M.Sc. (Physiotherapy), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Low back pain (LBP) is one of the commonest and most costly medical problems in both the low and high income countries accounting for 75-90% of compensation costs. Compensation costs for LBP in South Africa in the year 2000 were approximately two hundred million rand and about 30 000 people suffer from neck and back problems on a daily basis. Physiotherapy treatment modalities are commonly used in the management of LBP but there is no consensus on the choice of treatment modalities. A cross-sectional survey was used to investigate the treatment modalities used by physiotherapists in Kwazulu-Natal (KZN) for the management of chronic low back pain (CLBP). The objectives of the study were to establish the commonly used physiotherapy modalities in the management of CLBP, the reasons behind the selection of those modalities and the extent to which the physiotherapists in KZN used evidence based modalities when managing CLBP. Self-Administered questionnaires were posted to all registered physiotherapists in KZN, that is, six hundred and eighty-five (685) physiotherapists. A 31% (213) response rate was achieved, of which 20.6% (141) met the inclusion criteria and 10.5% (72) were excluded. The results established that general exercises (30%); spinal mobilisation (28%); myofascial release (18%), education (12%) and training of local stabilisers (12%) were the commonly used treatment modalities in the management of CLBP. The key reasons for the selection of the treatment modalities were the undergraduate education received; own clinical experience and the attendance of postgraduate courses/physiotherapy conferences. Treatment modalities were not selected on the basis of the current available evidence hence evidence-based practice is not employed by physiotherapists in KZN in the management of patients with CLBP.

Student Number : 9903082V - MSc (Med) dissertation - Faculty of Health Sciences / Chronic infection with the hepatitis B virus (HBV) is endemic to sub-Saharan Africa and south-east Asia where it is a major risk factor for the development of cirrhosis and hepatocellular carcinoma (HCC). Currently available therapy is only effective in a small subset of chronic carriers. The development of novel treatment modalities for the management of HBV therefore remains an important global medical objective. Sequence plasticity of the HBV genome is limited by its small size and the overlapping nature of its open reading frames (ORFs). These features make HBV an ideal target for therapy based on nucleic acid hybridization. The use of ribozymes (RNA enzymes) and antisense molecules to inhibit gene expression is well documented. The recent discovery of RNA interference (RNAi) has added to the arsenal of therapy based on nucleic acid hybridization. RNAi is the process whereby short RNA duplexes (called short interfering RNA or siRNA) mediate the sequence-specific post-transcriptional silencing of genes homologous in sequence to the siRNA. siRNA function by guiding a protein complex (RNA Induced Silencing Complex or RISC) to target mRNA for degradation or translational repression. The protein X ORF (HBx ORF) is a conserved region of the HBV genome and is common to all viral transcripts. HBx is required for infection by the virus and plays an important role in the establishment of chronic infections in vivo as well as in the development of HCC. RNAi targeted against the HBx ORF may therefore prove useful as treatment of chronic HBV infection. Plasmid based expression cassettes capable of endogenously generating short hairpin RNA (shRNA) targeted to the HBx ORF were constructed. The shRNA function as substrates for the RNAi machinery and are processed into siRNA. The ability of the expression cassettes to knockdown markers of HBV gene expression was tested in a human hepatoma cell line. A panel of 10 U6 promoter-driven shRNA expression vectors was generated. The U6 promoter (an RNA polymerase III promoter) is normally involved in the transcription of small nuclear RNA and as such is ideal for the generation of shRNA of precisely defined length. Three cytomegalovirus (CMV) promoter-driven shRNA expression cassettes incorporating ribozymes that produce defined hairpin sequences were also generated. The CMV promoter (an RNA polymerase II) promoter is involved in the transcription of large messenger RNA. Two hammerhead ribozymes lying 5’ and 3’ of the shRNA encoding sequence were incorporated into the cassette. Cis-cleavage by the ribozymes releases a shRNA of defined length thereby overcoming the limitations imposed by extraneous sequences from CMV promoter-driven transcription. U6 promoter-driven shRNA expression vectors efficiently knocked down markers of HBV replication in liver cells. The CMV promoter-driven expression vectors were incapable of inhibiting HBV gene expression; however shRNA generated in vitro from these vectors mediated efficient knockdown of HBV replication. shRNA-mediated inhibition of gene expression therefore holds promise as a novel treatment strategy for the management of HBV and other mobile genetic elements.

No description available.

Previous surveys of mental health professionals regarding theoretical orientation and the use of various treatment modalities provided valuable information concerning the nature of mental health delivery but primarily focused on professionals providing services to dominant-culture clientele. The present study focused on those degreed workers whose primary clientele were American Indian. Questionnaires were returned by 140 mental health workers who are American Psychological Association (APA) members of American Indian descent, members of the Society of Indian Psychologists (SIP), employees of the Indian Health Service (IHS), and graduate psychology students. Questionnaire responses were analyzed in terms of orientation and treatment modality for various subgroups of respondents. In addition, demographic data (e.g., age, sex, emphasis of graduate study, intervention level, work setting, and service delivery to primary age groups) were compared for Indian and non-Indian respondents. The results provide a unique assessment of current trends in therapeutic approaches used in mental health service delivery with American Indians.

Proximal humeral fractures requiring surgical stabilization remain a therapeutic challenge, and a fully functioning joint is rarely the outcome after traumatic proximal humeral fractures. A systematic review was conducted to present the current state of knowledge concerning the postoperative rehabilitation. Tree databases was searched (PubMed, PEDro and the Cochrane library), presenting 25 publications eligible for further review and assessment. The literature was evaluated using PEDro and The Swedish Council on Health Technology, SBUs, evaluation grading system GRADE. The main functional impairments were pain and reduced range of motion in the shoulder joint, and were measured by several different scoring systems for functional outcome. Reported results were contradictory and inconsistent, and current studies typically lack randomization, and independent evaluation, with a resultant inability to produce clinical conclusions. According the post-operative rehabilitation procedure, only careful conclusions can be drawn from the literature reviewed which does not focus on, emphasize or explore the physiotherapeutic interventions at any length. It was therefore not possible to compare or connect the Axelina rehabilitation regimen with the literature. The Axelina rehabilitation program of the shoulder joint, are the most commonly used regimen at the physiotherapeutic ward at Uppsala University hospital. Neither was it possible to determine if the post-operative treatment should be different according to classification of fracture or method of stabilization. The results from this systematic review suggest that the data from the published literature are inadequate for evidence-based decision making as regards the treatment and post-operative rehabilitation for complex proximal humeral fractures.

The world, including developing countries such as South Africa, is burdened with deeply rooted women sexual health challenges such as dysmenorrhea. Dysmenorrhoea, also known as, "period pains", while not life-threatening, has been troubling many women of childbearing age since ancient times. Many interventions and drugs are available and approved for use in the treatment of dysmenorrhea. However, dysmenorrhea remains least understood, many cultures and religions of the African countries still regard it as a "taboo" subject because it is a sexual and reproductive issue, and means of coping are considered indigenously "women’s knowledge”, as such increasingly, women negotiate with cultural beliefs and practices in the management of dysmenorrhea. South Africa, as a multicultural society, allows the practice of different types of health care systems such as dysmenorrhea management. Extensive efforts are being made by the government and the healthcare sector to understand and document the indigenous health knowledge for safe practices in improving the overall health of South Africans. Moreover, this study was conducted. This study aimed to understand the indigenous perspectives of the meaning and treatment modalities of dysmenorrhea among Batlokwa women. Purposive and snowball sampling was used to select participants. The findings were used to develop strategies to empower Batlokwa women with dysmenorrhea knowledge. This study was premised on a conviction that Batlokwa women have a unique perspective on dysmenorrhea meaning and treatment modalities based on their ethnicity background. The study was conducted in two phases. Phase 1 was the empirical phase which was qualitative and was divided into two parts to address the first two objectives of the study. The population for Phase 1 constituted of the Batlokwa Traditional Health Practitioners (THPs) and Indigenous Knowledge Holders (IKHs). In part one modified photovoice approach was used to collect data in four different stages: • • Stage 1 – brainstorming and photograph taking training • • Stage 2 – taking photographs • • Stage 3 – Individual interviews • Stage 4 – modified Lekgotla discussion Data analysis for part one followed steps of photovoice data analysis guided by questioning the acronym “PHOTO” (Hussey 2006). The process involved photograph selection, contextualising and codifying. Photovoice enabled Batlokwa women (Traditional Health Practitioners and Indigenous Knowledge Holders) to share indigenous dysmenorrhea knowledge. Photographs taken by the participants were used to understand their perspectives regarding the meaning and treatment modalities of dysmenorrhea. Part two used in-depth interviews to collect data from women. In-depth interviews were conducted with different women to enhance the knowledge gained from the photovoice study. It was also to capture additional information that should have been missed during the photovoice study. Content data analysis was used in part two to provide detailed guidance for the coding process and analysis. The Africana Womanism theory was used as a framework to guide the study process and discussion of the findings and was grounded within critical realism worldview. This provided means to follow a systematic structure of understanding how the indigenous dysmenorrhea knowledge surfaced and maintained within the Batlokwa ethnicity. Five major themes were identified: holistic understanding of dysmenorrhea meaning; self-naming and definition of dysmenorrhea; diagnostic processes in indigenous health care practices; treatment modalities of dysmenorrhea; roles of THPs and IKHs in treatment and prevention of dysmenorrhea. Phase 2 addressed the third objective, which developed strategies to empower Batlokwa women with dysmenorrhea knowledge. Experts from indigenous knowledge holders, traditional health practitioners, health and education sectors. To reach consensus, a modified Lekgotla discussion utilising an expert panel reviewed items for importance, clarity, applicability, validity and reliability, with items subsequently amended or removed as such clear strategies which apply to the demographic group was developed to empower Batlokwa women with dysmenorrhea knowledge / Thesis (PhD (Nursing))--University of Pretoria, 2020. / Nursing Science / PhD (Nursing) / Unrestricted

No description available.

In order to obtain perspectives of Canadian dentists on the quality of the undergraduate education received in orthodontics and the extent of orthodontic services provided, a descriptive survey was constructed. Methods An anonymous, web-based survey was created using Survey Monkey® (Palo Alto, USA), and distributed to registered dentists in Canada via links in newsletters and mass emails. Results There were 427 respondents. Results showed that 71% of dentists provide some orthodontic treatment, and 33% of them offered only space maintainers. A total of 23% treated most of their patients requiring interceptive treatment, compared to 15% for those requiring comprehensive treatment. A driving time greater than 1 hour to the closest orthodontist resulted in a 16% increase in the provision of orthodontic treatment by the general dentists. The undergraduate orthodontic education was deemed above average by 21.4% to 50.5% of the respondents. Conclusions The percentage of dentists currently providing orthodontic services to their patients is similar to previous reports. A driving time of more than 1 hour is an influencing factor on the provision of orthodontic treatment by Canadian general dentists. The quality of undergraduate orthodontic education provided has improved over the last 25 years, although some amelioration may be beneficial.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-17T20:45:16Z No. of bitstreams: 1 Andréia Cristina de Oliveira Silva.pdf: 1199678 bytes, checksum: 371b5a5aa25f1178d00c0d687e7bd352 (MD5) / Made available in DSpace on 2018-07-17T20:45:16Z (GMT). No. of bitstreams: 1 Andréia Cristina de Oliveira Silva.pdf: 1199678 bytes, checksum: 371b5a5aa25f1178d00c0d687e7bd352 (MD5) Previous issue date: 2016-12-12 / Non-specific neck pain (NS-NP) is characterized by multifactorial causes, such as a change in the mobility or functioning of viscera that are found in the abdominal cavity, due to a possible neural relationship between these two regions. Thus, the objective of this study was to evaluate the pain, cervical mobility and electromyographic activity of the upper trapezius (UT) muscle in patients with NS-NP pre and post immediately visceral manipulation (VM) and after 7 days. This study was a placebo-controlled, randomized, blind study of subjects with IC. Thirty individuals with NS-NP were divided into two groups: Manipulation Group: 15 subjects treated with visceral manipulation and Placebo Group: 15 subjects receiving placebo treatment. The possible effects of the therapy were verified by the analysis of the pain performed through the Numeric Pain Rating Scale (NPRS) and by the measurement of the area of pain, the electromyographic activity of the UT muscle and the cervical mobility. In the analysis of mobility and pain verified by the area of pain, NPRS and algometry, no significant difference (p> 0.05) was found between the studied groups. The results obtained in the ANOVA of the group interaction (F = 0.09, p = 0.05, p2 <0.001) and treatment vs group (F = 0.69, p = 0.49, p2 = 0.006), showed no influence of VM on the amplitude of the electromyographic signal of the UT muscle. The present study demonstrated that a single intervention of visceral manipulation, of the stomach and liver, does not alter the pain, cervical mobility and electromyographic signal of trapezius muscle descending fibers, both in immediate posttraining and after 7 days. / A cervicalgia inespecífica (CI) pode ser decorrente de causas multifatoriais, como por exemplo, uma alteração na mobilidade ou funcionamento de vísceras que se encontram na cavidade abdominal, devido à uma possível relação neural entre essas duas regiões. O objetivo desse estudo foi avaliar a dor, mobilidade cervical e a atividade eletromiográfica (EMG) do músculo trapézio fibras descendentes (TFD) em pacientes com CI pré e pós mobilização visceral (MV) imediata e após 7 dias. Esse foi um estudo, placebo controlado, randomizado cego, composto por 30 indivíduos com CI distribuídos em dois grupos: GM: 15 indivíduos tratados com mobilização visceral e GP: 15 indivíduos que receberam tratamento placebo. Os possíveis efeitos da MV foram verificados pela análise da dor realizada por meio da Escala Numérica Verbal de Dor (ENVD) e pela mensuração da área de dor, pela atividade eletromiográfica do músculo TFD e pela mobilidade cervical. Na análise da mobilidade e da dor verificada pela área da dor, ENVD e algometria, não foi encontrada nenhuma diferença significativa (p>0,05) entre os grupos estudados. Os resultados obtidos na ANOVA das interações grupo (F=0,09, p=0,05; p2 <0,001) e tratamento vs grupo (F=0,69, p=0,49; p2 =0,006), não demostraram influência da MV na amplitude do sinal EMG do músculo TFD. O presente estudo demonstrou que uma única intervenção de manipulação visceral, do estômago e fígado, não altera a dor, mobilidade cervical e sinal eletromiográfico do músculo trapézio fibras descendentes, tanto no pós tratamento imediato, como após 7 dias.

The motivation for this study is the increase of treatment needs of heroin dependents at SANCA, (South African National Council of Alcohol and Drug Abuse) Witbank. SANCA Witbank wants to ensure that the most effective treatment can be supplied. Research goals are to: &#61656; Do a literature study of out-patient treatment programmes. &#61656; Assess the needs of heroin out-patient dependents with regard to out-patient treatment programmes. &#61656; Make recommendations with regard to out-patient treatment programmes for heroin dependents. It was an exploratory research subject and the data collection methods were qualitative and quantitative. Interview schedules were used as research tools. Schedule B was completed by the researcher with heroin dependents that visited SANCA Witbank for the period 31 January 2005 to 4 February 2005. Schedule A was completed by the researcher with personnel of SANCA out-patient clinics and the questions were discussed and completed telephonically. The conclusion is that the treatment programme of SANCA Witbank is in line with the rest of the drug dependent field and only minimal recommendations were made. / Social Work / MA(SS)(MENTAL HEALTH)