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No description available.

The aim of this study was to improve current counselling services at the Auckland Spinal Unit. This purpose was achieved by co-researching the topic with people who have extensive experience of living in the community with a spinal cord injury to reveal what they believe was helpful, or believe would have been helpful, in terms of the counselling, when they were newly injured. Listening to the stories of the research participants, through supervision of my own practice, doing a literature review and writing a journal became sources that provided rich knowledges to reflect on my current counselling practice. A qualitative study was conducted using aspects of action research, feminist research and post-structuralist methods. In November 2005, an information pack was mailed to the sixteen patients who had been discharged from the Auckland Spinal Unit between June 2002 and June 2004, who were under the age of sixty -five and lived in the Auckland area, inviting them to participate in this research. Seven people agreed and were available to participate. I interviewed these seven participants, using unstructured interviews. All the interviews were audio-taped and then transcribed verbatim. These verbatim transcripts were then sent back to the participants for any additions/deletions/alterations they chose to make. To initiate the reflecting process, I then went through all the interviews and identified common themes. I understand that if the research participants had been involved in this process, other themes might have emerged for them. The themes identified were loss and grief as a result of a spinal cord injury, sexuality, family (whanau) involvement and how counselling services should be positioned in a setting such as the Auckland Spinal Unit. These themes formed the iii foci of the chapters, with an additional chapter on weaving cultural threads into counselling. The main findings of the study centre on the very important role of counselling at the Auckland Spinal Unit. In particular, the study highlighted the importance of counselling as a place for conversations that make room for multiple positionings and multiple versions of events, a space that respects a patient's hopes, beliefs and dreams for his/her life (which often does not include wheelchairs, catheters and caregivers) but that also supports the patient to make meaning of living life with a spinal cord injury. The study also identified the importance of sexuality counselling. Not including sexuality as a topic in the rehabilitation services provided perpetuates dominant discourses that a person with a spinal cord injury does not want sexual intimacy or cannot be sexually intimate and cannot have children. Family (whanau) involvement in and family's becoming part of the rehabilitation team was very important to most participants. This study looks at how this involvement can be achieved and explores some of the structures currently in place at the Auckland Spinal Unit to facilitate this involvement. Participants in this study expressed a desire for counselling to be highly accessible to both themselves and their families (whanau). They would prefer the counsellors to get to know the patients in their own environment first (in their rooms), so that the patients are positioned to have agency to make choices about how they would like to use the available counselling services. The study concludes with my personal journey of working as a counsellor at the Auckland Spinal Unit and how this research has shaped and fine-tuned my practice.

Resumo Acidentes e violências são responsáveis por elevadas taxas de mortalidade e morbidade causadas pelas lesões deles decorrentes. Entre essas lesões, os traumas da coluna vertebral, especificamente, e aquelas com comprometimento da medula espinal apresentam-se como um grande problema de Saúde Pública, uma vez que a maior parte dos lesados é composta de jovens e no auge da sua produtividade, tanto profissional quanto pessoalmente, além de as lesões serem responsáveis por seqüelas, geralmente, irreversíveis. Raros foram os estudos encontrados, que demonstrem a distribuição epidemiológica dessas lesões no Brasil. O trabalho objetiva conhecer o perfil das internações por traumas de coluna segundo características dos pacientes, lesões, causas externas que as produziram, bem como aspectos relativos às suas internações. O material de trabalho refere-se às internações SUS (dados do Banco do SIH/SUS) para traumas de coluna (S12, S14, S17, S19, S22, S24, S28, S29, S32, S34, S38, S39, T02.0, T02.1, T04.1, T04.2, T09.3 e T09.4 da CID-10*) As internações por traumas de coluna correspondem a cerca de 0,2% do total de internações no país e cerca de 2,7% do total de internações por lesões decorrentes de causas externas. Essa proporção, bem como a taxa de internação por traumas de coluna, foi crescente no período analisado na pesquisa. O grupo do sexo masculino, na faixa de 20 a 29 anos, é o mais comumente afetado, embora, em casos específicos, como o das internações decorrentes de quedas, observe-se aumento da proporção de idosos e também da população feminina. O nível lombo-sacral agrega cerca de 60% do total de internações por trauma de coluna, seguido pelo nível cervical (cerca de 28%). Os traumas de nível cervical apresentam a maior proporção de traumas com comprometimento medular, com cerca de 45,8% do total de traumas no ano de 2005. Segundo o tipo de causa externa que ocasionou a lesão, cerca de 40% das internações são decorrentes de lesões causadas por quedas. Os acidentes de trânsito correspondem a cerca de 30% e as tentativas de homicídio, 7% do total de internações por traumas de coluna. O tempo médio de permanência dos pacientes vítimas de traumas de coluna variou de 8,2 a 9,2 dias nos anos analisados, com significativas diferenças segundo o nível da lesão e comprometimento medular. Quando comparados aos custos das internações por causas externas, de modo geral, as internações por trauma de coluna apresentaram valores maiores, variando também segundo o grau de comprometimento medular e nível da lesão. A análise epidemiológica das internações por traumas de coluna esclareceu aspectos interessantes referentes às principais causas externas envolvidas, qualidade das informações disponíveis, custos e gastos para o sistema de saúde, bem como um panorama do perfil das vítimas, permitindo o planejamento de ações específicas para promoção da saúde e cuidados dessa população. * Classificação Internacional de doenças 10ª Revisão, 1995 / Abstract Accidents and violence are responsible for high taxes of mortality and morbidity by the consequences of trauma. In this injuries the vertebral column traumas, specifically and with spinal injury are an important problem for Public Health, because the most of the victims are young persons in the top of her productive life. The most of injuries are responsible for irreversible consequences. Just a little number of epidemiologycals studies where found in Brazil. This research objective is describe the traumas´s hospitalizations by victims characteristics and external causes what was the basic cause for the hospitalization. The material reference are SUS hospitalizations (SIH/SUS) for column traumas (S12, S14, S17, S19, S22, S24, S28, S29, S32, S34, S38, S39, T02.0, T02.1, T04.1, T04.2, T09.3 e T09.4 da CID-10*). The column traumas are almost 0,2% by the total of Brazil´s hospitalizations and 2,7% by the injuries hospitalizations by external causes. This number was in elevation between the years f this research. The male group by 20-29 years old was most commun affected. The hospitalizations by consequence off falls show an elevation in elders group and female group. In the sacral level there is 60% by the total of hospitalizations follow by cervical level (28%). In the cervical level we can see the most causes of spinal injury with almost 45,8% by the total. Studying the external causes almost 40% by the hospitalizations in all years, are by traumas in consequence by falls. The traffic accidents are 30% and violence 7% by the total of hospitalizations. The middle time by the hospitalizations was between 8,2 to 9,2 days with important differences when analized in the level of injury. About costs, when compare with external causes general, the column traumas show higher values. This epidemiological analize could show interesting aspects about external causes with column traumas as consequence, information quality, costs, and victims by this kind of trauma, with important dates for actions for health promotion and care of this population. * CID 10ª Review, 1995

Resumo Acidentes e violências são responsáveis por elevadas taxas de mortalidade e morbidade causadas pelas lesões deles decorrentes. Entre essas lesões, os traumas da coluna vertebral, especificamente, e aquelas com comprometimento da medula espinal apresentam-se como um grande problema de Saúde Pública, uma vez que a maior parte dos lesados é composta de jovens e no auge da sua produtividade, tanto profissional quanto pessoalmente, além de as lesões serem responsáveis por seqüelas, geralmente, irreversíveis. Raros foram os estudos encontrados, que demonstrem a distribuição epidemiológica dessas lesões no Brasil. O trabalho objetiva conhecer o perfil das internações por traumas de coluna segundo características dos pacientes, lesões, causas externas que as produziram, bem como aspectos relativos às suas internações. O material de trabalho refere-se às internações SUS (dados do Banco do SIH/SUS) para traumas de coluna (S12, S14, S17, S19, S22, S24, S28, S29, S32, S34, S38, S39, T02.0, T02.1, T04.1, T04.2, T09.3 e T09.4 da CID-10*) As internações por traumas de coluna correspondem a cerca de 0,2% do total de internações no país e cerca de 2,7% do total de internações por lesões decorrentes de causas externas. Essa proporção, bem como a taxa de internação por traumas de coluna, foi crescente no período analisado na pesquisa. O grupo do sexo masculino, na faixa de 20 a 29 anos, é o mais comumente afetado, embora, em casos específicos, como o das internações decorrentes de quedas, observe-se aumento da proporção de idosos e também da população feminina. O nível lombo-sacral agrega cerca de 60% do total de internações por trauma de coluna, seguido pelo nível cervical (cerca de 28%). Os traumas de nível cervical apresentam a maior proporção de traumas com comprometimento medular, com cerca de 45,8% do total de traumas no ano de 2005. Segundo o tipo de causa externa que ocasionou a lesão, cerca de 40% das internações são decorrentes de lesões causadas por quedas. Os acidentes de trânsito correspondem a cerca de 30% e as tentativas de homicídio, 7% do total de internações por traumas de coluna. O tempo médio de permanência dos pacientes vítimas de traumas de coluna variou de 8,2 a 9,2 dias nos anos analisados, com significativas diferenças segundo o nível da lesão e comprometimento medular. Quando comparados aos custos das internações por causas externas, de modo geral, as internações por trauma de coluna apresentaram valores maiores, variando também segundo o grau de comprometimento medular e nível da lesão. A análise epidemiológica das internações por traumas de coluna esclareceu aspectos interessantes referentes às principais causas externas envolvidas, qualidade das informações disponíveis, custos e gastos para o sistema de saúde, bem como um panorama do perfil das vítimas, permitindo o planejamento de ações específicas para promoção da saúde e cuidados dessa população. * Classificação Internacional de doenças 10ª Revisão, 1995 / Abstract Accidents and violence are responsible for high taxes of mortality and morbidity by the consequences of trauma. In this injuries the vertebral column traumas, specifically and with spinal injury are an important problem for Public Health, because the most of the victims are young persons in the top of her productive life. The most of injuries are responsible for irreversible consequences. Just a little number of epidemiologycals studies where found in Brazil. This research objective is describe the traumas´s hospitalizations by victims characteristics and external causes what was the basic cause for the hospitalization. The material reference are SUS hospitalizations (SIH/SUS) for column traumas (S12, S14, S17, S19, S22, S24, S28, S29, S32, S34, S38, S39, T02.0, T02.1, T04.1, T04.2, T09.3 e T09.4 da CID-10*). The column traumas are almost 0,2% by the total of Brazil´s hospitalizations and 2,7% by the injuries hospitalizations by external causes. This number was in elevation between the years f this research. The male group by 20-29 years old was most commun affected. The hospitalizations by consequence off falls show an elevation in elders group and female group. In the sacral level there is 60% by the total of hospitalizations follow by cervical level (28%). In the cervical level we can see the most causes of spinal injury with almost 45,8% by the total. Studying the external causes almost 40% by the hospitalizations in all years, are by traumas in consequence by falls. The traffic accidents are 30% and violence 7% by the total of hospitalizations. The middle time by the hospitalizations was between 8,2 to 9,2 days with important differences when analized in the level of injury. About costs, when compare with external causes general, the column traumas show higher values. This epidemiological analize could show interesting aspects about external causes with column traumas as consequence, information quality, costs, and victims by this kind of trauma, with important dates for actions for health promotion and care of this population. * CID 10ª Review, 1995

<p>Sixty-five to 78% of sample populations of individuals with chronic spinal cord injury (SCI) have symptoms of spasticity, but current assessment tools and management strategies are inadequate. Therefore, the purpose of this thesis was to: 1) conduct a review of the definition, pathophysiology, and management of symptoms of spasticity in individuals with SCI, 2) develop and assess a new self-report scale designed to measure the impact of spasticity on daily life in people with SCI and 3) examine the effects of body-weight supported treadmill training (BWSTT) and tilt-table standing (TTS) on spasticity outcomes. 1) Spasticity was found to be a relevant concern for the SCI population and possibly responsive to activity-based intervention. A need was identified, however, for an assessment tool that allows individuals with SCI to report the impact of their spasticity. 2) In total, 89 individuals with chronic SCI participated in three phases of scale design: development, pilot testing, and evaluation of test-retest reliability and construct validity. The Spinal Cord Injury Spasticity Evaluation Tool (SCI-SET) was developed as a 7 -day recall self-report questionnaire that takes into account both the problematic and useful effects of spasticity. The internal consistency (a) and intraclass correlation coefficient of the SCI-SET were 0.90 and 0.91, respectively. Construct validity was supported by correlations (r=-0.48 to 0.68; p</p> / Doctor of Philosophy (PhD)

Orientador: Yvens Barbosa Fernandes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T18:49:05Z (GMT). No. of bitstreams: 1 Cavalcante_RodrigoAlvesdeCarvalho_M.pdf: 47962870 bytes, checksum: 30187744bcc8d761f23631f51a4d472c (MD5) Previous issue date: 2012 / Resumo: Fraturas da coluna tóraco-lombar tem alta prevalência em todo mundo e, portanto, exige dos cirurgiões de coluna uma constante tomada de condutas no sentido de propor a melhor forma de tratamento para os doentes acometidos com essas fraturas. A melhor forma de tratar as mesmas seria então tentar agrupá-las, classificá-las e a definir a presença ou não de instabilidade, definindo uma conduta de tratamento clínico ou cirúrgico. Dentre os vários sistemas de classificações existentes para classificar essas fraturas, os mais utilizados na atualidade são o Thoracolumbar Injury Classification System (TLICS) escore e sistema de Classificação da ArbeitgemeinschaftOsteosynthesefragen (AO). Nesse estudo foi utilizado o escore TLICS recentemente publicado para avaliar retrospectivamente 49 doentes tratados cirurgicamente entre 2003 a 2009 no Hospital das Clínicas da Unicamp e no Hospital Dr. Mário Gatti em Campinas-SP, por fraturas em coluna tóraco-lombar. O TLICS recomendou tratamento em 47 de 49 pacientes operados (96%), sendo identificada correlação estatística significante do mesmo, com o sistema de classificação AO (p= 0.0088), com status neurológico( p=0.001) e a correlação da classificação AO com status neurológico( p=0.041), utilizando o teste de Fischer. Os resultados do presente estudo permitem concluir que esse escore é acurado para predizer a conduta cirúrgica no tratamento dessas lesões / Abstract: Fractures of the thoracic and lumbar spine have a high prevalence worldwide, therefore, requires the spine surgeons conduct a continuous decision to propose the best treatment for patients affected with these fractures. The best way to treat the same would then try to group and classify them and after that define its stability or instability, a defining conduct of clinical or surgical treatment. Among the various classification systems exist to classify these fracture, the most frequently used are TLICS score and Arbeitgemeinschaft fur Osteosynthesefragen (AO) classification system. We used the recently published TLICS score to evaluate retrospectively 49 patients treated surgically between 2003 to 2009 at the Hospital of UNICAMP and Dr. Mário Gatti Hospital in Campinas-SP, for fractures at the thoracolumbar spine. The TLICS score recommended treatment in 47 of 49 operated patients (96%), being identified a significance statistical analysis correlation between the same with the AO classification system (p=0.0088), the TLICS score and neurological status (p=0.001) and the AO classification system and neurological status (p=0.041); therefore, the results presented in this article show be accurate to predict the surgical treatment of these lesions / Mestrado / Neurologia / Mestre em Ciências Médicas

Gymnastics is noted for involving highly specialized strength, power, agility and flexibility. Flexibility is perhaps the single greatest discriminator of gymnastics from other sports. The extreme ranges of motion achieved by gymnasts require long periods of training, often occupying more than a decade. Gymnasts also start training at an early age (particularly female gymnasts), and the effect of gymnastics training on these young athletes is poorly understood. One of the concerns of many gymnastics professionals is the training of the spine in hyperextension—the ubiquitous ‘arch’ seen in many gymnastics positions and movements. Training in spine hyperextension usually begins in early childhood through performance of a skill known as a back-bend. Does practising a back-bend and other hyperextension exercises harm young gymnasts? Current information on spine stretching among gymnasts indicates that, within reason, spine stretching does not appear to be an unusual threat to gymnasts’ health. However, the paucity of information demands that further study be undertaken.

No description available.

Excerpt: The above study has many of strengths, including an important topic, excellent sample size, well-articulated design and questionnaire, thorough factor analysis with goodness-of-fit tests, a clear explanation of the rationale for the findings, as well as their current applications in the medical field. Despite these strengths, the fit of the findings to the five-factor model of Elhai and Palmieri (2011) would appear to be lower than the fit to a two-factor model, a model that explains the data well. Therefore, we recommend that practitioners refrain from adopting and implementing the five-factor model for PTSD treatment in traumatic spinal injury victims due to insufficient support at this time.