Submitted by Maike Costa (maiksebas@gmail.com) on 2016-02-05T14:33:59Z No. of bitstreams: 1 arquivototal.pdf: 1146190 bytes, checksum: 0a43ed25bde19c7667c471fb5d1710ca (MD5) / Made available in DSpace on 2016-02-05T14:34:00Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1146190 bytes, checksum: 0a43ed25bde19c7667c471fb5d1710ca (MD5) Previous issue date: 2014-06-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The following research is centered on the construction of the female body in contemporary society, from the development of an ethnographic experience in a women’s fitness gym, located in a popular neighborhood in the city of João Pessoa, during the period from December 2012 to December 2013. The objectives of the study are to investigate how the body is built on the practices and discourses of a women’s fitness center, which control mechanisms, and profiles of femininity constituted in everyday fitness facility. Moreover, it is also a main interest of this study to examine the practices of an organized sociability, as to understand the socio anthropological construction of the body in the context of those health centers. The research involves middle-aged adult women attending a women's fitness club and the results are structured into main axes of analysis, namely: the morality of practices around the body, the represented tangible types and the not stated performance identified by body movements. The study revealed that the corporeality is constituted by a broad network of meanings that involves my own body as revealed the survey. Therefore, the femininity stands out and pervades the maternal, the marital, the media and the religious fields, such as the changes that happen during the middle-aged period; a dynamic of permanent construction between subjects and the social environment. / A pesquisa que se segue tem como eixo central a construção do corpo feminino na atual sociedade, a partir do desenvolvimento de uma experiência etnográfica em uma academia de ginástica só para mulheres, localizada em um bairro popular da cidade de João Pessoa, no período entre os meses de dezembro de 2012 a dezembro de 2013. Os objetivos do estudo são investigar de que maneira o corpo é construído nas práticas e nos discursos da academia de ginástica só para mulheres, quais os mecanismos de controle que influenciam tal construção, e os perfis de feminilidade constituídos no cotidiano da academia de ginástica. Além disso, também é de interesse deste estudo examinar as práticas de sociabilidade organizadas, para assim, compreender a construção sócio antropológica do corpo no contexto da academia. A pesquisa envolve mulheres adultas de meia-idade, frequentadoras de uma academia de ginástica feminina e os resultados estão estruturados em três amplos eixos de análise, quais sejam: as práticas de moralidade em torno do corpo, os tipos corpóreos representados e o plano do nãodito identificado pela performance dos movimentos corporais. O estudo revelou que a corporeidade está constituída a partir de uma ampla rede de significações. Destaca-se, portanto, uma feminilidade que permeia os campos maternal, midiático, religioso, matrimonial e as mudanças ocorridas no período da meia-idade feminina, numa dinâmica de construção permanente entre sujeitos e o meio social.

This thesis deals with the problem of empty nest. The theoretical part is devoted to the description of this phenomenon. The first chapter deals with the term of empty nest, with the time span when it occurs, and with the cause and consequences for all family members. In the second chapter the thesis discusses the difference between the present and the past of this syndrome, and the tendencies of young people to this problem. The third chapter brings actual suggestions for solution of the empty nest syndrome. The praktical part contains the results of dialogues, which were carried out with respondents over 40. years of age. The awareness of the empty nest syndrome among the respondents is good this is one of the results. Another one is the fact that the respondents have had personal experince with the syndrome or they know about it from their friends families. A very important result was that the respondents agreed with the start of a new service which would provide help to parents with the empty nest syndrome. The practical part also contains a project, focused on the implementation of the service to parents with this syndrome.

A evolução do conhecimento acerca das funções dos meniscos e do tratamento das suas lesões, impulsionada pelo advento da cirurgia artroscópica, consagrou e popularizou a meniscectomia por esta via, por ser uma técnica menos invasiva, com menor morbidade e menores custos hospitalares, a ponto de torná-la, atualmente, a cirurgia ortopédica mais frequentemente realizada no mundo. Embora a maior parte dos pacientes submetidos a esta intervenção cirúrgica tenha resultados favoráveis e resolução rápida dos sintomas, percebe-se que parte considerável dos pacientes, especialmente os mais idosos, não apresenta uma evolução póscirúrgica satisfatória, apresentando piora dos sintomas e, eventualmente, necessitando de nova cirurgia. Partindo da hipótese que em determinados pacientes a meniscectomia, em vez de tratar, precipita e acentua um desequilíbrio biomecânico do joelho, o autor realizou estudo observacional prospectivo não-controlado com 86 pacientes de ambos os gêneros, com idade superior a 50 anos (média de 60,2 ± 7,1 anos), submetidos à meniscectomia artroscópica para tratamento de lesão do menisco medial de natureza degenerativa, com o objetivo de determinar variáveis demográficas, clínicas, anatômicas e cirúrgicas relacionadas aos resultados desfavoráveis. As avaliações funcionais pré e pós-operatórias foram realizadas utilizandose o Índice do KOOS (Knee Injury and Osteoarthritis Outcome Score), aplicado a todos os pacientes antes da cirurgia e 60 meses depois. Após análise estatística dos resultados obtidos, o autor verificou que 10 fatores podem ser considerados preditivos das meniscectomias mediais artroscópicas neste grupo etário, sendo quatro fatores fortemente associados aos resultados desfavoráveis: lesão da raiz posterior do menisco medial, dor pré-operatória intensa, claudicação antes da cirurgia e tempo decorrido entre o início dos sintomas e a cirurgia; dois fatores foram considerados moderadamente associados aos resultados desfavoráveis: presença de edema de medula óssea na ressonância magnética (RM) préoperatória e duração da cirurgia; quatro fatores foram considerados associados de modo fraco aos resultados desfavoráveis: Índice de Massa Corporal (IMC) >= 30 kg/m2 , varismo do joelho, presença de cisto poplíteo na RM pré-operatória e extensão da ressecção do menisco medial / The evolution of knowledge concerning meniscal functions and the treatment of their injuries, boosted by the development of arthroscopic surgery, has established and popularized arthroscopic meniscectomy due to its less invasiveness, less post-operative morbidity and lower hospital costs, to the point it has become, nowadays, the most frequently performed orthopedic procedure in the world. Although the majority of patients undergoing this operation is quite pleased with the outcomes and with the prompt resolution of their symptoms, it is noticeable that a considerable amount of patients with meniscal injuries, mainly the older, does not have a satisfactory postoperative outcome, with worsening of symptoms after being operated on and occasionally requiring another surgery. Based on observations of his medical practice and on the assumption that meniscectomy, rather than treat, can hasten and accentuate a biomechanical imbalance of the knee in those patients, the author conducted an observational prospective uncontrolled study with 86 patients of both genders, aged over 50 years old (average 60.2 ± 7.1 years), who underwent arthroscopic meniscectomy for the treatment of degenerative medial meniscal lesions, aiming to determine demographic, anatomical, clinical and surgical variables related to poor outcomes. The functional pre and post-operative evaluations were performed using the KOOS index (Knee Injury and Osteoarthritis Outcome Score) applied to all patients before surgery and 60 months later. After statistical analysis of the results, the author found that 10 factors can be considered predictors of arthroscopic medial meniscectomy in this age group: four factors were strongly associated with unfavorable results - posterior root lesion of the medial meniscus, intense pre-operative pain, claudication before surgery and time elapsed between onset of symptoms and surgery; two factors were moderately associated with unfavorable results - bone marrow edema in preoperative magnetic resonance imaging (MRI) and surgery time length; four factors that were weakly associated with poor results - bone mass index (BMI) >= 30 kg/m2, varus knee, poplyteal cyst in pre-operative MRI and extension of meniscal ressection

Orientador: Mara Patrícia Traina Chacon Mikahil / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Física / Made available in DSpace on 2018-08-20T15:04:08Z (GMT). No. of bitstreams: 1 Antunes_Melissa_M.pdf: 1711920 bytes, checksum: 375abf471bd7eb2613a89fe1a745a1b7 (MD5) Previous issue date: 2012 / Resumo: A disfunção do sistema nervoso autonômico e o aumento de doenças crônico- degenerativas se manifestam junto ao processo de envelhecimento, levando à alterações da modulação autonômica cardíaca, e consequentemente da variabilidade de freqüência cardíaca. Com relação à resposta dos sistemas nervoso autônomo e cardiorrespiratório as respostas adaptativas são ainda menos esclarecedoras evidenciando-se os questionamentos quanto à carga ideal de treinamento para a aquisição de adaptações proporcionais aos protocolos de treinamento isolados. Adaptações autonômicas decorrentes do treinamento físico aeróbio já são bem estabelecidas pela literatura, como a ocorrência da bradicardia de repouso e melhorias nos índices de variabilidade da frequência cardíaca. Contudo, outros tipos de treinamento, como o treinamento concorrente, que associa o treinamento com pesos junto ao treinamento aeróbio, são questionados sobre as adaptações obtidas. Este trabalho objetivou avaliar as adaptações autonômicas em resposta ao treinamento concorrente em homens e mulheres entre 40 e 60 anos, com hábitos de vida não ativos. Os voluntários foram subdivididos em 4 grupos, sendo um de treinamento concorrente para homens (TCH), um de treinamento concorrente para mulheres (TCM), grupo sedentário homens (SH) e grupo sendentário mulheres (SM). Antes e após 16 semanas do protocolo experimental, os voluntários foram submetidos à avaliação dos componentes autonômicos cardiovasculares expressos pela variabilidade da frequência cardíaca (no domínio do tempo e da freqüência), obtidos e analisados por meio dos registros dos intervalos RR do eletrocardiograma coletados em repouso supino e em respiração espontânea. Para avaliação da aptidão cardiorrespiratória (VO2pico) foi realizado um protocolo de rampa, em esteira rolante, com incrementos crescentes de velocidade até a exaustão. A força muscular foi avaliada por meio do teste de uma repetição máxima (1-RM). Dentre os resultados obtidos, foi possível verificar que o programa de treinamento concorrente proposto parece não alterar e não interferir negativamente nas variáveis cardiovasculares de repouso. Para nenhum dos grupos estudados foi verificada redução da frequência cardíaca de repouso, da pressão arterial, nem alterações nas variáveis autonômicas cardíacas. Além disso, na avaliação cardiorrespiratória, o TCH e o TCM apresentaram melhora significativa para o VO2pico (TCH = pré: 31,63±5,37 e pós: 35,78±5,23ml/kg/min; TCM = pré 26,18±3,00 e pós: 28,41±2,34). Para o grupo TCM ganhos semelhantes foram observados quando o percentual de modificação foi calculado. Já o componente da força muscular houve melhora significativa para o grupo TCH nos três exercícios testados (supino pré: 68,88±5,79 e pós: 86,13±9,78 kg; leg press pré: 190,63±28,02 e pós: 315,25±67,74 kg; rosca direta pré: 36,75±3,06 e pós: 46,50±4,69 kg) e para o TCM em apenas dois exercícios testados (supino pré: 39,87±4,58 e pós: 46,75±6,62 kg; rosca direta pré: 23,50±3,81 e pós: 26,00±2,13 kg). Desta forma, o treinamento concorrente parece ser uma boa alternativa como metodologia de treinamento e ganhos associados nas várias capacidades físicas estudadas, porém não causou alterações na função cardiovascular. Investigações adicionais são necessárias para estabelecer o efeito dos treinamentos com pesos e concorrente nas variáveis cardiovasculares de repouso / Abstract: The autonomic nervous system dysfunction and the increase in chronic degenerative diseases are manifested by the aging process, leading to changes of the autonomic modulation cardiac, and therefore the heart rate variability. Regarding the response of the autonomic nervous system and cardiorespiratory adaptive responses are even less enlightening evidencing the questions regarding the optimal training load for the acquisition of proportional adjustments to the training protocols alone. Autonomic adjustments resulting from physical training are already well established in the literature, such as the occurrence of bradycardia at rest and improvement in indices of heart rate variability. However, other types of training, such as concurrent training, combining weight training with aerobic training, are asked about the changes obtained. This study aimed to evaluate the autonomic adaptations in response to concurrent training in men and women between 40 and 60 with non-active lifestyle. The volunteers were divided into four groups, one with concurrent training for men (TCH), one with concurrent training for women (TCM), group sedentary men (SH) and group sedentary women (SM). Before and after 16 weeks of the experimental protocol, subjects underwent evaluation of cardiovascular autonomic components expressed by heart rate variability (time domain and frequency), obtained and analyzed through the records of the electrocardiogram RR intervals collected at rest supine and breathing spontaneously. To evaluate the cardiorespiratory fitness (VO2peak) was performed a ramp protocol on a treadmill with increasing speed increments until exhaustion. Muscle strength was assessed by testing one repetition maximum (1-RM). Among the results, it was verified that the proposed concurrent training program do not seem to change and do not adversely affect the cardiovascular variables at rest. None of the groups was verified reduction in resting heart rate, blood pressure, or changes in autonomic variables. Moreover, in cardiorespiratory evaluation, TCH and TCM showed significant improvement for VO2peak (TCH = pre: 31,63 ± 5,37 and after: 35,78 ± 5,23ml/kg/min; TCM pré 26,18 = ± 3,00 and after: 28,41 ± 2,34ml/kg/min). For the group TCM similar gains were observed when the percentage change was calculated. Since the component of muscle strength significantly improved for the TCH arm in the three exercises tested (supine before: 68,88 ± 5,79 and after: 86,13 ± 9,78 kg, leg press before: 190,63 ± 2,28 and after: 315,25 ± 67,74kg; before arm curl : 36,75 ± 3,6 and after: 46,50 ± 4,69kg) and the TCM in just two exercise tested (supine before: 39,87 ± 4,58 and after: 46,75 ± 6,62 kg); before arm curl: 23,50 ±3,81 and after: 26,00 ± 2,13 kg .) Thus, concurrent training seems to be a good alternative training methodology and gains in the various physical capabilities assessed, but did not cause changes in cardiovascular function. Further investigations are needed to establish the effect of weight training and competing in cardiovascular variables at rest / Mestrado / Atividade Fisica Adaptada / Mestre em Educação Física

Emotional Intelligence (EI) has been relatively unstudied after young adulthood. Yet there are a variety of reasons to expect that EI may be different at mid life than in young adulthood. Normative life experiences may lead to increases in EI, and as the array of different environments and experiences increases with age, one might expect greater individual differences in EI. Similarly, if EI is located somewhere at the intersection of personality and intelligence, as some have speculated, it may follow a course of structural differentiation similar to cognitive abilities. EI may be more closely linked to social variables such as loneliness and friendships at mid life, and its relation to established personality and ability factors such as the Big Five (Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness) and fluid and crystallized abilities may also vary with age. These hypotheses were investigated in samples of 292 young adults and 246 mid life adults, using the Schutte Self Report Emotional Intelligence Inventory, the NEO-Five Factor Personality Inventory, markers of crystallized and fluid ability from Horn's Crystallized/Fluid Sampler, and a variety of other measures. Mid life adults scored higher on overall EI scores, but evidenced no greater range of individual differences than did young adults. A series of exploratory and confirmatory factor analyses revealed no greater differentiation in the mid life sample either among dimensions of EI or between EI and personality and intelligence variables. Finally, EI appeared equally predictive of social variables in each sample. Results are discussed from the perspective of lifespan and aging literature on emotion, personality, and social functioning. Qualifications for the inference of age-related change in cross sectional designs are considered, along with advantages and disadvantages of factor-analytic and covariance structure modeling methodology. Implications, particularly for psychotherapy with each age group, are discussed.

Les relations entre les fonctions cognitives (FCog), les variables d’effort maximal et les facteurs de risques cardiovasculaires ont été peu étudiées chez des sujets obèses. Les objectifs de notre étude étaient: 1) de comparer les FCog chez des sujets obèses ayant une aptitude aérobie plus ou moins grande (HF-OB et LF-OB) aux FCog de sujets sains appariés par l’âge (SSAA) et 2) de trouver des prédicteurs indépendants des FCog parmi les variables d’effort et les facteurs de risques cardiovasculaires mesurés. Quarante-neuf sujets obèses et 14 SSAA ont été recrutés. Les participants ont effectué un test d’effort cardiopulmonaire incrémental maximal (avec mesure d’échanges gazeux et bioimpédance cardiographique) sur ergogycle. Les FCog ont été mesurées à l’aide d’une batterie de tests neuropsychologiques. Les sujets obèses étaient divisés en deux groupes selon que leur V ̇O2pic/masse maigre était au-dessus ou en-dessous de la médiane du V ̇O2pic /masse maigre du groupe (HF-OB ou LF-OB, respectivement). La flexibilité, la vitesse de traitement et la mémoire à court-terme n’étaient pas statistiquement différentes entre les HF-OB et les SSAA et ces deux groupes démontraient de meilleures performances dans ces domaines que les LF-OB. Les SSAA avaient de meilleures performances aux tests d’inhibition que les LF-OB et les HF-OB. En résumé, une plus grande aptitude aérobie chez des sujets obèses était associée à des FCog préservées dans tous les domaines évalués, sauf l’inhibition. / The relationship between cognitive function (CF), peak exercise parameters and cardiovascular risk factors has been poorly studied in obese subjects (OB). The goals of this study were: 1) to compare CF in higher-fitness and lower-fitness OB (HF-OB and LF-OB) vs. age-matched healthy controls (AMHC) according to their aerobic fitness level (V ̇O2peak) and 2) to find independent predictors of CF within the measured cardiovascular risk factors and peak exercise parameters. Forty nine OB and 14 AMHC were recruited. Maximal cardiopulmonary exercise test (with gas exchange analysis and impedance cardiography) was performed during an incremental ergocycle test. As well, CF was measured with a neuropsychological test battery. Obese subjects were divided into 2 groups according to the median V ̇O2peak divided by lean body mass (V ̇O2peak/LBM): the obese lower-fitness (LF-OB, n=22) and the obese higher-fitness (HF-OB, n=27). Cognitive flexibility, processing speed and short-term memory were not statistically different in HF-OB vs. AMHC and those two groups showed better performances in these domains when compared to the LF-OB group. The AMHC group performed better in tests measuring inhibition compared to the LF-OB and HF-OB groups. In summary, higher aerobic fitness in obese subjects was associated with preserved CF in every evaluated domains except for inhibition.

Indiana University-Purdue University Indianapolis (IUPUI) / Menopausal symptoms, primarily hot flashes, are a pressing clinical problem for both naturally menopausal women and breast and ovarian cancer patients, with a high societal and personal cost. Hot flashes are poorly understood, and animal modeling has been scarce, which has substantially hindered the development of non-hormonal treatments. An emerging factor in the hot flash experience is the role of anxiety and stress-related stimuli, which have repeatedly been shown to influence the bother, frequency, and severity of hot flashes. Causal relationships are difficult to determine in a clinical setting, and the use of animal models offers the ability to elucidate causality and mechanisms. The first part of this work details the development and validation of novel animal models of hot flashes using clinically relevant triggers (i.e., compounds or stimuli that cause hot flashes in clinical settings), which also increase anxiety symptoms. These studies revealed that these triggers elicited strong (7-9 °C) and rapid hot flash-associated increases in tail skin temperature in rats. In a surgical ovariectomy rat model of menopause, which typically exhibit anxiety-like behavior, hot flash provocation revealed an ovariectomy-dependent vulnerability, which was attenuated by estrogen replacement in tested models. An examination of the neural circuitry in response to the most robust flushing compound revealed increased cellular activity in key thermoregulatory and emotionally relevant areas. The orexin neuropeptide system was hyperactive and presented as a novel target; pretreatment with selective and dual orexin receptor antagonists significantly diminished or eliminated, respectively, the response to a hot flash provocation in ovariectomized rats. The insertion/deletion polymorphism of the serotonin transporter has been linked to increased anxiety-associated traits in humans, and subsequent studies prolonged hot flashes in SERT+/- rats, which also caused hot flashes in highly symptomatic women. These studies indicate the orexin system may be a novel non-hormonal treatment target, and future studies will determine the therapeutic importance of orexin receptor antagonists for menopausal symptoms.

Cognitive failures (CF) refers to the experience of daily attentional lapses or workingmemory mishaps; for example, reading something and instantly forgetting what you haveread, or experiencing missing out on obvious information from street signs. Relationsbetween CF and psychological stress have been found, where higher levels of stress indicatea higher risk of experiencing CF, and the other way around. Psychological stress is proven tobe moderated by physical activity. However, there are scarce findings on the directrelationship between physical activity and CF. This thesis investigates by a cross-sectionalobservational design if there is a relationship between cognitive failures and physical activityin the middle-aged population. All data were collected by a web-based survey with thequestionnaires CFQ, IPAQ and PSS-10 followed by the short task Digit Span. The sampleconsisted of 78 participants between the ages of 50-65 (M = 56). A two-stage hierarchicallinear regression was performed. The results showed no association between CF and physicalactivity, however CF was associated with stress and sex. The results are confirming previousfindings in terms of the relationship between CF and stress, as well as the small, yetsignificant, sex difference where women tend to report higher levels of stress and higherlevels of CF. Further research is of need, to investigate the direct interventional effectphysical activity could have on CF in the general population. / “Cognitive failures” (CF) syftar på de dagliga hjärnsläpp man upplever relaterade tilluppmärksamhet, arbetsminne och perception; till exempel att läsa något och omedelbartglömma vad du har läst, eller att missa att notera uppenbara gatuskyltar. Samband mellan CFoch psykologisk stress har hittats, där högre nivåer av stress indikerar högre risk för CF, ochvice versa. Psykologisk stress har visats minskas av fysisk aktivitet. Det finns dock få fyndom det direkta sambandet mellan fysisk aktivitet och CF. Den här uppsatsen undersökergenom en tvärsnittsdesign om det finns ett samband mellan CF och fysisk aktivitet i dengenerella medelålders befolkningen. Studien genomfördes genom en webbaseradundersökning med enkäterna CFQ, IPAQ och PSS-10 följt av en kort objektiv övning.Urvalet bestod av 78 deltagare mellan 50-65 år (M = 56). En tvåstegs-hierarkisk linjärregression genomfördes. Resultaten visade inget signifikant samband mellan CF och fysiskaktivitet, dock fanns samband mellan CF och stress samt kön. Denna studie bekräftar tidigarefynd både gällande sambandet mellan CF och stress såväl som en mindre, men signifikant,könsskillnad, där kvinnor tenderar att rapportera högre nivåer av stress samt högre nivåer avCF. Framtida studier i ämnet behövs för att undersöka den direkta interventionella effektenfysisk aktivitet kan ha på CF i den generella befolkningen.

Unemployment is a growing concern in todays modern society for both young and middle aged people. Previous studies have discussed the correlation between health and unemployment and multiple factors decide its long term effects. The intention of this study is to compare how young and middle aged people are effected by unemployment. The purpose of the comparative method is to clarify the extent of the different age groups social problems. This literary study is based on literary research that has been analyzed and summarized in a telling, reasonable and valued fashion. I have chosen Durkheims theory of society. I have used the different theories and empiricism to find a correlation and answer the intent of the paper. The result show that both young and middle aged people experience negative effects of unemployment. Young people experience both psychological and somatic effects through reduced wellbeing, increased risk of anxiety, dangerous behavior, substance abuse and premature death. Older people are effected by increased risk of psychological issues and substance abuse that can lead to somatic health problems. Support that strengthen the individual financially and socially seems to generate the best result to reduce negative effects on the individual. When comparing unemployment in young and middle aged people, it seems that socio-economical background and the possibility of social support are the most important factors. Age is a poor indicator to decide how unemployment affect the individual psychologically and somatically. / Arbetslöshet är idag ett växande problem i västvärlden för såväl unga sompersoner i medelåldern. Tidigare studier har diskuterat orsakssambandet mellanhälsa och arbetslöshet och flera faktorer ligger till grund för hur gruppenarbetslösa påverkas av sin situation. Studiens syfte är att jämföra hur ungasrespektive personer i medelålderns hälsa påverkas av arbetslöshet samt förståvilka i dessa ålderskategorier som i större uträckning drabbas av arbetslöshet.Den komparativa metoden har som syfte att analysera, beskriva och tydliggöraomfattningen av det sociala problemet för olika åldersgrupper genomjämförelser. Forskningsöversikten bygger på forskningslitteratur somanalyserats och sammanfattats i en berättande, resonerande och värderande stil.Resultatet har analyserats utifrån Durkheims samhällsteori. Resultaten somframkommit pekar på att såväl unga som personer i medelålder påverkasnegativt av arbetslöshet. Unga personer påverkas både psykiskt och fysisktgenom ökad risk för ångest, minskad känsla av välbefinnande, ökatriskbeteende, ökad risk för missbruk och förtidig död. Äldre personer påverkasgenom ökad risk för psykiska besvär, högt blodtryck och ökad risk förmissbruksproblematik. Resurser som stärker arbetslösa ekonomiskt samtsocialt stödjande insatser verkar ge bäst resultat för at minska negativ påverkanför individen. I jämförelsen av hur unga och personer i medelåldern påverkasav arbetslösheten framkom att det är socioekonomisk bakgrund och möjlighettill socialt stöd som är avgörande. Ålder är en svag indikator för att avgöra hurarbetslöshet påverkar individen psykiskt och fysiskt.

OBJECTIVES: Acoustic stapedius reflex threshold (ART) tests are included in a standard clinical acoustic immittance test battery as an objective cross-check with behavioral results and to help identify site of lesion. In traditional clinical test batteries, middle-ear admittance of a 226 Hz probe is estimated using ear-canal measurements in the presence of a reflex-activating stimulus. In the wideband (WB) acoustic immittance ART test used in this study, the pure-tone probe is replaced by a WB probe stimulus and changes in absorbed power are estimated using ear-canal measurements in the presence of the activator. The ART is defined as the lowest level at which a criterion change in admittance (clinical) or absorbed power (WB) is observed in the presence of the activator. In the present study, ARTs were obtained in adults with normal hearing using the clinical, manual method and with a new WB automated adaptive threshold detection method. It was hypothesized that the WB test would result in lower ARTs than the clinical test because reflex-related changes in power absorbance could be observed across multiple frequency bands in the WB test compared with a single frequency in the traditional test. DESIGN: Data were collected in a prospective research design. ARTs were obtained in ipsilateral and contralateral conditions using 500, 1000, 2000 Hz, and broadband noise (BBN) activators on a clinical system and on an experimental WB system. The bandwidth of the BBN activator was 125 to 4000 Hz on the clinical system and 200 to 8000 Hz on the wideband system. ARTs were estimated at both tympanometric peak pressure (TPP) and ambient pressure on the WB system. Data were collected in both ears of 39 adults (21 males) of mean age 47.7 years (range 23-72 years). Differences in ARTs among the three threshold estimation methods (clinical, WB at TPP, WB at ambient) were examined using the general linear model repeated measures test in SPSS. Post-hoc pairwise comparisons were completed with Bonferroni correction for multiple comparisons. Statistical significance was defined as p < 0.05 for all analyses. RESULTS: ARTs obtained on the WB system at TPP and ambient pressure were significantly lower than obtained on the clinical system. ARTs obtained on the WB system at TPP were significantly higher than at ambient pressure in the 500 and 2000 Hz ipsilateral conditions. CONCLUSIONS: WB automated adaptive ARTs in normal-hearing adults were lower than for clinical methods when measured at TPP and ambient pressure. Lower presentation levels required to estimate ART in the WB test may be more tolerable to patients. Patients with ARTs that are not present at the maximum level of a traditional reflex test may have present ARTs with a WB ART test, which may reduce the need to refer for additional testing for possible retrocochlear involvement. Automation of the test may allow clinicians more time to attend to the other requisite tasks of a hearing evaluation and make the system useful for telehealth applications.