Title The objectification of using of kinesio taping to influence a muscle tone in epicondylitis. Objectives The aim of this master thesis is to find an effect of inhibitive kinesiotape application to muscle tone of hypertonic m. extensor digitorum communis and to pain of lateral epicondyl in lateral epicondylitis. Method The master thesis is divided to theoretical part and empirical research, which is based on the first part. The evaluation of m. extensor digitorum communis tension after kinesiotape application is provided by myotonometry method. The measurement is performed in 5 tested persons before and after two-day kinesio tape application. The questionaire Numeric pain rating scale helps to find a change of pain before and after kinesio tape application and then the dependence of pain to muscle tone change. Results The myotonometer measurement found a decrease of m. extensor digitorum communis tension for 4 from 5 tested persons after two-day application. The pain of lateral epicondyl was reduced for all probands. Keywords lateral epicondylitis, tennis elbow, muscle tone, kinesio taping, myotonometer

A utilização da eletroestimulação muscular é uma estratégia utilizada para investigação da fadiga neuromuscular. Entretanto, esta técnica é pouco aplicada na musculatura extensora do cotovelo em função de limitações biomecâncias (atuação de músculos sinergistas), neurais (influência de reflexo neural) e fisiológicas (facilidade em atingir estados de potencialização pós-ativação e fadiga). Portanto, o objetivo deste estudo foi padronizar procedimentos para avaliação neuromuscular da musculatura extensora do cotovelo. Para isso, foram realizados três estudos que envolveram a adequação da técnica de eletroestimulação e um \"estudo principal\" para validar um novo protocolo de avaliação neuromuscular. Após resultados positivos em estudos complementares, a presente dissertação propôs a validação de um protocolo para análise neuromuscular com contrações submáximas para a musculatura extensora do cotovelo. Vinte participantes com idade de 25,1 ± 6,8 anos foram submetidos, em dias diferentes, a dois esforços, um a fim de promover fadiga central e fadiga periférica respectivamente. Antes e após os esforços envolvendo fadiga (periférica ou central) foram realizadas avaliações de fadiga neuromuscular para musculatura extensora do joelho (protocolo já validado) e musculatura extensora do cotovelo (protocolo proposto). Verificou-se que: (i.) o modelo de análise proposto não promove nenhum tipo de fadiga ou potencialização pós-ativação; (ii) a resposta de um pulso controle no início e no fim do modelo de análise proposto promovem respostas diferentes; (iii) o modelo proposto foi capaz de identificar redução da resposta neuromuscular; (iv) o esforço envolvendo fadiga central não promoveu fadiga central significante; (v) a utilização de um modelo matemático para investigação de fadiga neuromuscular (coeficientes resultantes de uma regressão linear) com os valores de estimulação em contrações submáximas foi sensível a fadiga mas não foi capaz de discriminar fadiga central e periférica. É possível concluir que o modelo de análise proposto para a musculatura extensora do cotovelo apresentou sensibilidade para verificar a fadiga neuromuscular. Entretanto, este não foi capaz de discriminar fadiga central e periférica. A utilização da regressão linear parece ser uma boa estratégia para diferenciar os dois modelos de fadiga e deve ser estudada com mais profundidade futuramente. / Muscular electrostimulation is a strategy used to investigate neuromuscular fatigue. However, this technique is poorly applied in the elbow extensor muscles due to the limitations of biomechanics (acting of synergistic muscles), neural (influence of neural reflex) and physiological (easiness to achieve post-activation and fatigue states of potentiation). Therefore, the purpose of this study was to standardize a neuromuscular evaluation strategy for the elbow extensor musculature. Thus, three complementary studies aimed at adjusting the electrostimulation technique and one \"main study\" to validate a new neuromuscular assessment protocol were realized. After positive results in complementary studies, the present dissertation proposed a protocol validation for neuromuscular analysis with submaximal contractions on the elbow extensor musculature. Twenty participants with 25.1 ± 6.8 years old performed, on different days, two efforts, one to promote central fatigue and peripheral fatigue respectively. Before and after the exercise involving fatigue (peripheral or central) there were realized neuromuscular fatigue evaluations for knee extensor muscles (protocol already validated) and elbow extensor musculature (protocol). The results indicate that: (i) the proposed analysis model does not promote any type of fatigue or post-activation potentiation; (ii) the response of a control pulse at the beginning and end of the proposed analysis model promotes different responses; (iii) the proposed model was able to identify reduction of neuromuscular response; (iv) the effort involving central fatigue did not promote significant central fatigue; (v) the use of a mathematical model to investigate neuromuscular fatigue (coefficients resulting from a linear regression) with the values of stimulation in submaximal contractions was sensitive after fatigue but was not able to discriminate central and peripheral fatigue. It is possible to conclude that the proposed analysis model for the elbow extensor musculature presented sensitivity to verify the neuromuscular fatigue. However, it was not able to discriminate central and peripheral fatigue. The use of linear regression seems to be a good strategy to differentiate the two models of fatigue and should be studied in more depth in the future.

Arthritis is one of the most common manifestations of aging and is the single largest cause of disability in the UK, US, Australia, and Canada among people age 30 years and older. Osteoarthritis of appendicular joint surfaces exhibits alterations of bony tissue in and around the joint surface. The degree to which osteoarthritis of articular surfaces occurs as a function of age and sex can be resolved with cemetery populations of known individuals, such as the Terry (19-20th century) and Spitalfields (17-18th century) collections upon which I report (n = 322; 162 males and 160 females). Using the five point scoring system 0-4 of lipping from the Chicago Standards Guide I ask whether (1) age has an influence on the accumulation of OA; (2) sex differences are present in patterns of OA; and (3) population origin is responsible for explaining intensity of OA.

How does a social welfare officer know when a parent with mental illness or behavioral symptoms is harmful to the children? As a social you are confronted with different ethical dilemmas on a daily basis. The social welfare officers have to follow their own authorities, laws, guidelines and regulations while at the same time do everything to satisfy their clients’ needs. This inconsistency can sometimes be difficult to handle. The purpose of this study was to gain knowledge and a better understanding of how social welfare officers handles their elbow room in the field of actions to support the children of parents with mental illness. We have conducted a qualitative study where we interviewed six social welfare officers using the “vinjett” method. All social welfare officers included in the study are working with children of parents with mental illness. By using Michael Lipsky’s theory of Street-Level Bureaucrats we intended to get an understanding of how social welfare officers would act in specific situations. Our study shows that social welfare officers’ first contact is with the parents for a judgment of their capacity as parents. The results shows that the social welfare officers, who we interviewed, felt that they had a wide elbow room with resources to determine and shape different actions for the children of parents with mental illness but at the same time they experienced different barriers which may limit the alternatives in their decision-making. The majority of the social welfare officers in our study felt that they were aware of the power and control they possesses, which also are defined in Lipsky’s theory.

The aim of the thesis, is to find the transient force applied by an individual transient liquid slug on an elbow at the end of a horizontal line due to an impact. The liquid slug is driven by pressurized air in a tank located upstream of the pipeline. The time dependent pressure distribution along the elbow and a vertical extension segment after the elbow was solved, with a 1-D numerical approach along a curved line mesh. For this purpose / firstly, a 3-D axial turbulent velocity profile function was assumed for the slug, with its shape allowed to sway towards the convex side of the elbow along the curved mesh with the aid of a calibration tool. Then, the pressure values were calculated by using 1-D application of Reynolds Equations in cylindrical polar and cartesian coordinates for the elbow and the vertical extension segment, respectively. The transient force acting on the elbow and the following vertical extension segment was found by using these calculated pressure values and applying conservation of momentum principle over the volume elements selected along the elbow and the vertical extension segment. For the analysis of the slug motion from the pressurizer tank to the elbow, a previously written computer code BOZKUS-2 was utilized. Then, the elbow and the vertical extension segment calculations in this study were made with a new code KAYHAN, which is an improved version of BOZKUS-2. The calculated transient force and impact pressures at the elbow were also compared with those from previous studies.

<p>How does a social welfare officer know when a parent with mental illness or behavioral symptoms is harmful to the children? As a social you are confronted with different ethical dilemmas on a daily basis. The social welfare officers have to follow their own authorities, laws, guidelines and regulations while at the same time do everything to satisfy their clients’ needs. This inconsistency can sometimes be difficult to handle. The purpose of this study was to gain knowledge and a better understanding of how social welfare officers handles their elbow room in the field of actions to support the children of parents with mental illness. We have conducted a qualitative study where we interviewed six social welfare officers using the “vinjett” method. All social welfare officers included in the study are working with children of parents with mental illness. By using Michael Lipsky’s theory of Street-Level Bureaucrats we intended to get an understanding of how social welfare officers would act in specific situations. Our study shows that social welfare officers’ first contact is with the parents for a judgment of their capacity as parents. The results shows that the social welfare officers, who we interviewed, felt that they had a wide elbow room with resources to determine and shape different actions for the children of parents with mental illness but at the same time they experienced different barriers which may limit the alternatives in their decision-making. The majority of the social welfare officers in our study felt that they were aware of the power and control they possesses, which also are defined in Lipsky’s theory.</p>

Einleitung Die klinische Bedeutung einer radio-ulnaren Inkongrunz (RUI) bei Hunden mit Ellbogengelenksdysplasie, sowie die präzise Bestimmung einer geringgradigen RUI sind umstrittene Fragestellungen in der Kleintierorthopädie. Zielstellung (1) die 3D-Technik zur Bestimmung einer RUI in ihrer Genauigkeit zu verbessern (2) mit Hilfe dieser verbesserten Technik, die Beziehung zwischen Ausprägung und Grad einer vorliegenden RUI und dem Ausmaß an damit verbundenen Gelenkschäden im medialen Kompartiment des Ellbogengelenkes zu untersuchen. Material und Methoden In einer ersten Studie wurden 63 CT-basierte 3D-Modelle der radio-ulnaren Gelenkpfanne mit bekannter RUI (-2mm, -1 mm, 0 mm, +1 mm, +2 mm), unter Verwendung einer Kugel, welche genau der Incisura trochlearis jedes individuellen Modells angepasst war, bezüglich der vorhanden RUI untersucht. Diese Messungen erfolgten geblindet in zufälliger Reihenfolge der 63 Modelle und wurden hinsichtlich Spezifität und Sensitivität ausgewertet. In der zweiten Studie wurden 86 Ellbogengelenke klinischer Patienten retrospektiv mit der neuen 3D-Kugel-Methode bezüglich ihrer RUI vermessen. Dieser Wert wurde in Beziehung mit dem in der Arthroskopie diagnostizierten Gelenkschaden im medialen Kompartiment gesetzt (Korrelation nach Pearson und logistische Regression), wobei die Gelenke in zwei Gruppen unterteilt wurden; die mit geringen Veränderungen (FPC-Gruppe) und solche mit fortgeschrittenen Schäden (MCD-Gruppe). Ergebnisse Unter Verwendung der Kugel-Methode betrug die mediane Sensitivität eine RUI auf einen Millimeter genau zu bestimmen 0,94 wobei die mediane Spezifität bei 0,89 lag. Der intra-Class-Korrelationskoeffizient für die interobserver Übereinstimmung betrug 0,99. 14 % der Gelenke wiesen eine negative RUI auf, 40 % zeigten keine messbare RUI und 46 % wiesen eine positive RUI auf. Das Quotenverhältnis (odds ratio) für das Vorliegen fortgeschrittener Gelenkschäden betrug für jeden Millimeter RUI 6,4. Schlussfolgerungen Die Anwendung der Kugel-Methode verbessert die Diagnose der RUI deutlich. Der vermutete Zusammenhang zwischen RUI und Gelenkschäden konnte mit der klinischen Studie bestätigt werden. Allerdings ist bemerkenswert, dass 40 % der Gelenke keine RUI aufwiesen. Somit ist davon auszugehen, dass andere Faktoren neben einer RUI an der Pathogenese klinisch beobachteter Gelenkschäden beteiligt sind. Ebenso ist festzustellen, dass ca. 15 % der Gelenke eine negative RUI aufweisen. Somit scheint es nicht gerechtfertigt alle Gelenke mit einer Form der Ellbogenosteotomie zu behandeln, da eine negative bzw. positive RUI und insbesondere keine RUI unterschiedliche geometrische Korrekturen benötigen. / Introduction The clinical significance of RUI in dogs with elbow dysplasia and precise estimation of small degree of RUI are controversial topics in small animal orthopedics. Objectives (1) improve the accuracy of the 3D technique for the estimation of RUI (2) using the improved technique to examine the relationship between the shape and degree of present RUI and the amount of related joint damage in the medial compartment of the elbow joint. Material and methods In a first study, 63 CT-based 3D models of the radio-ulnar joint cup with known RUI (-2 mm, -1 mm, 0 mm, mm +1, +2 mm) were examined us-ing a sphere, which was exactly fitted to the trochlear ulnar notch of each individual model. The assessment of the radioulnar joint conformation was evaluated blindly in a random manner and analized in respect to sensitivity and specificity. In the second study, 86 elbow joints of clinical patients were retrospectively graded with the new 3D sphere technique with respect to their RUI. This value was correlated with the arthroscopically diagnosed joint damage in the medial compartment, where the joints were divided into two groups. Those with minor changes (g-FPC) and those with advanced damage (g-MCD). Results By using the sphere fitting technique, the median sensitivity of a RUI on a millimeter basis was 0.94 and the median specificity was 0.89. The intra-class correlation coefficient for interobserver agreement was 0.99. In the clinical joints 14 % had a negative RUI, 40 % showed no measurable RUI and 46% had a positive RUI. The odds ratio for the presence of advanced joint damage for every millimeter RUI was 6.4 Conclusions The application of the sphere fitting technique significantly improves the diagnosis of the RUI. The assumed relationship between RUI and joint damage could be confirmed in the clinical study. However, it is noteworthy that 40 % of the joints showed no RUI. Thus, it can be assumed that other factors besides RUI are playing rule in the pathogenesis of clinically observed joint damages. Also it should be noted that approximately 15 % of the joints have a negative RUI. Thus, it does not seem to be wise to treat all the joints with a type of elbow osteotomy, as a negative or positive RUI and in particular no RUI need different geometric corrections

The question of the appropriateness and effectiveness of students' personal writing is a longstanding one in the academy. In composition studies, the ideological fight over personal and academic writing is most often represented by the oft-studied but rarely changed Bartholomae/Elbow debate. In literary studies, reader-response critics in particular have wrestled with the problems and possibilities of subjective interpretation. Yet despite scholastic interest in issues of personal writing, discussions have remained primarily theoretical and have relied mainly on anecdotal evidence. While small-scale case studies valuably illuminate the processes of an individual student or two, the conversation would be profoundly bolstered by empirical data. How common are personal responses, really? Further, while many believe that any presence of first-person pronouns signals personal, subjective writing, anecdotal cases suggest that there are several categories of personal writing, and that these different types of expressivism produce a range of rhetorical effects. The current study attempts to name and refine these categories--using the distinctions of General claim, Writer-based prose, Personal experience, and Personal claim—to begin to fill in this empirical gap. Is it a mistake to lump all use of personal reference into the category of "personal writing"? Would helping students distinguish between these varying types of personal references inform their stylistic and rhetorical choices? By reviewing a sample of 30 short papers written by college students in a general requirement literature survey course, I will examine how frequently--and in what ways--students reference themselves when responding in writing to a work of literature. / text

La masse corporelle et la direction des charges sont des facteurs qui peuvent modifier la morphologie des surfaces articulaires qui sont généralement orientées et de taille suffisante pour résister aux charges chroniques. Chez les hominoïdes, les forces de tension et compression, générées par la locomotion, sont transmises à travers l’articulation du coude. Ces espèces ont une morphologie similaire de l’extrémité distale de l’humérus, mais qui présente certaines différences selon la taille des individus et leurs modes de locomotion. Ce projet tente de caractériser plus exhaustivement cette variation en analysant la largeur des surfaces articulaires ainsi que leur position et orientation par rapport à l’axe long de la diaphyse. La prémisse de ce mémoire est que, chez les espèces plus arboricoles, la morphologie de l’articulation distale de l’humérus répond aux stress transverses générés par les puissants muscles fléchisseurs du poignet et des doigts qui traversent le coude obliquement. En revanche, les espèces plus terrestres présentent une morphologie permettant de résister aux forces axiales provenant du contact avec le sol. Des coordonnées tridimensionnelles et des mesures linéaires ont été recueillies sur un échantillon squelettique d’individus des genres Homo, Pan, Gorilla et Pongo. Les résultats obtenus révèlent que l’orientation et la position des surfaces articulaires de la trochlée correspondent aux types de locomotion, or leur taille et celle et du capitulum semblent être influencées par la taille des individus. L’hypothèse suggérant que les stress reliés aux divers modes de locomotion des hominoïdes influencent la morphologie de l’articulation distale de l’humérus est donc supportée. / In hominoids, tensile and compressive forces generated by locomotion and upper-limb use are transmitted through the elbow joint. It has been noticed that the distal humerus of hominoid is morphologically very similar across species. However, some studies have suggested that articular shape varies in relation to size and locomotor modes. This project is an attempt to characterize more thoroughly distal humeral variation in hominoids. It considers the humeral trochlea not only as a structure by itself, as it has been done before, but as an articulation that varies in orientation relative to the diaphysis. Indeed, there is evidence that articulations have a minimum size and are generally oriented to better resist habitual loads. This project tested the hypothesis that predominantly arboreal species are expected to present joints that have a size, position and orientation of articular surfaces to better resist shear loads generated by the strong finger and wrist flexor muscles crossing the elbow obliquely. Consequently, predominantly terrestrial species should present articulations shape and orientation that are better to resist axial load generated by ground reaction forces. Ten landmarks and two linear measurements were taken from a skeletal sample including specimens from the Homo, Pan, Gorilla and Pongo genus. Results show that orientation and position of humeral trochlea joint surfaces correlate with locomotor modes and that length of the articular surfaces seems to be better correlated with size. The main hypothesis suggesting that stress related to locomotion in hominoids should influence the morphology of distal humeral joints is therefore supported.

Objectives: To study the treatment practice of chronic tennis elbow (TE) among general practitioners (GPs) and physiotherapists (PTs), the effects of a simple, graded home exercise regime versus expectation, the effects of eccentric versus concentric exercise, and the involvement of the substance P – NK1 receptor system in the peripheral, painful tissue of chronic TE patients by positron emission tomography (PET). Materials and methods: A postal survey regarding therapeutic methods used in patients with chronic TE was sent to 129 GPs and 77 PTs, 81 subjects with chronic TE were randomly and blindly assigned to either an exercise group or a wait list group, 120 subjects were randomly assigned to either eccentric or concentric exercise and ten subjects were examined by PET and the NK1 specific radioligand [11C]GR205171. Results: High proportions of GPs and PTs used ergonomic counselling and stretching in the treatment of chronic TE. The majority of GPs prescribed passive anti-inflammatory measures such as sick leave and anti-inflammatory medication. Many PTs prescribed dynamic, particularly eccentric, exercise. Graded dynamic exercise according to a simple low-cost protocol, has better effect on pain than a wait-and-see attitude. Adjusted for outcome affecting variables, eccentric graded exercise has quicker effect than concentric graded exercise. During PET scan with the NK1 specific radioligand [11C]GR205171, voxel volume and signal intensity of this volume was significantly higher in the affected than the unaffected arm in subjects with unilateral chronic TE. Conclusions: GPs and PTs used many treatments to a similar extent but differed regarding the use of exercise. Chronic TE responds favourably to graded dynamic exercise aimed specifically at the painful tissue. The exercise should stress the eccentric work phase. The substance P – NK1 receptor system seems to play a part in the peripheral, painful tissue of a chronic, soft tissue pain condition such as chronic TE. / Epi-X