeks of gestation) or are small for gestational age (SGA; <10th % for gestational age). The majority of LBW infants in India and in most developing countries are a result of SGA. LBW is a strong predictor for size in later life because SGA infants seldom catch-up to normal size during childhood.Maternal nutrition is an important factor from a public health point of view because it is modifiable through appropriate public health interventions. In urban Indian populations, despite the routine antenatal program, there has been a high prevalence of LBW and SGA babies. Micronutrients such as vitamin B12, vitamin B6 and folate that are involved in the 1-C methyl metabolism are thought to play a key role in fetal programming. Studies have shown that vitamin B12 deficiency leads to hyperhomocysteinemia especially in populations that consume predominantly cereal based diet, as seen in India. Dietary calcium is known to be related to pregnancy - induced hypertension (PIH); a morbidity affecting ~11% of first pregnancies. PIH also increases the risk of adverse birth outcomes.I established a prospective cohort study of 637 pregnant women at St. John’s Medical College Hospital, Bangalore, India. These pregnant women were followed antenatally for their dietary intakes, health status and birth outcomes.The food frequency questionnaire (FFQ) is commonly used in epidemiological studies for assessing dietary intakes. I validated FFQ against multiple 24-hour dietary recalls (24-HDR) and observed a significant correlation between the two methods for vitamin B12, vitamin B6 and folate intakes. Correlations between the dietary intakes assessed by FFQ and the blood biomarkers (micronutrient status) indicated a good correlation between energy- adjusted vitamin B12 and micronutrient status.Intakes of vitamin B12, vitamin B6, folate and food groups rich in these vitamins were related to adverse birth outcomes. Intakes of vitamin B12 in the 1st and 2nd trimester of pregnancy correlated negatively with homocysteine (Hcy) status and positively with the birth weight. Vitamin B12 intakes also correlated negatively with Hcy concentrations in the 1st and 2nd trimester of pregnancy. I found that low intakes of cereals and dairy products in the 2nd trimester of pregnancy were associated with SGA.Evidence shows that micronutrient deficiencies exist during pregnancy indeveloping countries. In the 1st trimester approximately 50% of the pregnant women were vitamin B12 deficit, 30% had vitamin B6 deficiency and 12% with folate deficiency. Almost 38% of the subjects had elevated Hcy levels at the 1st trimester. Maternal vitamin B12 showed significant negative correlation with plasma Hcy levels within trimester after adjusting for other micronutrients. Women categorised as vitamin B12, vitamin B6 or folate deficient and those who had hyperhomocysteinemiain the 1st trimester of pregnancy had a high prevalence of adverse birth outcomes such as LBW, SGA and preterm births. High maternal plasma Hcy concentration inthe 1st trimester seemed to be a determinant of LBW after adjusting for potential confounders.Several lines of evidence show that calcium and calcium - rich food groups may play an important role in determining adverse birth outcomes particularly preterm births. I observed that mothers of preterm babies and LBW had low intakes of calcium and calcium - rich food groups. Pregnant women with PIH had significantly higher incidence of preterm births. Calcium - rich food groups include dairy products and cereals and I have seen an association between low dairy intakes and high prevalence of SGA babies. These findings suggest that combination ofnutrients as in food groups would be responsible for the adverse birth outcomes.Collectively, the results presented in this thesis indicate a preventive role for calcium in PIH and a beneficial role of specific food groups (cereals and dairy) in reducing the incidence of SGA and preterm births. Women with low maternal vitamin B12 status and hyperhomocysteinemia have higher risk of having a LBW baby. My findings would encourage interventional studies to delineate the cause effect relationship between maternal dietary / nutritional influences on maternal morbidity and birth outcomes.

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Olsen, Nynne. "Functional outcome for older adults with movement disabilities : A cross-sectional study." Thesis, Jönköping University, HHJ, Institutet för gerontologi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-52819.

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Background: Previous research have found that different factors have associations with the level of function. Only few studies investigate the population of older adults with movement disabilities. Objective: The objective was to investigate how childhood socioeconomic status, education, gender, rural/urban living, and cohort affects functioning in late adulthood for people with movement disabilities. Six hypotheses were tested. Method: The sample was selected from the Swedish Adoption/Twin Study of Aging, and consisted of n=69 older adults with self-reported movement disability, mean age 78 years. They have all participated in motor function testing, which is an objective measure of function. Mann-Whitney U test, Kruskal-Wallis H test and binary logistic regressions were performed. Result: No significant difference were found between low/high childhood socioeconomic status, low/high education, men/women, rural/urban, and early/late cohort. Associations were found between age, urban living, later cohort and poorer functional level. Conclusion: The results indicate that the older adults from Sweden aging with a movement disability might have equal opportunity to develop and maintain functional ability. The participants all have a movement disability and it is possible that the disability is the main factor determining the functional level.

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Hylton, LeQuan M. "PERCEPTIONS OF THE HOMELESS TOWARD NONPROFIT HUMAN SERVICE PROVIDER." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4280.

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As the debate intensifies regarding developing remedies to meet the needs of America’s homeless, one solution is for governmental agencies to collaborate with and employ organizations from the nonprofit sector to assist with the needs of the homeless population. Included in the nonprofit sector, faith-based organizations (FBOs) have historically been a source of debate and contention in terms of collaborations with the government. However, Presidents Reagan, George H. Bush, Clinton, George W. Bush, and Obama have embraced the idea of including FBOs in the pool of service providers offering human services. In the Richmond, Virginia region, FBOs and nonreligious nonprofit organizations provide a range of human services to a substantial population of homeless clients. Yet, whether the homeless population prefers services offered by FBOs versus nonreligious nonprofits in general and for specific categories of service is unknown. These specific categories of service include alcohol treatment and recovery, counseling, drug treatment and recovery, food pantries, health care, job training and placement, short-term and long-term shelter, and meal sites. In addition, this study seeks to identify models using variables from this study that predict the preference for each category of service. Since homeless clients overall and specific human service preferences are an unknown, the importance of this study is to inform policymakers, those in the nonprofit sector, researchers, and other interested parties of these preferences. A study of this nature is also important to compare policy implementation to the preferences of the homeless to ensure the implementation accounts for principles of social equity. In addition, a study of this nature seeks to fill a literature gap by examining and understanding the intersections of demographic characteristics and preferences. Using the cohort and the rational choice theories, this study examines the preferences of homeless individuals for particular types of service providers.

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Barros, Susana Raquel Moura. "Diabets and the incidence of cancer in a Portuguese urban cohort." Master's thesis, 2013. https://repositorio-aberto.up.pt/handle/10216/72354.

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Barros, Susana Raquel Moura. "Diabets and the incidence of cancer in a Portuguese urban cohort." Dissertação, 2013. https://repositorio-aberto.up.pt/handle/10216/72354.

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"A cohort analysis of wage structure and participation during economic transition in urban China." Thesis, 2006. http://library.cuhk.edu.hk/record=b6074260.

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One purpose of the thesis is to find the role of the cohort effect in changes in the wage structure of urban China. We construct synthetic cohort data from the repeated cross-sections of Urban Household Survey (UHS) 1988-2002, and get a series of interesting results on wages. Our analysis is not only the first study in cohort patterns of wage structure in economic transition, but also the first study that systematically discusses the winners and losers during economic transition in urban China. Besides, our study makes contributions in the further discussion of factors influencing cohort effect. Furthermore, the thesis provides the first study in the role of cohort effect in estimating returns to education and age premium. Lastly, this thesis decomposes factors affecting the growth of wage and wage inequality, and finds that the cohort effect is mainly responsible for the rapid wage growth and inequality increase in urban China.
The last twenty years have witnessed an economic transition for many countries, including the former Soviet Union, Central and Eastern Europe, as well as China. Different from other countries, China has been experiencing a gradual and partial economic transition since the late 1970s. The consequences of the economic transition in all these countries are also quite different. Other transitional economies have recorded abrupt recessions, as reflected in negative GDP growth, a decline in wage, and an increase in unemployment. As a stark contrast, China has experienced a smooth and rapid economic growth in the last two and a half decades of economic transition. Its GDP growth has kept on a leading level with that of the whole world. Besides, the wage level, as well as wage inequality, has risen substantially.
The other purpose of this thesis is to find the role of the cohort effect in the dramatically declining labor force participation of urban China. Our study reveals that the cohort effect explains much of the decline in the labor force participation. This is the first study in analyzing labor participation in economic transition using synthetic cohort data, and we find that estimation of cross-section analysis of life-cycle participation is quite misleading. Besides, our study presents the first analysis of the wage structure effect on participation after separating the cohort effect from the age effect. Will higher inequality cause incentive effect or disincentive effect? Will results differ for men and women? This thesis provides a thorough analysis, and makes important contributions to the literature.
This thesis conducts research on wage structure and labor force participation during economic transition in urban China. One major contribution of this thesis is to separate the cohort effect from the age effect in analyzing labor market behavior in economic transition. Given the dramatic changes to the Chinese economy and society in the past half century, cohort quality, cohort size, cohort preference, and even labor market opportunities for each cohort will be very different. Therefore, inter-cohort differentials in labor market behaviors may be quite significant. However, previous studies usually employed cross-section analysis, and have ignored the cohort effect, which mixed up cohort effect and age effect and might cause the serious problem of bias in estimation. Our analysis avoids this problem.
Han Jun.
"September 2006."
Advisers: Juncen Zhang; Hongbin Li.
Source: Dissertation Abstracts International, Volume: 68-03, Section: A, page: 1109.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (p. 196-223).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.

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Ramsoomar, Leane. "Risk and protection: alcohol use among urban youth within the birth to twenty (BT20) cohort." Thesis, 2016. http://hdl.handle.net/10539/19636.

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Submitted in fulfilment of the requirements for the degree of DOCTOR OF PHILOSOPHY Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2015
Background: South Africa (SA) faces a formidable threat to public health attributable to alcohol use. The heavy burden of alcohol-attributable morbidity, mortality and social harms borne by SA youth is concerning. In a series of papers, this study examined: current national trends in adolescent alcohol prevalence; the associations of prevalence with alcohol-related mortality; and the implications of the overall findings for alcohol policy in SA. The study also investigated adolescent alcohol use and its determinants at key developmental stages (early and late adolescence), among 1 647 urban adolescents in Soweto, South Africa. Employing a socio-ecological framework, multiple risk and protective factors that determine adolescent alcohol behaviours at late adolescence were empirically tested. Methods: Data originated from seven sources: two national household, (South Africa Demographic and Health Survey-SADHS); two school-based youth risk behaviours surveys (YRBS); and two phases of a mortuary-based sentinel surveillance study. Additionally, a cross-sectional survey of adolescent alcohol use and its determinants was nested within Birth to Twenty (Bt20), a birth cohort study which prospectively follows 3273 children and their mothers from its inception in 1990 to date. Following a review of national data among 13- 19 year olds, bivariate analysis of alcohol use and alcohol-related harm among 13- 19 year olds, and alcohol use and mortality among 15-19 year olds, respectively, pertinent policy implications are discussed. Descriptive statistical analyses examined alcohol prevalence at early (13 years) and late (17/18 years) adolescence in the Bt20 cohort, while bivariate and multivariate analyses determined the associations and predictive values of socio-demographic, individual, and interpersonal factors on adolescent alcohol behaviours. Multi-level generalised linear mixed modelling determined if community level variables explain variability in the likelihood of having engaged in alcohol behaviours at 17/18 years old. Results: Nationally, alcohol use was stable but high among adolescents at 20 - 25% (SADHS) and 49 - 50% (YRBS) over the period 1998-2008. Twelve percent of adolescents initiated alcohol use before age 13. Significant gender differences existed in alcohol consumption, with a predominance of male drinking. Binge drinking increased significantly among females from 1998 to 2003. Homicide, suicide and unintentional deaths among 15- 19 year olds were significantly* associated with positive blood alcohol concentration. Within the Bt20 cohort, lifetime and current alcohol use, and binge drinking, is prevalent, and increases with progression from early to late adolescence. Consistent with national findings, significantly* more males than females engaged in all alcohol behaviours. The frequency of lifetime alcohol use increased from 22% in early adolescence to 66% in late adolescence. Gender, maternal education, and socio-economic status (SES) predicted lifetime alcohol use in early adolescence, while marital status was an additional predictor of the same in late adolescence. In late adolescence, bivariate regression models indicated that alcohol refusal self-efficacy, alcohol expectations, peer influence, household SES, neighbourhood economic level and community level SES were significantly associated with lifetime alcohol use. However, multi-level analyses revealed no direct association between community SES and adolescent alcohol behaviours. Discussion: The high prevalence of lifetime, current alcohol use, and binge drinking, together with early alcohol debut indicates that, alcohol use is a significant public health problem facing SA youth. Adolescent drinking behaviour is the result of a complex interplay between individual, interpersonal and community-related risk and protective determinants. Empirically validated risk and protective factors represent potential points of intervention for prevention and reduction of adolescent drinking. This necessitates multi-faceted responses for prevention on one end of the continuum and harm reduction on the other. Conclusion: Findings challenge current regulatory alcohol policies, the implementation of which falls short of ensuring that minimum drinking age laws are adequately effected. In addition, regulatory policies appear inadequate in ensuring that strategies translate into a reduction in harmful alcohol use by SA youth. Authoritative and consistent implementation of regulatory policies, in addition to harm reduction strategies, is necessary. *p<0.01

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Sogunle, Eniola Olufunmilayo. "The association between mode of delivery and early adulthood overweight or obesity in an urban South African birth cohort." Thesis, 2018. https://hdl.handle.net/10539/25358.

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A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the Degree of Master of Science in Epidemiology and Biostatistics, February 2018
Background Obesity is an important public health problem and rates have reached epidemic proportions in many countries. South Africa has one of the highest rates of obesity in Africa, with about 38% of the population (and about 44% of adults) estimated to be overweight or obese in 2013. Caesarean section (CS) as a mode of child delivery has been reported to be associated with a low bacterial richness that predisposes infants to being overweight or obese; this early life deprivation is presumed to persist to adulthood. The aim of this study was to determine if mode of delivery is a predictor of early adulthood overweight or obesity. Methods This was a retrospective analysis of data that was collected from a prospective cohort study (Birth to Twenty Plus) established in 1990. A total of 889 young adults aged 21-24 years were included in the analysis. Pearson’s chi-square and Kruskal-Wallis tests were used to assess associations between covariates and BMI categories, and prevalence of overweight or obesity among young adults, across mode of delivery categories. Multiple logistic regression models were fitted to examine the association between mode of delivery and early adulthood overweight or obesity. Results Of the 889 participants, 793 (89.2%) were delivered vaginally, 24 (2.7%) were delivered by assisted VD, and 72 (8.1%) were delivered through CS. The numbers of overweight and obese young adults were 175 (19.7%) and 106 (11.9%), respectively. Caesarean section was significantly associated with obesity in young adults, after adjusting for potential confounders (OR 1.99, 95% CI 1.00–3.94, p=0.049). However, no significant association was observed for overweight + obese combined. Conclusion Caesarean section was statistically associated with early adulthood obesity but not overweight + obesity combined. Mothers and physicians should, however, reduce the use of CS as a delivery procedure unless entirely required. This is due to the higher odds of obesity in later life, the potential biological link between CS and obesity, and the statistically significant associations reported.
XL2018

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Brassell, Shane (Nee Hodges). "Prevalence of Disability in a Cohort of HIV-Infected children attending an urban paediatric HIV Clinic in Johannesburg, South Africa." Thesis, 2018. https://hdl.handle.net/10539/25224.

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A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Medicine, Johannesburg, 2018
Background: With the success of evolving antiretroviral therapy (ART), human immunodeficiency virus (HIV) has become a chronic condition, however, children infected with HIV have been shown to have developmental difficulties and disabilities. This study aimed to investigate the extent of disability among a cohort of HIV infected children in South Africa and whether they are being referred and accessing rehabilitative services. Methods: A cross-sectional study was conducted at an HIV clinic in Johannesburg. Caregivers/parents were interviewed about their child, using the Ten Question Screen for Disability Questionnaire (TQSD) along with a general additional questionnaire devised by the researchers on medical history, services referred to and accessed and socioeconomic status (SES). Clinical data, from the child’s clinic file were recorded. Results Of the 200 children whose caregivers/parents were interviewed, 50.5% experienced disabilities were 58.4% of those had more than one co-existing disability. Of the children who reported disability only 46% had been referred to one or more of the following support services; audiologist, physiotherapist (PT), psychologist, occupational therapist (OT) and/or speech and language therapist (SLT). Previous diagnosis of tuberculosis (TB), lower respiratory tract infections (LRTI) and low pre-combination ART (cART) CD4% were found to be associated factors in the presence of developmental disability and/or delay. Conclusion The prevalence of children with HIV and disability is high and these children are not being referred to and/or accessing the appropriate support services. Government policy and clinic practice need to shift their focus of management of children living with HIV, in order to integrate services that can assist children reach their developmental potential and improve their quality-of-life.
XL2018

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Feeley, Alison Bridget Bernadette. "The impact of dietary habits and practices during adolescence on the risk of obesity: the birth to twenty cohort." Thesis, 2013. http://hdl.handle.net/10539/12696.

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Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Health Sciences, 2012
Background: South Africa is not exempt from the obesity epidemic and latest figures show that a third of adult men and two-thirds of adult women are either overweight or obese. Concomitant are changes in dietary habits and practices which have been implicated in the risk of obesity. Concern is that obesity and related non-communicable diseases (NCDs) manifest at younger ages. Adolescence, as well as being a stage during the life course when eating attitudes and behaviours are formed, is a particular time when the aetiology of NCDs becomes evident. Little is known about the dietary patterns during adolescence in South Africa, and if policymakers are to attempt to reduce the burgeoning statistics relating to obesity then it is important to understand adolescent dietary habits and eating practices. Aims: To describe adolescent dietary habits and practices among South African adolescents and how they might influence obesity risk. Methods: This study used a mixed methods study design, using both historical and prospective data and included four study components in both an urban (components 1-3) and a rural setting (component 4). Firstly, a cross-sectional assessment of fast-food intake of urban 17-year-olds from the Birth to Twenty Cohort (Bt20); secondly, a longitudinal descriptive analysis of dietary habits and practices of the Bt20 participants over a five-year period, between ages 13 – 17 years followed; thirdly a longitudinal assessment of the relationship between dietary habits, change in socio-economic status (SES) and obesity in the Bt20 adolescents was conducted; and finally, an exploratory survey assessing the availability of fast foods in a rural area. Results: The cross-sectional analysis showed that mean fast food intake was 8.1 (4.6) items and 7.2 (4.7) items/week for males and females respectively. Furthermore, the kota (or quarter) was the most popular fast food item and on average it provided 5 370 kJ, 51 g fat (of which 13 g Saturate fatty acids (SFA)). The longitudinal analysis showed that poor dietary habits and practices were embedded by the age of 13 years and were characterised by: high fast food consumption with at least five items/week consumed from the age of 13 years. Breakfast (weekday and weekend) consumption declined for both genders and females ate breakfast less regularly than males. Snacking while watching television increased with age: with females consuming more (4.0 (4.8) - 7.3 (5.9)) snacks per week than males (3.3 (4.5) - 6.0 (5.8). Two-thirds of participants ate their main meal with their family but among girls there was a trend towards eating this meal less regularly with increasing age. Confectionery consumption remained the same, around nine items/week for males and 10 items/week for females. Lunch box usage declined with age, conversely the number of tuck shop purchases increased with age. The prevalence of combined overweight and obesity was (8.1%) and (27%) in 17-year-old males and females respectively. In males only, soft drink consumption was associated with obesity denoted by BMI z-score and fat mass (p<0.05). In the final multivariate model, soft drink consumption remained positively and significantly associated with both outcomes and „acquiring‟ a fridge over the 12-year period remained negatively associated with both BMI z-score and fat mass (p<0.001). Among females, no associations were found. Thus further data on other lifestyle variables are needed to understand better the exposures related to obesity risk in females. In the rural setting fast food was found to be available albeit a limited variety; two-thirds of the collected samples were either vetkoek (fried dough balls) or fried chips (yielding between 943 kJ – 5 552 kJ and 11 g – 64 g fat). Compared to the kotas available in Soweto, the samples obtained in the rural setting contained more energy and fat (6 300 kJ, 60 g fat vs. 5 369 kJ, 51.5 g fat). Conclusions: This research highlights that poor dietary habits and practices prevail in adolescence which may be implicated in negative health outcomes in later life. Of concern is the finding that poor dietary habits were embedded by the age of 13 years which suggests that interventions need to target families and children prior to adolescence in order to reduce the pervasiveness of these habits in the older child. The prevalence of combined overweight and obesity is higher than the national statistics for both boys and girls at the age of 17-years. This research confirms that some dietary behaviours are associated with obesity risk namely soft drink consumption – but in males only. However soft drink consumption may be a marker for other lifestyle behaviours associated with obesity. Other dietary habits were not shown to be associated with obesity in neither males nor females, which highlights the difficulty in the measurement of exposures relating to diet. This study also showed in males at least, that socio-economic factors are important when considering obesity risk. The availability of fast foods in a relatively impoverished rural area is concerning as it may indicate that this community is undergoing nutritional changes such as those seen in urban environments. With urbanisation and economic transition, households experience a change in SES and these changes drive behaviour which can either enable or disable health outcomes. In this study SES improvement, e.g. fridge ownership seems to enable certain behaviours which can be obesogenic. However we cannot halt development in this context but we must devise ways to improve lifestyle choices which will promote health rather than impede it.

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Ginsburg, Carren. "Residential mobility in greater Johannesburg: patterns, associations and educational outcomes amongst children in the birth to twenty cohort." Thesis, 2011. http://hdl.handle.net/10539/10842.

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The United Nations has projected that Africa’s urban population will expand from fourth largest to becoming the second largest of the world’s regions by the year 2050. Patterns of migration and urbanisation have therefore been highlighted as significant focus areas for research and policy. Movement has the potential to result in improved living conditions and well-being, but may also reinforce inequalities and conditions of vulnerability. These consequences may pose particular risks in the case of children, and understanding the patterns, drivers and outcomes associated with child mobility is therefore critical. South Africa provides an important setting in which to explore child movements. The shift within the country from politically controlled migration to movement based on choice has resulted in high levels of mobility both to and within urban areas. Children have been shown to participate in such movements either independently or in conjunction with connected adults. However, there is currently little knowledge of the patterns and consequences of child residential mobility in South Africa, particularly within the urban environment. This PhD thesis attempts to address this research gap. Data from Birth to Twenty, a cohort of South African urban children living in Greater Johannesburg, was used to investigate three central research questions concerning residential mobility of cohort children over a 14 year period. Specifically, the thesis aimed to determine the frequencies and patterns of residential mobility observed over the first 14 years of the children’s lives, to examine the associations with mobility of children over a set of domains relating to the child, the child’s primary caregiver, and the child’s household and to assess the relationships between residential and school mobility and a set of educational outcomes. Routine data collected over the course of the Birth to Twenty study was supplemented with data from a Residential Move Questionnaire, administered to children’s primary caregivers in order to validate and provide additional information concerning the children’s residential movements over the time frame. The research objectives were achieved through the use of cross-sectional and longitudinal analysis techniques applied to these data. In particular, multilevel event-history analysis was used to model the children’s residential movements over time. Of the 3273 children enrolled into the cohort in 1990, two thirds of the children (64%) had moved home at least once by the time they reached 15 years of age. Nonetheless, a third of the children had never moved, indicating stability or a lack of opportunity for movement amongst this urban child population. Mobility was found to be more likely amongst children whose primary caregivers had no formal education and who lived in households with fewer assets and less access to services, suggesting that residential movement within this group of children was more common in the context of disadvantage. Extending these findings to an exploration of children’s educational outcomes revealed some unexpected results. The analyses provided evidence of a positive association between changes in residence and numeracy and literacy scores, and school mobility was found to be associated with grade repetition, however, a negligible relationship was found between residential mobility and school progression. In conclusion, mobility is associated with opportunities for some children in the cohort and challenges or hardships for others. However, even in the instance of movement connected to disadvantage, changes of residence did not prejudice children in terms of the educational outcomes investigated. This is suggestive of children’s possible resilience and adaptability in the face of change and highlights the potential for mobility to influence children’s lives positively. The findings concerning the relationship between mobility and child well-being run counter to trends observed in high-income countries and on that basis, the need for further research into dynamics associated with child mobility in other low- and middle-income country settings is highlighted. There is justification for monitoring child mobility in South Africa; mobility trends provide a valuable indicator of children’s living situations as well as the spatial and social changes occurring in the country more broadly. Keywords: residential mobility; internal migration; urban children; South Africa; eventhistory models; school progression; numeracy and literacy; school mobility

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Bruwer, Erna Jana. "Physical activity status, chronic stress, cardiovascular risk factors and telomere length in an urban South African teachers' cohort : the SABPA study / Erna Jana Bruwer." Thesis, 2014. http://hdl.handle.net/10394/14220.

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The dose-response relationship between physical activity (PA), disease and mortality has primarily been obtained from self-report questionnaires in Western populations. A major limitation of self-reported PA is the likelihood of measurement error and these recordings cannot account for all 24-h activities, thus negating the influence of sedentary time and daily light intensity activity. Modern-day studies using objective measures of PA are highly controversial in the description of PA, as well as reliable wear time of these objective devices to accurately assess PA behaviour. The aim of the research presented in this thesis was to ascertain the associations between seven-day objectively measured PA (expressed as time spent in four different metabolic equivalent of task (MET) categories), cardiovascular disease risk factors (24-h ambulatory blood pressure and central obesity), chronic stress (General Health Questionnaire total score and serum cortisol) and DNA damage (leukocyte telomere length) in a cohort of African and Caucasian school teachers recruited from the Dr Kenneth Kaunda Education District in the North West Province of South Africa. All parameters were objectively measured (the GHQ was only added for thoroughness on measures of cognitive perceived stress) in the study population. The Africans (n=96) were younger than the Caucasians (n=107) (48.33 versus 51.06 years, p=0.024), but presented with slightly higher waist circumferences, significantly higher 24-h ambulatory systolic blood pressure (SBP, p≤0.000), diastolic blood pressure (DBP, p≤0.000) and mean arterial pressure (MAP, p≤0.000); significantly higher perceived stress scores (GHQ total scores, p=0.001) and significantly shorter telomeres (p≤0.000). The hypertensive participants in the total group (Africans and Caucasians combined) recorded 2.2 hours (12.4%) more daily awake sedentary time than the normotensive participants (p=0.004) and sedentary time was also a slightly better predictor of hypertension than moderate and vigorous activity time (Odds ratio=1.00, p=0.006). Irrespective of race and sex, 24-h SBP and DBP measurements were respectively associated with daily awake sedentary time (ß=0.17, p=0.018 and ß=0.18, p=0.020), light activity time (ß=-0.15, p=0.043 and ß=-0.16, p=0.041), waist circumference (ß=0.45, p≤0.000 and ß=0.33, p≤0.000) and log serum gamma glutamyl transferase (γ-GT, alcohol use) (ß=0.18, p=0.018 and ß=0.24, p=0.004). An older age (ß=-0.28, p≤0.000), higher alcohol consumption (ß=-0.21, p=0.003) and increased central obesity (ß=-0.17, p=0.017) were associated with shorter telomeres. Attenuated cortisol levels (ß=-0.12, p=0.068) showed a tendency towards associations with longer telomeres that may indicate possible cortisol down regulation to protect against DNA damage. Time spent in the different MET-categories showed no direct associations with either cortisol or telomere length. However, a sensitivity analysis indicated that daily light intensity activity time was significantly correlated with lower waist circumference (r=-0.21, p=0.004); a parameter associated with both cortisol (ß=-0.22, p=0.003) and telomere length (ß=-0.17, p=0.017). The thorough recording of PA during the true awake time of 24-h cycles over a period of seven days ensured that the beneficial effect of light intensity activities, as well as the detrimental effect of sedentary time, was highlighted by this study. The average awake time of all ethnic and sex groups were around 17 hours per day, which was more than most previous studies using objective measures of PA. The exclusion of participants who did not comply through wearing the Actiheart for a full seven days (n=143, 40%) did, however, have a negative impact on sample size that may have affected the statistical power for uncovering some significant associations and the high participant burden of the Actiheart device became clear. Therefore, the researchers used the data of the full seven-day recordings to also determine the minimum number of consecutive days the Actiheart device could be worn to accurately estimate energy expenditure and PA. The two-day combination of Wednesday-to-Thursday did not differ from the weekly average TEE, as well as for all MET-categories in all ethnic and sex groups. This two-day combination is practically convenient and would lessen participant burden. Future researchers are urged to test this combination in other populations to standardize Actiheart wear time. It can be concluded from the findings in this study that less daily awake sedentary time, more light intensity activity time, as well as lower alcohol consumption favour improved health as it is beneficial to 24-h ambulatory blood pressure and helps to maintain a healthy waist circumference, which ultimately influence telomere shortening. Furthermore, the two-day combination of Wednesday-to-Thursday seems to be sufficient to accurately estimate weekly energy expenditure and habitual PA with the Actiheart apparatus.
PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2015

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夏子康. "A public partaking model of urban planning a cohort study in the case of redeveloping project of west gate downtown and Wan Hua station." Thesis, 1991. http://ndltd.ncl.edu.tw/handle/08391119428731204029.

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"Students with disabilities and high school completion: Systemic analysis of one four-year cohort of special education students in a large, urban-fringe, school district." UNIVERSITY OF WASHINGTON, 2009. http://pqdtopen.proquest.com/#viewpdf?dispub=3328513.

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Tsai, Su-Ying, and 蔡夙穎. "Population assessmentand comparison of health-related quality of life among urban, rural, and remote island community elderly in Taiwan--a cohort study of 2000-2003." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/22683783040496171261.

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博士
國立陽明大學
公共衛生研究所
92
Since 1994 the proportion of elderly people in Taiwan has exceeded 7%, which is the criterion for an aging society defined by World Health Organization (WHO). The age distribution of Taiwanese population is changing rapidly. The aging process and the frail elderly will trigger a huge demand for health services and medical needs. Previous survey in Taiwan reported that approximately 2.4%-5.4% of community old adults said they cannot perform some basic activities of daily living and 8.2%-9.0% reported they cannot perform some instrumental activities of daily living. Their quality of life suffers as a result, and capacity of independent living in their late life can be hampered. Health-related quality of life (HRQOL) assessment is a particularly important public health tool for the elderly in an era when life expectancy is increasing. The 36-item short form of the Medical Outcomes Study questionnaire (SF-36) was designed as a generic indicator of functional status and well-being for use in population surveys and clinical researches, and measurement of health-related quality of life was attempted with the goal of providing widely accepted criteria for evaluating the impact of disease conditions on subjects or patients. However, the epidemiology of HRQOL among the general population in Taiwan is not well studied. Furthermore, little attention has been given to the investigation of health status or health-related quality of life in affluent settings of the same country. The purpose of the study attempts to provide a profile of elderly population’s health-related quality of life from clearly defined community elderly samples in Taiwan, derived from urban (shihpai community), rural (Yuli community), and remote island (Kinchen community) districts and to explore a series of the impacts of health-related quality of life on associated factors. Main purposes were (1) to establish and compare population-based HRQOL elderly norms for the SF-36 among urban, rural, and remote island community elderly;(2) to explore the impacts of chronic diseases, medical care services, functional ability, and demographics factors on HRQOL; (3) to assess whether health-related quality of life was a predictor of three-year mortality; (4) to assess the effects of chronic diseases and clinical factors on three-year HRQOL changes; (5) to examine the relationship between lifestyle behavior over three year after HRQOL improvement or deterioration. This study design was an observational community-based cohort study over a three-year period. A population-based survey using the SF-36 among noninstitutionalized subjects 65 years of age and older was conducted in three districts. The government household registration system served as the sampling base for the survey. Door-to-door home visits based on a structured questionnaire were performed for data collection. Interviewers also collected information on subjects’ demographics, chronic disease medical history (or symptoms), use of health services, personal lifestyle, functional ability, fall event, and health-related quality of life. Of the potential 6053 study subjects, 4,424 participated in the baseline survey, and all were considered eligible subjects for a continuing fixed cohort study in 2003. After intense follow-up, 2,767 (74%) subjects were followed-up in three districts. Of the eight scales of SF-36, general health perception was the lowest scores (mean score = 64.2) and social functioning was the highest scores (mean score = 87.0) in Taiwanese elderly. The urban norms were significantly higher than the rural norms in seven scales of the SF-36 and significantly higher than the remote island norms in four scales, including physical functioning (84.6 vs 77.1), role limitations due to physical problems (77.8 vs 70.2), general health perceptions (70.5 vs 65.5), and role limitations due to emotional problems (90.6 vs 85.2). Remote island norms were significantly higher than urban and rural norms in vitality and mental health scales. Physical Component Summary (PCS) scores of urban population were significantly higher than those of rural and island populations (scores 52.6 vs 48.3 vs 49.3, respectively; P<0.05); mean Mental Component Summary ((MCS) scores among the island elderly were higher than urban and rural norms (scores 52.7 vs 49.6 vs 48.5, respectively; P<0.05) In the cross-sectional study, women had significantly poorer scores in all scales of the SF-36 than men (P<0.05). Higher education was significantly associated with increased scores in all scales, except for mental health scale. Scores of all scales were significantly reduced according to the number of chronic diseases a subject had. The need for domestic services and widespread body pain were also significantly associated with lower PCS and MCS scores. The elderly with cardiovascular disease, poor sleep, and depressive moods revealed that they had poorer scores on MCS wherever the subjects inhabited. Utilization of inpatient services, diabetes, stroke, and falls were significantly and independently associated with lower PCS scores. From follow-up data, three-year cumulative mortality rate for the study population was 5%, and cumulative mortality rate increased with age (P=0.001). Among the three districts, three-year cumulative mortality rate in the rural area was the highest (6.36%), followed by the remote island (4%), and urban areas (3.97%). For a five-point lower baseline score, a significant relationship between all scales and mortality was demonstrated, except for bodily pain (RR=1.02, 95% CI=0.99-1.04). A five-point decrement in baseline PCS score had a RR of 1.26 (95% CI: 1.18-1.35) as well as in baseline MCS score- Relative Risk (RR) of 1.08 (95% confidence interval (CI): 1.01-1.16). After three years follow-up, our results found that women in the urban district still reported poorer health on all scales of the SF-36 than did men in the urban district (P<0.05), except for three scales of role limitation due to physical problems and emotional problems and mental health, however, all scales between gender were not significantly different between rural and remote island elderly in the follow up survey, even though part scales revealed that men had better HRQOL than women in baseline survey. To compare baseline and follow-up profiles of eight scales for the SF-36, our study found that unadjusted mean scores on all scales were significantly higher (better) at follow up in urban areas, except for physical functioning; rural subjects’ HRQOL had an improvement three-year later in role-limitation due to physical problems and vitality scales, while bodily pain tended to deteriorate. The scores in remote island tended to improve in role limitation due to physical problems and emotional problems and general health perception while the scores declined in mental health. Among women, a similar relation with improvement in most scales of HRQOL was seen three years later in all three districts, however this was not the case for male elderly in the three districts. We attempted to stratify by gender to explore the effects of chronic diseases and clinical factors on three-year HRQOL changes after adjusting demographics and personal lifestyle using mixed model. The results in urban males revealed that depressive mood, need for domestic services, utilization of emergency services in baseline, hypertension, and poor sleep were independent predictors of three-year HRQOL deterioration after adjusting other possible confounding factors. Urban females revealed that unhappy mood, arthritis, cardiovascular disease, and stroke were directly associated with three-year HRQOL deterioration. Three-year HRQOL deterioration associated factors in rural males included need for domestic services, utilization of emergency services, poor sleep, and cardiovascular disease; those in rural females revealed that arthritis, unhappy mood, stroke, hypertension, utilization of emergency services in baseline were independent predictors of three-year HRQOL deterioration. The results of remote island males revealed that having cardiovascular disease, poor sleep, unhappy mood, and stroke were significant predictors of three-year HRQOL deterioration; those of females revealed that stroke, cardiovascular disease, and arthritis had a negative impact on three-year HRQOL deterioration. After discussing the impact of chronic diseases and clinical factors on HRQOL, our results showed that the negative effect indeed existed, but these factors played an irreversible role in later life. What are the modifiable predictors of HRQOL improvement and deterioration in later life? Our results found that good blood pressure control, normal figure, non-smoker, use of uterine cancer screening among women, and having no tired, asthmatic, and chest pain symptoms, and non-drinker were independently associated with improvement of HRQOL three years later. On the contrary, poor blood pressure control, smoking, no use of uterine cancer screening among women, and having tired and chest pain feeling were independently predictors of HRQOL deterioration after three years adjusting for other possible factors. In conclusion, there were significant differences between urban, rural, and remote island elderly populations in most scales of the SF-36. A significant relationship between most items, scales, and two summary measures of HRQOL and three-year mortality was demonstrated. It revealed that HRQOL measurement was significant predictor of mortality of the community elderly. Our results demonstrated that chronic diseases and clinical factors in baseline had negative effects on three-years later HRQOL changes, but these factors played an irreversible role in later life. The importance of healthy lifestyle and behavior in daily life is evident, because these factors are modifiable, including blood pressure control, normal figure, no use of tobacco and alcohol, use of uterine cancer screening among women.

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Dlamini, Siphosenkhosi Nathaniel. "The relationship between single mothering and adolescents' sexual behaviour in black families in urban South Africa: a retrospective analysis of the birth to twenty cohort." Thesis, 2015. http://hdl.handle.net/10539/18697.

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A thesis submitted to the faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfilment of requirement for the degree of Doctor of Philosophy 30th April, 2015
In South Africa, children are more likely to grow up in a single mother family than in any other family structure. A single mother refers to a mother who is living with children younger than 18 years of age and who is neither married nor living with a partner. A recent report by Statistics South Africa (2012) showed that at national level, in 2011, there were more children (42.5 %) aged below 5 years that lived with their biological mother only. And almost half (45.6 %) of those children are black African children. At the beginning of the Birth to Twenty cohort study, of the 3273 mothers and their children who were enrolled in the study, 1800 (almost 55 %) of them were single mothers and about 80 % (1440) remained single 10 years later. A wealth of research conducted abroad shows that children growing up in single mother families are associated with sexual behaviour that may jeopardise their well‐being. South Africa provides an important setting in which to explore the relationship between single mother families and their children’s sexual behaviour because of the statistics shown above. There is currently little knowledge about the relationship between the duration and timing of exposure to single mother families and the age of first sex for children. This thesis attempts to address this research gap. Retrospective data from the Birth to Twenty cohort (Bt20) was used to investigate whether there is an association between single mothering and adolescent sexual behaviour in the South African context, and to examine the impact of the duration and timing of exposure to single mother families for both adolescent males and females. Lastly, it sought to test mediating factors such as father and extended family involvement and other characteristics of the mother, like educational attainment and the age at which she had the child, on the relationship. Of the 3273 children and their mothers enrolled in the study in 1990, 1145 mother and their children were selected for this study and the children were 19 years of age at time of interviews. The study found that the average ages at first sex for children who have spent their entire lives in single mother families (fully exposed) and those who have always been in two-parent families (never exposed) are not significantly different from each other. Children who have been in single mother families for only some of their lives showed lower average ages at first sex, which suggests that they are more likely to start being sexually active at an early age than the other two groups. Children who were found to have spent more time (more than 9 years) in single mother families than in two‐parent families were found to be at higher risk than those who have been in two-parent and single mother families all their lives. When children have been partially exposed to single mother families before age 11, they are also more likely to engage in sexual activities than those who have been either fully exposed to or not exposed to single mother families at the same age. After controlling for demographic and socio-economic backgrounds, we found that maternal factors also have an impact on the age at which children start having sex. Children were found to be more likely to become sexually active before age 18 if they were born to a younger mother or a mother who had only primary education or no formal education. In addition, boys were found to be twice as likely to engage in sex by age 18 than girls, and were more than seven times likely to engage in sex by age 15, keeping all factors constant. Non-resident father contact and financial support are crucial determinants of delayed sexual activity at all developmental stages, and extended family support is important in early and late childhood. In conclusion, the main finding of this thesis is the importance of partial exposure to single mother families. Children who have been partially exposed to single motherhood were found to be at a higher risk of initiating sex earlier. This also shows how the instability of family structure might be a factor in adolescent sexual onset and this affects both boys and girls equally and at all developmental stages, despite the fact that boys are more prone to engage in sex at an early age than girls.

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Dissertations / Theses on the topic 'Urban cohorts'

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