Sammanfattning Syfte och frågeställningar Syftet med studien var att i ett test-retest utvärdera tillförlitligheten i den nyutvecklade kraftmätaren ISOP vad gäller isometrisk muskelkraft i handledens tre rörelseplan. Den frågeställning som låg till grund för studien var följande: Föreligger det någon signifikant skillnad i uppmätta värden vid upprepade mätningar av handledskraft vid två separata testtillfällen (s.k. “test-retest”)? Metod Ett test-retest utfördes på 20 stycken testpersoner (tio kvinnor/tio män, ålder 28-48 år, medelvärde 38,6 år), utan tidigare hand- eller handledsskada. Åtta mätningar utfördes i sex olika handledsriktningar: flexion, extension, radialdeviation, ulnardeviation, pronation och supination av dominant hand samt flexion och extension av icke-dominant hand. Varje mätning bestod av tre stycken tryck med maximal kraft i följd, samt i varje rörelseriktning, och resultatet beräknades som ett medelvärde av dessa (test 1). Testprotokollet upprepades identiskt efter en vecka (test 2). Som intern kontroll användes Jamar handdynamometer, vilken är sedan tidigare reliabilitetstestad. Resultat Sambandet mellan test 1 och test 2 analyserades med Pearson’s korrelations koefficient (r) samt Intraclass Correlation Coefficient (ICC) med ett p-värde satt till 0,001. Resultatet av Pearson r visade ett mycket starkt samband för 9 av 10 par med värden mellan 0,84-0,98, och ett starkt samband för det tionde paret med ett värde på 0,77. Sambandet stärks ytterligare av att ICC ligger mellan 0,88-0,99 för samtliga par. Ett beroende student’s t-test utfördes för att påvisa eventuella skillnader mellan testerna men inga signifikanta skillnader hittades och detta stärker sambandet mellan testerna. Signifikanta skillnader om p är mindre än 0,05. Slutsats Den nyutvecklade kraftmätaren ISOP uppvisar god reliabilitet med mycket starka – starka samband vad gäller test-retest. Inga signifikanta skillnader mellan mätningarna kunde påvisas. ISOP kan således anses vara tillförlitligt för bruk vid rehabilitering och utvärdering av handledsfunktion. / Abstract Aim and hypothesis The aim of this study was to evaluate the reliability of ISOP – a new isometric power device with regard to evaluating isometric muscle force in the three planes of wrist motion. The hypothesis was as follows: Is there a significant difference in isometric power when repeated measurements are conducted at two different time-intervals (so called ”test-retest”)? Method A test-retest protocol was performed in 20 volunteers (ten women/ten men, age range 28-48 years, average 38.6), with no prior hand or wrist injury. Eight measurements were done in six different directions of the wrist: flexion, extension, radial deviation, ulnar deviation, pronation and supination of the dominant hand, as well as flexion and extension of the non-dominant hand. Each measurement consisted of three sequential maneuvers using maximum force, and the results were calculated as an average of these (test 1). The exact same protocol was repeated after a week (test 2). As an internal control, the Jamar hand dynamometer was used as it has previously been proven reliable. Results The relationship between test 1 and test 2 were analyzed using Pearson’s correlation coefficient (r) and Intraclass Correlation Coefficient (ICC) with a p-value set at 0.001. The result of Pearson’s r showed a very strong correlation between 9 of 10 pairs tested, with values between 0.84-0.98, and a strong correlation for the tenth pair with a value of 0.77. The strength of the correlations were confirmed by the ICC which showed 0.88-0.99 for all pairs. A dependent t-test was additionally performed to test for possible deviations between the tests, but no significant differences were found (p>0.05) which strengthens the relationship between the tests. Conclusion The new isometric power device, ISOP, has a very strong to strong correlation in a test-retest situation. No significant differences between the measurements could be demonstrated. ISOP may thus be considered a reliable device for use in wrist rehabilitation and evaluation.

It has been claimed that action representations can be evoked by the image of a handled object (Tucker & Ellis, 1998). Contrary to this view, it may instead be the location of the object’s handle in visual space that generates a spatial code that in turn interacts with selection of response location. For example, an object with its handle extending into right visual space may bias attention to the right, resulting in a faster right- versus left-sided response (Cho & Proctor, 2010). In the current experiments I present evidence that under certain task conditions, images of objects evoke their corresponding action representations. When subjects engaged in laterality judgments to images of hands presented after or in conjunction with an image of a handled object, motor representations associated with that object were evoked. Although the location of the handle was irrelevant to the task, subjects were faster at responding when the depicted handle location and hand of response were aligned (i.e., right-handed key press to a right-handled frying pan) rather than misaligned. The effect of alignment remained constant across the response time distribution. When subjects made a crossed-hand response, the alignment effect was driven by a correspondence between the location of the object’s handle and the response hand, not the response location. These results contrast with what was found when observers responded to directional arrow cues in place of pictures of hands. With arrow cues, the observed alignment effect appeared to be driven by spatial correspondence between the location of the object’s body and the location of the response button. Moreover, in this case the alignment effect decreased across the response time distribution, in keeping with other cases of spatial compatibility effects (Proctor, Miles, & Baroni, 2011). I conclude that attention to an image of a hand can induce observers to activate motor affordances associated with pictured objects. / Graduate

Magister Public Health - MPH / Introduction: In-house contamination of drinking water stored in wide-mouthed buckets (even with lids) has been widely reported in epidemiologic investigations as vehicles for diarrhoea disease transmission. The long handled mukombe cup (LHM cup), recently developed by the National Institute of Health Research (NIHR), a department of the Ministry of Health and Child Care (MoHCC) in Zimbabwe, is a promising low cost dipping devise for extraction of water from wide-mouthed containers. Aim: The study aim was to assess the effectiveness and household acceptability of the long handled mukombe cup in reducing bacteriological contamination of drinking water stored in wide-mouthed vessels in the home in a peri urban settlement in Harare, Zimbabwe. Methodology: A randomised controlled trial of a long handled mukombe cup was conducted in Hatcliffe, Harare. After collecting baseline data on demographics, household water quality, and other sanitation and water handling practices, households were given basic health education before the two selected communities were randomly assigned to one of the two groups of 119 households each. The intervention group received the LHM cup while the control group received no intervention. Households were followed up after two months and assessed effectiveness and user acceptability of the intervention. Data Analysis: Data analysis was conducted using STATA 11. Descriptive statistics were calculated and reported as percentages, proportions, frequencies and measures of central tendency. Bivariate statistics were carried out to test independent associations between use of the LHM cup and E. coli. All analyses were conducted in an intention-to-intervene analysis. Results: A total of 230 households were analysed during follow-up. Samples of stored drinking water from intervention households were significantly lower in E. coli levels than those of control households (geometric mean E. coli of 0.8/100 ml vs 13.0/100 ml, p <0.0001). Overall, 78.4% (987/111) of samples from the intervention households met World Health Organization (WHO) guideline value of 0 cfu/100ml sample, while 52.1% of the 119 samples from control households met such a benchmark (p < 0.0001). In addition, 94.6% of intervention household samples were in compliance with this intervention or presented low risk, 27.7% of samples from control group households presented intermediate or high risk. There was a statistically significant association between LHM cup use and reduced E. coli bacterial contamination in stored drinking water (p < 0.05). There was no statistically significant difference in turbidity in both intervention and control groups, both for turbidity <5 and >5 (p = 0.071). Acceptability of the LHM cup was very high (100%). Conclusion: To our knowledge, this is the first study on the evaluation and acceptability of the LHM cup in the Sub-Saharan Africa. Positive results were recorded that showed that the LHM cup was effective in minimising E. coli contamination in the intervention group as compared to the control group. It is postulated that this is because the LHM cup reduces hand contact with stored water during scooping, thus maintaining improved water quality in communities in Zimbabwe that collect and store drinking water in wide-mouthed containers with lids where extraction is by scooping. However, more research is required to document the LHM cup's continued and effective use, durability and overall sustainability in the absence of any serious sampling or monitoring.

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