Submitted in fulfilment of the requirements for the Degree Philosophiae Doctor in Health Sciences, Durban University of Technology, 2017. / Background Cancer is a global concern because it affects and kills millions of people worldwide. In South Africa, patients frequently move between traditional health practitioners and radiation oncologists to seek cure of cancer, yet these health practitioners do not communicate with each other. Consequently, the treatment is often disrupted and imcomplete therefore compromising the survival of patients. The future of the health system in effective treatment of patients with cancer is dependent on health practitioners’ changing fundamentally in their co-operative practice. The aim of this study was to explore the practice of traditional health practitioners in the treatment of patients with cancer in order to describe a viable co-operative practice between them and radiation oncologists and ultimately develop traditional health practitioners as a component in the health system in the treatment of patients with cancer. Methods An exploratory descriptive qualitative study using an interpretive phenomenological approach was employed to collect data from 28 traditional health practitioners and four radiation oncologists in KwaZulu-Natal utilising snowball and stratified purposive samplings for the former and latter, respectively. Semi-structured face-to-face and group interviews were employed to collect primary data from traditional health practitioners and data from the radiation oncologists were collected through face-to-face and email interviews. Data were transcribed verbatim and analysed using framework analysis. Results It emerged that the referral of patients, in addition to external conditions, individual attributes, trusting attitudes of participants as well as organisational dynamics and philosophy of practice, were the main categories used by participants in their understanding of co-operative practice in KwaZulu-Natal. The patient is the main player in the co-operation between parties, and coordinates the health practitioners’ activities during treatment. Effective co-operative practice is time consuming and requires commitment, co-operation and training of the participants. Conclusion Considering the problems associated with treatment of cancer when patients move freely between the traditional health practitioners and radiation oncologists, resulting in interruptions in treatment, co-operative practice between the two health practitioners is paramount. The development of traditional health practitioners could result in extending their role in the management of cancer and therefore increasing the accessibility of cancer services. It follows that a workable practice between traditional health practitioners and radiation oncologists in the treatment of patients with cancer could be an inclusive health system where the parties work in parallel with the patient being the main actor in the collaboration. There should be a healthy relationship between all those involved in the collaboration in order to facilitate referral of patients between the health practitioners. / D

Submitted in partial compliance with the requirements for the Master’s degree in technology in Technology: Homoeopathy, Durban University of Technology, Durban, South Africa, 2017. / Background: According to Picavet and Schouten (2003) the incidence of neck pain is increasing at a greater rate than other spine problems (Hoving et al. 2004). Furthermore, chronic neck pain is a substantial burden to society with chronic neck pain being the fourth leading cause of disability worldwide (Hoy et al. 2014). Chronic mechanical neck pain (CMNP) has been defined as localised, asymmetrical neck pain with restricted range of motion and dysfunctional musculature (Grieve, 1988). Treatments for those suffering with chronic pain, which are non-surgical, appear to be the most beneficial for patients according to Haldeman et al. (2008). Giles and Müller (1999) have stated that spinal manipulation is the most effective method of treating spinal pain on its own. However, the literature suggests that there is benefit in combining manipulation with an “anti-inflammatory type” drug (Crawford 1988; Oberbaum 1998; Serrentino 2003). Many studies have been successfully conducted on Homoeopathic complexes to treat neck pain (Fisher 1986; Bohmer and Ambrus 1992; Hepburn 2000; Soeken 2004) however no study has yet to been carried out on the combination of Homoeopathic Simillimum (single remedy) and spinal manipulation for CMNP. Objective: The aim of this study was to determine if spinal manipulation and Homoeopathic Simillimum in combination are more relatively effective than spinal manipulation alone in the treatment of chronic mechanical neck pain. Methodology: This study was a randomised, blinded placebo controlled quantitative trial with a comparative clinical trial design. Thirty consenting participants with CMNP who met the inclusion criteria were randomly distributed between two treatment groups. Group A received spinal manipulation as well as Homoeopathic Simillimum and group B received spinal manipulation with placebo medication. Each participant received three treatments over a period of a week; with subjective and objective readings taken at every consultation. The subjective tools included the Numerical Pain Rating Scale and Canadian Memorial College of Chiropractic Neck Disability Index. Objective tools included the Algometer and CROM-II Goniometer. All data captured was analysed using SPSS version 24.0. Inferential and non-parametric analysis of the data were also be performed. Results: The results showed that no statistically significant differences were observed between the two groups in terms of subjective and objective measurements. However, there were statistically significant improvements seen in both groups equally in terms of ANOVA subjective and objective measurements i.e. both groups showed improvement. Conclusion: The results of this study concluded that no statistical or clinically significant changes were noticed between the groups and therefore the Homoeopathic Simillimum added no statistical significant improvements in those who received it over those participants who received placebo in the treatment of chronic mechanical neck pain. / M

M.Tech. (Homoeopathy) / Overweight and obesity is an excessive accumulation of fat and can be classified using the body mass index (BMI). Being overweight has a whole host of health-related risks, which includes metabolic syndrome and diabetes mellitus type II to name a few (Goedecke et al. 2005). Interleukin 6 (IL-6), secreted from the adipose tissue surrounding the waist line is responsible for a state of systemic chronic low level inflammation and plays a crucial role in the development of diseases associated with being overweight (Fantuzzi, 2005). Food sensitivities further contributes to this state of low level chronic inflammation. Symptoms of food sensitivities include, difficulty losing weight as well as over eating, which hinders weight loss in over weight individuals (Joyal, 2010). Anti-inflammatory diets such as the Mediterranean diet focuses on a diet rich in antiinflammatory foods, which is known to decrease chronic low level inflammation caused by being overweight and obese. (Galland, 2010). The aim of this study was to determine the comparative effect of the Mediterranean diet to a modified Mediterranean diet (excludes common food sensitivities) on the circulating levels of the inflammatory cytokine interleukin-6 (IL-6) in overweight females by measuring weight loss and IL-6 levels. The study was an experimental comparative study involving thirty female participants who were between the ages of 20-45 and were overweight (BMI 25-30 kg/m²). Potential participants attended an initial interview where they were screened by means of inclusion and exclusion criteria as well as a physical exam that included vitals, weight (kg), waist measurement (cm), hip-to-waist ratio and calculation of BMI. Individuals who met these criteria were sent for blood tests to measure their Interleukin 6 levels (IL-6). Those individuals with an IL-6 level of greater than 0.96pg/ml were then contacted to set up a first appointment. Participants were allocated to either the modified Mediterranean diet or to the Mediterranean diet using matched pairs. Participants attended a three week as well as a 6 week follow up to tract weight-loss progress.

M.Tech. (Homoeopathy) / In South Africa, approximately 61% of the population is believed to be overweight, obese or morbidly obese (Smith, 2010). Risk factors to developing obesity include a sedentary lifestyle, unhealthy diet and poor eating habits, smoking, age, medications such as corticosteroids and other illnesses such as polycystic ovarian syndrome, hypothyroidism and Cushing’s syndrome (Polsdorfer, 2011). Obesity is fast becoming a major problem in all communities in South Africa, not only in regard to the health of individuals but as it continues to increase the costs of health care in the country (Goedecke et al., 2005). The aim of this study is to determine the effect of a herbal formulation consisting of Caffeine, Coffea canephora bean, Coleus forskholii, Camellia sinensis, Evodiamine, Ilex paraguariensis and Phaseolus vulgaris on Body Mass Index and abdominal girth measurements in overweight and obese individuals. Previous studies conducted on the herbal formulation have shown positive results with regard to weight loss, however, the need for a longer trial period was indicated in order to establish long term results as in this study (Baillie, 2011a). The study was a twelve week, double-blind, placebo-controlled study. The participants were males and females between the ages of 18 and 45 years with a BMI between 25 and 35kg/m2. Sixty participants were recruited from the University of Johannesburg, as well as from the public sector, in response to posters posted at the university, local gymnasiums and fitness clubs and given to other Homoeopathic practitioners. Of the sample of sixty participants, thirty participants were placed in the experimental group and thirty in the placebo group according to matched pairing of gender and BMI. The groups received either two capsules of the herbal formulation consisting of Caffeine, Coffea canephora bean, Coleus forskholii, Camellia sinensis, Evodiamine, Ilex paraguariensis and Phaseolus vulgaris or two capsules of a placebo composed of pharmaceutical starch, from Monday to Friday. At the initial consultation, a detailed case history and the vital signs (including blood pressure, respiratory rate, heart rate and temperature) of the participants were taken. Their height and weight was determined and from these measurements, their BMI was calculated. Their abdominal girth was measured three times during each consultation, each time using a standardized method and the average measurement was obtained. The participants then returned for follow-up evaluations in the second, sixth and twelfth week of the study. At each follow-up consultation, the participants’ vital signs and abdominal girth measurements were taken again and their BMI calculated by measuring their weight. The data collected during the study was analysed using statistical techniques including the Shapiro-Wilk test, Friedman Analysis of Variance test, Mann-Whitney test and Wilcoxon Signed-Rank test.

M. Tech. / Purpose: Trigger points in the paraspinal muscles are commonly associated with lameness or stiffness in horses, and unless they are “released”, muscle power and flexibility are impaired and athletic performance is reduced (Rogers, Fischer, Pontinen, and Janssens, 1996). The aim of this study was to determine the immediate and the prolonged effects of Sacroiliac mobilization on spot tenderness within the Erector spinae muscles of performance horses. Method: Horses from a selected stable yard underwent a screening process under the supervision of a qualified Chiropractor and Veterinarian to identify horses suitable for the study. Thirty horses were selected for the study based on the inclusion and exclusion criteria. The sample was divided into two groups of fifteen horses. The experiment group received mobilization therapy for SI joint restrictions, while the control group did not receive any treatment intervention. Procedure: Horses received an initial treatment and two follow ups, totaling three treatments. The first follow up treatment was two days after the initial and the second was four days post initial treatment. During these treatment sessions, trigger points in the Erector spinae muscles were located in each horse and algometer measurements were taken. Sacroiliac restrictions were then identified using motion palpation and passive range of motion as indicators. The researcher performed a mobilization technique on the Sacroiliac joints of horses in the experiment group only, and thereafter both groups were reassessed two minutes later, via an algometer, for spot tenderness within the same trigger points. The Sacroiliac restrictions and trigger points were re-assessed without treatment two weeks later. Conclusion: The results indicated that low-velocity Sacroiliac mobilization was effective in increasing the pain-pressure tolerance within the Erector spinae muscles of performance horses immediately and over the treatment period of two weeks.

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