Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2007. / Background: Myofascial pain is the most common cause of persistent regional pain such as back pain, shoulder pain, tension-type headaches and facial pain. A variety of therapeutic modalities are proposed in the treatment of myofascial pain including massage. A variety of massage oils are available on the market, each claiming therapeutic efficacy. Most of these claims, however, have not been verified through clinical trials. Methods: A double-blinded placebo controlled study in which 80 subjects were randomly divided into 4 groups of twenty. Subjects in Group 1 received unscented mineral oil, those in Group 2 received scented mineral oil. Subjects in Group 4 received Arnica Massage oil while those in Group 4 received Blue Steel Arnica Massage oil. Results and Conclusions: The use of Arnica Massage oil or Blue Steel Arnica Massage oil resulted in almost 50 % pain reduction in the subjects after five days of self-administered treatment. Both these products can be recommended for the treatment of myofascial pain syndromes but one cannot be placed in preference to the other, as the results were similar with regards to their effectiveness.

Dissertation submitted in partial fulfilment of the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Motion palpation is an examination technique commonly used by chiropractors to identify a manipulable subluxation prior to manipulation. In order for its continued use, it must be validated. Many studies conducted on motion palpation’s inter-examiner reliability in the spine have shown it to be below average, however only a few studies have addressed its use in the extremity joints. No inter-examiner reliability studies on motion palpation were found for the elbow, let alone the symptomatic elbow with regards to chronic lateral epicondylalgia, a common disorder of the elbow effectively treated by the use of manipulation. Objectives The objectives of this study were to determine the inter-examiner reliability of motion palpation of the elbow for the asymptomatic elbow and the symptomatic elbow with regards to chronic lateral epicondylalgia. It also aimed to compare these results to determine any difference in reliability, the number of manipulable subluxations and the presence of manipulable subluxations in particular directions, between the two groups. Method Twenty participants (n=40 elbows) between the ages of 18 to 65, with one asymptomatic and one symptomatic elbow (chronic lateral epicondylalgia) were examined by three final year masters chiropractic students for the presence of manipulable subluxations in end play, using only motion palpation. The examiners were pre-trained, randomised and blinded. Each examiner individually motion palpated both elbows on each participant, in nine directions of motion palpation, incorporating the humeroulnar and proximal radioulnar joints. They were also required to identify which elbow was symptomatic. Fleiss’ kappa and percentage agreement (perfect percentage agreement and mean percentage agreement) were used to measure reliability. Paired non parametric Wilcoxon signed ranks compared the difference between both groups and McNemar’s chi square tests assessed the percentage of correctly identified symptomatic elbows for each examiner. A p value <0.05 was considered statistically significant. iv Results The asymptomatic elbows showed a poor range of kappa results, from 0.0683 to -0.1321, with a mean kappa of -0.0664. Perfect percentage agreement was 50% to 85% and mean percentage agreement was 83.30% to 94.99%. The symptomatic elbows’ kappa values ranged between -0.2691 to 0.4034 with a mean kappa of -0.0028. The humeroulnar medial to lateral direction of motion palpation had a moderate kappa value of 0.4034. Perfect percentage agreement ranged from 10% to 85% and mean percentage agreement from 69.94% to 94.99%. There was an insignificant difference in kappa values between the two groups (p=0.260), although there was a trend towards the asymptomatic kappa values being lower than the symptomatic values. The difference between symptomatic and asymptomatic elbows was significant in proximal radioulnar posterior to anterior glide in pronation (p=0.013), as well as proximal radioulnar rotation of the radial head on the ulna (p=0.008). Overall, more manipulable subluxations were found in the symptomatic elbows than in the asymptomatic elbows. The examiners correctly identified the symptomatic elbow in 65% to 90% of participants (p=1.000). Conclusions and Recommendations In conclusion, the inter-examiner reliability of motion palpation in the asymptomatic elbow was poor, and in the symptomatic elbow (chronic lateral epicondylalgia), poor to moderate. There was an insignificant difference in reliability between the two groups, although more manipulable subluxations were found in the symptomatic elbows overall. These were mainly in proximal radioulnar posterior to anterior glide in pronation, as well as proximal radioulnar rotation of the radial head on the ulna, two directions of motion that form part of Mills’ manipulation. This study also found that examiners were able to identify the symptomatic elbows with the use of motion palpation. It is recommended that future research continue from this study in assessing the identification and presence of manipulable subluxations in all the extremity joints. However the methodological problems with the statistical analysis need to be addressed.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Background: Hamstring muscle strains are a common musculoskeletal injury amongst athletes, with a high rate of recurrence that suggests room for improvement in the treatment and management of these injuries. Cibulka et al. (1986) suggest a possible link between injuries of the hamstring muscles and dysfunction of the sacroiliac joint. A study by Fyfer (2005) found that sacroiliac manipulation alone had a positive effect in the treatment of recurrent hamstring strains, but this was not combined with or compared to conventional treatment for muscle strain. Fox (2006) found that sacroiliac manipulation added to hamstring stretching increased the resultant flexibility of uninjured hamstring muscles. Objective: The purpose of this study was to determine the relative effectiveness that manipulation may have when combined with and compared to a regime of hamstring stretching and strengthening in the treatment of chronic hamstring strains. Method: Thirty two participants suffering from chronic hamstring injuries and concomitant dysfunction of the sacroiliac joint were randomly allocated into two treatment groups. Both groups attended six consultations over a period of three weeks. Group one received treatment in the form of proprioceptive neuromuscular feedback (PNF) stretching and resisted isometric exercises of the hamstring, and were taught a home routine consisting of static stretching of the hamstring and Theraband® exercises directed at the hamstring. Group two received the same treatment and home routine as those in Group one, with the addition of Chiropractic manipulation of the dysfunctional sacroiliac joint. Outcomes were obtained by using the Numerical Pain Rating Scale (NRS-101), inclinometer testing of passive straight leg raiser test, and algometer assessment of pain threshold in the injured hamstring muscle and ipsilateral sacroiliac joint. Results: Data was analysed using the SPSS version 18.0 (SPSS Inc. Chicago, Ill, USA). Subjective and objectives outcomes were measured quantitatively. The effect of the intervention was measured using repeated measures ANOVA testing. The time versus treatment group interaction effect assessed whether the effect of the different treatment over time is the same, with a p value of <0.05 being v considered significant. Both treatment groups showed improvement of outcomes, and manipulation showed a marginally non-significant trend of greater improvement with regards to sacroiliac joint algometry. Conclusion: This study did not provide conclusive evidence of either a benefit or no benefit of manipulation, but where non-significant trends were shown, it is likely that this was due to lack of statistical power and that with an appropriate a priori analysis being done a greater sample size may have shown the same effect to be statistically significant.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background : Many treatment options provide symptomatic improvement of joint function for osteoarthritis (OA) of the knee. Research suggests full kinetic chain (FKC) manual and manipulative therapy (MMT) and rehabilitation yields greater benefits than home rehabilitation alone. However this treatment combination has never been compared against FKC MMT alone. Objectives : Objectives: To determine the effectiveness of three FKC treatment protocols in the management of knee OA. Method : A single-blinded, randomised comparative trial of sixty-six patients with knee OA, equally allocated to three treatment groups: manipulation only, rehabilitation only or manipulation plus rehabilitation (a.k.a. combination group). Manipulation groups received bi-weekly FKC treatment, while a daily at-home stretching and exercise programme was prescribed to the groups receiving rehabilitation. Treatment lasted three weeks, with outcomes measure taken at baseline, pre-visit 4 and 1-week follow up. Primary outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and McMaster Overall Therapeutic Effectiveness (OTE) Tool. Results : There was a drop-out rate of 7.6% (n=5), with intent to treat analysis providing the missing data. All three treatment groups showed clinically and statistically significant changes in overall WOMAC scores from baseline to 1-week follow up. The combination group showed the largest improvement (50.5%), followed by manipulation (44.4%) and rehabilitation (33.6%). However, this difference between group improvement was not statistically significant (p= 0.156). Conclusion : All three intervention protocols showed statistically significant improvement in most outcome measures at 1-week follow-up. However, there was no statistically significant difference between groups and therefore it is concluded that the interventions appear to be equally effective in the short-term management of knee OA.

Preferences are fundamental to decision making and play an important role in artificial intelligence. Our research focuses on three group of problems based on the preference formalism Answer Set Optimization (ASO): preference aggregation problems such as computing optimal (near optimal) solutions, strategic behaviors in preference representation, and learning ranks (weights) for preferences. In the first group of problems, of interest are optimal outcomes, that is, outcomes that are optimal with respect to the preorder defined by the preference rules. In this work, we consider computational problems concerning optimal outcomes. We propose, implement and study methods to compute an optimal outcome; to compute another optimal outcome once the first one is found; to compute an optimal outcome that is similar to (or, dissimilar from) a given candidate outcome; and to compute a set of optimal answer sets each significantly different from the others. For the decision version of several of these problems we establish their computational complexity. For the second topic, the strategic behaviors such as manipulation and bribery have received much attention from the social choice community. We study these concepts for preference formalisms that identify a set of optimal outcomes rather than a single winning outcome, the case common to social choice. Such preference formalisms are of interest in the context of combinatorial domains, where preference representations are only approximations to true preferences, and seeking a single optimal outcome runs a risk of missing the one which is optimal with respect to the actual preferences. In this work, we assume that preferences may be ranked (differ in importance), and we use the Pareto principle adjusted to the case of ranked preferences as the preference aggregation rule. For two important classes of preferences, representing the extreme ends of the spectrum, we provide characterizations of situations when manipulation and bribery is possible, and establish the complexity of the problem to decide that. Finally, we study the problem of learning the importance of individual preferences in preference profiles aggregated by the ranked Pareto rule or positional scoring rules. We provide a polynomial-time algorithm that finds a ranking of preferences such that the ranked profile correctly decided all the examples, whenever such a ranking exists. We also show that the problem to learn a ranking maximizing the number of correctly decided examples is NP-hard. We obtain similar results for the case of weighted profiles.

Environmental restoration is emerging as a major driver in the repair and reversal of some of the world’s most severely degraded landscape systems, with growing interest in the status and composition of restoration efforts. Although much has already been written about the theory and practice of environmental restoration, both positive and negative, hitherto the literature has tended to overlook the complexity bound up in defining restoration discourses, and perhaps more importantly, the physical, material consequences instilled through such human choice. The mutability of discourses of environmental restoration means that it can be moulded and (re-)shaped by different actors and contexts, with different values and meanings attached to ‘nature’. There exist multiple and contested natures of environmental restoration - nature(s) both in the sense o f the properties of restoration, and also that which is restored to a site. In this doctoral thesis, I demonstrate how discourses of environmental restoration are defined and interpreted, which discourses (if any) appear to dominate, and how these are mobilised to produce ‘restored nature’. Attention is also awarded to the environmental implications incurred when such discourses are played out on the ground. The research is grounded empirically through reference to the case studies o f the Eden Project (Cornwall, UK), the National Forest Company (Derbyshire, UK), and the Walden Woods Project (Lincoln, MA) and their adoption of restoration practices. Analysing the processes and practices of environmental restoration within a framework of social nature and cultural landscapes serves to destabilise the dualism distancing nature from society - a preserve of environmental ethics and philosophy - for such synergy not only highlights how ideas of (restored) nature are socially constructed, but also addresses the material production of nature, reinforcing the interactions between natural and societal actors.

The main objective of my thesis paper is to determine which organizations from a wide range of NGOs, including their donor relationships, are susceptible to funding manipulation and why. Through review of a focused selection of literature and case studies, I seek to identify a pattern of characteristics or variables among the weaker organizations which increases vulnerability to such practices. I will review the organizations' size, market competition, funding strategies, and supply-led contracts. I intend to conclude with the various ways in which NGO's can protect against funding manipulation.

It is known that during fluid restriction, obligatory water losses continue and hypohydration develops and that restricted energy intake leads to a concomitant restriction of all other dietary components, as well as hypohydration, but the specific effects of periods of fluid and/ or energy restriction on fluid balance, electrolyte balance and exercise performance have not been systematically described in the scientific literature. There were two main aims of this thesis. Firstly, to describe the effects of periods of severe fluid and/ or energy restriction on fluid and electrolyte balance; secondly, to determine the effect of electrolyte supplementation during and after energy restriction on fluid and electrolyte balance as well as energy exercise performance. The severe restriction of fluid and/ or energy intake over a 24 h period all resulted in body mass loss (BML) and hypohydration, but whilst serum osmolality increases during fluid restriction (hypertonic hypohydration), serum osmolality does not change during energy restriction (isotonic hypohydration), despite similar reductions in plasma volume (Chapter 3). These differences in the tonicity of the hypohydration developed are most likely explainable by differences in electrolyte balance, with fluid restriction resulting in no change in electrolyte balance over 24 h (Chapter 3) and energy restriction (with or without fluid restriction) producing significant reductions in electrolyte balance by 24 h (Chapter 3; Chapter 4; Chapter 5; Chapter 6; Chapter 7). Twenty four hour combined fluid and energy restriction results in large negative balances of both sodium and potassium, and whilst the addition of sodium chloride to a rehydration solution ingested after fluid and energy restriction increases drink retention, the addition of potassium chloride to a rehydration solution does not (Chapter 4). Supplementation of sodium chloride and potassium chloride during periods of severe energy restriction reduces the BML observed during energy restriction and maintains plasma volume at pre-energy restriction levels (Chapter 5; Chapter 6; Chapter 7). iv These responses to electrolyte supplementation during energy restriction appear to be related to better maintenance of serum osmolality and electrolyte concentrations and a consequential reduction in urine output (Chapter 5; Chapter 6; Chapter 7). Additionally, 48 h energy restriction resulted in a reduction in exercise capacity in a hot environment and an increase in heart rate and core temperature during exercise, compared to a control trial providing adequate energy intake. Whilst electrolyte supplementation during the same 48 h period of energy restriction prevented these increases in heart rate and core temperature and exercise capacity was not different from the control trial Chapter 8). In conclusion, 24-48 h energy restriction results in large losses of sodium, potassium and chloride in urine and a large reduction in body mass and plasma volume and supplementation of these electrolytes during energy restriction reduces urine output, attenuates the reduction in body mass and maintains plasma volume and exercise capacity.

This research presents the design and evaluation of an intervention that introduces modification of time perceptions as one of the solutions to promote sustainable behaviours. It is demonstrated in this thesis that unnecessary energy use is often caused by temporal tensions, defined as the relation between actions to be performed and available time. This research proposes that it is possible to deliberately reduce temporal tensions, and this can motivate people to behave more sustainably. Persuasive technology and human-computer interaction provided the tools needed to manipulate time perceptions and therefore bring about changes in the specific behaviours that result in unnecessary energy usage. Previous studies indicate that behaviours play an important role in energy consumption. From the different domains of energy use that could be examined, cooking was chosen to be the platform where the studies on behaviour change and energy use would take place. How behaviours influence energy use motivated the design of empirical studies to understand behaviours related to domestic energy use and identify what are the determinants of these behaviours. Each determinant was related to a strategy to be included on a behaviour change intervention. A wider survey was developed to understand students acceptance of a set of proposed energy saving techniques, and resulted in a vast volume of information about user preferences and intentions to perform the suggested energy saving behaviours for cooking. It emerged that participants rushed into the cooking tasks without much deliberation, consequently not following preparation procedures and thus using more energy. Information gathered during the first studies also showed that participants behaviours were partially motivated by the need to speed up the cooking process in order to reduce boredom when they were waiting for the food to cook, consequently resulting in extra energy usage. The knowledge gathered from the preceding steps and a literature review informed the design of strategies to modify the non-sustainable behaviours and promote energy saving. A user-centred design process involving an idea generation session and scenario analysis was used to provide a set of strategies to be embedded in an intervention, containing the specific methods to tackle the correspondent determinants of behaviours. The specific needs of the cooking activity indicated that an electronic intervention was an adequate platform to be implemented and tested. Two high resolution working prototypes of the electronic interventions were developed as mobile phone applications. The final study comprised the evaluation of the proposed interventions in improving aspects of the cooking activity, the acceptance of the interventions and effectiveness in promoting energy saving.

L'industrie de l'emballage, comme de nombreux industriels, veut construire ses propres représentations du consommateur final pour mieux le prendre en compte dans son processus de conception. Dans ce contexte, l'ergonomie est une des disciplines contributrices à la production de données inhérentes aux interactions entre le consommateur final et l'emballage. L'objectif de notre recherche est de mettre en place une méthode d'étude destinée à comprendre et analyser les critères d'usage et de préhension d'emballages de liquides alimentaires, et de faciliter leur intégration en conception. Nous avons pour cela couplé deux démarches. La première a été la mise en place de tests utilisateurs portant sur l'usage d'emballages de différents matériaux et de différentes formes, selon des critères de perception, de performance, de confort et de satisfaction. Parallèlement, notre deuxième démarche s'est centrée sur les caractéristiques biomécaniques de l'interaction main-bouteille, par la transposition de méthodes d'étude des outils à main vers les emballages. Nos principaux résultats portent sur l'impact de la forme des emballages sur la saisie, sur la comparaison des matériaux et son implication dans l'utilisation, et sur l'évaluation des poignées de saisie pour emballages de grands contenants. L'ensemble des tests portant sur la biomécanique de l'interaction main-bouteille a apporté des réponses sur les modalités de saisie à l'utilisation, et des résultats sur les rôles de la main dans la préhension, sur son utilisation et sur la perception que l'utilisateur en a. Nos travaux donnent lieu à un cahier de recommandations exploitable par l'entreprise.