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No description available.

No description available.

No description available.

No description available.

Of all the injuries resulting from falls, hip fractures are often the most stressful and produce high levels of disability. The costs of hip fracture for Older Adults are considerable. These include risks of mortality, immediate morbidity associated with surgery, the loss of independence and long term deterioration in levels of functioning. In addition to any loss of function related to physical trauma, psychological trauma i.e. fear of falling, may also produce a decline in levels of physical and social activity which is self imposed. This study investigated the efficacy of a brief cognitive intervention in improving outcome amongst older adults after hip fracture. Two groups of participants were investigated with one group receiving the cognitive intervention and the other group treatment as usual. No significant effect was found in reducing fear of falling. However significant differences were found post-study in cognitive function, instrumental activities and duration of hospital stay suggesting that the intervention was effective in enhancing the outcome of rehabilitation. These results are discussed in relation to self-efficacy theory.

This thesis explores the contrasting experience of the discharge of older people from hospital on a Care of the Elderly Unit and Medical/Surgical Unit in a District General Hospital in North Wales. It comprises both the results of a Fourth Generation evaluation (Guba and Lincoln, 1989) and the later development of a substantive grounded theory of the discharge process (Charmaz, 2000). Both elements of the thesis were informed by a constructivist approach to research and the presentation and style of the thesis reflects this orientation. Data were collected from all the main stakeholder groups (members of the multidisciplinary team, patients and carers, members of the primary health care team) using a variety of methods including semi-structured interviews, documentary analysis and periods of observation. These data were then fed into a series of hermeneutic cycles in an effort to reach consensus about desired change. Barriers to both consensus and change were identified and explored largely in terms of the threat they posed to traditional medical power bases. The subsequent theory suggested that the differences between the Units could be explained largely in terms of the orientations on the ward, one of which 'processed patients' with an emphasis on pace (speed of throughput) while the other 'processed people' with more recognition of the complex needs of older individuals. In both Units the role of the nurse was significant and comprised a number of key processes: pushing; fixing; informing and brokering. The ways in which these processes interact are considered and their impact on the discharge process described. The quality of the thesis is considered on a number of criteria and the extent to which the results can be recontextualised is addressed. Finally, implications for policy and practice in the light of recent developments are discussed.

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No description available.

This is the first history of the Qwathi to appear. It relates all the events which have shaped the historical consciousness of the Qwathi people. The first chapter deals with the foundation of the Qwathi chiefdom by Mtshutshumbe and his followers who emigrated from EmaXesibeni to Thembuland before 1700. It also covers the development of the various Qwathi clans. The reign of Fubu which is discussed in Chapter Two was characterised by warfare. The most important of these wars was the Qwathi-Thembu war of the beginning of the nineteenth century. Its importance lies in the fact that although the Qwathi were a small chiefdom, they were able to goad the Thembu nation into war, the results of which were indecisive, hence, in subsequent years, the Thembu were always cautious in their dealings with the Qwathi. Fubu's other wars, including those of the Mfecane, are also discussed. Chapter Three deals mainly with the Qwathi-Thembu relations during the reign of Dalasile, Fubu's son. These were at first cordial but they became strained when Ngangelizwe took over as Thembu king in 1863. Dalasile refused to involve the Qwathi people in Thembu conflicts with their enemies and he desired to pursue an independent line. In 1875, when Ngangelizwe accepted colonial control, Dalasile stood out against it but, under pressure from the agents of colonialism, he gave in. The period from 1875 to 1880 was one of passive resistence to colonial control. This erupted into Dalasile's rebellion against the colony from 1880 to 1881. Chapter Six deals with the surrender, relocation and the introduction of a new system of control called the "Ward System". The ruling house was replaced by appointed headmen most of whom were drawn from non-Qwathi communities. Chapter Seven deals with the rise and Fall of the Qwathi peasantry. The fall of the peasantry facilitated labour migracy which contributed to further deterioration of the Qwathi both economically and physically.