Computers are used for diagnostic and training in the neuropsychological rehabilitation. PLANTEST is a program for the IBM-PC that was developed for diagnostic support. It implements a test that gives information about the reduced ability of brain-injured patients to make plans regarding a certain task.The presented thesis describes a knowledge-based system that can be used to develop new test versions for PLANTEST. The program is called SolvePT and it can prove the solubility of test material used in PLANTEST. It can also automatically generate new test material. The program uses an exhaustive forward-chaining, depth-first search and is implemented in Prolog. The datastructures and algorithm of the program as well as space and time requirements are discussed. / Department of Computer Science

Clinical research has shown that patients experience difficulty in adjusting to their pre-morbid worker roles after they have been through a back rehabilitation programme. The pressure and competitiveness of modern day society to achieve competence and to survive has proven to be stressful, both for the injured and uninjured, the unemployed and employed. Back rehabilitation and the successful return of the injured worker to the workplace have been of great interest to industry for the last decade, due to the ever-increasing support of legislature for the injured. There is a range of medical interventions available but few of these achieve successful outcomes due in part to the fact that many intervention strategies do not take the patients perspectives into consideration. Therefore, the purpose of the study was to explore back rehabilitated clients perceptions and experiences of the challenges they face in adapting to their worker roles.

[Truncated abstract] Unicondylar knee arthroplasty (UKA) has re-emerged as a successful treatment option for isolated single compartment tibio-femoral joint osteoarthritis. However despite its increasing use, controversy still remains over fixed or mobile bearing tibial components, as there is a lack to prospective randomised studies reported in the literature. In addition, the theoretical advantages of the mobile bearing for knee kinematics, kinetics and clinical outcome have not been evaluated in vivo. The aim of this research study was to explore the clinical and biomechanical outcomes of the fixed and mobile bearing UKA. . . . When the results for the both studies were combined, utilising the Preservation and MG fixed bearing prostheses, there was a significant relationship between knee adduction moment, and a poor prognosis predicted from RSA. Those patients with translation or rotation of the tibial component in any direction above 1mm and 1.5 degrees respectively were considered to have a poor prognosis for long term fixation. Of the 28 patients, the 8 patients considered to have a poor prognosis, had increased knee adduction moments post-surgery (mean difference = 1.66Nm.kg-1, p = 0.007). There was no difference between the groups for knee flexion moment (mean difference 0.16Nm.kg-1, p = 0.844). Pre-surgery gait was unable to predict the post-surgery outcome, due to the significant changes in gait from pre- to post-surgery. Care must taken when implanting the Preservation mobile bearing prosthesis, as long term outcome is questionable. The mobile bearing prosthesis also produced the worst clinical outcome, however the theoretical advantages of the mobile bearing does not affect gait. Gait analysis is a useful tool to identify patient who are overloading their prosthesis, leading to potential early failure. Identification of these gait patterns can allow for early intervention to reduce joint load, and possible extend the longevity of the prosthesis.

The present study is part of a larger and ongoing research initiative investigating the cumulative cognitive effects of mild head injury in rugby union and focused specifically on high school rugby players. A comprehensive battery of neuropsychological tests was administered to top team high school rugby players (n = 47), and a non-contact sport control group of top team high school hockey players (n = 34). Direct comparisons of group mean scores and standard deviations across each neuropsychological test were carried out for the Total Rugby group versus the Total Hockey group as well as for the subgroups Rugby Forwards versus Rugby Backs. A correlational analysis was conducted to ascertain whether a relationship exists between the number of mild head injuries reported by the players and their cognitive test performance. Results of the group comparisons of means and variability on WMS Paired Associate Learning Hard Pairs - Delayed Recall provides tentative indications of the initial stages of diffuse damage associated with mild head injury in the rugby group and provides some evidence for impairment of verbal learning and memory in the Rugby Forwards group. The correlational analysis revealed no significant relationship between number of reported mild head injuries and cognitive performance. The findings and possible latent effects of the multiple mild head injuries reported by the rugby players are discussed in terms of brain reserve capacity theory and suggestions for future research are provided.

Previous research suggested that sleep onset insomnia was significantly reduced with the use of relaxation techniques; however, the majority of these studies used college student populations with mild to moderate insomnia. The objective of the present study was to assess the effectiveness of using muscle relaxation training in a clinical population known to have sleeping difficulties—cancer patients. Results of this study suggest that muscle relaxation training is an effective technique to reduce sleep onset insomnia in cancer patients, and perhaps also in any clinical group. The technique seems especially promising since it was shown to be effective with severe insomniacs suffering severe medical problems. Results of the study were discussed in terms of possible explanations for the efficacy of the treatment, potential uses of the technique with other clinical populations, and ease of teaching nonpsychologist health professionals to treat with muscle relaxation training.

The study seeks to identify factors affecting compliance to TB treatment and determine those that make some patients complete TB treatment in Andara district, Kavango region in Namibia. The self-efficacy model by Shortridge-Baggett and Van der Bijl (1996) was the conceptual framework which guided this study. A quantitative, cross-sectional, descriptive and comparative study design was used. Data was collected using a structured questionnaire administered by a registered nurse. A total of 49 respondents were interviewed: (23 compliant and 26 non-compliant). Informed consent was obtained from each respondent prior to data collection. SPSS and MS Excel were used to analyse data and describe differences between the two groups. Respondents (N=26) gave „feeling better‟ 7 (27%), „distance‟ 8 (31%), „lack of family support‟ 4 (15%), no food 2 (8%), side effects 2 (8%), other reasons 2 (8%) and medicines not working 1 (4%), as their reasons for not completing treatment. However, long waiting times at the clinic, non availability of food and lack of knowledge of TB or treatment are the significant factors contributing to non-compliance. / Health Studies / M.A. (Public Health)

This study aims to explore, and to a certain extent to clarify, what it means psychologically to experience Traumatic spinal cord injury (TSCI) in a South African spinal unit. The target time chosen for analysis is the acute medical period. The study presents a review of the literature on psychological adjustment to TSCI and then proceeds to introduce and extensively articulate the hermeneutic approach and methodology. Subsequently, an interpretive research strategy is presented for the purpose of studying the acute phase of TSCI. The data for the study was obtained by means of three dialogical interviews which were tape recorded, transcribed and analyzed with~n a cyclical framework consisting of three interdependent levels. The interpretive procedure is modeled upon the 'reading guide' developed by Brown, Tappan, Gilligan, Miller and Argyris (1989). The analysis follows a course from the individual psychological descriptions of the experience to the generation of a general, nomothetic narrative account of the acute phase. The findings are then discussed in relation to the existing literature and evaluated on the basis of the goals of the study. The study highlights the value of some of the 'stage' ways of thinking about SCI adjustment, while simultaneously stressing the need for placing adjustment within a more personalized, and individually meaningful context. Significant differences between the psycho-physical experiences of patients in the categories of complete and -incomplete SCI were found, which suggests that a sharper distinction be made in the literature between these two groups, in order to account for the marked variations in their experiences.-- The study also contains a number of shortcomings, such as a lack of understanding about certain historical and contextual factors which may have mediated the experiences of the trauma for the individuals concerned. These shortcomings and some suggestions fro their resolution are then discussed. The study concludes with an evaluation of the research strategy and methodology and also offers some suggestions for future research.

Traumatic brain injury (TBI) represents a significant and growing type of disability in South Africa. Coping with the impact of traumatic brain injury is one of the most difficult tasks that can confront a family, and family members experience a wide range of needs as the injured person progresses through rehabilitation. In South Africa, research on family needs following traumatic brain injury has thus far been neglected and rehabilitation resources are sadly lacking. For this reason it is necessary to accumulate knowledge about these families’ needs so as to assist with the planning of future rehabilitation programmes. The study aimed to explore and describe the needs of a sample of families with adult traumatic brain injury individuals in the Eastern Cape utilizing the Family Needs Questionnaire (FNQ). The research approach followed could be described as descriptive and exploratory in nature and was conducted within a quantitative framework. A biographical questionnaire and the FNQ were administered to a heterogeneous sample of 32 family members, including significant others and primary caregivers, of 16 adult traumatically brain-injured individuals, who sustained the TBI one to three years previously, and who underwent rehabilitation treatment at a private rehabilitation hospital in Port Elizabeth. A non-probability, purposive, and convenient sampling method was used. Descriptive statistics were computed to determine the importance and the perceived fulfillment of the needs. The results of the present study indicated that all 40 needs were endorsed by at least half the sample as being important to very important. Furthermore, 52.50% of the needs were endorsed by more than two-thirds of the sample as being important to very important. The needs were rank-ordered according to their importance ratings and the 10 mostly rated as important or very important were identified. These 10 needs were endorsed by between 84.38% and 93.75% of the family members as being important to very important. Six of the important or very important needs related to health information, two to professional support, one to community support, and one to emotional support. The relation between various participant, traumatically brain-injured individual and brain injury characteristics and the 10 important or very important needs, as well as the 10 needs more frequently rated as met were investigated and found to either have a limited or varied relationship. The 10 needs most often rated as met were endorsed by between 43.75% and 56.25% of the family members. Six of the met needs related to health information, two to community support, one to instrumental support, and one to treatment decisions. The highest unmet need was endorsed by 46.88% of the participants and related to the need to discuss their feelings with someone who has gone through the same experience. Based on the findings of the present study, further research on family needs following traumatic brain injury is suggested. It is also recommended that the Family Needs Questionnaire be used to evaluate existing rehabilitation programmes so as to make suggestions as to how to improve them. The results of this study suggested that family members would benefit from receiving educational information material, as well as referrals to professionals for advice and support.

M.Cur. (Intensive General Nursing) / It appears that the emotions of patients in.the process of undergoing coronary artery bypass graft surgery have an influence on the rate of mortality. Patients that must undergo this surgery often find themselves in a short term dependent position. The purpose of this study is to determine if the life-style functioning of the patients can be improved by means of a pre-operative rehabilitative educational programme introduced by the professional nurse. A conceptual framework of reference was compiled after completion of the literature review. This served as the preliminary structure of the pre-operative educational programme. The programme consists of three three components, viz. an education booklet, an educational evaluating model and the educationist. A quasi-experimental study was performed on 4 groups (2 experimental groups and 2 control groups) to determine the effect of the structured pre-operative educational programme on the following three factors: - satisfaction with self, others and life; -avoidance of hope threats and -anticipation of a future. From these factors three null hypotheses were formed. An analysis of the data indicated a significant difference between the groups that followed the programme and the groups that did not follow the programme. The null hypotheses were thereafter rejected. The primary recommendation of the study is that all patients in the process of undergoing coronary artery bypass graft surgery should follow a pre-operative educational programme. This programme has a positive influence on the life-style functioning of the patient and will thus promote the process of rehabilitation.

M.Cur. / The emotional state of health of pre-operative patients about to have coronary artery bypass graft (CABG) is a decisive factor in the outcome of the procedure. Nel (1989) carried out quantitative research to determine the effect of a pre-operative education programme on CABG patients. This education programme is based on the fact that a person's emotional disposition is a critical variable in his successful recovery from coronary disease. However, the researcher is of the opinion that although Nel's study made a positive contribution regarding this phenomenon, a quantitative research design does not reflect the real experience of the patients that follow a pre-operative education programme. In the researcher's view, a qualitative research design is more appropriate. The aim of the present qualitative, exploring, descriptive, contextual research is to explore and describe the experience of CABG patients exposed to a pre-operative education programme and to lay down guidelines for nursing staff in practice The research was conducted in three phases. One private hospital in Pretoria was use for the research.