During a traumatic insult to the brain, tissue is subjected to large stresses at high rates which often surpass cellular thresholds leading to cell dysfunction or death. Cellular events that occur at the time of and immediately after an insult are poorly understood. Immediately following traumatic brain injury (TBI), the neuronal plasma membrane may become disrupted and potentiate detrimental pathways by allowing extracellular contents to gain access to the cytosol. In the current study, neuronal plasma membrane disruption was assessed in vivo following moderate unilateral controlled cortical impact in rats using a normally cell-impermeant fluorescent compound as a plasma membrane permeability marker. This fluorescent dye was injected into the cerebrospinal fluid and was allowed to diffuse into the brain. TBI caused a widespread acute disruption of neuronal membranes which was significantly different compared to uninjured brains. Affected cells were present in cortex and hippocampal regions. These findings were complemented by an in vitro model of TBI where membrane disruption was quantified and its mechanisms elucidated. Permeability marker(s) were added to neuronal cultures before the insult as indicators for increases in plasma membrane permeability. The percentage of cells containing the permeability marker was dependent on the molecular mass, as smaller molecules gained access to a higher percentage of cells than larger ones. Permeability increases were also positively correlated with the rate of insult. Membrane disruption was transient, evidenced by a robust resealing within the first minute after the insult. In addition, membrane resealing was found to be dependent on extracellular Ca2+, as chelation of the ion abolished a significant amount of resealing. We have also investigated the effects of mechanically-induced plasma membrane disruptions on neuronal network electrical activity. We have developed a multielectrode array system that allows the study of electrical activity before, during, and after a traumatic insult to neurons. Endogenous electrical activity of neuronal cultures presented a heterogeneous response following mechanical insult. Moreover, spontaneous firing dysfunction induced by injury outlasted the presence of membrane disruptions. This study provides a multi-faceted approach to elucidate the role of neuronal plasma membrane disruptions in TBI and its functional consequences.

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

No description available.

Dissertation submitted in compliance with the requirements for the Masters Degree in Chiropractic at the Durban University of Technology, 2009 / Occupational injuries sustained by Emergency Rescue Care workers have been well documented. However, despite their high rates of injury, the literature regarding the risk factors for work-related musculoskeletal injuries (WRMSIs) in the fire service has not been well-established, especially in South Africa. Objectives: To determine the prevalence and risk factors for musculoskeletal injuries in the Durban Metropolitan Fire Department and to evaluate the relationship between selected risk factors and the prevalence of musculoskeletal injuries. Methods: This was a descriptive study from a large urban Fire Department employing 350 active firefighters. Using a cross sectional study design, a retrospective analysis investigated the musculoskeletal injury prevalence from 2006-2008 by means of a questionnaire. Individuals reported on demographics, injury location, injury etiology, injury nature, extent of treatment rendered and time lost from work. Additionally, data was obtained regarding smoking, occupational stress, fitness, protective gear and injury prevention advice given by the Durban Metropolitan Fire Department. A 41% response rate was achieved. Results: The point prevalence of WRMSIs was 33.6% and the period prevalence was 81.1% of the sample. Low back injuries (47.9%) and strain injuries (40.8%) were the most common, followed by knee (22.5%), shoulder (19.7%) and ankle injuries (19%). The most common causes included lifting heavy objects, working in awkward postures and running. Weight, ethnic group, stress, lack of nutritional advice and alcohol consumption were all significantly associated with the prevalence of injuries. Ex-smoking was significant in the prevalence of low back injuries, stress was significant in the prevalence of knee injuries and alcohol consumption was associated with the prevalence of shoulder injuries. Conclusion: WRMSIs are of great concern in the fire service as their prevalence is substantial. Evaluation and implementation of further preventative measures and advice based on the results of this study can be effective in reducing WRMSIs.

[Truncated abstract] Anterior cruciate ligament injuries are a major problem in sport. The purpose of this thesis was to investigate the causative factors of ACL injuries and to study the effect of various types of lower-limb training on underlying neuromuscular mechanisms involved in stabilisation and risk of ACL injury. Investigation of the mechanisms was conducted on controlled balance and strength tests as well as in sporting manoeuvres. It was aimed to assess if the neuromuscular changes map over into the performance of sporting manoeuvres and if potential for loading on the ACL and risk of injury was reduced or exacerbated . . . ACL strain can be decreased through reduction in the applied loads and greater knee flexion. Further to this, muscle activation has the ability to reduce loading on the ACL through co-contraction and selective activation patterns. This thesis demonstrated differing neuromuscular adaptations from various training types that map over into the performance of sporting manoeuvres. The research indicated that the Balance-Training was the most favourable in reducing potential for injury risk on the ACL. Alternatively strength training elicited neuromuscular changes that were likely to increase the risk of force on the ACL. The Machine+Balance training resulted in some negative and positive outcomes with the balance training tending to counteract the negative affects of machine weights training resulting in small improvements in muscular support and load reduction. This study provides us with better understanding of the underlying mechanisms from various training types and their potential affect on risk of ACL injury.

Thesis (M.S.)--University of Michigan, 1996.

Thesis (MMed) -- Stellenbosch University, 2010. / Bibliography / Chronic wounds afflict millions worldwide, incurring significant health care costs and chronic suffering. Clinicians are often unsure about treatment, resulting in poor outcomes. Objective To determine the scope of knowledge possessed by fifth year medical students, general practitioners (GP’s) and surgical registrars, concerning chronic wound management. Design Cross sectional study Methods Deans of eight South African medical schools received letters requesting information regarding time devoted to wound-care training. Knowledge-based questionnaires were distributed to final-year students at two universities, surgical registrars at three universities and general practitioners attending refresher courses. Result. Four medical schools replied, of whom only two offered formal teaching. 162 medical students, 45 GP’s and 47 surgical registrars completed questionnaires. The overall median (25th–75th percentiles) knowledge scores for registrars, GP’s and students were 65%;(55%–70%), 55%;(45%–65%) and 45%;(35%–50%) respectively. Whereas the scores of registrars and GP’s did not differ, the student scores were significantly less. Only 32% of registrars and 18% of GP’s attained scores of 70% or more. 96% considered training to be inadequate. Interest in wound-care was only mild to moderate, with more GP’s than registrars requesting literature. Conclusions Very little, if any training on chronic wounds is offered in South Africa. The levels of knowledge cannot be considered adequate for successful treatment, nor for teaching to undergraduates. This preliminary study cannot reflect the attitudes and knowledge throughout the country; however it is clear that there is a need for improved education about these conditions that have huge clinical and economic consequences.

Orientador: Rosana Rossi-Ferreira / Resumo: Introdução: As úlceras ou feridas crônicas, são lesões de pele que não cicatrizam e que podem comprometer desde a epiderme até as camadas mais profundas, como músculos, tendões e ossos. Definir um tratamento ideal, ainda é um desafio. A cicatrização, envolve a adesão ao tratamento pelo paciente, a reação do organismo à proposta terapêutica, o comportamento do paciente em relação aos cuidados com a ferida, o manejo com o curativo e os aspectos gerais da manutenção de sua saúde. As demandas sociais, econômicas e culturais, geram fortes influências no tratamento das feridas e atrapalham indiretamente a cicatrização. Objetivos: Correlacionar fatores sócio demográficos e educacionais como preditores para a ocorrência de feridas crônicas, comparando-se indivíduos saudáveis com portadores de feridas crônicas. Casuística e Método: Foram utilizados dois questionários semiestruturados, distintos e customizados com dados sócio demográficos e aspectos da doença. Delimitou-se duas populações: Grupo 1 - constituído pela população geral saudável e o Grupo 2 - constituído por pessoas portadoras de feridas crônicas. Resultados e discussão: Os dois grupos conhecem algum tipo de tratamento caseiro para tratar feridas, contudo não detém conhecimento suficiente sobre feridas crônicas e das terapias convencionais prescritas pela medicina. Ambos os grupos possuem crenças, mitos e preconceitos sobre cicatrização de feridas. Paciente e família não recebem informações por escrito de como devem fazer o... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Chronic wound is still a challenge for medicine, either to define its cause and for selecting an optimal treatment. Healing is a long and complex process. It involves adherence to the treatment by the patient, the reaction of the organism to the therapeutic treatment, the patient's behavior regarding wound care, handling the dressing, and general aspects to maintain health, especially if there are other chronic diseases. Social, economic and cultural demands can also generate strong influences upon the treatment of wounds and healing process, since the population, in general, believes in myths, misconceptions and prejudices about wound healing, a knowledge that has been passed on empirically for generations, which may be harmless or extremely harmful. The objective of this study was to correlate socio-demographic and educational factors as predictors for the occurrence of chronic wounds, comparing healthy individuals with patients with chronic wounds. Two semistructured instruments were employed; a questionnaire, specific and customized, seeking socio demographic data, knowledge about chronic wounds, medical treatment of wounds, alternative and unconventional therapies and knowledge about bio-curative. Two populations were delimited: Group 1 - constituted by the healthy population, in general, and Group 2 - constituted by people with chronic wounds. It was observed that both groups are aware of some kind of home treatment to treat wounds, but they do not have sufficient knowl... (Complete abstract click electronic access below) / Mestre

A study was conducted on the self-reported symptoms of Mild Traumatic Brain Injury sustained in Rugby Union at the pre- and post-season stages. A full sample of 30 rugby players at Rhodes University was compared to 27 non-contact sport controls. A reduced sample of 20 rugby players and 9 control participants provided improved control for education and IQ and was compared. Measures included the WAIS-III Vocabulary and Picture Completion Sub-tests to estimate IQ level, the symptom checklist on a widely used computer-based program (ImPACT), and a paper and pencil self-report 31-Item Post-Concussion Symptom Questionnaire. Independent and Dependent T-Test comparisons were conducted on the full and reduced samples. The symptoms reported by the rugby group appeared to be more pronounced on both the ImPACT Symptom Scale and the 31-Item Post-Concussion Symptom Questionnaire when compared to the control group at both the pre-and post-season stages. It was concluded that the rugby players demonstrated evidence to support the hypothesis of having sustained more previous concussions and reporting more symptoms at the pre-season stage when compared to comtrol participants. No prevalent changes for either the rugby or control groups were seen in dependent comparisons from pre-to post-season.

Submitted as the dissertation component in partial fulfilment of the requirements for the degree of a Masters in Technology in Chiropractic in the department of Chiropractic and Somatology, Durban University of Technology, Durban, South Africa, 2017. / Background: Hip pain is a common problem. Motion palpation is a manual technique applied by the hands in various degrees of joint motion that specifically evaluates range of motion in relation to specific anatomical landmarks, joint play and end feel. Motion palpation remains one of the most used diagnostic techniques and yet it remains unclear whether or not it is a reliable, sensitive and specific tool; especially in the hip joint. Objectives: This study assessed intra- and inter-examiner reliability and clinical responsiveness of motion palpation when it is used as a diagnostic tool in patients with non-specific unilateral anterior hip pain and unilateral asymptomatic hip joints. Methods: Ten participants, between the ages of 18 and 60, were included in this study (three ballet dancers, three golfers and four participants from the general population). The participants were assessed randomly by three blinded examiners. All of the participants then received one adjustment delivered by the researcher (half on the symptomatic side and half on the asymptomatic). The participants were then re-assessed. Data was recorded on a data collection sheet and analysed using SPSS version 23. Intra-examiner reliability and clinical responsiveness were analysed using McNemar’s test and the Chi-Square Test of Independence. Inter-examiner reliability was analysed using Fleiss’ Kappa. Results: Intra-examiner reliability showed to be markedly better on the left-hand side for all three examiners. Kappa scores for inter-examiner reliability varied from none to perfect. The average pairwise agreement scores ranged from 33.3% to 100% at the first assessment, and from 46.6% to 100% in the second assessment. A mean and standard deviation were calculated for the pairwise agreements which represented the sensitivity and specificity respectively. Both showed improvement between the first and second assessments which is positive for inter-examiner reliability. Clinical responsiveness was shown to be absent for examiners A and B but was present for examiner C on the left. Conclusion: This study found that, contrary to the expectations of many clinicians, motion palpation has limited to poor levels of intra-examiner reliability, inter-examiner reliability and clinical responsiveness. This is however limited by the small sample size and methodological limitations in this study. Therefore, the role of palpation as a diagnostic tool used in the diagnosis hip dysfunction may be limited. / M