The development of a uniform method of epidemiological assessment and grading of malocclusion has been of interest for several decades. Recently, Daniels and Richmond (2000) proposed a new orthodontic index namely the Index of Complexity, Outcome and Need (ICON). Their aim was to develop a single index for assessing treatment inputs and outcomes.<br /> <br /> The aim of this study was to critique the ICON and to assess to the extent to which each component of the ICON fulfils the ideal requirements of the ideal index as identified in a World Health Organization Report (WHO, 1966). The study was performed in three parts: 1) a gold standard was established to test reliability and validity of the ICON / 2) to assess ease of use and simplicity of the index / 3) and to test the applicability of the index on patients and study casts. The results showed that the ICON identified 25% of the cases as &lsquo / no treatment&rsquo / , as apposed to the 100% of the gold standard. Validity of the index was shown to be &lsquo / poor&rsquo / for complexity (? = 0.2) and degree of improvement (? = 0.34) and &lsquo / excellent&rsquo / for outcome. Reliability was high for all the components except for treatment need (? = 0.63). This study concluded that except for complexity and degree of improvement, the index performed well with respects to reliability, validity (of treatment outcome), ease of use and simplicity and applicability to patient and study casts.

No description available.

The aims of the research project were to observe the operation of stabilization ponds with a view to investigating the value of various existing approaches used in the design of both facultative and maturation wastewater stabilization ponds and, if possible, to produce a realistic and reliable method for pond design. This latter aim was to be carried out either through the modification of existing equations or by the development of a new approach. In addition it was also intended to investigate the phenomena of dissolved oxygen and thermal stratification within stabilization ponds. The required data for this work was obtained as a result of detailed observation of the four-pond wastewater treatment installation in the Cayman Islands, British West Indies. Details of flows, flow strengths, removal of BOD and faecal coliform organisms were collected and numerous profiles of the pond contents were carried out to investigate dissolved oxygen and thermal stratification. Information concerning temperatures, solar radiation, hours of sunshine, relative humidity, rainfall, evaporation and wind speed and direction were also recorded over the three year investigational period. The most common design methods, the first-order complete-mix approach of Marais and Shaw and the modified empirical approach of McGarry and Pescod as modified by Mara and Arthur, were studied in detail using the results collected. These two design approaches were those used for the initial design of the Cayman ponds. Suggestions were then made for modifications to the first-order, complete-mix equation with regard to the values of the reaction coefficients employed for the removal of organic matter and of faecal coliform bacteria. Modifications of the equations to obtain K (the first-order reaction coefficient for either BOD or faecal coliform removal) were suggested. Following that a new empirical design approach was developed using the data collected from the operational ponds together with the climatological information. The models were developed in three steps. Firstly, matrices of correlation coefficients were produced to discover the existance of any strong correlations between any of the dependent and independent variables considered. Secondly, the Stepwise Backward Selection procedure for multiple regression (SBS) was applied to select the most relevant preliminary variables for multiple regression models. Then finially, the relevant variables were grouped in ordinary least-squares multiple regression models using a Hierarquical Multiple Regression procedure (HMR) to construct the models. As a result of this work groups of semi-empirical and empirical models were produced_ Two semi-empirical design models were developed to express K as a function of loading and climatic factors. These two equations were for the removal of BOO and faecal coliforms in facultative ponds. Two other groups of empirical design equations with a total of fourteen possible design models relating pond efficiency to factors such as loading, retention time and climatic conditions were also produced for the design of facultative and maturation ponds in the Caribbean region treating weak and saline wastewater. Also carried out were extensive field investigations into the temporal and spatial distributions of dissolved oxygen and water temperature in the ponds and as to how these varied with climatic conditions.

This portfolio has three parts. Part one is a systematic literature review entitled ‘Patients' Psychosocial Experiences of Attending Specialist Palliative Day Care: A Systematic Literature Review’. Recent reviews conclude that the benefits of attending Specialist Palliative Day Care are likely to be in the social, psychological and spiritual domains. However these areas are not easily identified, leaving researchers and practitioners unclear as to what aspects of these domains patients most need and desire. The objective of this review was to systematically evaluate literature on patient perceived psychosocial experiences of attendance at SPDC. Twelve studies were included. Evidence showed that patients value a person-centred approach which reduces isolation, increases social support, encourages communication and provides activities. Future research could focus on investigating why patients value the psychosocial experiences reported in this review and how these experiences can be defined in a way that would be meaningful to clinical service commissioners. Once this has been done, clinicians can start to measure clinical effectiveness and devise justifiable interventions for this patient group. Part two is a qualitative study, using Interpretative Phenomenological Analysis (IPA) to explore patients’ perspective of attending SPDC. The importance of services helping patients cope with terminal illness has been emphasised throughout Department of Health (2000) and NICE (2004) cancer guidance. However, whether or not services are achieving this aim has been sparsely researched to date; particularly in relation to Specialist Palliative Day Care (SPDC). Eleven semi-structured interviews were carried out and analysed utilising qualitative methodology (Interpretative Phenomenological Analysis – IPA) to allow for an in depth investigation of SPDC. Emerging themes suggest that SPDC provides an environment in which patients are helped to cope by facilitation of acceptance of the reality of death, thereby freeing them to focus on 'life'. The study does not claim to provide the definitive answer to what processes may underpin attendance at SPDC, however in such an under researched area it provides a much needed exploration which can be built upon or challenged by future research. Part three comprises appendices relating to the research. This includes a reflective statement on the process of conducting the research, the challenges faced and the lessons learnt.

No description available.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1997. / Epidemiological studies on low back pain (LBP), conducted in a number of countries, strongly suggest that LBP is internationally a very common condition, imposing a significant social and economic burden on society. It however appeared that the epidemiology of LBP among the black population of South Africa had not yet been investigated. The purpose of this study was to determine the prevalence of LBP in the formal black South African township of Chesterville, and to assess the extent to which LBP adversely affects the lives of the residents, in order to establish the need for specialized low back care in this community. A further aim of the study was to assess the associations between certain individual factors and the prevalence ofLBP. A population-based epidemiological survey on LBP was conducted on a sample of 1 000 residents of the township of Chesterville. After a pilot survey of 25 households suggested that the characteristics of the households in Chesterville were fairly similar with respect to the objective of the study, a clustered sample of 300 lots was selected from a layout map of Chesterville. All residents, aged 13 or older, living on these lots were interviewed by the researcher until a sample of 1 000 subjects had been achieved. The total population of Chesterville is approximately 20 000; hence the sample size covers 5% of the population of study. / M

<p>Extremal quantile index is a concept that the quantile index will drift to zero (or one)</p><p>as the sample size increases. The three chapters of my dissertation consists of three</p><p>applications of this concept in three distinct econometric problems. In Chapter 2, I</p><p>use the concept of extremal quantile index to derive new asymptotic properties and</p><p>inference method for quantile treatment effect estimators when the quantile index</p><p>of interest is close to zero. In Chapter 3, I rely on the concept of extremal quantile</p><p>index to achieve identification at infinity of the sample selection models and propose</p><p>a new inference method. Last, in Chapter 4, I use the concept of extremal quantile</p><p>index to define an asymptotic trimming scheme which can be used to control the</p><p>convergence rate of the estimator of the intercept of binary response models.</p> / Dissertation

Dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technology: Homeopathy, Technikon Natal, Durban, 1994. / The atm of this study was to determine if homeopathy has a role to play in the treatment of warts. This study focuses only on external warts (excluding genital warts). A sample of thirty patients was taken from the greater Durban area, and from this sample fifteen were treated with Homeopathic simillimum treatment and the remaining fifteen received placebo treatment. The study was conducted using the double blind protocol with all medications being prepared and dispensed by a neutral homeopathic pharmacist. Every twenty SIX days for the duration of the six month trial, patients' warts were photographed and questionnaires completed, regarding the patients' perception to the treatment. The study was divided into three sections viz. Subproblem one, two and three. Subproblem one was the objective analysis of the treatment by means of colour photography. Trace outlines of the warts from the photographs were scanned onto a computer which calculated the surface area of the warts. Each group (i.e. the control and treatment group) was then compared with themselves (i.e. before and after treatment) using the paired T-test, With the control group p= 0.670, indicating there was no statistically significant difference. With the treatment group p = 0.264, indicating there was no statistically significant difference. When comparing the surface area of the warts treated with homeopathy as opposed to those treated with placebo using the unpaired T-test no significant difference was found between the two groups (p= 0.947). Subproblem two was concerned with the subjective analysis of the treatment by measuring the patients perception to the treatment with a questionnaire. Each .group was then compared with themselves (i.e.before and after treatment) using the paired T-test. With the control group p = 0.623, indicating there was no statistically significant difference. With the treatment group p= 0.1002, indicating there was no statistically significant difference between the beginning and end of the treatment (although this value was closer to 0.05 than the Il value of the control group and thus more significant). When comparrug the patients perception to the treatment of those treated with homeopathy as opposed to those treated with placebo using the unpaired T-test p= 0.947, indicating there was not a statistically significant difference between the two groups. Subproblem three was a comparative analysis of subproblem one and two. There was a positive correlation between the wart surface area and the patients perception to the treatment with those patients recervmg Homeopathic treatment (p= 0.0225, Jr= 0.8246). 60% of the treatment group patients improved, 20% worsened and there was no agreement between subproblem one and two with 20%. There was a poor correlation between the wart surface area and the patients perception to the treatment with those patients receiving Placebo treatment (p= 0.9957, r= 0.0025). 33.33% of the control group patients improved, 46.67% worsened and there was no agreement between subproblem one and two with 20%. It was thus concluded that although there was not a statistically significant difference between the control and treatment groups, there was a difference measured (as can be seen considering the frequency of occurrences) and therefore homeopathy does have a role to play in the treatment of warts. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Technikon Natal, 1997. / This clinical trial focused on evaluating homoeopathic simillimum treatment of hand osteoarthritis. Emphasis was placed on assessing changes in measurable clinical manifestations and participants pain perception related to this condition. A double-bl ind, placebo-controlled protocol was uti 1ized involving 30 participants chosen from respondents to advertising in the Durban newspapers. Participants were randomly assigned to receive homoeopathic simillimum or placebo treatment. Bilateral antero-posterior-, oblique- and lateral hand and wrist x-ray's were taken to diagnose osteoarthritis. Clinical evaluation utilized the following tools: 1. Collin dynamometer (hand grip-strength) 2. Finger goniometer (degrees of mobility) 3. Circumeter (joint circumference measurements) 4. Aesthesiometer (articular index of joint sensitivity) The lOl-point Numerical Rating Scale (Jensen et al. 1986) was used to test pain intensity and the Short Form McGi 11 pain questionnaire (Melzack 1987) was used to monitor participants pain perception. All tests and questionnaires were repeated monthly over the three month trial duration . / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / There have been few studies conducted to determine the effects of stretching as a therapy on its own in the treatment of low back pain. In response to this, the objective of this study was to evaluate the relative effectiveness of stretching the hamstring muscles on low back pain experienced by cyclists. Thirty two cyclists with low back pain were screened for lumbar facet syndrome, sacroiliac syndrome and myofascial pain syndrome of the quadratus Iumborum, gluteus medius and gluteus maximus muscles and randomly divided into two groups of sixteen. Detuned ultrasound was applied to the hamstring muscles of the patients in the placebo group twice a week for three weeks. Patients in the experimental group were involved in a stretching program whereby the hamstring muscles were passively stretched for three sets of thirty seconds duration, two days a week for three weeks. Both groups were evaluated in terms of subjective clinical findings by utilising the Oswestry Low Back Pain Disability Questionnaire, the Numerical Pain Rating Scale-101, and theti / M