PROGNOSTIC FACTORS PREDICTING FUNCTIONAL OUTCOME AT FOUR MONTHS FOLLOWING ACUTE ANKLE SPRAIN

PROGNOSTIC FACTORS PREDICTING FUNCTIONAL OUTCOME AT FOUR MONTHS FOLLOWING ACUTE ANKLE SPRAINBleakley C.M.1, O'Connor S.R.1, Tully M.A.2, Rocke L.G.3, MacAuley D.C.1, Bradbury I.4, Keegan S.4, McDonough S.M.11University of Ulster, Health & Rehabilitation Sciences Research Institute, Newtownabbey, United Kingdom, 2Queen's University, UKCRC Centre of Excellence for Public Health (NI), Belfast, United Kingdom, 3Royal Victoria Hospital, Department of Emergency Medicine, Belfast, United Kingdom, 4Frontier Science (Scotland), Kincraig, Inverness-shire, United KingdomPurpose: To identify clinically relevant factors assessed following acute ankle sprain that predict functional recovery at four months post-injury.Relevance: Ankle sprains are one of the most common musculoskeletal injuries with an estimated 5000 new cases occurring each day in the United Kingdom. In the acute phase, ankle sprains may be associated with pain and loss of function. In the longer-term there is a risk of residual problems including chronic pain or reinjury. Few studies have sought to examine factors associated with a poor long-term prognosis.Participants: 101 patients (Age: Mean (SD) 25.9 (7.9) years; Body Mass Index (BMI): 25.3 (3.5) kg/m2) with an acute grade 1 or 2 ankle sprain attending an accident and emergency department or sports injury clinic. Exclusion criteria included complete (grade 3) rupture of the ankle ligament complex, bony ankle injury or multiple injuries.Methods: Participants were allocated as part of a randomised controlled trial to an accelerated intervention incorporating intermittent ice and early therapeutic exercise or a standard protection, rest, ice, compression, and elevation intervention for one week. Treatment was then standardised in both groups and consisted of ankle rehabilitation exercises focusing on muscle strengthening, neuromuscular training, and sports specific functional exercises for a period of approximately four to six weeks. On initial assessment age, gender, mechanism of injury, presence of an audible pop or snap and the presence of contact during the injury were recorded. The following factors were also recorded at baseline and at one and four weeks post-injury: weight-bearing dorsi-flexion test, lateral hop test, presence of medial pain on palpation and a positive impingement sign. Functional status was assessed using the Karlsson score at baseline, at week four and at four months. Reinjury rates were recorded throughout the intervention phase and at four months.Analysis: A mixed between-within subjects analysis of variance (ANOVA) was used to determine the effect of each factor on functional status at week four and at four months. Significance was set at a Bonferroni adjusted level of 0.0125 (0.05/4).Results: Eighty-five participants (84%) were available at final follow-up assessment. Pain on weight-bearing dorsi-flexion and lateral hop tests at week four were both associated with a lower functional score at four months post-injury (P = 0.011 and P = 0.001). No other significant interactions were observed at any other timepoint (baseline or week one). There were only two reinjuries within the four month follow-up period with a further two reported at approximately six months post-injury. We were therefore unable to determine whether any factors were associated with an increased risk of reinjury.Conclusions: Potential prognostic factors on initial or early examination after acute ankle sprain did not help predict functional recovery at four months post-injury. However, pain on weight-bearing dorsi-flexion and lateral hop tests observed at four weeks were associated with a slower rate of recovery.Implications: Some clinical tests may help identify patients at risk of poor functional recovery after acute ankle sprain. However, further work is required to examine factors which may be predictive on initial assessment.Key-words: 1. Prognostic factors 2. Recovery 3. Ankle sprainFunding acknowledgements: Physiotherapy Research Foundation, Chartered Society of Physiotherapy, Strategic Priority Fund; Department of Employment and Learning, Northern Ireland.Ethics approval: Office for Research Ethics Committee (UK).

SYSTEMATIC REVIEW AND META-ANALYSIS: EFFECTS OF WALKING EXERCISE IN CHRONIC MUSCULOSKELETAL PAIN

SYSTEMATIC REVIEW AND META-ANALYSIS: EFFECTS OF WALKING EXERCISE IN CHRONIC MUSCULOSKELETAL PAIN O'Connor S.R.1, Tully M.A.2, Ryan B.3, Baxter D.G.3, Bradley J.M.1, McDonough S.M.11University of Ulster, Health & Rehabilitation Sciences Research Institute, Newtownabbey, United Kingdom, 2Queen's University, UKCRC Centre of Excellence for Public Health (NI), Belfast, United Kingdom, 3University of Otago, Centre for Physiotherapy Research, Dunedin, New ZealandPurpose: To examine the effects of walking exercise on pain and self-reported function in adults with chronic musculoskeletal pain.Relevance: Chronic musculoskeletal pain is a major cause of morbidity, exerting a substantial influence on long-term health status and overall quality of life. Current treatment recommendations advocate various aerobic exercise interventions for such conditions. Walking may represent an ideal form of exercise due to its relatively low impact. However, there is currently limited evidence for its effectiveness.Participants: Not applicable.Methods: A comprehensive search strategy was undertaken by two independent reviewers according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and the recommendations of the Cochrane Musculoskeletal Review Group. Six electronic databases (Medline, CINAHL, PsychINFO, PEDro, Sport DISCUS and the Cochrane Central Register of Controlled Trials) were searched for relevant papers published up to January 2010 using MeSH terms. All randomised or non-randomised studies published in full were considered for inclusion. Studies were required to include adults aged 18 years or over with a diagnosis of chronic low back pain, osteoarthritis or fibromyalgia. Studies were excluded if they involved peri-operative or post-operative interventions or did not include a comparative, non exercise or non-walking exercise control group. The U.S. Preventative Services Task Force system was used to assess methodological quality. Data for pain and self-reported function were extracted and converted to a score out of 100.Analysis: Data were pooled and analyzed using RevMan (v.5.0.24). Statistical heterogeneity was assessed using the X2 and I2 test statistics. A random effects model was used to calculate the mean differences and 95% CIs. Data were analyzed by length of final follow-up which was categorized as short (≤8 weeks post randomisation), mid (2-12 months) or long-term (>12 months).Results: A total of 4324 articles were identified and twenty studies (1852 participants) meeting the inclusion criteria were included in the review. Overall, studies were judged to be of at least fair methodological quality. The most common sources of likely bias were identified as lack of concealed allocation and failure to adequately address incomplete data. Data from 12 studies were suitable for meta-analysis. Walking led to reductions in pain at short (<8 weeks post randomisation) (-8.44 [-14.54, -2.33]) and mid-term (>8 weeks - 12 month) follow-up (-9.28 [-16.34, -2.22]). No effect was observed for long-term (>12 month) data (-2.49 [-7.62, 2.65]). For function, between group differences were observed for short (-11.57 [-16.06, -7.08]) and mid-term data (-13.26 [-16.91, -9.62]). A smaller effect was also observed at long-term follow-up (-5.60 [-7.70, -3.50]).Conclusions: Walking interventions were associated with statistically significant improvements in pain and function at short and mid-term follow-up. Long-term data were limited but indicated that these effects do not appear to be maintained beyond twelve months.Implications: Walking may be an effective form of exercise for individuals with chronic musculoskeletal pain. However, further research is required which examines longer term follow-up and dose-response issues in this population.Key-words: 1. Walking exercise 2. Musculoskeletal pain 3. Systematic reviewFunding acknowledgements: Department of Employment and Learning, Northern Ireland.Ethics approval: Not applicable.

The History of Arsaces, Prince of Betlis

Recounting the eventful travels of Selim, an intrepid young Arab who runs away from his parental home to learn about the world, The History of Arsaces, Prince of Betlis (1774) by the Co. Limerick-born Charles Johnston (c.1719–c.1800) is an inventive mixture of fictional genres and styles: romance, satire, sentimental narrative and oriental fantasy. The novel appeared at a politically charged moment, on the eve of the American revolutionary war and in the aftermath of the Bengal famine of 1769–70, world events that were linked by the nefarious operations of the ubiquitous East India Company. These momentous occurrences, polarising public opinion and stimulating Irish patriot sympathies in the mid-70s, provide the undercurrent to Johnston’s thoughtful examination of war, commerce, and empire through the lens of a fictional ‘history’. Enclosing a series of tales within tales, Johnston’s oriental romance offers its readers a remarkable concoction of Gulliver-inspired fantasy, political satire and moral reflection, played out within an expansive historical and geographical setting. As the Monthly Review, or, Literary Journal commented on its first appearance in 1774, The History of Arsaces provided ‘striking intimations, of the utmost national importance, with respect to over-grown empire, and colony connexions’.

Advertising Colonial Romance and Imperial Masculinity: The Promotion of Philip Meadows Taylor's Novels in Britain

The comments of Charles Kegan Paul, the Victorian publisher who was involved in publishing the novels of the nineteenth-century British-Indian author Philip Meadows Taylor as single volume reprints in the 1880s, are illuminating. They are indicative of the publisher's position with regard to publishing - that there was often no correlation between commercial success and the artistic merit of a work. According to Kegan Paul, a substandard or mediocre text would be commercially successful as long it met a perceived want on the part of the public. In effect, the ruminations of the publisher suggests that a firm desirous of acquiring commercial success for a work should be an astute judge of the pre-existing wants of consumers within the market. Yet Theodor Adorno, writing in the mid-twentieth century, offers an entirely distinctive perspective to Kegan Paul's observations, arguing that there is nothing foreordained about consumer demand for certain cultural tropes or productions. They in fact are driven by an industry that preempts and conditions the possible reactions of the consumer. Both Kegan Paul's and Adorno's insights are illuminating when it comes to addressing the key issues explored in this essay. Kegan Paul's comments allude to the ways in which the publisher's promotion of Philip Meadows Taylor's fictional depictions of India and its peoples were to a large extent driven in the mid- to late-nineteenth century by their expectations of what metropolitan readers desired at any given time, whereas Adorno's insights reveal the ways in which British-Indian narratives and the public identity of their authors were not assured in advance, but were, to a large extent, engineered by the publishing industry and the literary marketplace.

Making British Indian Fictions, 1772-1823

This book examines fictional representations of India in novels, plays and poetry produced between the years 1772 to 1823 as historical source material. It uses literary texts as case studies to investigate how Britons residing both in the metropole and in India justified, confronted and imagined the colonial encounter during this period. The study will situate the texts in relation to the shifting colonial context and to the changing attitudes towards India within Britain in general and on the part of Britons who had experience of living in India, such as East India Company men or their wives and daughters, in particular. Moreover, it will analyse how this literature responded to the increasing influence of the subcontinent on metropolitan culture. This book, then, approaches fictional texts as case studies that illuminate trends taking place within Britain such as the growing consumption of Indian-style imported goods and the commoditisation of an Indian aesthetic within British visual culture. Whilst the book will utilise fictional portrayals to comment upon shifts in the relationship between coloniser and colonised and to discuss the cross-cultural influences between the metropole and the colonial periphery, it also outlines how literary production and print capitalism played a part in shaping depictions of the subcontinent and stereotypes of the colonial 'other'. The study will also examine how representations of the subcontinent in British art and scholarship were influenced by metropolitan literary and popular culture. At the same time it will look at how representations by metropolitan authors influenced early-nineteenth century depictions by British authors who resided in India.

An Assessment of Psychological Need in Emergency Medical Staff in the Northern Health and Social Care Trust Area

Setting: Psychological stress is increasingly recognised within emergency medicine, given the environmental and clinical stressors associated with the specialism. The current study assessed whether psychological distress is experienced by emergency medical staff and if so, what is the expressed need within this population? Participants: Participants included ambulance personnel, nursing staff, doctors and ancillary support staff within two Accident and Emergency (A&E) departments and twelve ambulance bases within one Trust locality in NI (N = 107). Primary and secondary outcome measures: The General Health Questionnaire (GHQ-12, Goldberg, 1972, 1978), Secondary Traumatic Stress Scale (STSS, Bride, 2004) and an assessment of need questionnaire were completed and explored using mixed method analysis. Results: Results showed elevated levels of psychological distress within each profession except ambulance service clinical support officers (CSOs). Elevated levels of secondary trauma symptomatology were also found; the highest were within some nursing grades and junior doctors. Decreased enjoyment in job over time was significantly associated with higher scores. Analysis of qualitative data identified sources of stress to include low morale. A total of 65% of participants thought that work related stressors had negatively affected their mental health. Participants explored what they felt could decrease psychological distress including improved resources and psychoeducation. Conclusion: There were elevated levels of distress and secondary traumatic stress within this population as well as an expressed level of need, on both systemic and support levels.

Northern Ireland Policing Board Confidence in Policing Research: Key Drivers of Confidence

In January 2014, the Northern Ireland Policing Board (NIPB) commissioned the University of Ulster to conduct research into public confidence in policing to help inform the work of the Board and its oversight of police service delivery. More specifically, the research team were tasked with exploring ‘the key drivers of confidence in Northern Ireland’. To date, the subject of ‘confidence in policing’ within a Northern Ireland context has been relatively under researched, both in academic and policy terms. Thus, the present research is the first empirical research to be produced in the country to empirically assess confidence in policing from a cross section of society – including the key dynamics and drivers that underpin police confidence at a community level.

The report begins with a comprehensive review of academic literature, policy documents and contemporary events related to confidence in policing. The research then provides an overview of the methodology used to undertake the research, with the remainder of the report comprised of the findings from the survey. The report concludes with an overview of the central findings along with a series of recommendations.

The influence that politicians, community leaders and the media have on confidence in the police in Northern Ireland

n January 2014, the Northern Ireland Policing Board (NIPB) commissioned the University of Ulster to conduct research into public confidence in policing to help inform the work of the Board and its oversight of police service delivery. More specifically, the research team were tasked with exploring ‘the influence that politicians, community leaders and the media have on public confidence in policing in Northern Ireland’. To date, the subject of ‘confidence in policing’ within a Northern Ireland context has been relatively under researched, both in academic and policy terms. Thus, the present research is the first empirical research to be produced in Northern Ireland which considers the issue of confidence in policing from the perspective of community leaders, politicians and the media – including the key influences and dynamics which underpin police confidence at a community level.

The report begins with a comprehensive review of academic literature, policy documents and contemporary events related to confidence in policing. The research then provides an overview of the methodology used to undertake the research, with the remainder of the report comprised of the findings from the discussions with representatives from the media, political parties and the community and voluntary sector who participated. The report concludes with an overview of the central findings along with a series of recommendations.

Northern Ireland Neighbourhood Watch: Participatory Mapping and Socio Demographic Uptake

Northern Ireland Neighbourhood Watch (NINW) was formally introduced to Northern Ireland in 2004 by the Police Service of Northern Ireland, Northern Ireland Policing Board and Northern Ireland Office. However, there has been little research to data as to participation in, or success of, the schemes. This research report provides one of the few empirical examinations of NINW. Using GIS mapping and socio-demographic data from the Northern Ireland Neighbourhood Information Service (NINIS), the research explores participation in NINW schemes set against religion, deprivation and crime levels at the Census Output Area (COA) level across Northern Ireland. While the research largely confirms the limited impact of neighbourhood schemes as noted in international literature, at a local level in Northern Ireland the findings evidence a distinct pattern of uptake, with the vast majority of participants in the schemes residing in affluent, low-crime, mainly Protestant areas of the country

Community Perspectives On Public Order Policing in Northern Ireland

In 2011 the Chief Constable of the PSNI commissioned a review of public order policing in Northern Ireland, following closely behind a review of public order policing in Britain undertaken by Her Majesty’s Inspectorate of Constabulary (HMIC) (2011). As part of the review, the PSNI decided to adopt a ‘twin-track’ approach, with an internal review of organisational practice, experiences and roles/responsibilities; and an independent external review of community experiences of public order policing across the country. The external strand to the review was publically tendered during the first half of 2012 and was awarded to a joint bid by the University of Ulster and the Institute for Conflict Research. The overall aim of the research was to inform the PSNI’s review of public order policing in the widest possible sense so that community experiences and attitudes may be considered by the PSNI as part of decisions taken about future changes in police strategy and tactics on public order issues, with full cognisance of their community impact. In regard to the specific objectives, the research was tasked with the following:

• Provide qualitative information on community experiences and attitudes to public order policing;
• Identify critical issues, dilemmas and debates resulting from public order policing as delivered by the PSNI – both in terms of communities directly and indirectly affected;
• Highlight issues for the PSNI consideration in terms of carrying out its task of maintaining public order while upholding the human rights of all; and
• Explore the above issues in respect of both the PSNI’s style and tactics, along with community attitudes and approaches.

A comparative study of translation strategies applied in dealing with role languages. : A translation analysis of the video game Final Fantasy XIV

Localisation is the process of taking a product and adapting it to fit the culture in question. This usually involves making it both linguistically and culturally appropriate for the target audience. While there are many areas in video game translations where localisation holds a factor, this study will focus on localisation changes in the personalities of fictional characters between the original Japanese version and the English localised version of the video game Final Fantasy XIV: A Realm Reborn and its expansion Heavensward for PC, PS3 and PS4. With this in mind, specific examples are examined using Satoshi Kinsui's work on yakuwarigo, role language as the main framework for this study. Five non-playable characters were profiled and had each of their dialogues transcribed for a comparative analysis. This included the original Japanese text, the officially localised English text and a translation of the original Japanese text done by myself. Each character were also given a short summary and a reasoned speculation on why these localisation changes might have occurred. The result shows that there were instances where some translations had been deliberately adjusted to ensure that the content did not cause any problematic issues to players overseas. This could be reasoned out that some of the Japanese role languages displayed by characters in this game could potentially cause dispute among the western audience. In conclusion, the study shows that localisation can be a difficult process that not only requires a translator's knowledge of the source and target language, but also display some creativity in writing ability to ensure that players will have a comparable experience without causing a rift in the fanbase.

La divination par les sorts dans le monde oriental méditerranéen du IIe au VIe siècle après J.-C. : étude comparative des sortes Homericae, sortes Astrampsychi et tables d'astragalomancie en Asie mineure

Cette thèse se propose de comparer exhaustivement trois systèmes de divination par voie de tirage au sort qui ont été contemporains dans l’antiquité tardive. À l’aide d’une analyse rigoureuse des thèmes évoqués, des stratégies rhétoriques employées, du vocabulaire présent et des probabilités d’obtention des réponses offertes, plusieurs points communs ressortent. Les énoncés positifs et négatifs se veulent, dans tous les cas, équilibrés et ils optent souvent pour des variantes temporelles afin de tempérer les prédictions. Lorsqu’ils ne s’appliquent pas à des questions spécifiques, ils misent sur l’imaginaire des consultations littéraires qui allie proverbes et éléments épiques, sans toutefois déroger des thèmes communs liés aux préoccupations quotidiennes des consultants. La rhapsodomancie s’inscrit dans cette mouvance et prouve à quel point l’épopée est une source propice à l’élaboration de systèmes oraculaires, sans jamais que le contexte narratif et littéraire des vers sélectionnés n’entre en jeu.

Mémoire de licence La réception du message donné dans Le Petit Prince : Une étude sur la réception et l’interprétation du message donné dans Le Petit Prince par Antoine de Saint-Exupéry chez l’adulte et l’enfant.

Le présent travail est une étude sur Le Petit Prince, d’Antoine de Saint-Exupéry. Le but principal du mémoire est d’analyser la réception du message chez le lecteur adulte et chez le lecteur enfant. Nous avons analysé comment l’enfant et l’adulte interprètent le message donné par l’oeuvre, parsemée d’images et d’allégories, des citations qui son devenues symboliques avec le temps. Ensuite, nous avons analysé les personnages dans le but d’interpréter leur sens symbolique. Pour réaliser cette recherche, nous avons regardé plusieurs interprétations allégoriques. Les résultats de notre étude nous ont permis d’affirmer que la réception du message n’est pas la même chez le lecteur adulte et le lecteur enfant. Les résultats de cette étude montrent enfin qu’il est trop difficile pour le lecteur enfant de comprendre le sens moral d’une image allégorique, tandis que le lecteur adulte est plus apte à interpréter l’image allégorique en s’appuyant sur son expérience de la lecture et de son expérience de la vie quotidienne. L’auteur utilise l’image symbolique dans la littérature pour montrer avec plus de clarté la condition humaine. En conclusion nous apprenons que Le Petit Prince nous fait réfléchir sur la vie de la façon plus profonde et philosophique.

Two Women; On the Cinematic Experience in Installation Art

Thesis (Ph.D.)--University of Washington, 2016-07

Creating Educational Immersive Environments Using a Computer Game Engine: Case Studies and Design Theory

This paper aims to crystallize recent research performed at the University of Worcester to investigate the feasibility of using the commercial game engine ‘Unreal Tournament 2004’ (UT2004) to produce ‘Educational Immersive Environments’ (EIEs) suitable for education and training. Our research has been supported by the UK Higher Education Academy. We discuss both practical and theoretical aspects of EIEs. The practical aspects include the production of EIEs to support high school physics education, the education of architects, and the learning of literacy by primary school children. This research is based on the development of our novel instructional medium, ‘UnrealPowerPoint’. Our fundamental guiding principles are that, first, pedagogy must inform technology, and second, that both teachers and pupils should be empowered to produce educational materials. Our work is informed by current educational theories such as constructivism, experiential learning and socio-cultural approaches as well as elements of instructional design and game principles.