This thesis is the culmination of a series of studies designed to improve the management of musculoskeletal (MSK) injury in an infantry training centre (ITC Catterick, UK). The overall aim of this thesis is to develop and evaluate a management strategy for MSK injury during Combat Infantryman’s Courses (CIC) training. Included is an epidemiological study of MSK injuries in the British Army (Study1), a risk factor model for MTSS (Study 2) and two randomised controlled trials (RCTs) in which the effects of prevention (Study 3) and rehabilitation interventions (Study 4) were examined. The aim of Study 1 was to quantify incidence, type and impact of the MSK injuries during military CIC training (26 weeks). Over a two year period (April 2006 -March 2008), 6608 British infantry CIC trainees completed an informed consent form to take part in this study. A prospective epidemiological study was conducted. Data for the injuries were reported according to: onset, anatomical location, diagnosis and regiment-specific incidence, week and months, impact and occupational outcome. It was clearly demonstrated that MSK injuries are a substantial burden to the British Army. Injury rate was 48.65% and overuse injury was significantly higher than acute and recurrence. Most overuse injuries occurred in the lower limb (82.34%) and were more frequent (p <0.01) in the first phase of training (Weeks 0-13). One third of the recruits (33%) were discharged prior to completion of training. A further 15% (n=991) were removed from training for further rehabilitation. Rehabilitation time ranged from 21 to 168 days and 12% of total training time was lost due to injury (equivalent to 155,403 days of training). Owing to its high severity index, medial tibial stress syndrome (MTSS) is argued to be the most impactful of these injuries despite only being second most frequent. Implications for practice and research (Study 1): MSK injuries are a significant burden to the British Army and strategies to improve prevention and treatment need to be explored. An initial focus on MTSS is warranted. In order to develop interventions for Studies 3 and 4 it is necessary to identify those risk factors for developing MTSS. The aim of Study 2 was to determine prospectively whether gait biomechanics and/or lifestyle factors can identify those at risk of developing MTSS. Again, British Infantry male recruits (n = 468) were selected for the study. Based on a review of the literature of known risk factors for MSK injury, plantar pressure variables, lifestyle factors comprising smoking habits and aerobic fitness as measured by a 1.5 mile timed-run were collected on the first day of training. A logistic regression model for membership of the MTSS and non-MTSS groups showed that an imbalance in foot pressure (heel rotation = pressure on the medial heel minus pressure on the lateral heel) was the primary risk factor for MTSS. Low aerobic fitness and smoking habit were also important, but were additive risk factors for MTSS. The logistic regression model combining all three risk factors was capable of predicting 96.9% of the non-injured group and 67.5% of the MTSS group with an overall accuracy of 87.7%. Implications for practice and research (Study 2): Foot pronation, as measure by heel rotation, is a primary risk factor for MTSS. Previous studies have shown that gait retraining can change risk factors for injury. The aim of Study 3 was to examine the effectiveness of gait retraining on reducing risk factors associated with MTSS and on reducing the incidence of MTSS during the subsequent 26 week training period. British Infantry recruits (n = 450) volunteered for the study and baseline plantar pressure variables were recorded on the first day of training. Based on the findings of Study 2, those with abnormal foot pronation at baseline (n = 134, age 20.1 ± 2.03 years; height 167 ±1.4 cm; body mass 67 ± 2.4 kg) were randomly allocated to an intervention (n = 83) or control group (n = 83). The intervention group undertook a gait retraining program which included targeted exercises three times a week and biofeedback on risk factors once per week. Both groups continued with the CIC training concurrently. Injury diagnoses over the 26 week training regimen were made by physicians who were blinded to the study. Post-measures of plantar pressure were recorded at 26 weeks. There was a significant reduction in the pronation (p <0.001) and overall difference survival function between MTSS and non-MTSS (Log rank test X2 = 6.12, p = 0.013). The absolute risk reduction was 60% in the intervention group. Implications for practice and research (Study 3): Gait retraining can reduce risk factors and incidence of MTSS injury. Based on such positive findings for the prevention of MTSS in Study 3, it was hypothesised that gait retraining may also have potential for the rehabilitation of MTSS. The aim of Study 4 was to examine the effectiveness of a gait retraining on plantar pressure variables, pain intensity and time spent in rehabilitation due to MTSS. Recruits diagnosed with MTSS but not responding to current treatment were eligible for this study (n = 66, age 20.85 ± 2.03 years; height 167 ±1.4 cm; body mass 67 ± 2.4 kg). The participants were randomly allocated to an intervention (n = 32) or control group (n = 34). In order to overcome the debilitating pain suffered by MTSS patients during exercise, the intervention group received a corticosteroid injection prior to the gait retraining programme. The control group continued with the current rehabilitation programme. There were significant improvements in terms of time to reach peak heel rotation (p<0.001), pain intensity (p<0.001) and positive occupational outcome in the intervention group (p<0.019). Implications for practice and research (Study 4): A combined corticosteroid-exercise intervention is beneficial in normalising plantar pressure, reducing rehabilitation times, pain intensity and occupational outcome of MTSS.

The study aims to explore different aspects of urban public space. It does so through the case study of the medial debate concerning the planned redevelopment of Heden, an open central publicly owned area in Gothenburg, Sweden. The case study revealed the highly contested meanings of Heden, as well as different understandings of public space. The study also points to the dilemma of making urban public space readable and convivial, while maintaining it inclusive and open for everyone. The medial debate circles around the newly publicized redevelopment plan for Heden. In the plan the local government proposes the addition of more activities and functions to Heden. Thereby, they wish to attract new target groups to Heden. This proposal has met with some approval in the medial debate, but also with harsh critique. Some critics voice the concern of to whom public space is redeveloped. Other critics want to see more extensive redevelopment of Heden, to cover it with “inner city”. Others yet wish a future Heden to have a more explicit focus on sports. The study examines these differing opinions and their possible consequences for the “publicness” of urban public space.

The desktop publishing revolution of the 1980s is currently repeating itself in 3D, referred to as desktop manufacturing. Online services such as Shapeways have become available, making personalized manufacturing on cutting edge additive manufacturing (AM) technologies accessible to a broad audience. Affordable desktop printers will soon take over, enabling people to fabricate / Engineering and Applied Sciences

It is well established that older adults show a deficit in episodic memory. The associative deficit hypothesis (ADH) (Naveh-Benjamin, 2000) suggests that an age-related reduced ability to create links between units of information is a major contributor to the episodic deficit. It has been a robust finding that older adults show a disproportionate decline in associative memory relative to item memory when compared to young adults. Previous researchers have investigated the role of the frontal lobes (FL) by studying the effect of reduced attentional resources in the associative deficit. However, they have not found that divided attention in young adults produces the disproportionate associative decline seen in aging and it is thought that some cognitive process other than the allocation of attentional resources may contribute to the associative deficit. The present study intended to use a divided attention (DA) task that also engages medial temporal brain regions (MTL) in order to tax additional parts of the network involved in creating associations and provide indirect support for the role of the MTL in the associative deficit. However, the associative memory deficit in older adults was not replicated due to unique poor associative memory performance of some young adults in the study. Analyses excluding these participants show support for the role of the MTL in the associative deficit. However, the young poor performers may provide support for the role of FL function in the associative deficit and show that poor associative memory may not be limited to the older adult cohort.

This paper begins with a basic overview of the key concepts of classical and virtual knot theory. After introductions to concepts such as knot diagrams, Reidemeister moves, and virtual links, the paper discusses the bikei algebraic structure and the fundamental bikei. The paper describes an algorithm that converts fundamental bikei presentations to matrix representations, and then completes the resulting matrices. These completed matrices can return the value of two link invariants.

In der vorliegenden Studie wurde isoliert der biomechanische Effekt einer zusätzlichen, nicht-winkelstabil verriegelten, inferomedialen Kalkarschraube bei nagelosteosynthetischer Versorgung einer instabilen 2-Segment-Fraktur am proximalen Humerus im Vergleich zu einer Nagelosteosynthese ohne Kalkarschraube untersucht. Weiterhin wurde die Knochenmineraldichte in der inferomedialen Region des Humeruskopfes mit sechs umliegenden Regionen verglichen.16 Humeri von weiblichen Spendern waren in zwei Gruppen zu je acht Humeri aufgeteilt. Alle Präparate wurden mit dem MultiLoc® Humerusnagelsystem (DePuy Synthes, West Chester, USA) versorgt. Während die eine Gruppe (Basic) eine „Standardbesetzung“ mit drei proximalen und zwei distalen Bolzen aufwies, kam in der anderen Gruppe (Calcar) zusätzlich eine nicht-winkelstabil verriegelte Kalkarschraube zur Anwendung. Die Proben erfuhren Torsions- und Kompressionsbelastungen zur Ermittlung der Steifigkeiten, wurden zyklischen Belastungen ausgesetzt und unterlagen abschließend einer Belastung bis zum Versagen. Ein Vergleich der Gruppen ergab keine signifikanten Unterschiede. In Anbetracht einer verhältnismäßig hohen Knochenmineraldichte in der inferomedialen Region des Humeruskopfes erscheint das Konzept der zusätzlichen inferomedialen Abstützung als eine prinzipiell sinnvolle Methode. Allerdings erwies sich die Verwendung einer zusätzlichen nicht-winkelstabil verriegelten inferomedialen Kalkarschraube bei instabiler subkapitaler 2-Segment-Fraktur des proximalen Humerus als nicht biomechanisch vorteilhaft.

Injury to the medial malleolus, the distal end of the tibia and one of the bones comprising the ankle joint, can occur in various loading scenarios. Open reduction/internal fixation (ORIF) to reattach the malleolar fragment to the proximal tibia can be achieved via various devices, however small fragments are particularly challenging to treat. In this study, computational finite element analysis (FEA) was utilized to investigate the fixation of transverse medial malleolar fractures by two cancellous screws or by a new fixation device, the Medial Malleolar Sled™. Cadaveric testing assessed the performance of the two constructs in both tension and torsion. Following experimentation, the cadaveric study was modeled in SolidWorks and analyzed via FEA to validate the model against the experimental results. Overall, stress analysis was indicative of areas of relatively higher stress concentrations that correlated with failure locations in the experiment. Such results speak to the predictive nature of the tension and torsion models created in the study, and to the general utility of computational modeling for the study of biomechanical systems.

Chronic neuropathic pain is often difficult to treat due to its resistance to therapeutic intervention. This is due in part to the poor understanding of the physiological mechanisms involved in the establishment and maintenance of neuropathic pain states. The neuropathic pain model, chronic constriction injury of the sciatic nerve, produced robust pain hypersensitivity in our mice. It also induced significant changes in the mitogen activated protein kinase family, and the cannabinoid and µ-opioid systems in three different brain areas involved in the modulation or regulation of pain states. CCI induced a 2.5 fold increase in mRNA of the kinase Raf-1 in the PAG of mice. Raf-1 is part of the ERK cascade in the MAP kinase family of proteins. The MAPK family of proteins has previously been shown to be involved in the establishment and maintenance of chronic neuropathic pain via central sensitization and the PAG is a critical regulator of nociceptive input and is part of the descending pain pathway, which has also been shown to have a role in central sensitization. CCI also resulted in significant decreases in the µ-opioid receptor agonist DAMGO stimulated [35S] GTPγS binding in the medial thalamus, and the cannabinoid receptor agonist, WIN 55, 212-2 stimulated [35S] GTPγS binding in the anterior cingulate cortex. These effects were not due to an overall decrease in µ-opioid receptor or cannabinoid receptor 1 binding, suggesting that the chronic pain-like condition resulted in a desensitization of these receptors. Both the medial thalamus and the anterior cingulate cortex are brain areas involved in the medial pain pathway which, along with the limbic system, have been shown to be involved in the affective component of pain processing. These data are the first to demonstrate changes in these three cellular systems in the respective brain areas of the mouse in response to chronic neuropathic pain. The novel findings presented in this dissertation provide new areas of investigation for the treatment of this debilitating disease.

Death, Murder, Manslaughte As a Medial Topic The subject of this diploma thesis is the analysis of the texts which concern violent death. Printed media articles and articles from news portals on the internet are being analysed. The work focuses on the manner death is presented and how the picture of the dead and of the manslayer is created. How the words "murder" and "manslaughter" alternate in various cases, their euphemisms and their relationship to reality is being researched. The method of stylistic and content analysis are being used.

<p>Neuroimaging studies of episodic memory, or memory of events from our personal past, have predominantly focused their attention on medial temporal lobe (MTL). There is growing acknowledgement however, from the cognitive neuroscience of memory literature, that regions outside the MTL can support episodic memory processes. The medial prefrontal cortex is one such region garnering increasing interest from researchers. Using behavioral and functional magnetic resonance imaging measures, over two studies, this thesis provides evidence of a mnemonic role of the medial PFC. In the first study, participants were scanned while judging the extent to which they agreed or disagreed with the sociopolitical views of unfamiliar individuals. Behavioral tests of associative recognition revealed that participants remembered with high confidence viewpoints previously linked with judgments of strong agreement/disagreement. Neurally, the medial PFC mediated the interaction between high-confidence associative recognition memory and beliefs associated with strong agree/disagree judgments. In an effort to generalize this finding to well-established associative information, in the second study, we investigated associative recognition memory for real-world concepts. Object-scene pairs congruent or incongruent with a preexisting schema were presented to participants in a cued-recall paradigm. Behavioral tests of conceptual and perceptual recognition revealed memory enhancements arising from strong resonance between presented pairs and preexisting schemas. Neurally, the medial PFC tracked increases in visual recall of schema-congruent pairs whereas the MTL tracked increases in visual recall of schema-incongruent pairs. Additionally, ventral areas of the medial PFC tracked conceptual components of visual recall specifically for schema-congruent pairs. These findings are consistent with a recent theoretical proposal of medial PFC contributions to memory for schema-related content. Collectively, these studies provide evidence of a role for the medial PFC in associative recognition memory persisting for associative information deployed in our daily social interactions and for those associations formed over multiple learning episodes. Additionally, this set of findings advance our understanding of the cognitive contributions of the medial PFC beyond its canonical role in processes underlying social cognition.</p> / Dissertation