Made available in DSpace on 2014-06-11T19:33:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-08-14Bitstream added on 2014-06-13T18:44:48Z : No. of bitstreams: 1 santos_mjp_dr_araca.pdf: 438923 bytes, checksum: 1893aba26b44643aa75f1f27e03945d3 (MD5) / O objetivo desta pesquisa foi analisar os níveis de atividade da alfa-amilase, de cortisol salivar e avaliar o comportamento durante o tratamento odontológico, de pacientes portadores de retardo do desenvolvimento neuropsicomotor (rdnpm), participantes da dinâmica de arte, comparando seus valores segundo os procedimentos odontológicos realizados (cirurgia, dentística e prevenção), o gênero, a idade, estímulo artístico, odontopediatria e comportamento. Participaram 71 crianças, sendo 52 portadoras de rdnpm assistidos no Centro de Assistência Odontológica a Portadores de Necessidades Especiais (CAOE), e 19 crianças neurologicamente saudáveis, assistidas na clínica de Odontopediatria, da Faculdade de Odontologia de Araçatuba-FOA-UNESP; todos na faixa etária de 6 a 12 anos e de ambos os sexos. Os pacientes selecionados foram divididos em grupos, de acordo com a necessidade de tratamento odontológico (cirurgia, dentística, e prevenção). Esses mesmos pacientes foram analisados segundo o gênero (masculino e feminino) e a idade, agrupados em dois blocos, um de 6 a 9 anos e outro de 10 a 12 anos. Os níveis de alfa-amilase e cortisol salivar foram avaliados em 3 situações: inicialmente os pacientes foram calibrados por meio de análise de seus níveis habituais de cortisol e alfa amilase, através da coleta de saliva, no período da manhã, na situação SEST (sem estímulos odontológicos ou artísticos). Os mesmos pacientes foram atendidos nos consultórios, na situação TO, onde receberam tratamentos odontológicos e as coletas de saliva foram realizadas após as assistências, para se analisar os níveis de cortisol e alfa-amilase, sem a participação deles nas atividades do projeto da arte. Na situação EATO, os pacientes participaram das atividades... / The purpose of this study was to analyze the levels of alpha-amylase and salivary cortisol and to assess the behavior during dental treatment of patients with neuro-psychomotor development retardation (NPDR), who received art´s dynamics, comparing their values according to the accomplished dental procedures (surgery, dentistry and prevention), gender, age, artistic stimulus, pediatric dentistry and behavior. The study included 71 children aging from six to twelve years old, from both genders: 52 with NPDR assisted at the Dental Care Center for Patients with Special Needs (CAOE - Centro de Assistência Odontológica ao Excepcional, Araçatuba, São Paulo, Brazil), and 19 neurologically healthy children, assisted at the Pediatric Dentistry Clinic, both from Araçatuba School of Dentistry, UNESP. These patients were divided into groups, according to the dental treatment necessity (surgery group, dentistry group and preventive group), and analyzed according to gender (male or female) and age (grouped into two sub-groups: from 6 to 9 years old and from 10 to 12 years old). Alpha-amylase and salivary cortisol levels were evaluated in three situations. Initially, the patients were calibrated through the normal cortisol and alpha-amylase levels, in the morning, in the situation called WDAS (without dental treatment and without artistic stimulus). The same patients were attended at the Clinics, in the situation called DT (dental treatment), where they received dental treatments and, following, saliva collection, in order to analyze the levels of cortisol and alpha-amylase, without receiving activities from the arts project. In the situation called DTAS (with dental treatment and artistic stimulus), previously to the dental treatments, patients took part in art’s dynamics activities, and saliva collection was accomplished... (Complete abstract click electronic access below)

Many Supported Residential Facility (SRF) residents express a desire to live in more independent accommodation, however relatively few achieve this. Two of the issues preventing this are a lack of housing alternatives and support. This study examines the relevant literature and legislation, to gather documentary evidence and demographic data about South Australian SRFs and their residents. This is augmented by interviews with five key informants, to discover what other factors inhibit SRF residents from moving on to alternative accommodation. Findings indicate that recovery and rehabilitation are inhibited in SRFs and that current standards are barely sustaining people. Data suggests that legislation has a negative impact on residents and service delivery. This research recommends that the South Australian Government take up its legislative and ministerial responsibility to SRFs and their residents as a matter of urgency, especially in relation to fire safety. Secondly, that there is a review of The Legislation to incorporate citizenship rights and individualised care. And lastly, that in the interim, funding tied to service agreements is made available to SRFs, so that they become a place to recover and not the end of the line.

Stroke recovery is complex and poorly understood. As a legacy of pervasive pessimism in the face of limited treatment, it is conceptualised and researched from biomedical and psychosocial perspectives that address impairment, problems of performance, quality of life, burden and disruption. Little stroke research is conducted once professional input has ceased, and yet considerable change occurs after this period with evidence that post-stroke wellbeing is independent of impairment and function -- many people do well in the face of poor prognoses, while others remain miserable despite 'good recovery'. Current advances in acute stroke management are generating increasing optimism, but lack of understanding about individuals' post-stroke experiences and long-term outcomes continues. While it is recognised that the impact of stroke on the lives of survivors and families is profound, rehabilitation focuses on recovery as task achievement and measured functional outcomes. For many survivors and their families 'recovery' is contested, ambiguous and extended. For some, it becomes a lifetime marathon because stroke represents an assault, not only to the body, but to the self and the lifeworld -- it is a 'life' event. This narrative inquiry into life after stroke explores recovery as a process taking place over time and conceptualised as a life transition. The work is grounded in narrative theory with the concept of transition providing the lens and focus for the research, its processes and analyses. Individuals' stories remain intact enabling evocation of diverse stroke meanings and the mapping of individual experience. Bringing these whole stories into conversation with each other elucidates post-stroke transition which is interpreted in light of theories of response to traumatic loss and informed by narrative theory. The thesis presents stories of trauma, loss and grief, situated in past lives and selves where assumptions about selves and future lives are shattered. The future makes no sense in terms of participants' past and present lives; life plots are lost and stroke therefore represents 'lost futures'. Stories of moving on to new lives are focused on being and doing in the present and have an expectant view of life. Although mindful of past lives and enduring losses, survivors actively engage in processes to reconfigure their lives with hope for a meaningful future. Transition is interpreted as 'reconfiguring the future'. The life tasks of reconfiguration are embedded in dynamic models of traumatic loss where grief is conceptualised as recursive movement between loss and meaning reconstruction evident in narratives that slowly move towards wellbeing. Despite broad recognition that loss and grief are part of the stroke experience, they are rarely addressed; where attention is paid it is likely embedded in explanatory models of staged response that oversimplify human experience. This thesis offers a new framework. It represents a fresh interpretation that highlights the ongoing traumatic impact of stroke. The post-stroke journeys of survivors and families are affected by individual circumstances and meanings. Although their stories are permeated with loss, many people move forward towards lives worth living. This interpretation suggests ways of reconfiguring lives in the face of devastation and ongoing traumatic loss. The work identifies a complex interaction of individual, emotional and social factors contributing to transitions to wellbeing following stroke and thus adds to a prospective vision of post-stroke life that can inform rehabilitation, discharge and stroke support strategies. Post-stroke transition will be enhanced when we use narrative framing and understanding to guide rehabilitative practice that uses meaning-centred models to prepare survivors and their families for a return to the lifeworld. / Thesis (PhD)--University of South Australia, 2009

Stroke recovery is complex and poorly understood. As a legacy of pervasive pessimism in the face of limited treatment, it is conceptualised and researched from biomedical and psychosocial perspectives that address impairment, problems of performance, quality of life, burden and disruption. Little stroke research is conducted once professional input has ceased, and yet considerable change occurs after this period with evidence that post-stroke wellbeing is independent of impairment and function -- many people do well in the face of poor prognoses, while others remain miserable despite 'good recovery'. Current advances in acute stroke management are generating increasing optimism, but lack of understanding about individuals' post-stroke experiences and long-term outcomes continues. While it is recognised that the impact of stroke on the lives of survivors and families is profound, rehabilitation focuses on recovery as task achievement and measured functional outcomes. For many survivors and their families 'recovery' is contested, ambiguous and extended. For some, it becomes a lifetime marathon because stroke represents an assault, not only to the body, but to the self and the lifeworld -- it is a 'life' event. This narrative inquiry into life after stroke explores recovery as a process taking place over time and conceptualised as a life transition. The work is grounded in narrative theory with the concept of transition providing the lens and focus for the research, its processes and analyses. Individuals' stories remain intact enabling evocation of diverse stroke meanings and the mapping of individual experience. Bringing these whole stories into conversation with each other elucidates post-stroke transition which is interpreted in light of theories of response to traumatic loss and informed by narrative theory. The thesis presents stories of trauma, loss and grief, situated in past lives and selves where assumptions about selves and future lives are shattered. The future makes no sense in terms of participants' past and present lives; life plots are lost and stroke therefore represents 'lost futures'. Stories of moving on to new lives are focused on being and doing in the present and have an expectant view of life. Although mindful of past lives and enduring losses, survivors actively engage in processes to reconfigure their lives with hope for a meaningful future. Transition is interpreted as 'reconfiguring the future'. The life tasks of reconfiguration are embedded in dynamic models of traumatic loss where grief is conceptualised as recursive movement between loss and meaning reconstruction evident in narratives that slowly move towards wellbeing. Despite broad recognition that loss and grief are part of the stroke experience, they are rarely addressed; where attention is paid it is likely embedded in explanatory models of staged response that oversimplify human experience. This thesis offers a new framework. It represents a fresh interpretation that highlights the ongoing traumatic impact of stroke. The post-stroke journeys of survivors and families are affected by individual circumstances and meanings. Although their stories are permeated with loss, many people move forward towards lives worth living. This interpretation suggests ways of reconfiguring lives in the face of devastation and ongoing traumatic loss. The work identifies a complex interaction of individual, emotional and social factors contributing to transitions to wellbeing following stroke and thus adds to a prospective vision of post-stroke life that can inform rehabilitation, discharge and stroke support strategies. Post-stroke transition will be enhanced when we use narrative framing and understanding to guide rehabilitative practice that uses meaning-centred models to prepare survivors and their families for a return to the lifeworld. / Thesis (PhD)--University of South Australia, 2009

Stroke recovery is complex and poorly understood. As a legacy of pervasive pessimism in the face of limited treatment, it is conceptualised and researched from biomedical and psychosocial perspectives that address impairment, problems of performance, quality of life, burden and disruption. Little stroke research is conducted once professional input has ceased, and yet considerable change occurs after this period with evidence that post-stroke wellbeing is independent of impairment and function -- many people do well in the face of poor prognoses, while others remain miserable despite 'good recovery'. Current advances in acute stroke management are generating increasing optimism, but lack of understanding about individuals' post-stroke experiences and long-term outcomes continues. While it is recognised that the impact of stroke on the lives of survivors and families is profound, rehabilitation focuses on recovery as task achievement and measured functional outcomes. For many survivors and their families 'recovery' is contested, ambiguous and extended. For some, it becomes a lifetime marathon because stroke represents an assault, not only to the body, but to the self and the lifeworld -- it is a 'life' event. This narrative inquiry into life after stroke explores recovery as a process taking place over time and conceptualised as a life transition. The work is grounded in narrative theory with the concept of transition providing the lens and focus for the research, its processes and analyses. Individuals' stories remain intact enabling evocation of diverse stroke meanings and the mapping of individual experience. Bringing these whole stories into conversation with each other elucidates post-stroke transition which is interpreted in light of theories of response to traumatic loss and informed by narrative theory. The thesis presents stories of trauma, loss and grief, situated in past lives and selves where assumptions about selves and future lives are shattered. The future makes no sense in terms of participants' past and present lives; life plots are lost and stroke therefore represents 'lost futures'. Stories of moving on to new lives are focused on being and doing in the present and have an expectant view of life. Although mindful of past lives and enduring losses, survivors actively engage in processes to reconfigure their lives with hope for a meaningful future. Transition is interpreted as 'reconfiguring the future'. The life tasks of reconfiguration are embedded in dynamic models of traumatic loss where grief is conceptualised as recursive movement between loss and meaning reconstruction evident in narratives that slowly move towards wellbeing. Despite broad recognition that loss and grief are part of the stroke experience, they are rarely addressed; where attention is paid it is likely embedded in explanatory models of staged response that oversimplify human experience. This thesis offers a new framework. It represents a fresh interpretation that highlights the ongoing traumatic impact of stroke. The post-stroke journeys of survivors and families are affected by individual circumstances and meanings. Although their stories are permeated with loss, many people move forward towards lives worth living. This interpretation suggests ways of reconfiguring lives in the face of devastation and ongoing traumatic loss. The work identifies a complex interaction of individual, emotional and social factors contributing to transitions to wellbeing following stroke and thus adds to a prospective vision of post-stroke life that can inform rehabilitation, discharge and stroke support strategies. Post-stroke transition will be enhanced when we use narrative framing and understanding to guide rehabilitative practice that uses meaning-centred models to prepare survivors and their families for a return to the lifeworld. / Thesis (PhD)--University of South Australia, 2009