Understanding the experiences, needs, and strengths of people with incomplete spinal cord injury who can ambulate.

PURPOSE: To identify the experiences, needs, and strengths of people with incomplete spinal cord injury who can ambulate and to explore and discuss potential supports, services, and programs that would best assist them in the community. MATERIAL AND METHODS: In this qualitative descriptive study, interviews were the primary means of data collection. These were supplemented with descriptive standardized measures of function and life satisfaction. Qualitative data were analyzed thematically. RESULTS: Twenty-four participants were interviewed, their average age was 55 years and 46% were female. We identified three themes: 'I really couldn't go there', described the physical and social barriers experienced by participants, 'It'd be really nice to let the public know there are people out there like me' expressed the desire for greater social understanding of incomplete spinal cord injury, and 'I just don't quit', displayed the perseverance that participants demonstrated following their injury. CONCLUSION: Findings indicate service providers to improve the inclusion of ambulatory individuals with incomplete spinal cord injury in their programs. Suggestions include designing programs (community, healthcare, return to work, peer support), environments using the principles of universal design for people with incomplete spinal cord injury who ambulate, and increasing consideration of their perspectives.Implication for rehabilitation:People with incomplete spinal cord injury who can ambulate live with invisible impairments, which are often not acknowledged by family, friends, health professionals, and people with complete spinal cord injuryThey may feel excluded from activities (organized by spinal cord injury associations) that were originally designed for people with complete spinal cord injuryGreater awareness among health professionals, friends, family, and people with complete spinal cord injury of the needs of people with incomplete spinal cord injury who can ambulate is needed to increase their inclusion.

Regression of low-grade squamous intra-epithelial lesions in young women.

BACKGROUND: The aim of this study was to assess the probability of low-grade squamous intra-epithelial lesion (LSIL) regression in young women, and to examine the factors associated with this regression. METHODS: In a longitudinal study of human papilloma virus (HPV) infection, female adolescents aged 13-22 years were examined every 4 months by cytology, colposcopy, and HPV DNA status. Both prevalent and incident LSIL cases were included in the analysis, with regression defined as at least three consecutive normal Pap smears. FINDINGS: Median follow-up time from baseline (defined as the time of first LSIL diagnosis) for the 187 women with LSIL was 61 months (IQR 34-80). Median time they had been sexually active at diagnosis was 3.2 years (2.6-6.5). Probability of regression for the entire cohort was 61% (95% CI 53-70) at 12 months and 91% (84-99) at 36 months of follow-up. No associations were found between LSIL regression and HPV status at baseline, sexual behaviour, contraceptive use, substance or cigarette use, incident sexually transmitted infection, or biopsy. Multivariate analysis showed that only HPV status at the current visit was associated with rate of regression, whether infection was caused by one or more viral types (relative hazard=0.3 [95% CI 0.21-0.42], and 0.14 [0.08-0.25], respectively). INTERPRETATION: The high rate of regression recorded in this study lends support to observation by cytology in the management of LSIL in female adolescents. Negative HPV status was associated with regression, suggesting that HPV testing could be helpful in monitoring LSIL.