A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements of the degree of Master of Arts / The study reviews the literature concerning mild head injury and post concussion symptoms. It then investigates the applicability of international findings to South African patients. Three groups of subjects are compared: mildly injured, noninjured, and instructed malingerers. The study establishes base rates of postconcussive symptoms in the noninjured subjects, scores on tests of cognitive ability among the noninjured subjects, expectations regarding postconcussive sequelae among the noninjured subjects, the perceptions of injured subjects of their preand postmorbid status, and relationships between subjectively experienced symptoms and cognitive deficits am.ong injured subjects. Injured subgroups are examined to investigate pre-, peri-, and post-injury factors associated with development of postconcussive complaints. No differences in cognitive performance were found between the injured and noninjured groups. Time since injury did not affect cognitive performance, apart from on a copy task. It was found that injured subjects reported lower pre-injury levels of incidence of symptoms than those reported by noninjured subjects. No differences were found between post-injury reporting of postconcussive complaints and those symptoms reported by noninjured controls. Some postconcussive symptoms were nevertheless found to correlate with certain measures of cognitive performance. Instructed malingerers responded differently noninjured injured and not injured subjects, reporting fewer pre-injury complaints and mere post-injury complaints. They also performed more poorly on several cognitive measures. Test scores that effectively identified malingerers were then re-examined, and cut-off rates suggested for differentiating malingerers from genuinely injured subjects. / Andrew Chakane 2018

Introduction Road traffic collisions in developing countries contribute towards the greatest burden of disabilities and fatalities globally. Concern has arisen about the high proportion of pedestrians involved in collisions in South Africa. Aim This study describes the epidemiology of motor vehicle collisions involving pedestrians in eThekwini Municipality from 2001 to 2006, aiming to identify opportunities for prevention and informing policy. Methods An analytic cross-sectional study design was used. Data was obtained from the eThekwini Transport Authority database (police accident reports), and the Nationallnjury Mortality Surveillance System (mortuary reports). Exposure variables included pedestrian and drivers' demographics and collision environment. Death and injury were the outcome variables measured. Population data was obtained from Statistics South Africa. Results Pedestrians' injuries decreased from 7 445 to 6 288 (incidence risk: 241 to 193 per 100 000) from 200 I to 2006. Annual case fatality rose from 4.9% (366 deaths in 200 I) to 6.8% (430 deaths in 2006). Child pedestrians aged 5 to 9 years had a 77% increased risk of injury relative to other children. The fatality risk ratio of male to female pedestrians was 3.8 (95% Confidence Interval: 1.7 to 9.3). Male drivers aged 30 to 34 years had a 68% increased collision risk relative to all other male drivers and eight times (Incidence risk ratio: 8.0; 95% Confidence Interval: 6.2 to 10.3) the risk of female drivers. Only 3.4% of collisions occurred on freeways but accounted for 19.6% of pedestrian fatalities. Few (1.5%) collisions involving pedestrians occurred at night in unlit conditions but constituted more than four times the number of fatalities as number of collisions in these conditions. / Thesis (MMed.)- University of KwaZulu-Natal, Durban, 2009.

In einer längsschnittlichen Untersuchung wurden 64 Patienten der unfallchirurgischen Abteilung einer Universitätsklinik 10 Tage und 3 Monate nach einem Verkehrsunfall untersucht. Erhoben wurden die posttraumatische Belastungssymptomatik und Gedankenkontrollstrategien. Zum ersten Untersuchungszeitpunkt (10 Tage) zeigt sich eine der Posttraumatischen Belastungsstörung (PTB) äquivalente Belastungssymptomatik bei 14,1% und nach 3 Monaten eine PTB-Prävalenz von 39,1%. Es zeigen sich Zusammenhänge zwischen einigen Gedankenkontrollstrategien und PTB-Symptomatik nach 10 Tagen und, in schwächerer Ausprägung auch nach 3 Monaten. Im Ergebnis einer explorativen Auswertung zeigt sich, daß insbesondere die Strategien «Ablenkung» und «Sorgen» eine relevante Rolle im Zusammenhang mit der PTB-Symptomatik spielen. / In a longitudinal survey 64 inpatients of an emergency clinic were examined 1 week as well as 3 months after a motor vehicle accident. Posttraumatic stress symptoms and strategies of thought control were assessed. Ten days after the accident, a posttraumatic stress symptomatology is observable in 14.1% of patients, 3 months after the accident the prevalence of posttraumatic stress disorder (PTSD) is 39.1%. Strategies of thought control are correlated with posttraumatic symptomatology 10 days after the accident and after 3 months. The result of an explorative data analysis shows an important role of the control strategies ’distraction’ and ’worry’ in correlation with posttraumatic stress symptoms. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

This study examined the physiological response of 22 participants (three groups of six, one group of four) during four auto extrication simulations (AES) wearing full personal protective equipment. Heart rate (HR) and core temperature (C T) were monitored continuously from baseline thoughout the AES until 45-min recovery. Blood pressure (BP), ear canal temperature (EC T), subjective measures of exertion and thermal stress were taken at baseline, post AES and clean-up, and at 45-min recovery. The average extrication completion time was 33 minutes. Average AES HR was 118 beats•min -1, a 50% increase over HR during hall duties (79 beats•min -1). HR during AES was classified as ‘heavy work.’ C T increased significantly from baseline 37.19 °C to 37.83 °C post AES. At 45 -min recovery, C T was significantly elevated from baseline (37.37 °C; p<0.05). C T and EC T did not correlate well (r=0.004), and EC T significantly underestimated C T at al time points. C T and HR were strongly correlated at al measurements (r=0.89). Mean rating of perceived exertion (RPE) post AES and post clean up was 14.0 (between ‘somewhat hard ‘ and ‘hard’) on Borg 20 point scale. RPE showed strong relationships with physiological variables of peak HR expressed as % of age predicted max (r=0.70), and physiological strain index (PSI) (r=0.76). Rating of perceived thermal stress (RPTS) increased significantly from baseline (1.23 `comfortable') to post AES (4.4, `hot'). RPTS had significant moderate strength relationships with PSI (r=0.56) and C T (r=0.52). Differences did exist in al measurements between roles within the AES team with worker firefighters (n=14) demonstrating the highest HR, BP, rise in CT, and RPE. Medics (n=5) had the lowest recorded HR, BP, & RPE. The results suggest that vehicle extrication is a physically demanding task for firefighters and 45 minutes recovery is sufficient for HR, BP, psychophysical measures, but not C T to return to baseline. The findings have implications for those firefighters who may be presented with repeated AE and/or fires and other activities across a shift. It is recommended that ear canal temperature measurements not be used as a field measure of CT as it had no relationship with C T and significantly underestimated actual C T. Future studies are needed to determine oxygen consumption and energy expenditure required to complete auto extrications.

Understandings of the longer-term experiences of recovery from road trauma are limited. Many studies to date have examined the psychological and psychiatric consequences of road accidents in the short term, but few have moved to a focus on the psychosocial and subjective aspects of recovery, and the longer-term challenges of this process. (For complete abstract open document)

Thesis (Ph. D.)--University of North Texas, Aug., 2007. / Title from title page display. Includes bibliographical references.

Thesis (M.S.)--University of Wyoming, 2007. / Title from PDF title page (viewed on June 17, 2008). Includes bibliographical references (p. 23-27).

Thesis (M.Ed.)--Memorial University of Newfoundland, 1997. / Restricted until June 1998. Bibliography: leaves 98-102.

Thesis (Ph. D.)--University of Missouri-Columbia, 2008. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on July 22, 2009) Includes bibliographical references.

In einer längsschnittlichen Untersuchung wurden 64 Patienten der unfallchirurgischen Abteilung einer Universitätsklinik 10 Tage und 3 Monate nach einem Verkehrsunfall untersucht. Erhoben wurden die posttraumatische Belastungssymptomatik und Gedankenkontrollstrategien. Zum ersten Untersuchungszeitpunkt (10 Tage) zeigt sich eine der Posttraumatischen Belastungsstörung (PTB) äquivalente Belastungssymptomatik bei 14,1% und nach 3 Monaten eine PTB-Prävalenz von 39,1%. Es zeigen sich Zusammenhänge zwischen einigen Gedankenkontrollstrategien und PTB-Symptomatik nach 10 Tagen und, in schwächerer Ausprägung auch nach 3 Monaten. Im Ergebnis einer explorativen Auswertung zeigt sich, daß insbesondere die Strategien «Ablenkung» und «Sorgen» eine relevante Rolle im Zusammenhang mit der PTB-Symptomatik spielen. / In a longitudinal survey 64 inpatients of an emergency clinic were examined 1 week as well as 3 months after a motor vehicle accident. Posttraumatic stress symptoms and strategies of thought control were assessed. Ten days after the accident, a posttraumatic stress symptomatology is observable in 14.1% of patients, 3 months after the accident the prevalence of posttraumatic stress disorder (PTSD) is 39.1%. Strategies of thought control are correlated with posttraumatic symptomatology 10 days after the accident and after 3 months. The result of an explorative data analysis shows an important role of the control strategies ’distraction’ and ’worry’ in correlation with posttraumatic stress symptoms. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.