Although there are many instruments available to assess patient adaptation to cancer, there are few instruments which can be used to assess family members of cancer patients' adaptation to cancer. The present study was conducted to determine the internal structure and factor reliability estimates of a new instrument, the Family Adaptation to Medical ILLness Inventory (FAMILLI). The analysis of the FAMILLI was conducted using respondents (N=139) with family members of cancer. Respondents' ages ranged from 18 to 70 and many types of cancer, such as lung, breast, colorectal, prostate, brain, and cervical, were represented. The study was conducted in two phases, the pilot study and the major investigation.During the pilot study, respondents from a midwestern university setting and the oncology department at a midwestern hospital (N=28) completed the FAMILLI and participated in feedback groups. The pilot study helped to refine the demographic information sheet and to reduce the number of questions on the FAMILLI from 55 to 35 questions. In addition, interesting demographic questions were added to the demographics forms.The major study (N= 117) was conducted to test the initial factor structure of the FAMILLI and to test convergent and discriminant validity. A principal components extraction yielded a six factor solution which was judged best in terms of statistical structure and theoretical parsimony. The six factors to emerge were 1) factor one, "personal needs," 2) factor two, "attitudes toward leisure and work activities," 3) factor three, "anger and blame," 4) factor four, "receiving support," 5) factor five, "seeking medical information," and 6) factor six, "family responsibilities."Convergent and discriminant validity were tested using the Cancer Behavior Inventory (CBI-B) and the Satisfaction With Life Scale (SWLS). It was hypothesized that the FAMILLI would demonstrate convergent validity with the CBI-B. Four of the six factors (factors 2, 3, 4, and 5) significantly correlated with the CBI-B. The SWLS was used to test discriminant validity. Five of the six factors (factors 1, 2, 3, 4, and 6) correlated significantly with the SWLS. Thus, the FAMILLI did not demonstrate discriminant validity with an instrument used to measure global assessment of quality of life. Further research is needed to test the reliability and validity of the FAMILLI. / Department of Counseling Psychology and Guidance Services

This thesis explores the links between emotion processing and social participation in the acute and chronic phases of stroke. Three aspects of emotion processing are examined: 1) Emotion Perception 2) Emotion Regulation 3) Depression and Anxiety. Social Participation refers to engagement in life situations including a range of social activities and social networks. Stroke survivors are known to experience a reduction in social participation, independently of activity limitations. The current research tests the hypothesis that impairments in any of the aspects of emotion processing may affect social participation. Previous research has established that following stroke, difficulties in emotion perception and depression and anxiety occur, but there is little research on post stroke emotion regulation difficulties. While the link between post stroke depression and anxiety and social participation has been explored, this is not the case with emotion perception or emotion regulation. In a pilot study, emotion processing and social participation measures were administered to stroke patients. Emotion processing difficulties were shown to occur in stroke survivors and were significantly correlated with social participation. In the main study participants’ emotion processing, social participation and activity limitations were assessed at 2 and 18 months post stroke. In the acute phase, all three aspects of emotion processing correlated with social participation, but only emotion regulation predicted social participation restrictions independently of activity limitations. In the chronic phase, emotion processing correlated with social participation, with emotion regulation and depression predicting social participation independently of activity limitations. Further analyses revealed acute phase problems with emotion perception predicted chronic phase social participation limitations, while acute phase social participation restrictions predicted chronic phase depression and emotion regulation. These findings highlight the importance of the links between emotion processing and social participation post stroke. Future research priorities in this field are outlined.

A dissertation presented in partial compliance with the requirements for the Master's Degree technology: Chiropractic, Durban Institute of Technology, 2002. / Low back pain is estimated to effect 60-90% of the world's population sometime during their lives while 20-30% of people suffer from low back pain at any given time (Cassidy and Burton, 1992:3). Locally, epidemiological studies into low back pain have revealed incidence rates of 57.6% amongst black South Africans (Van der Meulen, 1997) and between 70 and 80% amongst Indians and Coloureds (Docrat, 1999). The use of spinal manipulation with the emphasis on restoring joint mobility, has been proven to be one of the most effective and cost effective approaches in the management low back pain of a mechanical origin (Di Fabio, 1992). McMorland (2000), showed in a study of 199 patients, that spinal manipulation resulted in an average of 52.5% and 52.9% reduction in low back pain and disability respectively. Panjabi (1992:1) has postulated a theory of a 'neutral zone' around which the passive lumbar spine operates. He describes the neutral zone as a region of intervertebral motion around the neutral posture where little resistance is offered by the passive spinal column. It is, according to Panjabi (1992:1), possible for this neutral zone to increase with injury to the spinal column or with weakness of stabilising muscles, which could result in low back pain. The trunk muscles therefore have to be able to co-contract isometrically to control the neutral zone and protect the spinal tissue from excessive motion (Richardson et aI.1990). The transversus abdominis muscle and multifidus muscle have been identified as playing an important role in the complex synergistic interaction of the trunk (Norris, 1995). The above concept involving muscles attempting to maintain a neutral zone is commonly referred to as 'core stabilisation' (Norris, 1995). / M

Dissertation submitted in the partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1997. / Symptomatic cervical spondylosis is a common condition in patients over the age of forty. This condition has been successfully treated by means of chiropractic adjusting. However, to date little research has been conducted to investigate whether the combination of chiropractic adjusting and an alternative therapy may be more effective than just chiropractic treatment alone. The purpose of this study was to investigate whether the combination of chiropractic adjusting and an Anthroposophical remedy, Disci comp.cum Stanno, would be more effective in the treatment of symptomatic cervical spondylosis than chiropractic adjustments alone. It was hypothesized that cervical spine manipulation, and the combination of chiropractic adjusting and the Disci remedy would both be effective in the treatment of symptomatic cervical spondylosis. Moreover, with reference to objective and subjective clinical findings, it was assumed that the combined chiropractic adjustments and the Disci remedy would be more effective than chiropractic adjusting alone. The study was a controlled, double-blind clinical trial consisting of thirty patients, fifteen comprising the control group and fifteen the experimental group. The age range of the sample group was from forty to seventy-nine years. The patients were randomly divided into the two groups. The control group was treated with chiropractic adjustments to the / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2002. / Headaches have been described as the most common medical complaint in society (Dalessia 1987:3), and Tension-type headaches constitute approximately 80% of these (Martin 1993:22). Although Episodic tension-type headache is more prevalent than Chronic tension-type headache and may have a greater societal impact, Chronic tension-type headache has by far a greater individual impact (Schwartz et aI, 1998) on the patient. The exact causes of Chronic tension-type headaches are not known and, as a result, treatment is commonly symptomatic in nature and aimed at reducing pain. To date, treatment commonly involves the use of drugs and with it comes the threat of drug-induced side-effects (Bendtsen et aI, 1996). The purpose of this study was to investigate two non-pharmacological treatments in the management of Chronic tension-type headaches, namely the relative effectiveness of Spinal Manipulative Therapy (SMT) in conjunction with Trans-cutaneous Electrical Nerve Stimulation (TENS), as compared with SMT and placebo TENS. ABSTRACT It was hypothesized that SMT in conjunction with TENS would provide a greater immediate and short-term benefit in comparison to SMT and placebo TENS in the treatment of mild / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Technikon Natal,1997. / Asthma, one of the most frustrating medical conditions known to man, has been a thorn in the side of physicians world wide. A condition that seems to consist of all exceptions and no rules has resulted in endless debates regarding the correct treatment protocol for its management, which at present only seem to subdue the patient's symptomatology rather than eliminate them. The ever increasing number of asthmatic sufferers and the increasing number of deaths related to asthma are both reflections of the inadequacy of present treatment protocols and therefore demonstrate the need for their revision. It is thus the aim of this study to ascertain the therapeutic efficacy of spinal adjustive procedures a n the management of asthma. Patients were obtained for this study by consecutive sampling, whereby any patients presenting to the Chiropractic Clinic at Technikon Natal, as a response to the newspaper adverts and pamphlets placed ln the greater Durban area, were considered for the study. Of these patients, only those who conformed to the specified delimitations and diagnostic criteria were accepted. The study was divided into 3 distinct periods. The first, called the baseline study, required the entire sample of 30 patients to undergo subjective and objective tests, whilst receiving no chiropractic treatment, in order to establish the patients' astrunatic condition. The second period, called the initial treatment period, required the entire sample to undergo further subjective and objective testing while receiving chiropractic treatment, which comprised soft tissue therapy and adjustments of fixations in the CO-C2 and T2-T7 areas. / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2004. / Arthrogenic muscle inhibition (AMI) is the reflex inhibition of the muscles that surround an injured joint in consequence to disturbed afferent feedback originating from the receptors of that joint. The resultant altered afferent innervation of the motor neuron pool leads to a decrease in recruitment ability within the motor neuron pool, a decrease in contraction force of the muscles that fall within the motor neuron pool, and hence the clinical manifestation of AMI as a decrease in muscle strength. Spinal manipulation has been proposed to activate mechanoreceptors and proprioceptors within and around the manipulated joint. The altered afferent input arising from their stimulation is thought to cause changes in motor neuron excitability. In this respect, sacroiliac manipulation has been shown to effectively reduce muscle inhibition and increase muscle strength of the quadriceps muscle group in patients with anterior knee pain. The focus of AMI has been aimed primarily at the quadriceps muscle group whereas little information is available on the functional properties of the muscles moving the hip joint. Thus, the purpose of the present cohort study was to determine the short - term effect of sacroiliac manipulation on ipsilateral hip muscle strength and subjective low back pain intensity in thirty male subjects presenting with low back pain, attributable to chronic sacroiliac syndrome. The first objective of the study was to evaluate the short - term effect of sacroiliac manipulation on the strength of the musculature of the ipsilateral hip joint for the actions of flexion, extension, adduction and abduction by means of the Cybex Orthotren II Isokinetic Rehabilitation System, with respect to objective clinical findings. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban Institute of Technology, Durban, 2006. / The purpose of this study was to evaluate the immediate and short term effects of spinal manipulative therapy on the club head velocity of amateur golfers suffering from mechanical low back pain. This purpose was identified as low back pain which has been noted as the most common musculoskeletal problem affecting amateur and professional golfers. In the right handed golfer the golf swing produces a distinctly asymmetric trunk motion, involving a combination of left axial rotation and right lateral bending. The significant lateral bending, shear, compression and torsional forces that the lower back contends with during the golf swing causes a peak compression load of more than eight times the body weight. In addition it is found that at the end of the follow through phase the golfer's lumbar spine is rotated and hyperextended. This is known as the reversed C position, in which the facet joints approximate and in addition torsional stress is placed on the annular fibers of the disc. With repetitive swings and incorrect form the lumbar facets bear the brunt of the abnormal forces on the lumbar spine. IV In addition to this, during the downswing phase of a golf swing the role of the multifidus is to limit flexion whilst the external oblique muscle induces rotation of the lumbar spine. Together both muscles produce rotation in the lower lumbar spine. Thus the golf swing, particularly during the downswing phase, places a tremendous burden on the multifidus muscle and may cause; o muscle injury which will contribute to the golfer's low back pain and I or o joint injury as a result of muscle fatigue. Furthermore the resultant uncontrolled contractions of the multifidus muscle produces torsion to the facet joints and disc. It is therefore likely that facet syndrome may be the main cause of low back pain in golfers, as modern golf publications urge golfers to use a maximum state of spinal rotation to generate a high club head velocity. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, Durban, 1998. / The aim of this study was to determine the effectiveness of adjustments versus the use of ultrasound in the treatment of mechanical neck pain. It was hypothesized that treatment with adjustments over a four week period, with a further four week follow-up period, would be more effective than ultrasound in terms of improving patients' cervical ranges of motion and their perceptions of pain and disability. Thirty consecutive patients suffering from mechanical neck pain were randomly assigned to either the adjustment or ultrasound groups. An experimental design was employed, whereby both groups received treatment twice a week for four weeks. After a follow-up period of a month, the patients were re-assessed. Measurements of the cervical spine ranges of motion with the CROM goniometer, algometer readings, and the completion of the Numerical Pain Rating Scale-101, CMCC Neck Disability Index and the Short Form McGill Pain questionnaires were performed before the first, fourth and final treatments as well as at the one month follow-up consultation. The data were then transferred to spreadsheets and underwent statistical analyses, using a 95 % confidence level. Analyses within each group were performed, using the Wilcoxon Signed Rank test and various readings were compared. The reading taken before the first treatment was compared to the reading taken before the final treatment. The initial reading was then again compared with the reading taken at the one month follow-up consultation. Comparison of the results of both treatment groups was statistically evaluated, using the Mann-Whitney U-Test. The comparison was made using the readings of the first, fourth and final treatments, as well as the one month follow-up consultation. This was done for all measurement parameters. / M

The study of coping with stress has been disjointed, lacking a coherent model. The present work proposes a theoretical framework for understanding coping based on approach and avoidance. Approach and avoidance are discussed in terms of the psychoanalytic concepts of defense and working through and other historical precursors as well as recent research on coping with traumatic events. Two experiments are presented. The first consists of a scale-construction study of the Cohen Roth Approach Avoidance Scale, a self- report measure of coping strategies. A revised version of this scale is proposed based on factor-analytic data from a mixed-stress sample. Experiment 2 is a study of the long-term impact of rape. Seventy-three women, who were victims of rape an average of eight years ago, were given questionnaires covering the following areas: demographics, nature of the assault, coping styles, and current level of functioning. Most of the sample was found to still be in moderate to severe distress. The relationships between outcome and demographics, situational variables, and behavior after the assault are discussed in the context of prior research in this area. Approach and avoidance strategies, measured by the revised Cohen Roth Approach Avoidance Scale, had a complex relationship with outcome. This relationship is discussed in the context of the theoretical model of coping presented in the Introduction, focusing on the difficulty women have in resolving the trauma of rape. / This thesis was digitized as part of a project begun in 2014 to increase the number of Duke psychology theses available online. The digitization project was spearheaded by Ciara Healy.