Written language expression in linguistically diverse classrooms in the Western Cape : a case study

Includes abstract.Includes bibliographical references (leaves 181-195).This study investigated the current performance, values, present and further opportunities and barriers to written language in ordinary, linguistically diverse intermediate phase classrooms in the Western Cape. A single, within-site case study was conducted in one grade 5 and one grade 6 classroom in an urban school

Laparoscopy and loop colostomy : a new approach to extra-peritoneal rectal injuries

Includes bibliographical references.Distal rectal washout and presacral drainage appear to have little or no influence on the morbidity and mortality in patients with low-energy trauma to the rectum. The ever-increasing popularity and obvious advantages of minimal access surgery have prompted surgeons to apply its use to a variety of surgical diseases, including trauma-related conditions. This study retrospectively reviews and examines the safety and efficacy of laparoscopy and the formation of a diverting sigmoid loop colostomy through an abdominal wall trephine, in a limited number of carefully selected patients with isolated extra-peritoneal rectal injuries. The patient is thus spared a major laparotomy wound. The value of distal rectal washout and presacral drainage in such injuries is also examined

Pope John Paul II: a psychobiographical study

This psychobiography is focussed on the life of Pope John Paul II, whose historical personage epitomises the redemptive theme of triumph over tragedy and eternal hope. A phenomenological approach to the study allowed the researcher to observe the subject’s lived experience through the theoretical lens of Erik Erikson’s psychosocial development theory as well has having his faith development illuminated by Fowler’s faith development theory. Together, these theories highlighted significant aspects of Pope John Paul II’s personality development, for the greater purpose of uncovering the significance of his historical personage by reconciling his spiritual, political and academic attributes. This psychobiographical undertaking was grounded in qualitative research in the form of a single case. Two methodological strategies were used in this study. Firstly, Alexander’s model was used to organise, extract, prioritise and analyse data. The indicators of salience ensured that all significant parts of biographical data were carefully considered for analysis. Guba’s criteria for trustworthiness guided the methodology to ensure reliable data extraction and interpretation. Posing specific questions to the data enabled the researcher to extract units of analysis relevant to the aim of the study. Secondly, the use of conceptual frameworks and matrices enabled the longitudinal exploration, categorisation and description of the stages of psychosocial and faith development. The findings of this psychobiographical study of Pope John Paul II strongly support the importance of Erikson’s (1950) theory in understanding the processes of personality development in an individual life. In this psychobiographical study, the complex process of adaption and growth was highlighted by Erikson’s (1950) theory and placed periods of Pope John Paul II’s development in context. This study also demonstrated that gaining meaning in life through faith (Fowler, 1981) provides the individual with greater internal support when adjusting to life changes. Furthermore, greater intentionality on the part of therapists to thread faith and spirituality into their practice, is evidence of the eugraphic impact of this study

Management of penetrating injuries of the upper extremities

Background: Routine surgical exploration after penetrating upper extremity trauma (PUET) to exclude arterial injury leads to a large number of negative explorations and iatrogenic injuries. Selective non-operative mana

Management of penetrating neck injuries

Background: Routine surgical exploration after penetrating neck injury (PNI) leads to a large number of negative neck explorations and potential iatrogenic injury. Selective non-operative management (SNOM) of PNI is gaining favour. The present study assessed the feasibility of SNOM in PNI. Methods: Seventy-seven consecutive patients with PNI presenting to a tertiary trauma centre were included in this prospective study from September 2009 to December 2009. All patients were managed according to Advanced Trauma Life Support guidelines, and either underwent emergency surgery or were managed without surgery, based on clinical presentation and/or outcome of special investigations. Results: Eight patients (10 per cent) were haemodynamically unstable at presentation. Foley catheter balloon tamponade (FCBT) was successful in stopping active bleeding in six of these patients, and diagnostic angiography revealed an arterial injury in five. The remaining 69 patients were managed using SNOM. Angiography or computed tomography was done in 41 patients (53 per cent), and showed arterial injury in 15. These injuries were treated surgically (7 patients), radiologically (stenting in 3) or conservatively. Contrast swallow and/or endoscopy were performed in 37 patients (48 per cent) for suspected oesophageal injury, but yielded no positive results. During follow-up no missed injuries were detected. Conclusion: FCBT was useful in patients with PNI and active bleeding. Stable patients should undergo additional investigation based on clinical findings only. Copyrigh

An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre

Background. Traumatic brain injury (TBI) can result in significant morbidity and mortality if not diagnosed in a timely manner. Brain computed tomography (CT) is the diagnostic gold standard but is of limited availability in most South African public hospitals, resulting in transfer of TBI patients to tertiary hospitals. Objective. To describe the referral patterns and outcomes of patients with TBI referred to Groote Schuur Hospital Trauma Centre. Methods. This was a retrospective audit of all patients admitted to the Trauma Centre who had a brain CT scan for suspected TBI between 1 February 2022 and 31 March 2022. Demographic data (age, sex), mechanism of injury and Glasgow Coma Score were recorded. Referral pathways were determined, and final disposition of patients was recorded. Results. A total of 522 patients had a brain CT for TBI. Of these, 314 (60.1%) were referred from other hospitals. CT scan was abnormal in 178 (34.1%) patients. Three hundred and two (58.6%) were discharged home within 24 hours. The mean time between referral and CT scan was 13 hours. Conclusion. More than half of patients referred for a CT scan were discharged from the Trauma Centre within 24 hours of admission, which indicates additional costs and inefficiencies in the health system. These data are useful to guide resource planning and allocation for district hospitals, since less expensive point-of-care modalities now exist to diagnose TBI, and which are useful in indicating the prognosis of patients.  

The Elbow-EpiTrainer : A method of delivering graded resistance to the extensor carpi radialis brevis. Effectiveness of a prototype device in a healthy population

This document is the Accepted Manuscript version of the following article: Navsaria R, Ryder DM, Lewis JS, et al, 'The Elbow-EpiTrainer: a method of delivering graded resistance to the extensor carpi radialis brevi:. Effectiveness of a prototype device in a healthy population', British Journal of Sports Medicine, Vol. 49(5):318-322, March 2015, available online at: http://bjsm.bmj.com/content/49/5/318. Published by the BMJ Publishing Group Limited.Background: Tennis elbow or lateral epicondylopathy (LE) is experienced as the lateral elbow has a reported prevalence of 1.3%, with symptoms lasting up to 18 months. LE is most commonly attributed to tendinopathy involving the extensor carpi radialis brevis (ECRB) tendon. The aim of tendinopathy management is to alleviate symptoms and restore function that initially involves relative rest followed by progressive therapeutic exercise. Objective: To assess the effectiveness of two prototype exercises using commonly available clinical equipment to progressively increase resistance and activity of the ECRB. Method: Eighteen healthy participants undertook two exercise progressions. Surface electromyography was used to record ECRB activity during the two progressions, involving eccentric exercises of the wrist extensors and elbow pronation exercises using a prototype device. The two progressions were assessed for their linearity of progression using repeated ANOVA and linear regression analysis. Five participants repeated the study to assess reliability. Results: The exercise progressions led to an increase in ECRB electromyographic (EMG) activity (p0.7) between the first and second tests for five participants. Conclusions: Manipulation of resistance and leverage with the prototype exercises was effective in creating significant increases of ECRB normalised EMG activity in a linear manner that may, with future research, become useful to clinicians treating LE. In addition, between trial reliability for the device to generate a consistent load was acceptable.Peer reviewedFinal Accepted Versio

Negative pressure wound therapy management of the "open abdomen" following trauma: a prospective study and systematic review

INTRODUCTION: The use of Negative Pressure Wound Therapy (NPWT) for temporary abdominal closure of open abdomen (OA) wounds is widely accepted. Published outcomes vary according to the specific nature and the aetiology that resulted in an OA. The aim of this study was to evaluate the effectiveness of a new NPWT system specifically used OA resulting from abdominal trauma. METHODS: A prospective study on trauma patients requiring temporary abdominal closure (TAC) with grade 1or 2 OA was carried out. All patients were treated with NPWT (RENASYS AB Smith & Nephew) to achieve TAC. The primary outcome measure was time taken to achieve fascial closure and secondary outcomes were complications and mortality. RESULTS: A total of 20 patients were included. Thirteen patients (65%) achieved fascial closure following a median treatment period of 3 days. Four patients (20%) died of causes unrelated to NPWT. Complications included fistula formation in one patient (5%) with spontaneous resolution during NPWT), bowel necrosis in a single patient (5%) and three cases of infection (15%). No fistulae were present at the end of NPWT. CONCLUSION: This new NPWT kit is safe and effective and results in a high rate of fascial closure and low complication rates in the severely injured trauma patient