Background Persistent musculoskeletal pain is a multi-factorial entity, influenced by biological, genetic and psychosocial factors. Psychosocial factors, such as individuals' beliefs and experiences, need to be considered in the management of such pain. While extensive research has explored beliefs of individuals with spinal pain, less is known about individuals' beliefs regarding shoulder pain. Objectives To explore beliefs about the cause of pain in individuals with persistent rotator cuff-related pain, as well as the experiences of the effect of pain on their daily lives. Design A mixed methods design, using semi-structured interviews and validated outcome questionnaires. Method Five men and five women, aged 47–68 years, with shoulder pain for at least three months were recruited. Individual semi-structured interviews were audio-recorded, transcribed verbatim and analysed using the general inductive approach. Results/findings Four key themes emerged. The cause of pain, ‘Understanding the pain’, was described in terms of anatomical factors within the context of the participants' lives. The pain impacted all areas of life, creating another theme, ‘It affects everything’. Participants responded to their pain by adopting certain, ‘Pain-associated behaviours’ and sought information for diagnosis, general management and exercise prescription, ‘Emotional responses and the future’. Conclusions The participants with rotator cuff-related pain believed the cause of their pain to be local to the shoulder region. However, they also described various stressors in their work-, sports- and family-related lives. Rehabilitation may need to include educating the individual, expanding their understanding regarding pain mechanisms and appropriate interventions, based on individual goal-setting.

The project explores the design development of housing within the scenario of Post Disaster Rehabilitation of populations displaced by natural disasters. By looking at the house as a system that combines two distinct phases of rehabilitative housing, namely Transitional Housing and Durable Housing, the design seeks to reduce the complications of relocation every time there is a need to move on to the next phase of shelter aid. To truly make the house construction an owner driven experience, the system aims to be designed such that it can manipulated by the owner/user to suit their long term needs and personal tastes. By doing so, the house strives to imbibe a sense of belonging, making it less likely for the shelter to be rejected by the owner. For this purpose, the aesthetic of the shelter would need to be carefully designed and organic patterns of settlement growth studied to realize the need of the types of public, semi public and private spaces.

Purpose: To explore perceptions and initial outcomes of patients with rotator cuff-related pain to a pain education session. Materials and Methods: Ten individuals with persistent rotator cuff-related pain (≥3 months duration) attended an individual pain education session. They completed patient-reported outcomes measures on a weekly basis, three weeks prior and three weeks following the session. Individual semi-structured interviews were conducted three weeks following the pain education. Interviews were recorded, transcribed verbatim, and analyzed using the General Inductive Approach. Results: There were two over-arching key themes: firstly, ‘Participants’ Perspectives’ of the session generated four themes: Improved understanding of ‘the whole’; Mindful self-awareness; Taking charge; “The pain is still there”. Their understanding of pain was reconceptualised, evident by their ability to describe the role of neurophysiological mechanisms, stress and general well-being towards their pain. The second over-arching key theme, ‘Participants’ Recommendations’, had two themes: Integrating neuroscience with pathoanatomical knowledge and Educating other health professionals. Pain levels decreased post-pain education compared to pre-pain education. Conclusions: Following the pain education session, participants had greater understanding of factors influencing their shoulder pain. Pain education, in addition to pathoanatomical information may be useful as part of treatment for persistent rotator cuff-related pain.

Um die Effektivität der Sporttherapie insbesondere im Rahmen der medizinischen Trainingstherapie zu erhöhen, müssen nach Sportverletzungen wie die vordere Kreuzbandruptur besondere Anforderungen an die Therapie gesetzt werden. Gründe sind die vom Kostenträger determinierte Rehabilitationszeit und eine anzustrebende komplikationslose sportliche Aktivität nach der Rehabilitation des Sportlers. Eine mögliche Alternative stellen offene kinetische Systeme dar. Diesen wird jedoch eine zu hohe Beanspruchung für das frische Transplantat unterstellt. Ziel war es, die Wirkung des offenen und des geschlossenen Systems im rehabilitativen Krafttraining an Patienten nach VKP zu untersuchen. Dazu wurden 34 Patienten (Alter 30 ± 9,9 Jahre, Gewicht 75,9 ± 13,2 kg, Größe 178,5 ± 5,5 cm) in eine randomisiert zweischenklige Trainingsstudie unter realen klinischen Bedingungen eingeschlossen (N=17 je Gruppe). Zur Überprüfung der Wirkung der Trainingstherapie wurden ein Isokinet (120°/s), Lachmanntest mittels Rolimeter sowie manuelle Umfangsmessungen jeweils vor und am Ende der Rehabilitation eingesetzt. Die Ergebnisse zeigten signifikanten Kraftzunahmen der Knie-Extensoren und Flexoren (p<0,05) in beiden Gruppen. Zwischen beiden Gruppen lagen keine signifikanten Unterschiede im Ausmaß der Entwicklung der Kraftfähigkeiten vor (p>0,05). Die vorderen Schubladen blieben bei beiden Trainingsgruppen unverändert (p>0,05). Die Befunde zeigen, dass möglicherweise das offene kinetische System im rehabilitativen Krafttraining eine sinnvolle Ergänzung darstellen kann. / To increase the effectiveness of sports therapy particularly in the context of medical training therapy, must be put in the treatment of sports injuries such as anterior cruciate ligament special requirements. Reasons are the cost of carrier-determined rehabilitation time and a desirable complication-free sporting activity for the rehabilitation of the athlete. A possible alternative are open kinetic systems but it is deemed too high a load for the fresh graft assumed. The aim, the effect of the open and the closed system was examined in the rehabilitative strength training in patients after retail price. These were 34 patients (age 30 ± 9.9 years, weight 75.9 ± 13.2 kg, 178.5 ± 5.5 cm size) were enrolled in a randomized study with two groups under real clinical conditions. To check the effects of exercise therapy were used with an isokinetic (120 ° / s), Lachmann test using Rolimeter and manual volume measurements before and at the end of rehabilitation. The results showed significant increases in strength of knee extensors and flexors (p <0.05) in both groups. Between two groups were not significantly different in the degree of development of strength abilities before (p> 0.05). The laxity of LCA remained unchanged in both training groups (p> 0.05). The findings show that potentially, the open kinetic system in rehabilitative strength training be a useful addition.

Over the last 30 years, the juvenile justice system and juvenile correctional ideology shifted to become more punitive in nature. However, studies examining this shift are lacking in the literature. The present study will attempt to assess what correctional ideology, rehabilitative or punitive, is dominant within juvenile corrections by conducting a national survey to juvenile facility directors. This study will be based on prior literature, most of which has focused upon line staff in an adult correctional setting. From this prior literature, more specifically from the work of Cullen et al. (1989), scales will be created to determine the correctional orientation of the key administrators in juvenile facilities. This will allow us to assess whether the correctional ideology driving the juvenile system has in fact become punitive. The findings from this study have the opportunity to alter the current status quo in juvenile corrections.

This lecture takes a dual-targeted approach in: 1) acquainting the audience with newer neuroimaging techniques applied to the consequences of vestibular dysregulation following noise or blast-induced mild traumatic brain injury (mTBI); and 2) considers treatment and rehabilitation modalities of vestibular and balance dysfunction in order to help veteran’s resume normal activities-of-daily-living. Relevant examples from each targeted lecture will be provided. Intended Audience: Professionals interested in the area of vestibular and balance assessment, neuroimaging, and rehabilitation.

Background: This study, the first of its kind, originated with the need for a brace (an ankle foot orthosis), to constrain ankle plantarflexion and dorsiflexion within a motion threshold of <5°. A conventional thermoplastic, solid brace failed during a quasi-static loading study, informing the investigation and development of an experimental carbon composite brace, maximizing stiffness and proximity of shank and foot cylindrical shells to provide the required degree of control. Methods: Two experiments were conducted: a quasi-static loading study, using cadaveric limbs (n = 2), and a gait study with healthy subjects (n = 14). Conditions tested were STOP, FREE, and CONTROL. Data for all studies were collected using six motion-capture cameras (Vicon, Oxford, UK; 120 Hz) tracking bone-anchored markers (cadaveric limbs) and skin-anchored markers (subjects). In the quasi-static loading study, loading conditions were congruent with the gait study. Study 1 involved a quasi-static loading analysis using cadaveric limbs, compared motion data from a conventional thermoplastic solid brace and the experimental brace. Study 2 involved quantifying ankle plantarflexion and dorsiflexion in subjects during treadmill walking, in brace STOP, FREE, and CONTROL conditions. Findings: The experimental brace in STOP condition consistently constrained ankle plantarflexion and dorsiflexion below the motion threshold of <5°, across all studies. Interpretation: Collectively, these findings demonstrate (1) that a conventional thermoplastic, solid brace was ineffective for clinical applications that required significant motion control, and (2) that ankle motion control is most effective when considered as a relationship between the brace, the ankle-foot complex, and the external forces that affect them both.

Dizziness is very common, but it is never normal. Dizziness can make performing daily activities, work, and walking difficult. Inner ear balance problems can make people dizzy when they turn their head, which can cause problems during walking and make people more likely to fall. Most of the time dizziness is not from a life-threatening disease. Often, dizziness is related to a problem of the vestibular (or inner ear balance) system. Vestibular disorders can be caused by infections in the ear, problems with the immune system, medications that harm the inner ear, and rarely from diabetes or stroke because of a lack of blood flow to the inner ear. Stress, poor sleep, migraine headaches, overdoing some activities, and feeling anxious or sad can increase symptoms of dizziness. Updated guidelines for the treatment of inner ear disorders are published in this issue of the Journal of Neurologic Physical Therapy. The guideline recommends which exercises are best to treat the dizziness and balance problems commonly seen with an inner ear problem.

This short dissertation briefly examines the English law statutory provisions and the English judicial approach relating to the clean break principle. A comparison between English law and South African law (in particular s 7 of the Divorce Act 70 of 1979) shows the latter to allow the application of the clean break principle, but rigidity in the legislative wording and further rigidity in the wording by the courts result in the clean break principle not being a dominant feature of South African divorce law. A detailed analysis of South African case law follows in which the fundamental issues relative to the clean break principle are examined, namely the one third rule, universal partnership, misconduct and its effect on court orders, the nature of a contribution and what property is distributed on divorce. Trends in maintenance orders are looked at and how these affect the clean break principle, in particular rehabilitative maintenance and token maintenance wards. / Law / LL.M.

A free and appropriate public education is promised to every child in the United States. However, zero tolerance school discipline policies have broken that promise, pushing students out of the classroom and into the school-to-prison pipeline. Despite the growing body of research demonstrating negative social and economic impacts of exclusionary discipline, public school administrators have been slow to adopt innovative policies that provide rehabilitative alternatives. The purpose of this study was to compare, using the consequences of innovations application of Rogers's diffusion of innovations theory, the impact of various school district approaches to school discipline on suspension rates while controlling for race and socioeconomic status. This study used a quantitative, nonexperimental, nonequivalent groups, posttest-only research design using secondary analysis of data reported by 218 school districts in a New England state for the 2016-17 school year. Analysis of covariance indicated that there is a significant relationship between approaches to school discipline and suspension rates when controlling for racial and socioeconomic composition (p < .05). Race and economic disadvantage significantly influenced suspension rates (p < .001), and districts implementing alternatives differed significantly in their racial and socioeconomic compositions (p < .001). Policy implications include the promotion of alternative approaches to school discipline. Implications for social change include evidence to support the work of those addressing the needs underlying student behavior rather than crime and punishment models to produce safe and supportive schools and dismantle the school-to-prison pipeline.