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Stability assessment of isolated lateral malleolar supination-external rotation-type ankle fracturesNortunen, S. (Simo) 23 January 2018 (has links)
Abstract
Isolated lateral malleolar supination-external rotation (SER) -type ankle fractures without incongruity on the standard radiographs can be either stable or unstable depending on the status of the deep deltoid ligament. Neither clinical signs of injury on the medial aspect of the ankle nor the displacement of fibular fracture on mortise radiographs seem to predict stability. Therefore, stress testing has been adopted in clinical use. No “gold standard” method exists but the manual external rotation (ER) stress test is the most extensively studied. The ER stress test has some disadvantages, and other methods—such as gravity stress radiography and magnetic resonance imaging—have been suggested instead. However, the evidence to support the use of these methods is still insufficient.
The aims of this dissertation were to assess the roles of (1) morphological factors from standard radiographs of 286 patients, (2) clinical findings on the medial side of the ankle and gravity stress radiography of 79 patients, and (3) MRI of 61 patients in evaluating the stability of the ankle mortise in patients with unimalleolar SER-type fractures with no talar shift on standard radiographs. The ER stress test result was considered to be the reference for stability throughout these studies.
We found that a fracture line width < 2 mm in lateral radiographs, only two fracture fragments, and female sex are independent factors predicting a stable ankle mortise. Neither clinical signs on the medial side of the ankle nor gravity stress radiography alone predict the stability of the ankle mortise accurately. According to our MRI findings, total tears of the deep deltoid ligaments are rare, and partial tears are common in this this patient group. The reliability of the MRI assessment is only moderate.
In conclusion, patients with non-comminuted fractures and < 2 mm displacement on lateral radiographs have stable ankle mortises and need no further stress testing. The gravity stress radiography is an accurate test for the evaluation of the ankle mortise stability only if the clinical signs indicate a similar result with the gravity stress radiographs. The use of MRI provides no additional benefit compared to ER stress testing for stability evaluation of an SER-type ankle fracture. / Tiivistelmä
Supinaatio-ulkokiertomekanismilla syntyneet isoloidut ulkokehräsluun murtumat ilman röntgenkuvassa näkyvää telaluun siirtymää voivat olla joko vakaita tai epävakaita nilkan sisemmän nivelsiteen syvän lehden tilasta riippuen. Kliinisessä tutkimuksessa todettujen nilkan sisäreunan vamman merkkien tai röntgenkuvauksella todettavan ulkokehräsluun murtuman virheasennon ei ole osoitettu ennustavan nivelhaarukan mahdollista epävakautta, joten nilkkaa kuormittaen tehtäviä röntgenkuvauksia on otettu kliiniseen käyttöön. Mikään näistä kuvausmenetelmistä ei ole niin sanottu kultainen standardi, mutta ulkokiertovääntötestiä (ER-testi) on tutkittu laajimmin. ER-testin käyttöön liittyy kuitenkin ongelmia, joiden vuoksi niin sanottua painovoimakuvausta tai muun muassa magneettikuvausta (MRI) on ehdotettu käytettäväksi sen sijaan. Näiden menetelmien käyttöä tukeva tieteellinen näyttö on kuitenkin vielä riittämätöntä.
Tämän väitöskirjatyön tarkoituksena oli tutkia (1) 286 potilaan tavallisista kuormittamattomista röntgenkuvista morfologisten tekijöiden, (2) 79 potilaan nilkan sisäreunan kliinisen tutkimuksen ja painovoimakuvauksen sekä (3) 61 potilaalla MRI:n merkitystä ja tarkkuutta arvioitaessa supinaatio-ulkokiertomekanismilla syntyneiden ulkokehräsluun murtumien vakautta. ER-testin tulosta käytettiin referenssinä nivelhaarukan vakaudelle kaikissa osatöissä.
Sivukuvasta mitattuna ulkokehräsluun murtuman leveys < 2 mm, vain kahden kappaleen murtuma ja naissukupuoli ovat itsenäisiä vakaata nivelhaarukkaa ennustavia tekijöitä. Kliininen tutkimus tai painovoimakuvaus eivät yksinään pysty ennustamaan nivelhaarukan vakautta riittävän tarkasti. MRI:n perusteella sisemmän nivelsiteen syvän lehden täydelliset repeämät ovat tässä vammatyypissä harvinaisia mutta osittaiset repeämät ovat hyvin tavallisia huolimatta ER-testin tuloksesta. MRI:n tulkinnan luotettavuus on ainoastaan kohtalainen.
Yhteenvetona voidaan todeta, että ilman ilmeistä telaluun siirtymää röntgenkuvassa yksinkertaiset supinaatio-ulkokiertomekanismilla syntyneet ulkokehräsluun murtumat ovat vakaita eikä nivelhaarukan vakauden testaaminen ole tarpeen, jos murtumaraon leveys sivukuvassa on < 2 mm. Painovoimakuvaus on luotettava, mikäli sen tulos on sama ulkoisten vamman merkkien kanssa. Magneettikuvauksesta ei ole hyötyä arvioitaessa tämän nilkkamurtumatyypin vakautta.
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Underwater 3D Surface Scanning using Structured LightTörnblom, Nils January 2010 (has links)
In this thesis project, an underwater 3D scanner based on structured light has been constructed and developed. Two other scanners, based on stereoscopy and a line-swept laser, were also tested. The target application is to examine objects inside the water filled reactor vessel of nuclear power plants. Structured light systems (SLS) use a projector to illuminate the surface of the scanned object, and a camera to capture the surfaces' reflection. By projecting a series of specific line-patterns, the pixel columns of the digital projector can be identified off the scanned surface. 3D points can then be triangulated using ray-plane intersection. These points form the basis the final 3D model. To construct an accurate 3D model of the scanned surface, both the projector and the camera need to be calibrated. In the implemented 3D scanner, this was done using the Camera Calibration Toolbox for Matlab. The codebase of this scanner comes from the Matlab implementation by Lanman & Taubin at Brown University. The code has been modified and extended to meet the needs of this project. An examination of the effects of the underwater environment has been performed, both theoretically and experimentally. The performance of the scanner has been analyzed, and different 3D model visualization methods have been tested. In the constructed scanner, a small pico projector was used together with a high pixel count DSLR camera. Because these are both consumer level products, the cost of this system is just a fraction of commercial counterparts, which uses professional components. Yet, thanks to the use of a high pixel count camera, the measurement resolution of the scanner is comparable to the high-end of industrial structured light scanners.
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Smrt očima novoanglických puritánů / The Puritan view of death: attitudes toward death and dying in Puritan New EnglandHolubová, Petra January 2011 (has links)
The Puritan attitude toward death in seventeenth- and early eighteenth-century New England was ambivalent and contained both terror at the possibility of eternal damnation and hope for deliverance. The joyful theme of the migratio ad Dominum resonated with the Saints only at times when they were convinced divine grace was actively working in their lives, but when they saw they were backsliding, the horror of death prevailed. Puritan anxiety about death was caused by tensions inherent in the doctrine of predestination, which implied man's dependence on God's inscrutability, and in the doctrine of assurance, which implied that self-doubt was more desirable than full assurance of salvation. What complicated any verification of the presence of grace was man's endless potential for self-deception. Memento mori gave urgency to the Puritan work ethic and the effective use of time. The anxiety about one's destiny began in early childhood when death and its ensuing horrors for the depraved were used as a means of religious instruction to provoke spiritual precocity and conversion. This early immersion into the discourse about death has been erroneously interpreted as a proof of the non-existence of childhood in Puritan New England. Deathbed scenes depicted in Puritan spiritual biographies were designed as examples...
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[en] EXPERIMENTAL PSYCHOLOGY AND EDUCATION IN BRAZIL: FROM THE DAWN OF THE SCIENTIFIC DISCOURSES TO THE LABORATORIES AND PSYCHOLOGICAL EXAMINATION PRACTICES IN BRAZILIAN SCHOOLS / [pt] PSICOLOGIA EXPERIMENTAL E EDUCAÇÃO NO BRASIL: DO DESPONTAR DOS DISCURSOS CIENTÍFICOS AOS LABORATÓRIOS E PRÁTICAS DE EXAME PSICOLÓGICO NAS ESCOLAS BRASILEIRASHUGO LEONARDO ROCHA SILVA DA ROSA 08 September 2016 (has links)
[pt] O presente trabalho é uma investigação histórica dos discursos e práticas de exame psicológico que se manifestaram no contexto da educação brasileira na virada do século XIX para o século XX. O levantamento de obras em psicologia publicados na segunda metade do século XIX e início do XX foi realizado na base da Internet Archive. Já as fontes primárias produzidas no Brasil foram levantadas na Biblioteca Nacional, no setor de Obras Gerais para livros e na Hemeroteca Digital para os textos publicados na imprensa brasileira. Primeiramente, será abordada a emergência da psicologia experimental na Europa a partir de algumas obras de época, discutindo questões que estavam em pauta entre os experimentalistas. Em um segundo momento, o texto se deterá em questões historiográficas da psicologia no Brasil, tratando de alguns problemas no campo ao mesmo tempo em que busca situar a psicologia experimental em uma pluralidade de discursos em torno de uma psychologia. Por último, o texto trabalhará inserções da psicologia experimental na educação brasileira e como ela estava articulada a outros discursos e práticas que almejavam, por meio da educação do corpo e do espírito das crianças, a manutenção da ordem social e o progresso do país. / [en] This work is a historical research on discourses and practices of psychological examination that have emerged in the context of Brazilian education in the late nineteenth and early twentieth century. The documents published in the second half of the nineteenth and early twentieth century were sought on Internet Archive. The texts produced in Brazil were fetched in the National Library: the search for books took place in the Obras Gerais sector and all the articles from Brazilian press were found in Hemeroteca Digital. First, we debate the emergence of experimental psychology in Europe from some works published at that time, analyzing issues that were on the agenda of experimentalists authors. After, it aims to discuss historiographical aspects of psychology in Brazil, dealing with some problems in the field at the same time it seeks to place experimental psychology in a plurality of speeches around a psychologia. Finally, it discusses the presence of experimental psychology in Brazilian education and how it was articulated to other discourses and practices that crave for, through the body and spirit education of the children, the maintenance of the social order and the progress of the country.
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La sculpture sur bois polychrome des XIe et XIIe siècles en Bourgogne / Roman wood sculptures from BurgundyBertoni Cren, Nadia 15 January 2013 (has links)
Le corpus de sculptures romanes en bois de la région de Bourgogne est réuni pour la première fois dans un catalogue, complété par une documentation photographique et bibliographique. Les vingt-cinq sculptures répertoriées sont étudiées du point de vue stylistique, iconographique, technique. Au XIIe siècle, une véritable école de sculpture en bois monastique semble se déployer dans les limites du duché de Bourgogne, à l’origine d’une grande variété d’apports formels et techniques. Les sculptures les plus représentatives pour la compréhension des nombreux apports sont étudiées dans le détail. Leurs relations stylistiques avec les manuscrits de la renaissance carolingienne, la sculpture ottonienne et la sculpture monumentale contemporaine en pierre sont indiquées par l’analyse des caractéristiques internes qui distinguent les différents langages formels. La description iconographique montre la dénotation précise avec laquelle le sujet sacré est figuré. Les procédés techniques de création sont comparés par l’examen direct des sculptures, et par la récolte des données disponibles. Pour plusieurs œuvres, de nouvelles datations sont proposées ; des sculptures inédites et des artistes précis sont mis en lumière. Les apports de la sculpture sur bois de la région auvergnate sont précisés. La tradition des reliques insérées dans les sculptures est vérifiée par rapport au rôle plus ou moins significatif qu’elle peut avoir dans l’élaboration de la forme. Un chapitre est consacré à la méthodologie de l’étude de la polychromie des sculptures en bois. Les conservateurs-restaurateurs sont investis d’un rôle crucial dans la collecte scientifique des données qui témoignent de l’histoire des techniques artistiques. Des propositions pour améliorer les procédures d’examen et de documentation sont avancées. / For the first time, the corpus of Roman wood sculptures from Burgundy is gathered together in a catalogue, with added photographic documents and bibliography. The twenty-five sculptures are listed and studied from a stylistic, iconographic and technical point of view. In the XIIth century, an actual school of monastic wood sculpture seemed to develop within the boundaries of the duchy of Burgundy, bringing a great diversity as far as formal and technical contributions are concerned. The sculptures that are the most representative to help the understanding of those numerous contributions are thoroughly studied. Their stylistic relationships with manuscripts dating back from the Carolingian Renaissance, with the Ottonian sculpture and the contemporary monumental stone sculpture, are pointed out with the analysis of internal characteristics, setting apart different formal languages. The iconographic description shows the specific denotation used in the representation of the holy character. The technical processes of creation are compared through the direct examination of the sculptures and through the collection of usable information. For several pieces, a new dating was suggested; new sculptures and specific artists are brought to notice.The contributions of the wood sculpture from the Auvergne region are specified. The tradition of inserting relics into sculptures is put in relation to the relatively important influence it can have on the building of the shape. One chapter is dedicated to the methodology in the study of wood sculptures’ polychromes. The conservators-restorers play a crucial part in the act of scientifically collecting information attesting the evolution of artistic techniques. Some suggestions are put forward to improve the processes of examination and the collecting of information.
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An investigation into Historically Informed Performance Practice among South African flute pedagogues and playersMonard, Merryl Katherine 20 November 2008 (has links)
This study investigates the status of Historically Informed Performance Practice among the South African flute-playing fraternity. Consequently, grounds are established on which to claim a lack of the implementation of Historically Informed Performance Practice in South African flute pedagogy and playing. The main research question that underpins this study is: <ul> <li>Why is there a lack of integration of Historically Informed Performance Practice into the mainstream of current flute performance practice among South African flute pedagogues and players?</li></ul> This research question is addressed through three sub-questions: <ul> <li>Is there an awareness of Historically Informed Performance Practice in South Africa as outlined by performance and pedagogy internationally?</li> <li>How is Historically Informed Performance Practice incorporated into the South African flute examinations system? </li> <li>Does the knowledge of Historically Informed Performance Practice prepare one to be a balanced musician or flautist?</li> </ul> The findings that emerge from the investigation of the research questions are: <ul> <li>South African flute pedagogues fail to differentiate between Historically Informed Performance Practice and ‘authenticity’. This could be attributed to the fact that relatively little research and discourse into Historically Informed Performance Practice has been conducted by South African scholars and musicologists. </li> <li>While Historically Informed Performance Practice is thought to enhance students’ performances of Early Music, resulting in better-balanced musicians, it has not been significantly exploited by South African flute players.</li> <li>South African flute students are superficially aware of some elements of performance practice, but are generally not historically informed with regard to the performance of Early Music.</li> <li>There is no clear indication of Historically Informed Performance Practice being incorporated into the South African independent flute examination system.</li> <li>While there are numerous specialists in Early Music locally, flute pedagogues and players perceive them to be scarce, perhaps due to a lack of discernable demand for historically informed performances by South African audiences.</li> </ul> The research synthesises questionnaire and interview data from local flute pedagogues, Early Music specialists and both national and international flute students in an attempt to discover the reason for the lack of Historically Informed Performance Practice in South Africa. Additionally, a survey of websites detailing South African Early Music activity is performed using the Internet, in order to ascertain if the basis for a future in Historically Informed Performance Practice exists nationally. Lastly, content analyses of the three primary South African independent examination boards’ syllabi and of the former flute periodical, Flufsa News, elucidate the status of Historically Informed Performance Practice nationally. / Dissertation (MMus)--University of Pretoria, 2008. / Music / unrestricted
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Bedömningsmakten : Berättelser om stat, lärare och elev, 1960‐1995 / The Power of Examination : Narratives about State, Teacher and Pupil, 1960-1995Widén, Pär January 2010 (has links)
Avhandlingen handlar om hur bedömningssystemet i bred bemärkelse presenterades i betygsdebatten i samband de politiska besluten om betygssystemet för gymnasiet mellan 1960 och 1995. Avhandlingen tar sin utgångspunkt i de berättelser som konstruerades under perioden. Syftet är att spåra och tolka förändringar i berättelserna om bedömning i anslutning till det politiska projektet att demokratisera och individualisera skolsystemet. Fokus är särskilt riktat mot de bedömningstekniker och innebörder för relationen mellan stat, lärare och elever som aktualiserades i samband med de två gymnasiereformerna. Härigenom synliggörs en viktig definitionskamp om statens förhållande till individen - lärare och elever - och hur makten i den nya enhetliga och demokratiska gymnasieskolan skulle förstås och organiseras. Avhandlingen pekar också på hur berättelser konkurrerar och hur en berättelse kan ges olika innebörder i förhållande till det politiska projektet att skapa en skola som tar till vara elevernas demokratiska möjligheter och lika villkor. / This thesis explores how the system of examination, in broad terms, was presented in the debate about grading around the political decisions regarding the upper secondary school between 1960 and 1995. The point of departure is the narratives that were constructed during the time period. The main objective is to trace and interpret changes in the narratives of evaluation as a part of the political project of democratization and individualization of the school system. Special attention is given to the different grading techniques and implications for the relation between State, teacher and pupil that surfaced in and around the school reforms in 1964 and 1994. This also sheds significant light on the meaning constructions and struggle around the State’s relation to the individual - teachers and pupils - and how power was to be viewed and organized in the new homogenous and democratic school. The thesis also shows the rivalry of narratives and how a narrative can be given various meanings in relation to the political project of creating a school that advocates the democratic opportunities and equal rights of pupils.
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Avaliação da responsividade da escala de avaliação funcional para distrofia muscular de Duchenne-domínio marcha / Evaluation of responsiveness of the functional rating scale responsiveness for children with Duchenne muscular dystrophy - gait domainEduardo Vital de Carvalho 04 December 2017 (has links)
A marcha é um importante biomarcador na evolução funcional das crianças com distrofia muscular de Duchenne (DMD). A escala de Avaliação Funcional - domínio marcha (FES-DMD-DOMÍNIO MARCHA) foi desenvolvida e teve sua confiabilidade demonstrada em estudo prévio. Atualmente, as escalas funcionais são necessárias para fundamentação da tomada de decisão clínica e como medidas de desfecho em pesquisas científicas e, para tanto, devem ser confiáveis, validas e responsivas. O objetivo do presente estudo foi determinar a responsividade da FES-DMD-domínio marcha no período de um ano, considerando suas três fases e o escore total. Trata-se de estudo observacional, longitudinal e retrospectivo. Foi estudada amostra de 160 avaliações funcionais a partir de filmagens de 32 crianças com DMD (5 a 15 anos). A atividade da marcha foi pesquisada com intervalos de avaliações de 3 meses, totalizando 5 coletas (0, 3, 6, 9 e 12 meses). A responsividade foi analisada por meio dos testes estatísticos tamanho do efeito (TE) e resposta média padronizada (RMP). A responsividade nos intervalos de avaliação de três meses foi considerada de baixa a moderada para as três fases da escala (TE variando de 0.12 a 0.34 e MRP variando de 0.27 a 0.80); de baixa a alta para os intervalos de avaliação de seis meses (TE variando de 0.36 a 0.72 e MRP variando de 0.37 a 1.10); de moderada a alta para os intervalos de avaliação de nove meses (TE variando de 0.70 a 1.0 e MRP variando de 0.50 a 1.43) e alta no período de avaliação de um ano (TE variando de 0.74 a 1.34 e MRP variando de 0.88 a 1.53). O domínio marcha da FES-DMD se mostrou responsivo a partir do intervalo de três meses, aumentado sua capacidade de resposta ao longo das avaliações em até 12 meses. Recomenda-se o uso da FES-DMD-domínio marcha a partir do intervalo de seis meses, que apresenta responsividade, no mínimo moderada para fins de pesquisa, embora seu uso a partir de intervalos de avaliação de três meses possa oferecer informações relevantes nas tomadas de decisão clínico-fisioterapêuticas / March is an important biomarker in the functional evaluation of children with Duchenne muscular dystrophy (DMD). The Functional Scale Evaluation -march domain (FES-DMD-march domain) was developed and its reliability was demonstrated in a previous study. Currently, functional scales are necessary for the reasoning of clinical decision making and as an outcome measure in scientific research and to do so, must be reliable, valid and responsive. The aim of this study was to determine the responsiveness of the FES-DMD-march domain in a one year follow up, considering its three phases and the total score. It is an observational, longitudinal and retrospective study. A sample of 160 functional assessments from filming of 32 children with DMD (5-15 years) was studied. The course of the activity was studied at three monthly intervals evaluations totaling 5 samples (0, 3, 6, 9 and 12 months). Responsiveness was analyzed by statistical tests named effect size (ES) and standardized response mean (SRM). The responsiveness in the three-month evaluation intervals analyzed was considered low to moderate for the three phases of the scale (ES ranging from 0:12 to 0:34 and SRM ranging from 0.27 to 0.80); varied from low to high for the six-months evaluation intervals (ES ranging from 0.36 to 0.72 and SRM ranging from 0:37 to 1:10); varied from moderate to high for the nine-month evaluation intervals (ES ranging from 0.70 to 1.0 and SRM ranging from 0:50 to 1:43) and was high in one year evaluation period (ES ranging from 0.74 to 1.34 and SRM ranging from 0.88 to 1.53). The domain march of the FES-DMD scale showed responsive from the three-month interval, increased their responsiveness during the evaluations within 12 months. It is recommended the use of FES-DMD-march domain from the six-month interval, which presents responsiveness, at least moderate, although its use from three-month evaluation intervals may provide relevant information in clinical-physiotherapeutic decision-making
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Justification for a credit union to charter a bankEazell, Diane Patricia 01 January 2000 (has links)
No description available.
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Perceptions and experiences of investigators in the SAPS regarding the application of polygraph in criminal investigationsGumala, Manjula 21 January 2021 (has links)
In spite of the SAPS having a dedicated polygraph capacity since 1998, little research
has been conducted with regard to the use of the polygraph in criminal investigations.
Consequently, the aim of this research was to focus on the perceptions and
experiences of investigators in the SAPS regarding the application of polygraph testing
in criminal investigations, the application of the polygraph as an investigative aid, the
extent to which it is used by SAPS investigators to resolve criminal cases opened by
the general public and/or in internal departmental criminal investigations; and whether
or not it has helped to solve cases by giving direction and/or focus to the investigator
when an investigation is at an impasse.
A qualitative research approach was conducted among investigators within the SAPS.
The research design selected for this study was grounded theory. The sample
consisted of twenty investigators, ten of whom had previously used polygraph
examinations in their investigations and ten of whom had not.
Data was collected from interviews, document analysis, field notes and memoranda
which presented and detailed the perceptions and experiences of investigators in the
SAPS regarding the application of polygraph tests in criminal investigations. / Criminology and Security Science / M.A. (Criminology)
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