ABSTRACT Trauma in South Africa has been described as a “malignant epidemic” (Muckart DJ, 1991)5. Trauma is most acute in Sub-Saharan Africa, where deaths from trauma is higher than in any other region of the world where the risk of death from injury is greatest, especially for men aged 15-29 years (Murray CJL, in Bowley etal, 2002)5.The recognition of concurrent life threatening injuries is critical, given that patients with facial fractures seldom die in the absence of airway problems, massive bleeding, aspiration of blood into the lungs and massive head injury30. There are several reports in the literature regarding multisystem trauma and facial fractures. Head injuries are commonly associated with facial fractures, and facial fractures can be markers for brain injury16 .This study is aimed to identify the prevalence of head injuries associated with maxillofacial trauma in the Johannesburg General Hospital, Gauteng, South Africa. The data was collected from 1st January 2003 to 30th June 2003. A total of 196 patients with maxillofacial injuries were treated and 176 were included in the study. The data was analyzed using SASTM for WindowsTM. From the results it was found that of the 176 patients the majority were males comprising 88.07% of the study. Based on the GCS scores alone it was shown that 38.06% patients suffered head injuries. After reviewing patient records, it was found that of the whole sample only 31.25% of patients suffered true head injuries based on CT scan and neurosurgery findings. It was also shown that the most frequent mechanism of injury with headinjuries was gunshot wounds at 52.72% and the most common maxillofacial injury associated with head injury was panfacial fractures at 23.63%. In this study we also reviewed the outcome of the patients based on mortality rates. A total of 24 patients (13.63%) died from associated injuries. Of these patients 2 (1.13%) died from associated injuries due to polytrauma and 22 (12.5%) died due to severe head injury. We found that severe maxillofacial injuries involving the midfacial region such as panfacial fractures, zygomatic complex fractures and Le Fort fractures are frequently seen in patients with significant head injury. This should alert trauma unit personnel during assessment of patients to the fact that if a patient presents with significant midfacial trauma, one might expect that an underlying head injury is present. It is important to make note, that of the associated injuries present with maxillofacial trauma, involvement of the central nervous system including concussion, is the most frequent.

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No / Objective : To describe the common themes in the experiences and expressed information needs of patients undergoing head and neck surgery. Summary background data : Patients who suffer head and neck cancers and undergo surgery often report considerable psychological distress and impaired social functioning. To optimise survival, the decision about what treatment option to follow is often made quickly, with little support in terms of counselling or the provision of information. There is inadequate previous work exploring the content and delivery of information required by patients at this time. Patients and Methods : Participants included patients who had undergone surgery for head or neck cancer (n = 29) and their immediate relatives who were present at the initial consultation with the surgeon (n = 13). Patients were recruited from out-patient departments in two hospitals in the north of England. All interviews were conducted in participants' homes and were guided by a semistructured interview schedule devised both from literature and a pilot study. Results : Whilst most participants felt well informed about the surgical procedure they were undergoing, many reported feeling unprepared for the long-term lifestyle changes that occurred. Information, support and advice throughout the 3-6 months postoperative period was reported to be inadequate. The majority of participants did not ask any questions and did not perceive there was a choice regarding treatment. Individuals who wanted to take an active role in decisionmaking reported difficulties accessing information to enable them to do so. Conclusion : The findings of this study emphasise the need for individualised information provision defined not exclusively by the surgical procedure.

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (leaves 154-164).

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.

The purpose of this study was to examine the coping styles, beliefs, and symptoms of head-injured adults during long term recovery. Twenty-eight head-injured and thirty-two control subjects suffering from non-neurological illnesses or injuries participated. Subjects completed the Ways of Coping Questionnaire and two questionnaires developed for this study: the "Why Me?" Questionnaire assessed subjects' causal attributions and beliefs about responsibility and the Head-Injury Symptom List provided self-report of the severity of symptoms of head-injury. The coping and belief profiles of the two groups were compared. Head-injured subjects were more likely to place responsibility for their injury on others and to undertake personal efforts to effect their recovery. Various relations between injury attributions and coping styles were obtained. Among both head-injured and control subjects those who endorsed beliefs of retribution were more likely to cope by wishing they could change their situation. Responses to the Head-Injury Symptom List identified tiredness as the most pervasive symptom. Greater symptomatology was related both to a coping style characterized by lack of ability or willingness to engage in social activity or to seek social support and to beliefs that the injury had occurred to serve a meaningful purpose. Consistent with these quantitative results, interviews with head-injured subjects revealed themes of both loss and enhancement. A majority compared their recovery favorably with that of other individuals. In support of cognitive coping theory, this research demonstrates the feasibility of studying the coping capacities of head-injured individuals and shows that they have distinctive coping styles and beliefs which are related to each other. This knowledge should aid those trying to support the recovery of head-injured individuals by adding to the framework upon which interventions are based.

名古屋大学博士学位論文 学位の種類:工学博士 (論文) 学位授与年月日:平成1年12月8日

The use of conversational agents has increased across the world. From providing automated support for companies to being virtual psychologists they have moved from an academic curiosity to an application with real world relevance. While many researchers have focused on the content of the dialogue and synthetic speech to give the agents a voice, more recently animating these characters has become a topic of interest. An additional use for character animation technology is in the film and video game industry where having characters animated without needing to pay for expensive labour would save tremendous costs. When animating characters there are many aspects to consider, for example the way they walk. However, to truly assist with communication automated animation needs to duplicate the body language used when speaking. In particular conversational agents are often only an animation of the upper parts of the body, so head motion is one of the keys to a believable agent. While certain linguistic features are obvious, such as nodding to indicate agreement, research has shown that head motion also aids understanding of speech. Additionally head motion often contains emotional cues, prosodic information, and other paralinguistic information. In this thesis we will present our research into synthesising head motion using only recorded speech as input. During this research we collected a large dataset of head motion synchronised with speech, examined evaluation methodology, and developed a synthesis system. Our dataset is one of the larger ones available. From it we present some statistics about head motion in general. Including differences between read speech and story telling speech, and differences between speakers. From this we are able to draw some conclusions as to what type of source data will be the most interesting in head motion research, and if speaker-dependent models are needed for synthesis. In our examination of head motion evaluation methodology we introduce Forced Canonical Correlation Analysis (FCCA). FCCA shows the difference between head motion shaped noise and motion capture better than standard methods for objective evaluation used in the literature. We have shown that for subjective testing it is best practice to use a variation of MUltiple Stimuli with Hidden Reference and Anchor (MUSHRA) based testing, adapted for head motion. Through experimentation we have developed guidelines for the implementation of the test, and the constraints on the length. Finally we present a new system for head motion synthesis. We make use of simple templates of motion, automatically extracted from source data, that are warped to suit the speech features. Our system uses clustering to pick the small motion units, and a combined HMM and GMM based approach for determining the values of warping parameters at synthesis time. This results in highly natural looking motion that outperforms other state of the art systems. Our system requires minimal human intervention and produces believable motion. The key innovates were the new methods for segmenting head motion and creating a process similar to language modelling for synthesising head motion.

Published Article / Direct feeding damage to head lettuce (Lactuca sativa L.) by varying aphid populations in two differently constructed shadehouse structures (fully- and partially covered) was examined. Fresh lettuce head weight, the number of lettuce leaves formed, and the number of lettuce leaves infested with aphids were compared between the two structures. Warmer months showed a significant lower fresh lettuce head weight in the fully covered structure with more aphid-infested leaves. During June/September, the mean number of aphid-infested leaves and aphid infestation levels were significantly higher in the partially covered structure. Visible feeding damage to the lettuce crop was restricted, but asymptomatic damage in terms of a decrease in head weight did occur under severe infestation levels.