M. Tech. / The main purpose of this study was: • To determine the different diagnostic techniques chiropractors use in Gauteng South Africa. Objectives included: • To determine chiropractics attitude and opinions regarding the different Diagnostic Techniques they use in their practices. • To determine any statistically significantly correlations between answers. • To develop a demographic profile of Chiropractors in Gauteng South Africa. In the world today there are 80 000 chiropractors who are the primary physicians performing manipulations in order to treat problems such as lower back pain. Incidentally 85% of the western world will suffer from at some stage of their lives (Hecker and Daniel, 2004). The identification of the common functional and structural components of the adjustable lesion is critical to the management of these conditions. Unfortunately it has also contributed to the misconception that all manipulative disorders have the same pathological basis (Bergman, 2002). A questionnaire-based study comprising a non-probabilistic, non-random, convenience sample was used to determine the diagnostic techniques used v by the chiropractors actively practicing in Gauteng South Africa. A total of 58 Chiropractors responded to the questionnaire, forming the sample population that was used to calculate results. According to this study, all the responding chiropractors practicing here in Gauteng South Africa (n=58/58 100%), examine the spine to identify areas or subluxations that require adjustments/manipulation. There are a variety of diagnostic techniques methods that they use in everyday practice. Most commonly motion palpation(96.5%), static palpation(93.1%), pain description of the patient(82.8%), leg length discrepancy(55%), neurological tests(77.6%), visual postural analysis(61.4%), orthopedic tests(75%), plain static and stress x-rays(44.5%) and kinesiology muscle testing(10.4%) are used. The perceived reliability of these diagnostic techniques are also considered to be good.

This study examined the effectiveness of cautioning and education on simulating a mild traumatic brain injury on several neuropsychological measures. The measures used included the Word Memory Test (WMT), Wechsler Adult Intelligence Scales® - Third Edition (WAIS®-III), Wechsler Memory Scales®-3rd Edition instrument (WMS®-III), 16-item version of the Rey Memory Test, and a self-report symptom checklist. Five experimental groups were used including clinical and non-clinical controls, as well as three simulation groups. The design and implementation of this study also attempted to correct several methodological short comings of prior research by increasing the incentives for participants, expanding the generalizability of findings and examining research compliance and participant self-perception through debriefing. Discriminant analysis was utilized to determine if specific functions existed that would correctly classify and distinguish each experimental group. Several discriminant functions had at least moderate canonical correlations and good classification accuracy. Results also include utility estimates given projected varying base rates of malingering.

Background: Diagnostic accuracy and reliability of acquired apraxia of speech (AOS) in the presence of co-occurring aphasia and/or dysarthria is crucial for appropriate treatment selection and clinical decision making. However, overlapping symptomology and lack of operationalization of AOS assessment methods have contributed to inadequate interrater reliability of perceptual measures differentially diagnostic of AOS. Purpose: This study investigated factors influencing the operationalization of AOS assessment methods, primarily interrater reliability of perceptual characteristics of differentially diagnostic (i.e., phonetic and prosodic errors) measures in order to inform assessment methods in AOS with concomitant aphasia. In addition, several other factors influencing the operationalization of AOS assessment methods were explored including: the utility of a pre-existing stimulus readily available in a standardized aphasia assessment (WAB-R), interrater reliability of non-discriminatory characteristics of AOS (i.e., auditory groping and false starts), the influence of alternating motion rates (AMRs) and sequential motion rates (SMRs) on a diagnosis of AOS, and the influence of the WAB-R subtests on error production by diagnostic group. Methods: Forty participants presenting with varying aphasia subtypes and severities and potential motor speech impairment were included. Speech production errors were analyzed by four raters using narrow transcription methods in response to the WAB-R spoken language subtest stimuli (Naming, Repetition, and Spontaneous Speech subtests) of the WAB-R. Interrater reliability of perceptual measurement of both differentially diagnostic and non-discriminatory features of AOS when using consistent stimuli (WAB-R), measures (Apraxia of Speech Rating Scale) and trained raters using narrow transcription methods were examined. In addition, percentage agreement of AOS diagnoses with and without the inclusion of AMRs/SMRs, as well as the influence of WAB-R subtest on error production across groups with AOS with concomitant aphasia and those with aphasia only were also examined. Results: Both differentially diagnostic as well as non-discriminatory speech characteristics were shown to demonstrate adequate interrater reliability across a variety of aphasia subtypes and severities of both AOS and aphasia. Adequate agreement between a diagnosis of AOS with and without the inclusion of AMRs/SMRs was reported as well as a lack of significant differences of phonetic and prosodic error production between subtests. Conclusion: The current work provides preliminary evidence of adequate interrater reliability of perceptual features of AOS using consistent stimuli (WAB-R), measures (Apraxia of Speech Rating Scale), and trained raters using narrow transcription. Findings from this work also support the inclusion of the AMRs/SMRs in AOS assessment and highlight the importance of their role when assessing individuals with borderline/mild motor speech impairments. These preliminary results support the consistency and operationalization of assessment methods through the investigation of reliability of perceptual measurements of differentially diagnostic characteristics of AOS in the presence of aphasia.

In this MMed thesis I have reviewed retrospectively the pericardial aspirations performed between 1 July 1987 and 12th October 1989 at Groote Schuur Hospital, Cape Town. Documenting the reasons for aspiration, the complications of pericardiocentesis, and how cytologic, bacteriologic and biochemical examination of the aspirate influenced the clinicians' management of the 52 patients reviewed. The relatively low mortality of less than 2% is noted, in a procedure carried out for the relief of cardiac tamponade in 57% of the patients. A significant relationship between an ADA level higher than 51 international units per litre and a positive culture of mycobacterium tuberculosis from pericardial aspiration is demonstrated. The relatively low successful culture of mycobacterium tuberculosis (32% of the 29 patients clinically assessed as having tuberculous pericarditis) is noted, and recommendations to improve the yield from culture are made.

This thesis describes the development of an objective motor score (OMS) of Parkinson's disease that utilizes the Quantitative Motor Assessment Tool (QMAT) developed through efforts by the Intel Corporation and the Kinetics Foundation. Parkinson's disease (PD) is a movement disorder which is a member of a group of neurodegenerative diseases marked by the depletion or impairment of dopamine-producing cells in the brain. Since PD is chronic and degenerative, treatments are intended to either improve the quality of life for sufferers by superficially treating symptoms or slow and ultimately reverse the progression of the disease. No blood test or biomarker exists, so current assessment of the disease relies on a subjective tool called the Unified Parkinson's disease rating scale (UPDRS) which is a coarse scale that requires costly clinical administration and is subject to rater bias. The objective motor score described in this thesis exhibits excellent clinimetric properties, having demonstrated usability, validity, reliability, and responsiveness. It was calibrated to the motor section of the UPDRS, but in addition to high correlation with the motor UPDRS, it demonstrated an excellent ability to track deep brain stimulation treatment levels and to detect improvement in motor function of subjects due to dopaminergic treatment. With an excellent intraclass correlation coefficient, the OMS is a reliable measure and due to the objective nature of the test, it does not suffer from rater bias. Though these results come from the development phase, they suggest that confirmatory studies will firmly establish the excellent properties of the OMS. While further studies are in motion to improve upon the sensitivity of the OMS by exploring metrics of voice recordings and paced tapping tests, the OMS presented here is a complete and usable tool for assessing the severity of PD-related symptoms. In conjunction with the QMAT, it is ready to be used in clinical trials, clinical practice, and even in the homes of patients who suffer from PD. This makes it an invaluable tool that could begin to replace the UPDRS for use in PD research, reducing costs and confounding factors in studies as well as extending their capabilities into the home.

No description available.

Underwater robotic vehicles are used in a variety of environments that would be dangerous for humans. For these vehicles to be successful, they need to be tolerant of a variety of internal and external faults. To be resilient to internal faults, the system must be capable of determining the source of faulty behavior. However many different faults within a robotic vehicle can create identical faulty behavior, which makes the vehicles impossible to diagnose using conventional methods. I propose a novel active diagnosis method for differentiating between faults that would otherwise have identical behavior. I apply this method to a communication system and a power distribution system in a robotic vehicle and show that active diagnosis is successful in diagnosing partially observable faults. An example of an external fault is inter-robot communication in underwater robotics. The primary communication method for underwater vehicles is acoustic communication which relies heavily on line-of-sight tracking and range. This can cause severe packet loss between agents when a vehicle is operating around obstacles. I propose novel path-planning methods for an Autonomous Underwater Vehicle (AUV) that ferries messages between agents. I applied this method to a custom underwater simulator and illustrate how it can be used to preserve at least twice as many packets sent between agents than would be obtained using conventional methods.

No description available.

No description available.

Usability evaluation results in several usability problems and the non-UE developer is often not a part of the evaluation as it might deter the participant from reporting all the errors and also, conducting usability evaluation is a usability engineer's responsibility. Thus the evaluator needs to create unambiguous usability problem reports, which will help the developer fix the usability problems. This research involves the development and evaluation of the Usability Problem Diagnosis tool, which supports problem diagnosis through analysis and storage in a common database shared between the evaluation and the development team. This tool uses the User Action Framework as an underlying knowledge base to support problem diagnosis. / Master of Science