Tyrimo aktualumas. Apie 80 procentų pacientų su stuburo smegenų pažeidimais yra vyrai, paaugliai ir jauni suaugusieji. Dauguma jų yra aktyvūs, socialūs asmenys, kurių reabilitacijos tikslas po nugaros smegenų pažeidimo – grįžti į normalų gyvenimą pas šeimą, draugus, bendraamžius. Mokslininkai teigia, kad tradicinis vyriškas vaidmuo visuomenėje – tokie bruožai kaip stiprumas, emocijų kontrolė, savarankiškumas, jėga ir dominavimas trukdo vyrams ieškoti pagalbos. Be to, tradicinės vyriškumo savybės, įskaitant nepriklausomumą, sėkmę darbe, yra susijusios su bendru savęs vertinimu, todėl pakitimai gali turėti žymų poveikį. Teorinėje dalyje pristatoma identiteto samprata, tapatumą aiškinančios teorijos, kentėjimo trajektorijos samprata. Skiriamas vaidmuo nehegemoninio vyriškumo aptarimui, vyriškumo ir negalios sankirtų perspektyvai. Remiantis autorių įžvalgomis bandoma apibūdinti skirtingas vyriškumo formas. Analizuojama vyrų, patyrusių stuburo traumą, biografinė perspektyva, kaip įvykis, pertvarkantis ir perstruktūruojantis visą jų gyvenimą, keičiantis vyrų identitetą. Analizuojamas socialinis darbas, komandinis darbas reabilitacijos įstaigose. Darbe apžvelgiami fiziologiniai procesai, kurie aiškina fiziologines stuburo smegenų pažeidimo pasekmes, be kurių negalima paaiškinti psichosocialinių aspektų. Baigiamasis darbas nagrinėja vyrų, patyrusių stuburo traumą, patirtis, jų biografinę situaciją. Tyrimo tikslas – atskleisti vyrų, patyrusių stuburo traumą, biografinio ,,darbo“... [toliau žr. visą tekstą] / Topicalityoftheresearch. Approximately 80 percentofpatientswhohavesufferedspinalcordinjuries are men, teenagersoryoungadults. Majorityofthem are active, socialpersonswhoserehabilitationaimafterthespinalcordinjuryis to return to normallifeintheirfamilies, withtheirfriends, andcontemporaries. Scientistsstatethatthetraditionalman's role inthesociety - suchfeaturesasdiligence, controlofemotions, independence, poweranddomination - preventsthemfromsearchingforhelp. Moreover, thetraditionalmasculinitycharacteristics, includingindependence, success at work, isrelated to thegeneralself-evaluation,thus, changesmayhavesignificanteffect. Thetheoreticpartpresentstheconceptofidentity, theoriesexplainingpersonalidentity, theconceptofsufferingtrajectory. Attentionispaid to non-hegemonicdiscussionofmasculinity, theperspectiveofmasculinityanddisabilitycrossing. Onthebasisoftheauthors' insightsattempts are made to describeseparateformsofmasculinity. Thebiographicalperspectiveofmenwhohavesuffered spine trauma isanalyzedasaneventrearrangingandrestructuringtheirentirelife, changemen’sidentity. Socialworkandteamworkinrehabilitationinstitutions are analyzed. Theworksurveysthephysiologicalprocessesexplainingtheconsequencesofspinalcordinjurywithoutwhichthepsychologicalaspectscannot be explained. Thefinalworkanalyzestheexperienceofmenwhohavesuffered spine trauma, theirbiographicalsituation. Objectoftheresearch – to revealthebiographicalworkexperienceofmenwhohavesuffered spine trauma byapplying art... [to full text]

Background: Research suggests that cervical spine CT examination is over used for potential injury due to blunt trauma. Education of emergency providers regarding evidence-based guidelines can help reduce the over-use of CT examination, and the development of an evidence-based protocol for the management of patients with suspected cervical spine trauma may help promote more appropriate clinical use of radiologic imaging for cervical spine clearance. Purpose: The ultimate goal of this project is to develop a best-practice, evidence-based protocol for the management of patients with suspected cervical spine injury, in order to promote safe and efficient clinical clearance, as well as promote judicious and appropriate use of diagnostic imaging for suspected cervical spine injury. Methods: A retrospective chart review of emergency radiographic imaging studies obtained over a three-month timeframe for suspected cervical spine injury at a 300-bed hospital in Tucson, Arizona was performed to compare ordering practices with the ACR-AC. Descriptive statistics were used for data analysis. A web-based survey was conducted of facility stakeholders including emergency physicians, nurse practitioners and physician assistants regarding their views about clinical guidelines and protocols for radiographic and clinical clearance of cervical spine injury. Descriptive statistics and thematic analysis was used for survey responses. Results: Analysis of 263 imaging studies over a three-month timeframe demonstrated that 24.3% of cervical spine imaging studies obtained in three-month timeframe would be considered not appropriate based on the ACR-AC. The survey of emergency clinicians revealed that none of those who responded have a preference for referring to the ACR appropriateness criteria, and the majority of respondents did not support the implementation of a hospital protocol for the management of patients with suspected cervical spine trauma. Recommendations: An institutional protocol for suspected cervical spine injury developed from the ACR-AC with incorporation of clinical clearance criteria is recommended. To promote clinician acceptance, overcome resistance to implementation, and promote individualized patient care, the protocol should also include provider education and should allow for variance based on individual patient circumstances.

Ziel dieser Studie war es, neue Erkenntnisse über die epidemiologischen Merkmale von Patienten mit Atlasfrakturen zu gewinnen und die Komplikationsraten nach operativer und nichtoperativer Behandlung retrospektiv zu bewerten.:Inhaltsverzeichnis Abkürzungsverzeichnis ................................................................................................... 2 Einführung ......................................................................................................................3 1. Bedeutung der Halswirbelsäulenverletzungen............................................................3 2. Der 1. Halswirbel (Atlas)............................................................................................3 2.1 Anatomischer Aufbau ...........................................................................................3 2.2 Frakturen des Atlas................................................................................................5 2.2.1 Häufigkeit und Ursache......................................................................................5 2.2.2 Frakturtypen und Klassifikationen.....................................................................5 2.2.2.1 Jefferson-Fraktur....................................................................................6 2.2.3 Patientenpopulation............................................................................................7 2.2.4 Symptome ..........................................................................................................7 2.2.5 Diagnostik .......................................................................................................... 8 2.2.6 Therapie..............................................................................................................8 3. Zielsetzung der Arbeit...............................................................................................11 Publikation ....................................................................................................................12 4. Zusammenfassung der Arbeit ...................................................................................20 5. Abbildungsverzeichnis..............................................................................................23 6. Literaturverzeichnis ..................................................................................................24 7. Anlagen.....................................................................................................................27 7.1 Spezifizierung des eigenen wissenschaftlichen Beitrags ....................................27 7.2 Selbständigkeitserklärung ...................................................................................28 7.4 Danksagung.........................................................................................................31 / The purpose of this study was to gain new insights into the epidemiologic characteristics of patients with atlas fractures and to retrospectively evaluate complication rates after surgical and non-surgical treatment.:Inhaltsverzeichnis Abkürzungsverzeichnis ................................................................................................... 2 Einführung ......................................................................................................................3 1. Bedeutung der Halswirbelsäulenverletzungen............................................................3 2. Der 1. Halswirbel (Atlas)............................................................................................3 2.1 Anatomischer Aufbau ...........................................................................................3 2.2 Frakturen des Atlas................................................................................................5 2.2.1 Häufigkeit und Ursache......................................................................................5 2.2.2 Frakturtypen und Klassifikationen.....................................................................5 2.2.2.1 Jefferson-Fraktur....................................................................................6 2.2.3 Patientenpopulation............................................................................................7 2.2.4 Symptome ..........................................................................................................7 2.2.5 Diagnostik .......................................................................................................... 8 2.2.6 Therapie..............................................................................................................8 3. Zielsetzung der Arbeit...............................................................................................11 Publikation ....................................................................................................................12 4. Zusammenfassung der Arbeit ...................................................................................20 5. Abbildungsverzeichnis..............................................................................................23 6. Literaturverzeichnis ..................................................................................................24 7. Anlagen.....................................................................................................................27 7.1 Spezifizierung des eigenen wissenschaftlichen Beitrags ....................................27 7.2 Selbständigkeitserklärung ...................................................................................28 7.4 Danksagung.........................................................................................................31