published_or_final_version / Nursing Studies / Master / Master of Nursing

Background: Migraine trigger factors are precipitating factors that can contribute to an attack by increasing the probability of a migraine occurring. For some migraineurs, the headache phase is preceded by a transient disturbance in neurological function (an aura). An aura could be visual or sensory in nature. There are medications that can be used to treat a migraine attack when it occurs (acute medication) and medication that can be used to reduce frequency and severity of migraine attacks (prophylactic medication). Objectives: The primary aim of the study was to identify if there was a relationship between migraine trigger factors, auras and treatment. Methods: The study was conducted in 2014 in Port Elizabeth and consisted of two self-administered questionnaire-based surveys, one for pharmacists and one for migraine patients. Migraine patient questionnaires were distributed to migraine patients who frequented pharmacies, physiotherapy practices and health shops. A total of 18 pharmacist questionnaires and 173 migraine patient questionnaires were analysed. Results: Experiencing an aura before a migraine attack was reported by 43.9% of respondents and only “sometimes” by 22.5% of respondents. Visual auras were experienced by 92.0% of respondents who indicated that they suffered from migraine with aura and sensory auras were experienced by 71.5% of respondents, with 62.8% of respondents experiencing both visual and sensory auras. Trigger factors were experienced by 89.0% of respondents. There was no statistical relationship between aura and trigger factors, but there was a statistical relationship between trigger factors and visual aura at the 5% level (Chi-square = 7.966, d.f. = 1, p-value = 0.005). Cramér’s V showed a small practical significance at 0.218. About 80.0% of respondents used over-the-counter (OTC) medication and only 12.6% used migraine specific medication to abort a migraine attack. There was no statistical relationship between aura (visual or sensory) and abortive medication. There was a statistical relationship between abortive medication and the presence of trigger factors (Chi-square = 8.775, d.f. = 3, p-value = 0.032). Cramér’s V showed a small practical significance at 0.244. There was no statistical relationship in the presence of trigger factors between aura and abortive medication. Conclusion: Migraine is a complex disease which affects people of all ages. There appears to be a statistical relationship between visual auras and trigger factors and between abortive medication and trigger factors. There was, however, no statistical relationship between aura and abortive medication in the presence of trigger factors. Further studies need to be conducted to substantiate these findings.

M.Tech. / Verrucae vulgaris, commonly known as warts are benign growths due to infection with papillomaviruses, which occur mainly on the hands and feet (Gawkrodger, 2002). Verrucae are caused by a virus, the human papillomavirus (HPV) (Fitzpatrick and Aeling, 2001). Verrucae are a common skin problem, which account for approximately 5%-10% of the skin conditions seen in patients in many countries. The peak incidence ranging between the ages of 12 and 16, rarely being found in infants and the elderly (Gibbs and Degreef, 1997). Thuja occidentalis is a common homoeopathic remedy that has historically been used for the treatment of wart-like excrescences on cutaneous surfaces of the skin (Vermeulen, 1994). Based on homoeopathic principles, the toxicological symptoms of this remedy gives the therapeutic indications for which it is prescribed. Ricini oleum, commonly known as castor oil, for which there is an unknown mode of action, has been recommended for various cutaneous complaints, when applied externally (Grieves and Leyel, 1998). To date insufficient research has been conducted to confirm the effects of Thuja occidentalis and Ricini oleum on verrucae vulgaris. The aim of this study was to compare the efficacy of homoeopathically prepared, externally applied, Thuja occcidentalis 6cH and Ricini oleum 6cH, in the treatment of common warts, verrucae vulgaris. The study was a contextual, placebo controlled, double-blind research study. Forty-five participants ranging from 5 to 60 years old were recruited for this study. Participants who fulfilled the inclusion criteria were selected (Appendix A). Suitable participants completed a consent form, explaining all aspects of the study (Appendix B). Participants were required to complete a participant profile form, as well as an initial subjective questionnaire after which they were randomly placed into one of three treatment groups (Appendix C). Each participant was given a 25ml amber glass dropper bottle, which contained either Thuja occidentalis 6cH, Ricini oleum 6cH or the placebo. The placebo group was shared with another researcher conducting a similar study. The solutions were administered topically; two drops twice daily v and treatment lasted for ten days. A maximum of two verrucae were treated throughout the study and these lesions were kept covered at all times with a waterproof elastoplaster. Changes in symptoms were documented according to a questionnaire (Appendix D). The verrucae being treated were evaluated on three occasions; one day prior to commencement of the clinical trial, on day five of the trial, as well as on day ten. Each assessment involved photographs and physical measurements of the verrucae, as well as a subjective questionnaire, that the participant was requested to complete. The results were statistically analysed in terms of change in length, width and height of the verrucae. Results for the categorical responses were cross-tabulated with the respective treatments and chi-square tests were performed to compare efficacy of treatments. For the measured responses, the Friedman two-way analysis of verrucae was used to compare the responses to each treatment i.e. before, during and after each treatment. Based on the outcomes of this study, it was revealed that all three treatment groups responded with significant results, in terms of a decrease in overall size of the verrucae lesions. Two of the experimental groups, namely the Thuja occidentalis 6cH and the Ricini oleum 6cH groups, illustrated an overall decrease in size of verrucae from the start to the end of the clinical trial. The placebo group yielded the smallest decrease in overall size of verrucae, during this study. None of the participants noticed a change in their emotional status or physical status, while participating in the clinical trial. The duration of the trial was not sufficiently long enough. In addition, further research into this topic is required to assess whether the observations that were made in this study would result in eventual cure of the condition.

M.Cur. / Tuberculosis is regarded as a global health problem as accelerated by the impact of the HIV/AIDS epidemic. In South Africa it is regarded as a top national health priority. Taking treatment regularly prevents multi-drug resistance TB. The introduction of Directly Observed Treatment Short-course (DOTS) ensures that treatment supporters observe TB patients swallow tablets under direct supervision. In the area of research, treatment supporters are trained by South African National Tuberculosis Association trainers to supervise treatment. It happened on a regular basis that patients complain about various aspects of the observational progress, resulting in change of treatment supporters, some preferred to be supervised from the clinic. The researcher developed interest to find out about the shortcomings in the observation of TB patients by treatment supporters, so as to address those shortcomings. A qualitative, exploratory, descriptive and contextual research study was conducted to identify the experience of treatment supporters in observing tuberculosis patients on TB treatment and also, the experience of TB patients as observed by treatment supporters. Permission was obtained from both treatment supporters and TB patients. A pilot phenomenological interview was conducted from one TB patient and one treatment supporter supervising TB treatment, who met the selection criteria. The phenomenological interviews were conducted in Northern Sotho (Pedi), Shangaan, Tswana, Xhosa, Zulu, Southern Sotho and Northern Sotho (Tlokwa) from both treatment supporters and TB patients. The samples comprises of 14 TB patients and 14 treatment supporters supervising those TB patients. Steps were taken to ensure trustworthiness. Tesch’s method of data-analysis was followed to analyze the data. Results indicated that there are interfering factors relating to the working relationship between the TB patients and the treatment supporter. From the findings, facilitative factors are used as proposals to promote the observation of TB patients by treatment supporters. Strategies are described from the rationale, which explain how the proposal can be reached. The strategies were based on the study findings and the literature reviewed.

Word retrieval difficulties can affect individuals who have had strokes or head trauma (Goodglass & Wingfield, 1997) and to a lesser extent, typically aging adults. This can affect an individual's ability to name pictures accurately and quickly. Cues are used to help individuals with word retrieval difficulties in fmding specific words. Two commonly used cues are semantic and phonological cues. Semantic cues can be information about the word the person is trying to retrieve, such as its definition, and/or its functions. Phonological cues are usually the initial sound of a word that a person is attempting to retrieve. Previous research has suggested that both of these cues, in isolation, are effective in stimulating word retrieval during naming tasks (Li & Williams 1989; Stirnley & Noll 1991 ). However, research has not investigated the effects of combining these two cues during picture naming tasks. The current study observed participants under four different cueing conditions during a picture naming task with the Boston Naming Test. The four conditions include a control group (received no cues), a semantically cued group (received a semantic cue before being asked to name a picture), a phonologically cued group (received a phonological cue before being asked to name a picture), and a semanticallyphonologically cued group (received a semantic and phonological cue before being asked to name a picture). Each group was compared on number of items correctly named and response times. The results indicated that there was no statistically significant difference between the groups with regard to number of items named. There was a statistically significant difference found between the groups with regards to response times. These findings are discussed and compared to previous research and current word retrieval theories.

Dissertation submitted in partial compliance with the requirements for the Masterà ¢ s Degree in Technology: Chiropractic, Durban University of Technology, 2008. / Objectives: To determine the short-term effect of an inhaled, short-acting 2-agonist bronchodilator on chest wall expansion (cm) and lung function parameters (FEV1, FVC and FEV1/FVC%) in chronic moderate asthmatics. To determine the short-term effect of spinal manipulation (SMT) and ribcage mobilisation on chest wall expansion (cm) and lung function parameters (FEV1, FVC and FEV1/FVC%) in chronic moderate asthmatics. To determine the short-term effect of a combination of SMT, ribcage mobilisation and an inhaled, short-acting 2-agonist bronchodilator on chest wall expansion (cm) and lung function parameters (FEV1, FVC and FEV1/FVC%) in chronic moderate asthmatics. Methods: Forty-five chronic moderate asthmatics who met all the inclusion criteria of the study were divided into three groups of fifteen each. Group A received a short-acting 2-agonist bronchodilator, Group B received SMT and ribcage mobilisation and Group C received a combination of SMT, ribcage mobilisation and a short-acting 2-agonist bronchodilator. Baseline measurements and testing included chest wall expansion and the lung function parameters FEV1, FVC and FEV1/FVC%. These measurements were repeated 15 minutes post-intervention. Data was analyzed using SPSS version 15.0. Results: There were no statistically significant changes between pre- and post-intervention in the short-acting 2-agonist bronchodilator group with respect to any of the chest wall expansion measurements. There was a statisticallly significant increase in FEV1 between pre- and post-intervention in the short-acting 2-agonist bronchodilator group (p = 0.008). There was a statistically significant increase in the mean pre- and post-intervention axillary chest wall expansion (p = 0.014) as well as the mean of the half-way measurement (p = 0.014) and the overall mean chest wall expansion value (p = 0.001) following SMT and ribcage mobilisation. There were no statistically significant changes in any of the lung function parameter values following SMT and ribcage mobilisation. There was a significant increase for the half-way measurement in chest wall expansion (p = 0.018) in the combination of SMT, ribcage mobilisation and the inhaled, short-acting 2-agonist bronchodilator group. There were no statistically significant changes in any of the lung function parameter values in the combination of SMT, ribcage mobilisation and an inhaled, short-acting 2-agonist bronchodilator. For FEV1, the effect in the short-acting 2-agonist bronchodilator group vs. the SMT and ribcage mobilisation group was statistically significant (p = 0.018). There was no statistical difference in any of the chest wall expansion measurements and FVC and FEV1/FVC% parameters between all three groups. Conclusions The results did not point specifically to one intervention over another for all outcomes. SMT and rib mobilisation had no effect on the lung function parameters, at least in the short term. There was a statisticallly significant increase in FEV1 between pre- and post-intervention in the short-acting 2-agonist bronchodilator group.

Menopausal symptoms are common causes for women to seek treatment. The severity of symptoms vary from patient to patient and reduces the quality of life for many women. Most women reach menopause between the ages of 45 and 55, some not until 60 and some at an early age in their thirties or forties (Stoppler, 2008). Aim This study aimed to offer an alternative form of treatment for women that are experiencing the unpleasant symptoms that are experienced with menopause, since hormone replacement therapy, may have adverse effects in some women (Wang-Cheng, 2007). This double-blind placebo controlled study investigated the efficacy of a complementary formulation of Folliculinum D6 and Five-Flower Formula™, (Folliculinum D6, Rock Rose, Impatiens, Clematis, Star of Bethlehem, Cherry Plum ) in the treatment of menopausal symptoms in terms of participants’ perception of the treatment. iii This formula is currently available commercially as an unregistered product trading under the name of Femme Rosa. This formula was developed by Dr Maharaj, and is prepared by Natura®. The formula consists of Folliculinum D6 and Five-Flower Formula™. Methodology A total of 60 female participants who were going through natural menopause and currently experiencing menopausal symptoms took part in the study. They were randomly assigned according to the randomization sheet drawn up by the supervisor, 29 participants to the treatment group and 31 to the placebo group. The study was conducted over a period of six weeks and participants were required to attend two consultations at the Homoeopathic Day Clinic at the Durban University of Technology. Participants were recruited according to the inclusion criteria set out. During the first consultation the participants completed the Greene Climacteric Scale questionnaire and a concise case history was taken, thereafter each patient was handed two hot flush diaries to be completed one week before treatment and during the sixth week of treatment. Each participant was required to take one tablet every morning and evening for 6 weeks. Six weeks after the first consultation participants attended the second consultation and the Greene Climacteric Scale was completed for the final time and the hot flush diaries collected. iv Results The results of the first questionnaire and hot flush diary were used as a baseline for statistical analyses. As each group consisted of 29 and 31 subjects, non-parametric tests were used for data analysis. All statistical analyses were carried out using SPSS version 15.0. Conclusion An improvement was demonstrated in both treatment and placebo groups after treatment yet this improvement was not statistically significant. The only symptoms that improved in the treatment group were the hot flushes and psychological symptoms however, there were no significant differences between the treatment and placebo group. It was concluded that the complementary formulation of Folliculinum D6 and Five-Flower Formula™ was not statistically effective in the treatment of menopausal symptoms in terms of the participants’ perception of the treatment.

M.Tech. / Homoeopathy is considered to be a safe and effective modality of treatment for various ailments commonly encountered during pregnancy, such as constipation, exhaustion, pyrosis, backache, haemorrhoids, and varicose veins (Castro, 2004; Rothenberg, 2004). Pyrosis is defined as a burning sensation in the epigastric and sub-sternal region, which may radiate to the neck, throat, back and even the face, with rising of acid liquid from the stomach (Beers & Berkow, 1999; O’Toole, 2003). Pyrosis affects up to 85% of pregnant woman, the aetiology being complex and multi-factorial (Broussard & Richter, 1998; Page & Percival, 2000; Richter, 2005). The aim of the study was to determine the effect of homoeopathic similimum treatment on the frequency and severity of pyrosis during pregnancy, and also on the frequency which other antacid medication was taken. A qualitative, interventive, and descriptive study was conducted monitoring twelve participants over a period of five weeks. Non-probability purposive sampling was employed to select twelve pregnant women between 12-34 weeks gestation, suffering from pyrosis, and met the inclusion criteria for the study. Participants were recruited through referrals from midwives and advertisements placed in pharmacies and health stores. The participants evaluated their own symptoms on a daily questionnaire, recording how often they suffered from pyrosis, and also rating the severity of their discomfort. The questionnaire was completed for one week prior to treatment, and then for four weeks during which the participant received homoeopathic similimum treatment. The researcher interviewed each participant during three consultations. A thorough homoeopathic case history was taken during the initial consultation, capturing the totality of the participants’ symptoms on a case study form. After evaluation of the symptoms and repertorisation, a homoeopathic similimum remedy was prescribed. The choice of dosage and potency was individualized to the participant according to homoeopathic principles. A follow-up consultation was conducted after two weeks of treatment. During the follow-up consultation the participants’ symptoms were recorded on a follow-up sheet and their response to the treatment was evaluated. Where indicated the treatment was continued as before, the similimum remedy changed if indicated by a change in symptoms, or treatment stopped when no longer necessary. A final consultation was conducted after another two weeks. The symptoms were again recorded on a follow-up sheet, and the effectiveness of the similimum treatment was then evaluated. The data from the consultations were used to write in-depth case studies representing a qualitative evaluation of the study, based on the subjective experience of symptoms by the participants. Quantitative data was obtained from the daily questionnaires, and represented graphically. The means for all twelve cases, relating to the frequency and severity of pyrosis during the time of the study, were obtained from this data, and represented on bar graphs. From the case studies and questionnaires it was determined that there was an improvement in all twelve of the cases studied. All the participants, except for case five, eight, and nine, experienced improvement in the frequency that pyrosis was experienced. There was improvement of the severity of the symptoms in all twelve case studies. In case five, eight, and nine, the frequency of the symptoms of pyrosis didn’t decrease, but there was amelioration of the severity of the symptoms. In several cases there was also improvement of other concomitant symptoms and participants reported an overall improvement of their health. In case three the symptoms were no longer present after the first two weeks of treatment. No further treatment was required, and the participant remained symptom free for the remainder of her pregnancy. In all of the other cases the participants still continued to experience symptoms, but less frequently and suffered less discomfort. The symptoms were typically ameliorated when the prescribed remedy was taken. Provisional findings suggest that homoeopathic similimum treatment may be effective in managing pyrosis during pregnancy.

Abstract This study aimed to investigate the role played by treatment supporters in promoting patients’ treatment outcomes in six TB clinics of Ekurhuleni Metropolitan Municipality, Gauteng. A descriptive research design was used to study TB patients who were registered in the clinics in April and May 2006. Interviews were conducted on 216 new adult patients six months after their registration at clinics, all 30 treatment supporters of those who had supporters and the staff responsible for TB at the six clinics at which the patients were registered. The patients were grouped into those who had supporters 53% (n=115) and those who did not 47% (n=101). Patients’ response rate was 97%. Treatment outcomes were compared between these two groups. Results showed that significantly more supported patients achieved successful outcomes than patients who did not have supporters. The results did not change when transfers and deaths were excluded from the measurement. Successful treatment outcomes were significantly associated with treatment supporters having fewer than 10 patients, patients living with someone, patients of age 40 or more years, male patients, those whose highest education levels were tertiary and secondary. Patients and clinic staff said that supporters were useful in checking on patients’ treatment, giving medicine, counselling and advising patients on medication and in practical help. Conclusion: Treatment supporters had a significant role in promoting patients’ treatment outcomes. It is recommended that TB treatment programme staff should consider using treatment supporters in their programmes.

"Heat treatment is an important manufacturing process, which controls the mechanical property of metal parts, therefore contributes to the product quality. A Computerized Heat Treatment (CHT) system has been developed to model and simulate the heat transfer in furnace. When the part load and thermal schedule information is given with part and furnace specifications, the temperature profiles of parts in furnace can be calculated based on heat transfer principle. Therefore the part load and thermal schedule can be optimized to remove unnecessary delay time while the quality of heat treatment is ensured. In the thesis, the functions of CHT are enhanced with the capability of modeling and simulating the heat treatment processes with random part load and continuous furnaces. Methods to model random load and continuous furnace have been developed. Case studies with industry real data have been conducted to validate the system and to show effectiveness of the system. The system development is also introduced in the thesis."