M.A. (Psychology) / The Post Traumatic Amnesic Syndrome, which follows a mild closed head injury, seems to be a common occurrence in the field of neuropsychology. The syndrome is primarily characterised by a transient memory loss of daily events, normally commencing within days after the injury. The symptoms include absent-mindedness, an inability to remember names, dates, numbers and faces, commands and orders given at work. Due to the relatively uncomplicated nature of a mild closed head injury, the syndrome is often overlooked and underestimated in terms of its intensity and psychological damage. Patients are sent home after a brief observation period and medical staff are of the opinion that the patients will recover successfully, without experiencing much psychological or cognitive strain. It is usually thought that the syndrome does not last for more than three to four months. The aim of the research was to determine the nature of the experience of not being able to remember daily events, as part of the post traumatic amnesic syndrome. The influence of the syndrome on the patients' support persons was also investigated

M.Tech. / Purpose: The aim of this study was to evaluate the relative effectiveness of the application of soft tissue massage to the posterior neck muscles before, and after, chiropractic adjustment to the cervical spine in the treatment of cervical facet syndrome. To determine the most effective treatment protocol; the patient‟s perceptions and objective findings were used. These findings were assessed by completing a Visual Analogue Scale, a McGill Pain Questionnaire and a Vernon-Mior Neck Pain and Disability Index, and measuring the cervical spine range of motion using a Cervical Range of Motion goniometer. The questionnaires were completed and the ROM readings taken prior to treatment on the first, fourth and seventh visits. Method: Forty participants who met the inclusion criteria were randomly allocated to two different groups of twenty each. One group received soft tissue massage to the posterior neck musculature prior to the application of chiropractic adjustments to the subluxations of the cervical spine. The second group received the chiropractic adjustments to subluxations of the cervical spine that was followed by soft tissue massage to the posterior neck. Treatment took place over a period of three weeks, and participants were treated six times out of a total of seven visits. Procedure: Subjective data was collected at the first and fourth visit prior to treatment, as well as on the seventh visit by means of a Visual Analogue Scale (VAS), McGill Pain Questionnaire as well as a Vernon-Mior Neck Pain and Disability Index to assess pain and disability levels. Objective data was collected at the first and fourth visit prior to treatment, and at the seventh visit by means of a Cervical Range of Motion goniometer (C.R.O.M.). Data collected was analysed by STATCON. Results: Both groups improved well over time subjectively and objectively but none more superior. Statistically significant improvements in group 1 and group 2 were noted over the duration of the study with regards to pain, disability, and cervical spine range of motion.

Purpose: Trigger points may occur when muscle is subject to direct trauma, sustained tension, fatigue, radiculopathy, joint dysfunction and emotional stress, which may cause aberrant nerve conduction and dysfunction of the motor neurons. Any of these factors may increase the possibility of overload stress to a muscle and may convert a latent trigger point to an active one. In humans, due to muscle attachments, spinal manipulation causes reflex relaxation of associated and distal musculature. The purpose of this study was to assess the effects of upper cervical spine manipulation, specifically C1, on pain tolerance of trigger points over the erector spinae muscles in show-jumping horses. Method: This study consisted of two groups, the experimental and the control group, each consisting of ten horses. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. The only method of treatment that was administered to each horse was chiropractic manipulation to the most restricted side of the UPPER CERVICAL SPINE joint complex, from which the objective findings were based. Procedure: Both groups were examined for trigger points within the Erector Spinae muscles and these trigger points were assessed, via an algometer, for spot tenderness. All horses were then examined for a cervical restriction of the upper cervical spine. Only the experiment group had the restriction corrected by a chiropractic manipulation and thereafter both groups were reassessed two minutes later, and then again two weeks later, via an algometer, for spot tenderness within the same trigger points. Results: Statistically significant changes were found when comparing the algometer readings before the adjustment with the algometer readings after the adjustment on the right. Otherwise no statistically significant differences were found when comparing algometer readings before the adjustment with the algometer readings after the adjustment on the left, or when comparing the algometer readings before the adjustment with the algometer reading two weeks later bilaterally. Conclusion: The results were inconclusive with regards to immediate and prolonged effects of upper cervical spine manipulation, specifically C1, on pain tolerances over the erector spinae muscle. As this study was directed to a small group of subjects, accurate conclusions cannot be formulated due to the insignificant findings obtained from the study and further research needs to be performed on the effects of upper cervical spine manipulation on trigger points in horses. / Dr. Ashleigh Deall Dr. Alex Niven Dr. Chris Yelverton

No abstract available / Dissertation (MArch (Prof))--University of Pretoria, 2007. / Architecture / unrestricted

Employee turnover is a complex problem with many intertwining contributors. In general newly hired employees at an organization have a higher risk of injury. However, few studies have explored occupational injury as a predictor of employment duration. In this study we hypothesized that employees who sustained an injury during the early stages of employment were prone to higher turnover rates. All employees hired from 2012-2016 were identified using a large Midwestern manufacturing facilities human resources database (n=3765). Corresponding occupational injury information from the same time period was extracted from the onsite occupational health center. Employment duration was the dependent variable which was dichotomized as (i) working < 60 days or (ii) working ≥60 days. The 60-day threshold was based on the employer’s internal estimation of the duration of employment required to recover training costs. The primary independent variable was a first-time visit to the occupational health center within the first 60 days of employment, categorized as (i) no visit, (ii) a visit within 1-20 days, or (iii) a visit within 21-60 days. A secondary independent variable incorporated the nature of injury, classified as repetitive strain, acute sprain/strain, or other occupational injury types. Covariates included demographics (e.g., age, gender, and race/ethnicity), shift placement (e.g. first, second, third), and nature of assigned job (e.g., assembly, fabrication, maintenance). Incidence rates of first-time visits were calculated (i) across the full study period and (ii) for a reduced period that included only the first 60 days of employment. Logistic regression was used to estimate adjusted associations between the primary/secondary independent variables and the dependent variable. Of the 3765 employees, 1184 (31.5%) worked less than 60 days. About two-thirds were male, about half were white/Caucasian, and the overall mean age was 33.8±10.8 years. Between 2012 and 2016, 1105 first-time visits to the occupational health center were recorded for all new hires with an overall incidence rate (IR) of 47/100 person-years (PY). The IR for repetitive strain was 18/100PY. Of the 1105 first-time visits, 408 occurred within the first 60 days of employment with an overall IR of 85/100PY and an IR for repetitive strain of 36/100PY. Employees who visited the occupational health center in the first 20 days of employment were more likely to terminate prior to the 60-day threshold (adjusted odds ratio: 1.7; 95% confidence interval: 1.3-2.4). Elevated associations were seen for all nature of injury categories which occurred within 20 days when compared to non-injured employees. Overall, the results suggest that experiencing an occupational injury (in particular, a repetitive strain injury) within the first 20 days of employment is associated with termination before 60 days. Our results may not be generalizable to all manufacturing enterprises, and we do not make a distinction between voluntary and involuntary termination. However, the results indicate that employers should examine policies and practices to minimize the burden of injury among new employees and reduce turnover. In the case of the study facility, an extended or modified work hardening program could maximize new employees’ adaptation to the physical demands of manufacturing work.

This research is a prospective, descriptive survey of adult pedestrian injuries in Cape Town. It profiles 'at risk' pedestrians and describes their injuries, injury severity and outcome. The role which alcohol plays in these collisions is threaded through the thesis. Since no study of this nature has been done in South Africa, it provides baseline data on the epidemiology, alcohol-relatedness, clinical presentation and prevention of adult pedestrian collisions in the metropole. Data were collected prospectively on all injured pedestrians who presented consecutively, within six hours of being injured, to the Trauma Unit of Groote Schuur Hospital over a nine week period in 1993. Data were also gathered retrospectively from the state mortuary on all pedestrians who died before reaching hospital during the same time period. A total of 227 patients were included in the study. Data gathered included demographics, physiological response to injury, anatomical nature and severity of injuries as well as progress and outcome. Injuries were assessed and scored using the Abbreviated Injury Score (1990 revision) and the New Injury Severity Score. Alcohol consumption was assessed using four measures, viz. self-evaluation, clinical assessment, breath alcohol analysis and blood alcohol concentration (SAC). Data were analysed using SAS version 6. The study recorded a very high incidence of alcohol intoxication among injured pedestrians in Cape Town. This is highly suggestive of a causal link. One hundred and forty-one patients (62.1%) were found to have positive BACs; more than 40% had BACs in excess of 0.20 g/100ml. SAC positive pedestrians were found to have more severe injuries, to require longer hospitalisation periods and to need more complex management. They consequently cost more to treat than their sober counterparts. The comparison between the four methods of alcohol assessment revealed that self-evaluation and clinical assessment were poor screening tools. Breath alcohol analysis, using a Lion Alcolmeter S-D2, had a high degree of accuracy when compared to the SAC, which remains the 'gold standard'. It is therefore recommended that all traffic trauma patients be subjected to breath analysis. The study also generated recommendations for the prevention of pedestrian collisions. These address pre-crash, crash and post-crash factors. Control of drunken driving and walking, as well as road safety education, particularly to pedestrians, are key issues. However, there remains a need for improved road engineering and better monitoring of the roadworthiness of vehicles. This thesis highlights the severity of alcohol-related pedestrian injuries and the importance of preventative strategies.

This dissertation discusses distal humeral epiphyseal injuries in children, i.e. lateral condylar fractures, medial condylar fractures, fracture-separation of the distal humeral epiphysis and T-condylar fractures. Medial and lateral epicondylar fractures, being apophyseal, are excluded. The research was done at the Red Cross Children's Hospital Trauma Unit. It was based on two clinical retrospective studies and one case report: a: 60 lateral condylar fractures presenting from 1984 to 1987 -were reviewed. b: 12 fracture-separations of the distal humeral epiphysis presenting from 1984 to 1989 were reviewed. c: One case report of a medial condylar fracture with associated elbow dislocation The distal humeral epiphysis is the second most commonly injured epiphysis in the body, after that of the distal radius (Peterson 1972). Supracondylar fractures are the most common fractures around the elbow in children, making up 65% of the total (Canale 1987). Lateral condyle fractures have an incidence of 17.4%, compared to 3.2% for medial condylar fractures and 0.8% for T-condylar fractures (Canale 1987). At the Red Cross Children's Hospital, 60 displaced supracondylar fractures, 20 lateral condylar fractures and 2 to 3 fracture-separations of the distal humeral epiphysis are seen every year. Medial condylar fractures are rare.

In the Republic of South Africa, an autopsy is required in all cases of unnatural death, or in cases where the cause of death is unknown in terms of the Inquest Act of 1959. These are performed at the Salt River Medicolegal Laboratory by Forensic Pathologists and Registrars of the Department of Forensic Medicine and Toxicology of the University of Cape Town. The Salt River Medicolegal Laboratory serves the greater Cape Town area with a population of approximately 2,5 million, including the magisterial districts of Cape Town, Wynberg, Mitchell's Plain and Simonstown. Cape Town has one of the world's highest homicide rates and in 1986 the incidence was 56, 91 100000 population per annum. In contrast, Singapore has a homicide rate of only 2, 5/100 000, while the United States has an overall homicide rate of 7,7/ 100 000 population. In order to document the true impact of penetrating chest injuries, and to place mortality data in perspective, a retrospective descriptive study of all cases with fatal penetrating chest injuries admitted to the Salt River Medicolegal Laboratory in Cape Town during 1990 was undertaken. In 1990, a total of 5 758 cases was admitted to the Salt River Medicolegal Laboratory of which 1834 cases (39%) were the result of homicide. Of the homicide cases, 408 (22%) were the result of firearm injuries. A total of 2044 (35, 5%) cases admitted was deemed to have died of natural causes. This study identified a total of 841 cases of fatal penetrating injuries of the chest admitted during 1990, which constituted 22,6% of all non-natural cases admitted.

Participation in athletics is a popular pastime and form of entertainment. Children often begin to specialize in one sport at a young age in an effort to excel, which increases physical stress and the potential for injuries. Athletes participating in overhead sports are at increased risk of upper body chronic injuries, in part because the shoulder is an unstable hypermobile joint. Posture may also be affected in these athletes because of the demands placed on the upper body. The purpose of this study was to measure the upper body posture in a sample of Division I collegiate volleyball and softball athletes to investigate the prevalence of postural abnormalities and their relationship to pain or injury. Twenty-one Division I collegiate female athletes (seven volleyball; fourteen softball) who participated in their sport during the fall 2014 to spring 2015 seasons were studied. Athletes completed a pain and injury questionnaire, after which individual upper body posture measurements were made. Measurements included resting bilateral scapula position, head position, and shoulder position. An iPad mini camera was used with a commercial application (PostureCo, Inc.) to perform a photographic plumb line posture assessment with photographs taken in anterior, posterior, and lateral views. Posture analysis revealed a high prevalence (85.7 %) of forward head posture in this sample. Forward shoulder was noted in 42.9 % of the athletes and abnormal horizontal scapula position appeared to occur more frequently in the dominant arm (71.4 %) than in the non-dominant arm (47.6 %). Chi square tests determined that there was no statistically significant relationship between posture abnormalities and self-reported pain in this group of athletes. Results of this study -- although preliminary -- should be used to inform future research to investigate potential relationships between posture and pain/injury in overhead athletes.

A Research Report submitted to the Faculty of Health Sciences, University of the Witwatersrand Gauteng, 2017 / Background Soccer is a sport that is gaining in popularity in the elite and non-elite populations worldwide. As a result, the number of injuries in soccer is increasing. Hamstring injuries in particular, with a reported incidence rate as high as 63%, are of significant concern. Most hamstring injuries tend to occur during the swing phase of sprinting when hamstring activity is at its highest. As the speed of sprinting increases, greater mobility in the lumbo-pelvic area is required to maximise sprinting efficiency. Any abnormal or dysfunctional lumbo-pelvic movement during this phase could induce pain and hamstring injury. Lumbo-pelvic movement control dysfunction may therefore indirectly link abnormal lumbar spine movement to lumbo-pelvic pain and hamstring injury. The first aim of this study was to compare the performance of the erector spinae, gluteus maximus, hamstrings (biceps femoris) and quadriceps (rectus femoris) muscles in soccer players, with and without recent hamstring injuries, while performing isometric contractions, a functional squat and sprinting. The study’s second aim was to compare lumbo-pelvic movement control in soccer players with and without recent hamstring injuries. Method Thirty soccer players were selected to participate in this study. Fifteen were assigned to the injured group and 15 to an uninjured group. The injured group comprised players who had sustained a hamstring injury six months prior to the research and who had partially returned to training, and the uninjured group comprised players with no recent hamstring injuries and who were actively involved in full training. Players were matched in respect of age, height, weight and playing position. All players gave informed written consent, completed the physical activity, training and injury questionnaire, and the Oslo hamstring injury questionnaire. Physical tests, which included isometric contraction of the erector spinae, gluteus maximus, hamstrings (biceps femoris) and quadriceps (rectus femoris) muscles, a functional squat and a thirty-metre sprint were done. Muscle activity during these tests was recorded via electromyography (EMG). To determine the lumbo-pelvic movement control of the players, the dorsal pelvic tilt, waiter’s bow, one leg stand and prone knee bend tests were used. Cohen's d (parametric) and Spearman’s correlation coefficient (nonparametric) were used to calculate the effect size, and the Chi-square test and Fisher’s exact to analyse the lumbopelvic movement control data. To establish a statistical significance, the p-value of the study was set at p<0.05. Results EMG muscle activity during isometric contractions was lower in the erector spinae muscles (p=0.04) and biceps femoris muscle (p=0.02) of the injured group. Both these findings were statistically significant. There was no statistically significant difference in muscle activity during the functional squat between the study and uninjured groups. The results of the EMG activity in the thirty-metre sprint were determined to be significant as they demonstrated that the hamstring muscle (p=0.01) activation in the injured group was decreased in comparison with the uninjured group. During the performance of the lumbo-pelvic test, no association was found between the two groups in the dorsal pelvic tilt and one leg stand. The performance of the waiter’s bow (p=0.01) and prone knee bend (p=0.004) revealed statistically significant differences between the study and uninjured groups. The majority of the players in the injured group performed both of these functional tests incorrectly (WB n=10; PKB n=14). Conclusion The study found that the hamstring muscle is at great risk of injury during eccentric contraction of the hamstring muscles. This can be associated with poor lumbo-pelvic movement control, as the load on the hamstring muscle is increased to provide intersegmental stability around the neutral zone, the area of high spinal flexibility. / MT2017