Thesis (M.Sc. (Med.) (Emergency Medicine))--University of the Witwatersrand, Faculty of Health Sciences, 2012. / An audit of patients with moderate to severe head injuries in Leratong regional hospital ABSTRACT The aim of this study was to review the clinical presentation, underlying brain injury and clinical outcomes of moderate and severe traumatic brain injuries (TBI) patients managed in a regional hospital setting. The records of 95 patients with moderate and severe traumatic brain injury who were treated at Leratong hospital from 01 January to 31 December 2009 were studied. Demographic data, referral criteria to neurosurgeon, criteria for computerized tomography (CT) scan and their findings were reviewed. Outcomes were death, alive with and without complication/ disability. The relationships between outcomes, age, blood pressure, pulse, Glasgow coma scales (GCS) score, abnormal pupil and CT scan findings were analyzed. The following variables were statistically significant in showing a strong association with mortality; subdural haematoma (46%), lower GCS (5.8 ± 2.7), bradycardia (76.4 ± 29.7) and abnormal pupil characteristics (54%). All patients with perforating gunshot wounds to head died. However, 88% patients with brain contusions lived. Patients with a lower GCS (7.3 ± 3.3), hypotension (69.1 ± 25.7) and contusion (48%) had a strong association with development of complications and disability. In contrast, those with facial fractures (92%) were less likely to develop complications or die. Computerized tomography (CT) scan referrals had a poor outcome as result of delays in transfer. Moderate TBI patients treated in this setting did not experience a higher mortality when compared to figures in the literature. It was found that majority of patients (95%) required conservative management instead of craniotomies. Taking into account 46% of missing records regional hospitals might be appropriate facilities for triaging and a supervised conservative management of TBI. However, a need arise to review triage criteria to neurosurgeon while being specific to our South African hospital setting. Lastly, a conduction of a multicenter prospective study in regional hospitals will enable a more comprehensive understanding of head trauma at this level of care.

M.Sc. (Med.) (Epidemiology and Biostatistics), Faculty of Health Sciences, University of the Witwatersrand, 2011 / Introduction: Work - related injuries are of major public health importance because they have severe negative economic and social impacts to individuals, families, and a country’s economy as a whole. South Africa is a rapidly expanding economy and so there is great potential for workrelated injuries. Notably, a number of studies on work-related injuries in South Africa and globally are done at the industry level. While no effort to minimise occupational injuries at the enterprise level should be spared, more information is also required on the morbidity burden of these work-related injuries at the general population level. It was therefore against this background, that this research project was carried out. Objective: The objective of this study was to determine the association between injuries and occupations among workers aged 15 - 65 years. Methods: The dataset for this dissertation was extracted from the South African 2001 Labour Force Survey. Only respondents who reported having worked in the previous twelve months were included in the study sample (n=21,751). The outcome variable was injury over the previous twelve months. The explanatory variables were socio-demographic, occupation, and occupationally related characteristics. Logistic regression controlling for the socio-demographic characteristics was used to identify occupational and occupationally related predictors for incidence of injury at 95% confidence level. Results: Injury incidence of 4% (894/ 21751) was reported which was mainly associated with age, gender, ethnicity and province of residence at p<0.05. Male workers were more likely to sustain accidents than female workers with a risk ratio of male/female of 2.4 times. Unexpectedly, injuries increased with age. In respect to ethnicity, the Coloureds, Indian/Asians and Whites were 18%, 48% and 44% less likely to sustain injuries respectively compared to the vi African blacks while workers in the group called “Other” were 5.3 times at risk than African blacks. Adjusted analyses indicated that, workers in mining and quarrying (AOR=2.2), crafts and related trade (AOR=4.0), plant and machine operators (AOR=4.4) and elementary occupations (AOR=2.7) were predisposed to a higher risk of sustaining injury than other occupations. Surprisingly, permanent workers, those with written contract, pension contribution were found to have a higher likelihood of sustaining injuries than their counterparts. Conclusions: The incidence of injury to workers in South Africa was found to be at 4%. The older, male, and permanently employed workers were at a greater risk of sustaining injuries compared to young, female and casual workers respectively. In regards to occupations, mining and quarrying, crafts and related trade and elementary occupations elevated the risk of sustaining injuries than other occupations. It is highly recommended that occupation-specific programmes be instituted to minimise worker injuries particularly among the high risk work places. Further research is also required to investigate findings that were found to be inconsistent with existing literature namely; increase of injuries with increase in age, and why workers on permanent versus casual employment were more likely to sustain injuries.

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Health Sciences, 1987.

There is a large body of work investigating whiplash-associated injury in motor vehicles and its causation. Being unable to detect the actual injury and having to use the symptoms of the sufferer as a surrogate has made progress in understanding the injury causation slow. Still lacking are the causal relationships between the biomechanical load on the vehicle occupant in the crash, the resulting loading on the neck and the actual injuries suffered. The optimisation of the design of vehicle safety systems to minimise whiplash needs a better understanding of human tolerance to these injuries. This thesis describes the development of a mathematical multi-body C5/C6 motion segment model to investigate the causation of soft-tissue neck injury. This model was validated with available static in-vitro experimental data on excised motion-segments and then integrated into the existing, validated multi-body human head and neck model developed by van der Horst, to allow the application of realistic dynamic loads. The responses and injury sensing capability of the C5/C6 model were compared with available data for volunteers and cadavers in rear impacts. The head and neck model was applied to the investigation of a group of real rear impact crashes (n = 78) of vehicles equipped with a crash-pulse recorder and with known postcrash injury outcomes. The motion of the occupants in these crashes had previously been reconstructed with a MADYMO BioRID II dummy-in-seat model validated by sled testing. The occupant T1 accelerations from these reconstructions were used to drive the head and neck model. The soft-tissue loading at C5/C6 of the head and neck model was analysed during the early stage of the impact, prior to contact with the head restraint. The loading and the pain outcome from the vehicle occupants in the actual crash were compared statistically. For the longer-term whiplash-associated pain outcomes (of greater than 1 month duration) for these occupants, the C5/C6 model indicated good correlation with the magnitude of the shear loading on the facet capsule. In lower severity impacts, the model result supported a second hypothesis of injury to this motion segment: facet surface impingement.

Dissertation (Ph.D.)--The University of North Carolina at Greensboro, 2008. / Directed by Diane Gill; submitted to the Dept. of Exercise and Sport Science. Title from PDF t.p. (viewed Feb. 2, 2010). Includes bibliographical references (p. 99-102).

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2002. / Includes bibliographical references.

There is no abstract available for this thesis.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 4 uppsatser.

Diss. Stockholm : Karol. inst.

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 1999. / Includes bibliographical references.