Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2006. 88 leaves. / Myofascial pain syndrome is the second most common reason patients seek the help of health care workers. It costs billions of dollars each year in lost revenue due to loss of productivity and other costs. The treatment of myofascial pain syndrome has been extensively researched and it appears that dry needling and medicinal injections of trigger points are some of the most effective modalities. However, an unwanted side effect common to both these therapies is post-needling soreness. Despite being mentioned in passing by many authors, very little detail is available regarding post-needling soreness. It is unclear whether post-needling soreness arises from the trigger point itself, or whether the tissue damage caused by the needle insertion is responsible. Therefore, this study was aimed at investigating whether dry needling muscle tissue in asymptomatic subjects (i.e. subjects not suffering from myofascial pain syndrome) resulted in post-needling soreness. Two different dry needling techniques were also compared with a placebo group in order to determine which technique resulted in the least post-needling soreness. This study was designed as a prospective, randomised, placebo controlled experimental investigation. Sixty subjects were randomly allocated into three equal groups. Group one received the single needle insertion technique and the second group received the fanning dry needling technique. The last group formed the control group and the subjects were treated using the Park Sham Device (placebo needles). All the subjects were between the ages of 18 and 50 and were required to be asymptomatic in the low back region.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

A Charge Injection Device (CID) detector has been evaluated as a detector for simultaneous multielement atomic emission spectroscopy. The CID was incorporated into a special liquid nitrogen cooled, computer controlled camera system. Electro-optical characterization of the CID and camera system included determination of readout noise, quantum efficiency, spatial crosstalk, temporal hysteresis, spatial response uniformity, and linear dynamic range. The CID was used as a spectroscopic detector for an echelle grating spectrometer equipped with a direct current plasma emission source. The spectrometer was a standard commercial instrument modified to provide a reduced image format more suitable for use with the CID detector. The optical characteristics of this spectrometer, including wavelength coverage, and optical aberrations are described. The spectroscopic system was evaluated with respect to detection limits, linear dynamic range, and accuracy in both single element and simultaneous multielement modes. Detection limits compared well to literature values reported for photomultiplier tube detector based systems under similar conditions. CID detection limits were superior in the near infrared and visible wavelength region, comparable in the middle UV, and higher in the far UV. The detection limits were determined to be limited by background radiation shot noise. Several elements of a certified standard reference material were simultaneously determined in order to assess the accuracy of the spectroscopic system. The results were highly accurate, even when operating near or below the 3σ limits of detection. Spectral interferences for elements were avoided by using several analytical lines for each element. The results of these investigations indicate that the CID is a superior multichannel detector for analytical atomic emission spectrometry. The capability to simultaneously monitor a wide, continuous spectral range with high spatial resolution, high dynamic range, low readout noise, and insignificant signal crosstalk is now possible. Many analytical benefits of this approach, such as the potential capability to perform rapid qualitative and semiquantitative analysis and the ability to select the optimum spectral lines for highly accurate quantitative analysis are now readily achievable.

A dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / Myofascial pain syndrome is the second most common reason patients seek the help of health care workers. It costs billions of dollars each year in lost revenue due to loss of productivity and other costs. The treatment of myofascial pain syndrome has been extensively researched and it appears that dry needling and medicinal injections of trigger points are some of the most effective modalities. However, an unwanted side effect common to both these therapies is post-needling soreness. Despite being mentioned in passing by many authors, very little detail is available regarding post-needling soreness. It is unclear whether post-needling soreness arises from the trigger point itself, or whether the tissue damage caused by the needle insertion is responsible. Therefore, this study was aimed at investigating whether dry needling muscle tissue in asymptomatic subjects (i.e. subjects not suffering from myofascial pain syndrome) resulted in post-needling soreness. Two different dry needling techniques were also compared with a placebo group in order to determine which technique resulted in the least post-needling soreness. This study was designed as a prospective, randomised, placebo controlled experimental investigation. Sixty subjects were randomly allocated into three equal groups. Group one received the single needle insertion technique and the second group received the fanning dry needling technique. The last group formed the control group and the subjects were treated using the Park Sham Device (placebo needles). All the subjects were between the ages of 18 and 50 and were required to be asymptomatic in the low back region. / M

Instead of putting the emphasis on color in his orchestration, Brahms felt that the music was more important; not the orchestration. However, it would be a mistake to feel that he was deaf to orchestral color. When discussing color in regard to Brahms' orchestration it is necessary to realize that his use of color is much different than that of his contemporaries. This thesis discusses the four symphonies of Brahms and his usage of brass instruments within these symphonies, specifically the french horn, trumpet, trombone and tuba. It is apparent that he used considerable care in writing for the brasses as well as the other instruments and had complete command of the use of their individual colors.

The purpose of this study was to evaluate the efficiency of three common grips used in four-mallet playing. The three grips were referred to as (a) the Musser grip, (b) the cross stick grip No. 1, and (c) the cross stick grip No. 2. A thorough description (including illustrations) was given for each grip. The evaluation of efficiency was made through research testing, which was conducted by the author. Forty individuals participated in the research testing. Four tests were conducted, and each test had ten participants. The individuals who participated in Tests I, II and III had no previous four-mallet experience. The individuals who participated in Test IV had previous four-mallet experience. The evaluation of the efficiency covered by the four tests was limited to (a) horizontal movement of the outside mallet(s), (b) horizontal movement of the inside mallet(s), and (c) horizontal movement of the hand (s). According to Tests I, II and III, the majority of beginning four-mallet players will find the cross stick grip No. 2 the easiest and most efficient (as far as the three movements which were tested are concerned) of the three grips. However, some individuals (a much smaller percentage) will prefer either the Musser grip or the cross stick grip No. 1. Many beginners will find the Musser grip extremely difficult. A very small percentage of beginning four-mallet students will have poor efficiency using cross stick grip No. 2. According to the results of Test IV, the efficiency of the Musser grip and the cross stick grip No. 2 improve at a faster rate than does the efficiency of the cross stick grip No. 1. The movements tested in this study are extremely important when playing with four mallets. However, this study was limited to the testing of three types of horizontal movements and, therefore, did not cover all the aspects of four-mallet playing. Because all factors were not included in this study, no one grip was proven to be ultimately the "'best." Each individual four-mallet player must decide for himself which grip is best suited for his particular needs. The findings of this study should aid in making that decision.

Thanks to the development of new technology, musical instruments are no more tied to their existing acoustic or technical limitations as almost all parameters can be augmented or modified in real time. An increasing number of composers, performers, and computer programmers have thus become interested in different ways of "supersizing" acoustic instruments in order to open up previously-unheard instrumental sounds. This leads us to the question of what constitutes a super instrument and what challenges does it pose aesthetically and technically? This work explores the effects that super instruments have on the identity of a given solo instrument, on the identity of a composition and on the experience of performing this kind of repertoire. The super instrument comes to be defined as a bundle of more than one instrumental lines that achieve a coherent overall identity when generated in real time. On the basis of my own personal experience of performing the works discussed in this dissertation, super instruments vary a great deal but each has a transformative effect on the identity and performance practice of the pianist. This discussion approaches the topic from the viewpoint of contemporary keyboard music, showcasing examples of super instrument compositions of the 21st century. Thus, the main purposes of this practise based research project is to explore the essence and role of piano or toy piano in a super instrument constellation, as well as the performer's role as a "super instrumentalist". I consider these issues in relation to case studies drawn from my own compositional work and a selection of works composed by Karlheinz Essl and Jeff Brown.

La justice de proximité occupe, depuis plusieurs années, une place centrale dans les tentatives de réforme de la justice.Nonobstant la fréquence de son usage, la notion est dépourvue d'une définition clairement circonscrite par le droit positif et ne dispose pas davantage d'un statut théorique incontestable établi par la doctrine. De ce constat naît une interrogation fondamentale : quel sens donner à la justice de proximité ? Distincte de la proximité de la justice, la justice de proximité doit être appréhendée dans sa double acception pénale et civile. Tandis que la justice pénale de proximité renvoie à un mouvement de diversification du circuit de traitement des infractions de faible et moyenne gravité par la recherche d'une ou plusieurs formes de rapprochement entre la justice et le citoyen, la justice civile de proximité vise, par cette même méthode, à améliorer l'accès à la justice des litiges dont l'enjeu économique est faible ou modéré. Ainsi entendue, la justice de proximité repose sur la mise en oeuvre d'une pluralité d'instruments procéduraux et organisationnels au sein de l'institution judiciaire. Leur examen révèle les ambiguïtés dont ils sont parfois porteurs ainsi que leur manque de lisibilité et de cohérence. Cependant, certains mécanismes correcteurs sont envisageables afin que les imperfections de ces instruments ne compromettent pas irrémédiablement l'intérêt que présente la notion en vue de garantir la confiance des citoyens dans la justice. / The french expression ''justice de proximité" has been holding a specific place within the proposals for justice reforms for many years. Despite its increasing use, the concept is not clearly defined -or understood- in our discipline not even in a theoretical way. Thus, a new interrogation appears : how can we understand the precise meaning of such a concept ? Far from being defined as the "closeness justice", the notion of "justice de proximité" gets a double meaning :a criminal one and a civil one. While the first one puts the stress on the diversity in the way we deal with minor and major offenses- mainly through partnerships between the justice and the citizen- the civil dimension of the community justice concept aims at allowing to go to court all the contentions with low economical consequences. As far as this definition is right, the community justice relies on putting into practice several types of both procedural and organizational tools. A through analysis of the tools previously mentioned demonstrates a Jack of transparency and consistency. Nevertheless, some of them can be useful since they guarantee the citizens' confidence in their own justice.

O presente estudo verificou o aumento da resistência à perda de corte de instrumentos produzidos em liga de níquel-titânio, após tratamento de implantação iônica de nitrogênio. Para tal, foram utilizados vinte e um instrumentos da marca K3 ?ENDO, de n° 25.02, com 21 mm, divididos em dois grupos. O grupo 1 foi constituído por onze instrumentos submetidos à ação de uma câmara de implantação iônica de nitrogênio, servindo um deles como controle para a determinação da quantidade de íons implantados. O grupo 2 foi composto por dez instrumentos não submetidos ao processo de implantação iônica. Cada lima instrumentou 20 blocos de canais simulados 20.02 de 21 mm, previamente lavados em cuba ultra-sônica com detergente a 40°C por 10 minutos e depois com água bidestilada por mais 10 minutos. Os mesmos foram secos com jato de ar, voltaram para estufa a 40°C por 2 dias e finalmente pesados em balança analítica. Após cada instrumentação os blocos foram lavados em cuba ultra-sônica com detergente a 40°C por 20 minutos e pesados novamente. O ensaio de resistência à perda de corte foi realizado mediante a instrumentação de cada bloco com auxílio de um simulador de ação da instrumentação endodôntica, sendo a amplitude percorrida pelo contra-ângulo padronizada em 2,5 mm a cada penetração por 8 vezes atingindo um total de 2,0 cm para dentro do canal simulado, com força de penetração de 1,5 N. Quanto a resistência à perda de corte os resultados mostraram que os instrumentos implantados não apresentaram diferença estatisticamente significante em nível de 5 % (? = 0,5 %) até 20 usos. Porém, os instrumentos não implantados mostraram diferença estatisticamente significante (? = 0,5 %) entre 5 e 15 usos, 5 e 20 usos, bem como entre 10 e 20 usos. Ao compararem-se instrumentos implantados e não implantados, observou-se que em 5 e 10 usos não houve diferença estatisticamente significante (p>5%). Já na comparação entre ambos com 15 e 20 usos a diferença foi estatisticamente significante (? = 0,5 %). Lícito foi concluir, portanto, que o processo de implantação de íons de nitrogênio manteve a resistência à perda de corte de instrumentos produzidos em liga de níquel-titânio até 20 usos. Os instrumentos não implantados mostraram perda progressiva do poder de corte significativamente entre 5 e 15 usos, 5 e 20 usos, bem como entre 10 e 20 usos. Comparando-se instrumentos implantados e não implantados, observou-se que até 10 usos ambos comportaram-se igualmente no que respeita à perda de corte. Já na comparação entre ambos com 15 e 20 usos a diferença foi significativa. / The present study investigated the cutting ability resistance in nickel-titanium instruments after nitrogen ion implantation treatment. Twenty-one instruments of K3 ?ENDO brand, number 20.02, with 21 mm, were divided in two groups. The group 1 submitted 11 instruments to nitrogen ion implantation chamber, while on served as positive control for the determination of the ion implantation quantity. In group 2, the 10 instruments were not submitted to ion implantation treatment. Each file instrumented 20 acrylic blocks 20.02 with 21 mm, previously washed in ultrasonic container with detergent in 40°C for 10 minutes and then with bidestiled water for 10 minutes. They were dried and put in a 40°C stove for 2 days and finally weighed in analytic balance. After instrumentation the blocks were washed for 20 minutes and weighed again. The usage essay was realized through the instrumentation of each block using an endodontic instrumentation simulated action, with a 2,5 mm standardized distance for 8 times, getting a total of 2,0 cm inside the simulated canal with a strong penetration of 1,5 N. The results showed that there was no statistical difference in cutting resistance of instruments treated with ionic implantation process until 20 uses. Although in the non treated instruments there was a gradual reduce in cutting ability resistance from 5 to 20 uses. The conclusion was that the nitrogen ion implantation process increases the cutting resistance of nickel-titanium instruments.

La réforme « Hôpital, patients, santé et territoires » (HPST) de 2009 a positionné l’agence régionale de santé en tant que chef de file de la santé à l’échelle régionale. En mobilisant une approche par les instruments, notre thèse pose la question de la réalité de ce rôle de pilotage lors de la phase de sa mise en œuvre. En toile de fond, ce questionnement fait écho à une interrogation plus globale, à savoir : qui dirige la politique de santé au niveau local ? En investissant le secteur de la santé de la région Provence-Alpes-Côte d'Azur par l’angle original du secteur médico-social, notre analyse démontre que les instruments qui devraient être aux mains de l’ARS ne le sont qu’à la marge. Ainsi, chaque instrument, qu’il s’inscrive dans le sillon ancien de la planification ou qu’il relève d’une idéologie plus libérale nous donne à voir une répartition des compétences différente de celle initialement annoncée et légalement prévue. Concernant les instruments de la planification, une distinction s’opère entre ceux non financiers et ceux relevant de la répartition des crédits. Nous démontrons que, lorsque les instruments de planification à disposition de l’ARS présentent uniquement des aspects cognitifs, les organes de démocratie sanitaire créés par la Loi dispose d’une véritable marge de manœuvre à même d’influer sur son contenu. Les instruments adoptés de la sorte par l’ARS sont donc à la fois le fruit de la concertation entre acteurs de santé à l’échelle locale et témoignent d’une véritable capacité à agir de l’ARS sur ceux-ci. A contrario, dès lors que les instruments de planification revêtent une dimension financière, ils échappent à tout contrôle du niveau régional, l’ARS s’avère finalement inféodée au niveau national en la matière. Quant aux instruments au design proche de ceux du « new public management » (Appels à projets et contrats pluriannuel d’objectifs et de moyens notamment), la démonstration met en évidence une triple désubstantialisation de l’ARS. Par le haut, c’est-à-dire par un contrôle systématique et direct des instances nationales ; par le bas, l’ARS devant composer avec la fragmentation des institutions locales existantes sans disposer du dernier mot ; et par le musellement de la démocratie sanitaire locale dont les capacités sur ses instruments sont légalement et dans les faits réduites au minimum. / The 2009 reform “Hôpital, patients, santé, territoires” (HPST) made the « Agence Régionale de Santé » the leading health organism on a regional level. By using an instrument approach, our thesis exanimates the reality of this role during its application. This question echoes a more global issue: namely, who are health policies decided by, on a local level?By investigating the health field within the PACA region, through the lenses of the medico-social area, our work demonstrate that the instruments supposedly in the hands of the ARS are only barely so. Each instrument, whether it finds its origins in the old healthcare planning ideal or in a more liberal ideology, let us discover a distribution of competences different from what is legally intended.