A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1996. / The purpose of this investigation was to determine the efficacy of chiropractic treatment in the management of primary dysmenorrhea. The sample consisted of 30 patients who were randomly assigned to 2 groups, the control and experimental. This single blind study consisted of 16 visits, twice a week for the first 4 weeks and thereafter once a week for the next 8 weeks. During a menstrual cycle, prior to commencement of treatment, the patients were required to complete a Short-Form McGill Pain Questionnaire on the last day of dysmenorrhea and a Numerical Pain Rating Scale 101 on each day of experienced menstrual pain. These questionnaires were completed at home. Treatment for the experimental group consisted of soft tissue massage of the lumbar and thoraco-lumbar paravertebral. musculature combined with spinal manipulative therapy of the areas of fixation in the' lumbar and sacra-iliac regions. The control group received purely soft tissue massage of the lumbar and thoraco-lumbar paravertebral musculature. The areas of fixation were determined by motion palpation, joint challenge and tenderness to spinal palpation. There was no follow-upvisit conducted in this study. An analysis of the data revealed a statistically signiflcant improvement in the experimental group in terms of the Short Form McGill Pain Questionnaire (p=< 0,001) as well as for the control group (p=< 0,01), whilst in terms of the Numerical Pain Rating Scale 101 the experimental group showed an improvement (p=< 0,05) but the control group failed to show a significant change (p= 0,068). / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / It has generally been accepted that 60 to 80% of the general population will suffer from low back pain at some point in their life. (Kirkaldy - Willis, 1992). The use of manipulation for the treatment of low back pain is well documented but lumbar mobilization has undergone comparatively little investigation (Goodsell et al., 2000). Furthermore, there remains little evidence to advocate the use of Muscle Energy Technique (MET) in the form of a randomized clinical trial (Wilson, 2003). The purpose of this study was to determine whether patients with acute and sub-acute low back pain would demonstrate a reduction in disability after being treated with MET or specific passive mobilization. Both interventions are joint mobilization techniques the only difference being that one is passive and the other (MET), is an active technique / M

M.Tech.

M.Tech.

M.Tech. / Objective. Previous studies have provided evidence of cervical manipulation as an effective treatment in the management of cervicogenic headache reduction, however there is no record of studies ascertaining the effectiveness of biomechanical pelvic blocking in such treatment. This controlled clinical trial aimed at establishing biomechanical pelvic blocking as an alternative treatment for cervicogenic headaches yielding similar results. Methods. In this study 30 participants between the ages of 18 and 60, symptomatic of cervicogenic headaches were included in the clinical trial. These 30 participants divided in to three groups of equal size by means of random selection. Group A received cervical spine manipulation only, group B received biomechanical pelvic blocking and group C was treated by means of both cervical spine manipulation and biomechanical pelvic blocking. The design of this pilot study was such that the spinal manipulative therapy was the control between the groups, therefore allowing us to identify whether biomechanical pelvic blocking was effective in the treatment of cervicogenic headaches. The patients were treated 6 times, twice weekly over a period of three weeks. Objective data collected on the first, third and sixth visits by means of the Saunders digital inclinometer. Cervical Range of Motion digital inclinometry measurements taken were that of forward flexion, extension and both right and lateral flexion. Subjective data collected by means of The Numerical Pain Rating Scale and Mc Gill Pain Questionnaire as well as the Neck Disability Index. The Numerical Pain Rating Scale and the Mc Gill Pain Questionnaire measured the headache pain intensity and the Neck Disability Index ascertained the degree of cervical disability as well as neck pain intensity experienced by the patients. These questionnaires were completed by the patient on the first, third and sixth consultation. Results. In terms of the digital inclinometry assessment, statistically significant results existed although not consistently for the same group per ROM. Extension showed Group C demonstrating the greatest increase in terms of cervical extension range of motion. Statistically significant difference existed between the groups for extension ROM. Forward flexion calculated as the most improved for group C however, no statistically significant difference existed. Group A proved most effective in increasing both cervical left and right lateral flexion range of motion. The reliability of digital inclinometer in obtaining accurate measurements is questionable. The subjective data although overall no statistically significant difference was noted between the groups for the period of the treatments, a definite clinical significance was established, group A did show the greatest overall improvement in pain intensity. Group C followed group A, the difference between these groups indicating the small relevance of the pelvic blocking. The Neck Disability Index demonstrated the greatest improvement within group C followed by group A and then group B. This marked improvement in group C in comparison to group’s A and B is suggestive of the immediate effects of cervical manipulative therapy as well as the spinal compensation due to treatment of the pelvis by the means of blocking. As this questionnaire, serves to establish the patients’ perception in terms of cervical pain and disability it indicated the biomechanical pelvic blocking to be questionably effective in the improvement in neck disability and pain.

No description available.

Between August 1979 and September 1982, acute variceal haemorrhage has been managed in the University Department of Surgery, Glasgow Royal Infirmary by a policy of oesophageal tamponade and injection sclerotherapy. Haemorrhage was controlled in 90% of admissions with an admission mortality of 28%. Recurrent haemorrhage occurred in half the patients surviving their first admission to hospital despite entering a programme of elective sclerotherapy. The results of this management policy are reviewed and the means of selecting patients for more aggressive therapy discussed. The deficiencies of a modified Child's classification in selection of patients are highlighted and overcome by the development of a prognostic index obtained by regression analysis on data collected on patients managed over this 3 year period. The admission prognostic index clearly defines 'high' and 'low' risk groups and 'predicts' outcome following admission in 90% of patients. The use of this index is validated in a further group of patients managed by a similar policy. Further regression analysis is used to obtain a prognostic index for alcohol cirrhotic patients alone and to determine the factors associated with one year survival. These indices are used to audit the management policy. Prothrombin, creatinine and encephalopathy are shown to have a clear association with outcome when measured at the time of variceal haemorrhage whereas other factors such as albumin and haemoglobin emerge as having prognostic value when measured one month following the acute episode. The possible applications of these prognostic indices are investigated in a prospective two centre study assessing the efficacy of propranolol in preventing recurrent variceal haemorrhage. It is shown that they can be used to exclude patients from entry into a study assessing the longterm benefit of propranolol when the prospects of short-term survival are limited. Their value in auditing management and their possible use in withdrawing treatment are shown. The prognostic indices are used to compare results of treatment at the two hospitals and are shown to be of value in analysing the results of the trial. These prognostic indices provide an objective means of evaluating patient management and may allow selection of patients for consideration of other treatment options.

No description available.

No description available.

La vie à la rue est-elle compatible avec la possession d’un animal ? Derrière cette question provocatrice se dissimule une triste réalité : Faute de réponses institutionnelles et sociales appropriées pour la prise en charge du binôme homme/chien, de plus en plus de propriétaires d’animaux, en situation de précarité, se retrouvent aujourd’hui en France prisonniers de cette rue d’où ils ne peuvent plus sortir. Stigmatisés par une opinion publique souvent méfiante, les maîtres et leurs chiens partagent pourtant une relation forte sur laquelle les professionnels du social pourraient capitaliser afin de favoriser leur réinsertion. Au cours de cette recherche, nous tâcherons de mieux comprendre les tenants et les aboutissants de cette nouvelle forme de marginalité socio-canine. / Is homelessness well suited with dog ownership? This provocative question hides a sad reality: Presently in France, due to the lack of adequate institutional and social solutions to take charge of the man and dog team, more and more of these vulnerable homeless dog owners are trapped in homelessness making it more difficult to get out of the situation. The Public is very suspicious of them and they are stigmatized. Nevertheless, these owners and their dogs have developed a very special and strong relationship. Then social workers could build up on this peculiar bond so that to facilitate the rehabilitation of these homeless dog owners. Our research investigates the ins and outs of this new form of social marginalization induced by dog ownership. Furthermore, we shall present several innovative projects where canine mediation has been a key element for the successful social rehabilitation of these people.