154 resultados para Orthopaedic injury


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Introduction: The Accident Compensation Corporation (ACC) administers New Zealand’s (NZ) accident compensation scheme. Asians in NZ are apparently under-serviced by ACC and may be experiencing barriers to accessing services. This study identifies barriers that Asians in NZ face in accessing ACC’s injury-related services and compensations.

Methods
: By utilising a qualitative research design, 113 Chinese, Korean, Indian, and South East Asian participants residing in Auckland, NZ were recruited through maximum variation and purposive snowball sampling. Data were gathered during 2006 through 22 individual in-depth interviews and 14 focus group discussions based on semi-structured interview schedules. Interviewees included Asian general practitioners, traditional health providers, users and non-users of injury-related services, case managers and Asian community leaders. Data were analysed using a general inductive approach.

Findings: Results show that personal/cultural characteristics such as age, gender, English language competence, injury-related language competence, differing Asian worldviews, and consequent help-seeking behaviours act as barriers to accessing services and entitlements. This is exacerbated by logistical and environmental factors such as cost, transport, time, inadequate interpretation and translation services, as well as institutional barriers such as lack of information about services, culturally inappropriate services, discriminatory attitudes and employment risks.

Conclusion: It is evident that Asians living in NZ are experiencing several cultural, environmental and institutional barriers to accessing ACC services. There is clearly a need for more culturally relevant information and injury-related services if Asian immigrants’ use of such services and entitlements is to be increased.

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Personal adjustment following an acquired brain injury is influenced by a comprehensive, complex, and dynamic range of factors. This study found that a useful approach to service provision in the ABI sector would involve a holistic approach that addresses all life domains of the individual within an ecological systems framework.

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The thesis found results supporting the involvement of the Right Frontal area of the brain in the subjective wellbeing (SWB) of individuals. Additional results suggested SWB is dependent upon Core Affect, itself dependent upon the Right Parietal area of the brain. These results provide evidence that SWB and Core Affect are based upon a neurological substrate. The portfolio investigated the association between chronic medical conditions and anxiety disorders, and how the occurence of anxiety issues can affect overall psychological adjustment to illness.

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Using the 'integrative framework', based on the health promoting PRECEDE framework and Haddon's injury prevention strategies, as suggested by Gielen, a theoretical model for general practitioner involvement in the prevention of farm injury was developed. A listing of potential roles in farm injury prevention for general practitioners was produced.

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It was found that Urgency and lack of Perseverance were significantly elevated in women with self-injury or eating pathology, and significantly higher again in women with both these syndromes. A longitudinal design found that self-injury tends to progress from milder, compulsive forms, to more severe, impulsive forms over time. The portfolio examines the frequent co-occurrence of substance use and psychiatric disorders (Dual Diagnosis). Four primary conceptualisations of how dual diagnoses develop and present are discussed. These models are then applied to inform four case studies.

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The thesis' aim was to explore outcome after traumatic injury. Poorer physical health prior to injury and receipt of compensation explained variance in physical health 12 months after injury. Poorer mental health 3 and 12 months after injury was partly explained by stronger emotional reactions immediately after the injury, receipt of compensation, and lower perceived social support. The portfolio focuses on symptoms of depression and anxiety in those suffering chronic pain. Through four case studies who attended a pain management service, it is argued that psychological symptoms are able to be addressed concurrently with pain management strategies.

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Oxidative stress plays a central role in neuronal injury and cell death in acute and chronic pathological conditions. The cellular responses to oxidative stress embrace changes in mitochondria and other organelles, notably endoplasmic reticulum, and can lead to a number of cell death paradigms, which cover a spectrum from apoptosis to necrosis and include autophagy. In Alzheimer's disease, and other pathologies including Parkinson's disease, protein aggregation provides further cellular stresses that can initiate or feed into the pathways to cell death engendered by oxidative stress. Specific attention is paid here to mitochondrial dysfunction and programmed cell death, and the diverse modes of cell death mediated by mitochondria under oxidative stress. Novel insights into cellular responses to neuronal oxidative stress from a range of different stressors can be gained by detailed transcriptomics analyses. Such studies at the cellular level provide the key for understanding the molecular and cellular pathways whereby neurons respond to oxidative stress and undergo injury and death. These considerations underpin the development of detailed knowledge in more complex integrated systems, up to the intact human bearing the neuropathology, facilitating therapeutic advances.