513 resultados para Health Sciences, Obstetrics and Gynecology|Health Sciences, Rehabilitation and Therapy


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In this study, the portrayal of tanned skin and sun protection in magazines, television programs, and movies popular with Australian adolescents were analyzed. Images of models in magazines (n = 1,791), regular/supporting characters in television programs (it = 867), and regular/supporting characters in cinema movies (n = 2,836) for the 12-month period August 1999 to July 2000 were coded and analyzed. Alight tan was the most predominant tan level, and protective clothing was the most common sun protection measure displayed across all forms of media. There were significant associations between gender and tan levels in the television and movie samples. Although it is important to monitor the portrayal of tan levels and sun protection measures in media targeting adolescents, overall, the authors' findings revealed a media environment generally supportive of sun protection objectives.

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A systematic review of the literature on the effectiveness of physical interventions for lateral epicondylalgia ( tennis elbow) was carried out. Seventy six randomised controlled trials were identified, 28 of which satisfied the minimum criteria for meta-analysis. The evidence suggests that extracorporeal shock wave therapy is not beneficial in the treatment of tennis elbow. There is a lack of evidence for the long term benefit of physical interventions in general. However, further research with long term follow up into manipulation and exercise as treatments is indicated.

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Social isolation is a predictor of morbidity and mortality in older people. Speech pathologists often consider that communication disabilities associated with normal ageing (sensory loss, language and discourse changes) contribute to social isolation. The aims of this study were to describe the functioning of older people using the International Classification of Functioning, Disability and Health (WHO, 2001) as a conceptual framework for language and sensory functioning, communicative activity, and social participation, and to explore the relationship between communication (both at an impairment level and an activity level), social participation and personal factors (demographics and emotional health). In a prospective study, 47 women and 28 men aged 62 to 98 years (mean=74 yrs) completed objective and subjective assessments of functioning and participation, and provided personal information. Assessments were individually conducted in a face- to-face interview situation with the primary researcher, who was a speech pathologist. Assessments revealed the sample had predominantly mild hearing and vision impairments, unimpaired naming ability, frequent involvement in a wide range of communication activities, and variable social network size and social activities participation. Social participation was shown to be associated with vision, communication activities, age, education and emotional health. Naming and hearing impairments were not reliable predictors of social participation. It was concluded that professionals interested in maintaining and improving social participation of older people could well consider these predictors in community-directed interventions. Speech pathologists should therefore promote older people's involvement in everyday communicative activities while also limiting the impact of communication-related impairments, so that social participation is maintained in our ageing population.

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Research has suggested that the integrity of semantic processing may be compromised in Parkinson's disease (PD), which may account for difficulties in complex sentence comprehension. In order to investigate the time course and integrity of semantic activation in PD, 20 patients with PD and 23 healthy controls performed a lexical decision task based on the multi-priming paradigm. Semantic priming effects were measured across stimulus onset asynchronies of 250 ms, 600 ms, and 1200 ms. Further, PD participants performed an auditory comprehension task. The results revealed significantly different patterns of semantic priming for the PD group at the 250-ms and 1200-ms SOAs. In addition, a delayed time course of semantic activation was evident for PD patients with poor comprehension of complex sentences. These results provide further support to suggest that both automatic and controlled aspects of semantic activation may be compromised in PD. Furthermore, the results also suggest that some sentence comprehension deficits in PD may be related to a reduction in information processing speed.

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Background Control of the trunk is critical for locomotor efficiency. However, investigations of trunk muscle activity and three-dimensional lumbo-pelvic kinematics during walking and running remain scarce. Methods. Gait parameters and three-dimensional lumbo-pelvic kinematics were recorded in seven subjects. Electromyography recordings of abdominal and paraspinal muscles were made using fine-wire and surface electrodes as subjects walked on a treadmill at 1 and 2 ms(-1) and ran at 2, 3, 4 and 5 ms(-1). Findings. Kinematic data indicate that the amplitude but not timing of lumbo-pelvic motion changes with locomotor speed. Conversely, a change in locomotor mode is associated with temporal but not spatial adaptation in neuromotor strategy. That is, peak transverse plane lumbo-pelvic rotation occurs at foot strike during walking but prior to foot strike during running. Despite this temporal change, there is a strong correlation between the amplitude of transverse plane lumbo-pelvic rotation and stride length during walking and running. In addition, Jumbo-pelvic motion was asymmetrical during all locomotor tasks. Trunk muscle electromyography occurred biphasically in association with foot strike. Transversus abdominis was tonically active with biphasic modulation. Consistent with the kinematic data, electromyography activity of the abdominal muscles and the superficial fibres of multifidus increased with locomotor speed, and timing of peak activity of superficial multifidus and obliquus externus abdominis was modified in association with the temporal adaptation in lumbo-pelvic motion with changes in locomotor mode. Interpretation. These data provide evidence of the association between lumbo-pelvic motion and trunk muscle activity during locomotion at different speeds and modes. (c) 2005 Elsevier Ltd. All rights reserved.

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Background: There is limited information available on the requirement for postoperative analgesic drugs in patients submitted to total laparoscopic hysterectomy (TLH) compared with patients undergoing vaginal hysterectomy (VH). Aim: To compare the postoperative analgesic requirements in patients who underwent a TLH with patients who had a VH. Methods: Chart review of 53 patients who had TLH and 47 who had VH and were seen postoperatively by an acute pain management service in order to assess postoperative analgesic requirements. Patient controlled analgesia (PCA) was part of the standard protocol for postoperative pain management. Analgesic requirement was recorded as the mean doses of morphine and number of days that patients used non-steroidal anti-inflammatory drugs (NSAIDs), oxycodone and tramadol. Results: The requirement for total morphine was approximately half the dose in patients who had a TLH (10.8 +/- 12.6 mg) compared with patients who had a VH (19.4 +/- 21.9 mg) (P 0.017). The length of use of NSAIDs was significantly reduced in patients who had undergone a TLH (2.0 +/- 0.95 days) as compared with patients who had a VH (2.85 +/- 1.1 days) (P < 0.0001). Conclusions: Patients submitted to TLH require less postoperative analgesic drugs when compared with patients who had VH. Prospective randomised trials are warranted to compare analgesic requirements between patients submitted to TLH and VH.

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Dizziness and or unsteadiness, associated with episodes of loss of balance, are frequent complaints in those suffering from persistent problems following a whiplash injury. Research has been inconclusive with respect to possible aetiology, discriminative tests and analyses used. The aim of this pilot research was to identify the test conditions and the most appropriate method for the analysis of sway that may differentiate subjects with persistent whiplash associated disorders (WAD) from healthy controls. The six conditions of the Clinical Test for Sensory Interaction in Balance was performed in both comfortable and tandem stance in 20 subjects with persistent WAD compared to 20 control subjects. The analyses were carried out using a traditional method of measurement, total sway distance, to results obtained from the use of wavelet analysis. Subjects with WAD were significantly less able to complete the tandem stance tests on a firm surface than controls. In comfortable stance, using wavelet analysis, significant differences between subjects with WAD and the control group were evident in total energy of the trace for all test conditions apart from eyes open on the firm surface. In contrast, the results of the analysis using total sway distance revealed no significant differences between groups across all six conditions. Wavelet analysis may be more appropriate for detecting disturbances in balance in whiplash subjects because the technique allows separation of the noise from the underlying systematic effect of sway. These findings will be used to direct future studies on the aeitiology of balance disturbances in WAD. (c) 2004 Elsevier B.V. All rights reserved.

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Objectives: To investigate motor unit synchronization between medial and lateral vasti and whether such synchronization differs in closed and open chain tasks. Design: Electromyographic recordings of single motor unit action potentials were made from the vastus medialis obliquus (VMO) and multiunit recordings from vastus lateralis during isometric contractions at 30 degrees of knee flexion in closed and open chain conditions. Setting: Laboratory. Participants: Five volunteers with no history of knee pain (age, 30 +/- 3.32y). Interventions: Not applicable. Main Outcome Measure: The degree of synchronization between motor unit firing was evaluated by identifying peaks in the electromyographic averages of the vastus lateralis, triggered from motor unit action potentials in the VMO, and the proportion of power in the power spectral density of the triggered average at the firing frequency of the reference motor unit. The proportion of cases in which there was significant power and peaks in the triggered averages was calculated. Results: The proportion of trials with peaks in the triggered averages of the vastus lateralis electromyographic activity was greater than 61.5% in all tasks, and there was a significantly greater proportion of cases where power in the spectrum was greater than 7.5% (P = .01) for the closed chain condition. Conclusions: There was a high proportion of synchronized motor units between the 2 muscles during isometric contractions, with evidence for greater common drive between the VMO and vastus lateralis in closed chain tasks. This has implications for rehabilitation because it suggests that closed chain tasks may generate better coordination between the vasti muscles.

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Background. The mechanisms by which the abdominal muscles move and control the lumbosacral spine are not clearly understood. Descriptions of abdominal morphology are also conflicting and the regional anatomy of these muscles has not been comprehensively examined. The aim of this study was to investigate the morphology of regions of transversus abdominis and obliquus internus and externus abdominis. Methods. Anterior and posterolateral abdominal walls were dissected bilaterally in 26 embalmed human cadavers. The orientation, thickness and length of the upper, middle and lower fascicles of transversus abdominis and obliquus internus abdominis, and the upper and middle fascicles of obliquus externus abdominis were measured. Findings. Differences in fascicle orientation, thickness and length were documented between the abdominal muscles and between regions of each muscle. The fascicles of transversus abdominis were horizontal in the upper region, with increasing inferomedial orientation in the middle and lower regions. The upper and middle fascicles of obliquus internus abdominis were oriented superomedially and the lower fascicles inferomedially. The mean vertical dimension of transversus abdominis that attaches to the lumbar spine via the thoracolumbar fascia was 5.2 (SD 2.1) cm. Intramuscular septa were observed between regions of transversus abdominis, and obliquus internus abdominis could be separated into two distinct layers in the lower and middle regions. Interpretation. This study provides quantitative data of morphological differences between regions of the abdominal muscles, which suggest variation in function between muscle regions. Precise understanding of abdominal muscle anatomy is required for incorporation of these muscles into biomechanical models. Furthermore, regional variation in their morphology may reflect differences in function. (C) 2004 Elsevier Ltd. All rights reserved.