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Short-Term Effects of Increased Body Mass and Distribution on Plantar Shear, Postural Control, and Gait Kinetics: Implications for ObesityJeong, Hwigeum 15 July 2020 (has links)
Context: Obesity is a growing global health concern. The increased body mass and altered mass distribution associated with obesity may be related to increases in plantar shear that putatively leads to physical functional deficits. Therefore, measurement of plantar shear may provide unique insights on the effects of body mass and body distribution on physical function or performance. Purpose: 1) To investigate the effects of body mass and distribution on plantar shear; 2) To examine how altered plantar shear influences postural control and gait kinetics. Hypothesis: 1) a weighted vest forward distributed (FV) would shift the center of pressure (CoP) location forward during standing compared with a weighted vest evenly distributed (EV); 2) FV would increase plantar shear spreading forces more than EV during standing; 3) FV would increase postural sway during standing while EV would not; and 4) FV would increase peak braking force, plantar impulses, and plantar shear spreading forces during walking more than EV. Methods: Twenty healthy young males participated in four different tests: 1) static test (for measuring plantar shear and CoP location without acceleration; 2) two-leg standing postural control test; 3) one-leg standing postural test; and 4) walking test. All tests were executed in three different weight conditions: 1) unweighted (NV); 2) evenly distributed vest (EV) with 20% added body mass; and 3) front-loaded vest (FV), also with 20% added body mass. Plantar shear stresses were measured using a pressure/shear device, and several shear and postural control metrics were extracted. Repeated measures ANOVAs with Holms post hoc test were used to compare each metric among the three conditions (α = 0.05). Results: FV and EV increased both anterior-posterior and medial-lateral plantar shear forces in single-foot trials compared to NV. FV shifted CoP forward. FV and EV showed decreased CoP range and velocity and increased time-to-boundary (TTB) during postural control compared to NV. While EV increased medial-lateral plantar shear spreading force, FV increased anterior-posterior plantar shear spreading force during walking. Conclusion: Added body mass increases plantar shear spreading forces. Body mass distribution had greater effects during dynamic tasks. In addition, healthy young individuals seem to quickly adapt to external stimuli to control postural stability. However, the interactive effects between body mass and distribution may disrupt physical function and/or performance in other populations—such as elderly, obese, and diabetes. Plantar shear may play a critical role in clinical diagnosis. However, as it is the first step study, follow-up studies are necessary to further support the clinical role of plantar shear.
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Att lyssna med Jämnt svävande uppmärksamhet : En studie om hur psykoterapeuter lyssnar med utgångspunkt i Freuds begrepp / To listen with Evenly hovering attention : A study on how psychotherapists listen based on Freuds termAlsterlind-Waegle, Robert January 2021 (has links)
Inledning: Sigmund Freud omnämner 1912 för första gången i publicerad form det psykoanalytiska lyssnandets princip med begreppet Jämnt svävande uppmärksamhet (JSU) (1912/2002). Begreppet har frekvent refererats till i publikationer om psykoanalys och psykoterapi sedan Freud myntade det. Syfte: Syftet med föreliggande studie är att ge innebörd åt och förstå mer om Freuds begrepp och hur psykodynamiska psykoterapeuter med utgångspunkt i Freuds grundregel lyssnar kliniskt idag. Metod: Genom intervjuer med fem psykoterapeuter söks begreppets kliniska relevans och tillämpbarhet. Intervjuerna analyseras enligt en kombinerad deduktiv och induktiv Tematisk analys. Resultat: Resultatet visar att jämnt svävande uppmärksamt lyssnande utgörs av en historiserande positionering i förhållande till berättelsen. Lyssnande som läsning utgörs av uppmärksamhet efter semantiska och vokaliserande aspekter av mänskliga erfarenheter bortom språk och begrepp. Lyssnandet i samtalets form karaktäriseras av med-lyssnande. Diskussion: Analysen visar terapeuternas uppfattning av tillämpbarheten av JSU med hänsyn till begreppets referensvärde. Terapeuternas förståelse av och syn på dess kliniska relevans diskuteras utifrån tillgängliga forskningsresultat från studier av empatisk förståelse och kliniskt lyssnande inom psykoterapi. / Introduction: In 1912, Sigmund Freud first mentions in published form the principle of psychoanalytic listening with the concept ofEvenly Hovering Attention(EHA) (1912/2002). The term has been frequently referenced in publications on psychoanalysis and psychotherapy since Freud coined it. Research questions: The purpose of this study is to give meaning to and understand more about Freud's concepts and how psychodynamic psychotherapists, based on Freud's groundrule, listen clinically today. Method:Through interviews with five psychotherapists the clinical relevance and applicableness of the concept is sought. The interviews are analyzed according to a combined deductive and inductive Thematic Analysis. Results:The results show that evenly hovering attentive listening consists of a historizing positioning in relation to thestory. Listening as readingconsists of attention aftervocalizing aspects of human experiences beyond language. Listening in the form of conversationis characterized by co-listening. Discussion:The analysis shows the therapists' perception of the applicableness of EHAtaking into account the reference value of the term. The therapists' view of its clinical relevance is discussed based on available research results from studies of empathetic understanding and clinical listening in psychotherapy.
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