Thesis (Ph. D.)--West Virginia University, 2006. / Title from document title page. Document formatted into pages; contains xii, 226 p. : ill. (some col.), maps (some col.). Vita. Includes abstract. Includes bibliographical references (p. 214-225).

Thesis (H.S.D.)--Indiana University, 2003. / Includes bibliographical references (leaves 136-143).

Thesis (M.S.)--Purdue University, 2004. / Includes bibliographical references (leaves 47-50).

Thesis (doctoral)--Universität Mannheim, 2008. / Includes bibliographical references.

Thesis (MSc.)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: “Road deaths are no accident'. This is the slogan of Phase III of the Arrive Alive campaign which was launched on Monday, 23 November 1998. Traffic as well as the safety thereof should be the concern of every single person. Everyone is in some or other way exposed to traffic on a daily basis. The problems that are experienced with the effective enforcing of traffic regulations are extremely complex, consisting of numerous facets. It is also a problem that is experienced worldwide. Quite a few attempts have been made and are still being made in order to decrease the yearly carnage on our roads, both locally and nationally. Our main transport routes (the N1 route) carry an extremely heavy / large vehicle load. It is a problem that gets more serious each year as the number of vehicles on our roads increase. Therefor one can make the prediction that vehicle collisions will also increase on a yearly basis. The aim of this research was to identify existing geographic risk factors and human factors on the N1 route. The N1 route was selected because it is notorious for its high collision rate, and also because it is the main road transport route between the Cape and Gauteng. The number of accidents on a given track were expressed as the number of accidents per 100 million kilometers travelled, compensating for the different traffic volumes on the different tracks as well as the different track lengths. According to this a track was labelled either as a high risk or a low risk track. The seriousness of the accident was also categorized into two groups, namely serious or non-serious, depending on the severity of the injuries that were sustained in the accident. In this study it has been found that bad road and weather conditions had no significant effect on the number of accidents or the seriousness of the accidents. Although the route is not rated as challenging, it is important to mention that there is a serious tediousness aspect that is experienced over the long distances. Quite a few accidents seem to be contributed to some or other human error. Although the numbers are not standardized, certain trends could be identified when looking at the time of day, day in a week or monthly periods in a year when Stellenbosch University http://scholar.sun.ac.za/ more accidents took place. Finally, it has been found that a GIS has exciting application possibilities in solving traffic problems by implementing effective traffic management systems. To achieve this, existing problems and shortcomings need to be identified and addressed. However, without the help, support and co-operation of the public and authorities it would not be possible. / AFRIKAANSE OPSOMMING: “Padsterftes is geen ongeluk nie’\ so lui die slagspreuk vir Fase III van die Kom Veilig Daar - veldtog wat op Maandag, 23 November 1998 in werking getree het. Verkeer en die veiligheid daarvan raak elke landsburger persoonlik, omdat elkeen op een of ander wyse daagliks direk daaraan blootgestel word. Die probleme wat met die effektiewe toepassing van verkeersveiligheid ondervind word, is ‘n wereldwye probleem wat uit talle fasette bestaan. Verskeie pogings word tans op beide lokale en nasionale vlak aangewend om die hoeveelheid verkeersongelukke op Suid- Afrika se paaie te verminder. Suid-Afrika se hoofroetes (o.a. die N1 roete) dra geweldige hoe verkeersvolumes. Dit is ongelukkig nie net ‘n tydelike probleem nie, maar !n aspek wat jaarliks toeneem vanwee die toename in motorvoertuie. Daar is dus potensieel ook meer motorvoertuigongelukke. Hierdie navorsing het gevolglik ten doel gehad om bestaande risiko-faktore op die N1 roete te identifiseer, hetsy geografies of menslik. Die N1 roete is as studiegebied geidentifiseer vanwee sy berugtheid t.o.v. motorvoertuigongelukke, en ook omdat dit die hoof padvervoerroete tussen die Kaap en Gauteng is. Verskillende verkeersvolumes en trajeklengtes is in ag geneem ten einde die aantal ongelukke vir elke trajek te bereken. Hiervolgens is die trajekte as ‘n hoe-risiko of lae-risiko trajek getipeer afhangende van die aantal ongelukke wat op die betrokke trajek plaasgevind het, uitgedruk as die aantal ongelukke per honderd miljoen kilometer gereis. Daar is bevind dat slegte pad- en weerstoestande geen effek op die aantal of ernstigheidsgraad van die ongelukke gehad het nie. Behalwe vir die eentonigheidsaspek wat oor die lang afstande ondervind is, is die roete self nie buitengewoon uitdagend nie. ‘n Groot aantal van die ongelukke blyk direk of indirek die bestuurder se skuld te wees, wat aan ‘n verskeidenheid menslike faktore toegeskryf kan word. Alhoewel die syfers nie gestandaardiseer is nie, kon daar tog sekere tendense geidentifiseer word wat daarop dui dat daar sekere tye per dag, week, of jaar is wanneer hoer voorkomste van motorongelukke ondervind is. Ten slotte is gevind dat daar geweldig baie gebruiksmoontlikhede vir ‘n GIS bestaan om verkeersprobleme met korrekte en effektiewe verkeersbestuur die hoof te bied. T en einde dit te realiseer moet tekortkominge in bestaande praktyke aangespreek word, en moet die onontbeerlike hulp, ondersteuning en samewerking van die publiek en owerhede verkry word.

The purpose of this study was to determine whether age, gender and experience level of climbers and mountaineers have a relationship to the type of accidents or the immediate cause of accidents occurring in Colorado. Through examination of the relationship between climbing and mountaineering accidents and the selected variables, insight into accident prevention, as well as information that may be useful in developing training and curriculum on rock climbing and mountaineering practices can be gained. Categorical data on five variables from 114 accident reports were collected to conduct this study. The accident reports came from the American Alpine Club's publication Accidents in North American Mountaineering 1997-2007. All accidents that occurred in Colorado from 1997 through 2007 were used for this study. The study found that males had more accidents than females. It also found that climbers in the "experienced" category had more accidents than climbers in the "little or none" category. The study found a relationship between experience and type of accident, with more experienced climbers having more accidents. There was also a relationship between experience and cause of accidents, with more experienced climbers having more accidents.

Made available in DSpace on 2014-06-11T19:29:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2001Bitstream added on 2014-06-13T20:59:50Z : No. of bitstreams: 1 fuonke_a_me_botfm.pdf: 3019390 bytes, checksum: ab8dd084de9087784c2aa9b8d6025ae1 (MD5) / Este estudo descreve a ocorrência dos acidentes do trabalho (típicos, de trajeto, doenças profissionais e doenças relacionadas ao trabalho), contemplando aspectos relativos às empresas (setor e ramo de atividade econômica); a atributos dos acidentados (idade, sexo, estado civil e ocupação); a características dos acidentes (tempo decorrido após o início da jornada, causa externa, natureza da lesão, afastamento do trabalho e duração provável do tratamento) e ao local de atendimento, objetivando fornecer subsídios à implantação de programa de saúde do trabalhador no município. O material consiste de informações contidas em Comunicações de Acidentes do Trabalho (CAT), referentes aos casos ocorridos de 1º de julho de 1999 a 30 de junho de 2000 e registrados na agência local do Instituto Nacional do Seguro Social (INSS). As informações, transcritas para ficha de codificação, codificadas e digitadas por profissional treinado, foram processadas eletronicamente, utilizandose Programa Epi-Info, versão 6.04. No período do estudo foram registrados 521 acidentes do trabalho, assim distribuídos: 28 (5,4%) casos de doenças profissionais e relacionadas ao trabalho, 65 (12,5%), acidentes de trajeto e 428 (82,4%), acidentes do trabalho típicos. O pequeno número de casos de doenças registradas foi considerado indício de problemas de diagnóstico e, ou de registro desses agravos. Nos acidentes de trajeto e nos acidentes típicos ocorridos fora da empresa envolvendo meios de transporte: A) as lesões foram mais graves do que nos demais casos; B) as motocicletas participaram, respectivamente, de 51,3% e 66,7% dos casos e, as bicicletas, de 33,3% e 16,7%. Em relação aos acidentes típicos ocorridos nas empresas, observou-se que: A) de 55 acidentes pérfuro-cortantes ocorridos em empregados de hospitais e notificados ao Sistema de Vigilância... / This study describes the occurrence of work accidents (typically, of commuting, professional, and work related illnesses) looking at company related aspects (sector and type of economic activity); victim data (age, sex, status, and occupation); accident characteristics (length of time into shift of accident, external cause, nature of the lesion, time off work, and probable duration of treatment) and at the treatment center, with a view to providing subsidies for implanting the municipal program for workers heath. The material consists of information from Work Accidents Reports (Comunicações de Acidentes do Trabalho - CAT), between 1st July 1999 and 30th June 2000 registered at the local social security office of the Instituto Nacional do Seguro Social (INSS). This information, transcribed using code cards and computerized by a trained coder, processed electronically using Epi-Info, version 6.04. During the study period 521 accidents were processed: 28 (5.4%) professional and work related illnesses; 65 (12.5%), commuting accidents; and 428 (82.4%), typical work accidents. The small number of registered illnesses was considered an indication of diagnosis problems and/or of registration. In commuting and typical work accidents occurring outside the workplace involving transportation: A) the lesions were more serious than the other cases; B) motorcycles were involved in 51.3% and 66.7% respectively, and bicycles in 33.3% and 16.7%. From typical workplace accidents, we observed: A) of the 55 puncture/cut type accidents on hospital workers notified to the Epidemiological Monitoring System, only 6 were registered with Social Security; B) the companies which registered between one and four cases were mainly small; they had the highest percentage of cases requiring time off... (Complete abstract click electronic access below)

Falls are the most frequent cause of injury-related hospitalization and death for people 65 years and older in Canada (Canadian Institute of Health Information, 1998; Langlois et al., 1995; Raina & Torrance, 1996). Studies show the etiology of a falls to be a complex combination of factors that reflect physical, behavioral and social conditions operating alone, or in conjunction with environmental hazards (Speechley & Tinetti, 1991; O'Loughlin et al., 1993). However, the particular role of these factors in relation to falls that result in injury— the subject of this study— is less well understood. Fall-related injuries among frail, older, community-dwelling adults are the focus of this study due to the growing numbers of seniors living in the community who have multiple chronic conditions, the serious consequences of many of these events for this population, and the mounting costs related to treatment. The purpose of this study was to understand the extent and nature of fall-related injuries among frail older adults and to examine the patterns and compounding effects of a wide range of variables representing biological, behavioural, environmental, social and economic risk factors. Differences were examined for risk factors among fallers, nonfallers, injured and non-injured persons. The secondary data used for this study were provided through the University of Victoria Centre on Aging in British Columbia and are based on the Capital Regional District (CRD) Patterns of Care Survey 1995-96 (Centre on Aging, 1996). The data from the CRD Survey are based on interviews with frail community-dwelling seniors represented by two purposefully selected groups. One group consisted of over 3,000 seniors in the CRD receiving publicly-funded home support services in 1995, and the other, a matched sample of 810 seniors screened by age, gender and functional limitations, drawn from the 56,774 seniors in the CRD not receiving home support services. Five hundred and six participants were randomly selected from each group. Of the 1012 respondents to the CRD Survey, 245 reported a fall with an injury, 91 reported falling without an injury and 675 were non-fallers (fall data were missing for one case). Findings showed that 72.9% of those who fell reported being injured as a result of one or more of their falls. This injury rate is considerably higher than that found in other studies that look at the general population of persons aged 65 and over. These differences are explained by the precondition of frailty that defines the population in the CRD Survey. Findings also differ from most other studies in the lack of association found between falls with injury and advanced age or female gender, indicating the strong influence of frailty, regardless of age or gender, for this sample. The results indicate that considerable differences exist in the patterns and combined effect of multiple risk factors between older adults who fall and sustain an injury and those who do not. The findings both confirm and contradict the findings of earlier studies, as well as shedding light on factors not previously studied. This study was conducted from a critical gerontological perspective. This perspective is particularly relevant to the study of seniors’ issues that are influenced by a complex combination of factors— such as fall-related injuries— as it enables an examination of multiple perspectives of the issue within larger social, economic and political contexts. A critical gerontological framework was use in this study to guide the selection of variables, to explain the findings in light of previous knowledge, and to critically examine social policies that influence the ability to implement strategies for prevention. / Graduate

L’objet de cette thèse est de présenter les spécificités épidémiologiques, étiologiques et thérapeutiques de la pathologie neurovasculaire dans la population noire spécifique que constitue la population martiniquaise. En 1998, l’étude ERMANCIA I a permis de mettre en évidence une surincidence des accidents vasculaires cérébraux (AVC) en Martinique d’environ 40% par rapport à la métropole avec une haute prévalence de l’hypertension artérielle et du diabète. Ces résultats ont participé à la création en 2003 de la 1ère unité neurovasculaire aux Antilles. Le suivi à 5 ans des patients ERMANCIA I a révélé que la moitié était décédée et que 50% des survivants présentaient une démence vasculaire (soit le double des cohortes métropolitaines), probablement favorisé par une microangiopathie cérébrale sous-jacente souvent sévère amplifiant l’impact cognitif de l’AVC. Ce suivi a également permis d’identifier les faiblesses de la prévention secondaire en Martinique avec près de 80% des hypertendus qui restent mal équilibrés justifiant la création en 2006 d’un réseau de prévention. L’efficacité de ce réseau a été évaluée montrant un taux élevé de bon contrôle tensionnel (74% vs 39%, p=0,01) et une morbi-mortalité vasculaire moindre à 2,5 ans (8,3% vs 24%, p<0,001) que chez les patients contrôles. En 2012, ERMANCIA II a permis de révéler une diminution majeure (en moyenne 30%) de l’incidence des AVC dans la population martiniquaise et de la mortalité à 1 mois pour les patients ≤55 ans (20% vs 8%, p=0,03) probablement en raison d’une meilleure implémentation des mesures de prévention primaire et de la prise en charge en UNV respectivement. Nos données ont également permis de décrire certaines spécificités étiologiques des AVC chez les Martiniquais : grande fréquence de l’athérome intracrânien (pour lequel nous apportons des arguments en faveur d’une nouvelle classification), infarctus choroïdiens antérieurs dont nous décrivons le profil évolutif particulier, infarctus lacunaires multiples sévères. Deux étiologies plus « classiques » comme la drépanocytose et les IC sur morsure de serpent sont devenues anecdotiques. En revanche, une dysplasie carotidienne focale, étiologie déjà décrite mais supposée rare , pourrait être responsable d’un tiers des infarctus carotidiens d’origine indéterminée chez les Afro-Caribéens ≤55 ans exposant à un risque élevé de récidive sous traitement antiagrégant (28% à 14 mois), contre aucun pour les patients traités par endartériectomie. Sur le plan thérapeutique, nos résultats sont en faveur d’un surrisque hémorragique de la thrombolyse standard chez les patients martiniquais les plus âgés, probablement en rapport avec un cumul de lésions microangiopathiques plus important. En l’absence de neuroradiologie interventionnelle en Martinique, nos travaux montrent que certains patients avec occlusion artérielle proximale résistante à la thrombolyse IV standard peuvent bénéficier d’un complément de thrombolytique (0,1mg/Kg de tenecteplase). Une étude randomisée est prévue afin de mieux mesurer le potentiel thérapeutique de cette stratégie. Pour conclure, l’intérêt de ces données est que la population martiniquaise partage très probablement beaucoup de ses « particularités » avec d’autres populations noires encore peu décrites et pour lesquelles l’occidentalisation progressive du mode de vie risque d’accentuer le fardeau représenté par les AVC. / Our work presented herein aimed to describe the epidemiological, etiological and therapeutic features of the stroke pathology in the Martinican Afro-Caribbean population. In 1998, the first population-based epidemiological study, ERMANCIA I, showed a 40% greater firstever stroke incidence in Martinique compared to those observed in continental France, with a high prevalence of hypertension and diabetes. These results contributed to the creation, in 2003, of the first stroke unit in the Caribbean area. In the 5_year follow-up study, we found that half of the patients had died and that 50% of survivors were affected from vascular dementia (twice compared with continental French cohorts): this figure was probably favored by severe underlying cerebral microangiopathy that amplified the cognitive impact of stroke. We also identified a failure in the secondary prevention in Martinique, certified by nearly 80% of hypertensive patients still insufficiently controlled. As a result, in 2006, we developed a well-structured stroke prevention network. The efficiency of this network was attested by the high rate of good blood pressure control (74% vs. 39%, p=0.01) and the reduced vascular morbidity and mortality rate (8.3% vs. 24%, p <0.001) after a 30-month period of activity, in comparison with control “historic” patients. In 2012, ERMANCIA II study revealed a 30% reduction of first-ever stroke incidence and a reduced mortality rate at 1 month for patients ≤55 years (8% vs. 20%, p = 0.03), compared to these observed in ERMANCIA I, likely due to improvement of primary stroke prevention and the best stroke unit management at the acute phase, respectively. Based on our etiological data, we underline: 1) the relatively high frequency of symptomatic intracranial atherosclerosis, for which we propose a new definition; 2) the clinic-radiological features of stroke in the anterior choroidal artery; 3) the atypical picture of “malignant” multilacunar syndrome. On the other hand, stroke due to sickle cell disease or “trigonocephale” snakebite were only anecdotal. However, we found that carotid-bulb atypical fibromuscular dysplasia (CAFD), a very unusual previously described cause of stroke, could be responsible for up to the third of carotidterritory stroke of so-called undetermined etiology among patients ≤55 years. In addition, the relatively high rate of recurrence under antiplatelet (28% at 14 months), was dramatically reduced by endarterectomy in patients with CAFD. From a therapeutic point of view, our results showed an excess rate of post-thrombolysis symptomatic intracerebral hemorrhages in older patients, a figure probably linked to the severe underlying hypertension-triggered cerebral microangiopathy. Owing to the lack of neurointerventionnal option in Martinique, we tested a new therapeutic strategy in patients with a proximal arterial occlusion not responsive to standard IV thrombolysis, consisting in an additional administration of IV tenecteplase, 0.1mg/kg. Our preliminary results were promising, leading us to plan a randomized study. Finally, most of the characteristics of stroke in this Afro-Caribbean population are probably shared by the majority of black people. Thus, our results could have a universal impact in the understanding of stroke burden in blacks.

Thesis M. A. (Psychology) -- University of Limpopo, 2019 / The CVA patients normally do not know what to expect and often get confused by the change of behaviour that may result. This is because little is done on informing them of the risk factors, the stigma attached to CVAs, and also some strategies on how to deal with all the experiences CVAs bring along with them. The main aim of this study was to inquire more about the lived experiences of people with cerebrovascular accidents in Ga-Dikgale, Limpopo Province. Ten people living with CVAs’ in Ga-Dikgale village, in the Capricorn district, were selected and interviewed. The interviews were audio-taped, and later transcribed and translated. The original data was reduced and interrogated to identify some emerging meaning units which further led to emergence of themes. Phenomenology and the health belief model were chosen as the relevant lenses with which the study could be viewed. Phenomenology helps understand the individual from his or her point of view while the health belief model describes how a person’s belief towards his or her health status can affect their healing process, and these are lens with which to view this study. Snowball and purposive sampling methods were used for sampling participants and data was collected through semi-structured face- to-face interviews. IPA was used for analysing collected data in this study. Most participants in this study were found to still believe that CVAs are a result of witchcraft, while ignoring the main risk factors such as hypertension, high blood pressure and diabetes, to mention a few. The study also study revealed the daily experiences of living with CVAs. It is not an easy thing for others as they have to endure a lot of pain and also the embarrassment of being unable to control their bodies and emotions. / National Research Foundation (NRF)