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Low back pain and depression have been globally recognized as key public health problems and they are considered co-morbid conditions. This study explores both cross-sectional and longitudinal comorbid associations between back pain and major depression in the adult population in the United States. We used data from the Midlife in the United States survey (MIDUS), linking MIDUS II and III with a sample size of 2358. Logistic regression and Poisson regression models were used. The cross-sectional analysis showed significant associations between back pain and major depression. The longitudinal analysis indicated that back pain at baseline was prospectively associated with major depression at follow-up (PR 1.96, CI: 1.41, 2.74), controlling for health behavioral and demographic variables. Major depression at baseline was also prospectively associated with back pain at follow-up (PR 1.48, CI: 1.04, 2.13), controlling for a set of related confounders. These findings of a bidirectional comorbid association fill a gap in the current understanding of these comorbid conditions and could have clinical implications for the management and prevention of both depression and low back pain.

Introdução: As chamadas Medicinas Tradicionais, Complementares e Integrativas (MTCI) ou Práticas Integrativas e Complementares (PIC), contribuem para mudanças no modelo de cuidado à saúde. Objetivo: Promover reflexão sobre a contribuição de ambulatório de PIC de uma Universidade pública para o acesso às PIC e a formação profissional. Método: Descrição analítica da experiência referente a agosto/2018 a novembro/2021, baseada em relatos de acadêmicos, terapeutas voluntários e docentes. Resultados: Perspectivas de análise: processo de implantação do ambulatório, os atores envolvidos, promoção do acesso às PIC e o processo de formação acadêmica. Considerações finais: O referido ambulatório de PIC tem contribuído para a formação na área e também para a promoção do acesso às PIC, ao proporcionar atendimentos presenciais e remotos. Por meio de redes sociais, eventos e cursos, tem promovido interação com a comunidade, divulgação de conhecimentos científicos e formação profissional.

The second half of the 20th century saw the development of social thought in health in Latin America and the Caribbean in which the social sciences had a central role. Such an innovative development was based on the understanding that health and disease are social processes that require the understanding of different health contexts. The origins of this development dates back to the renewal of medical teaching in Latin America, which had important support from the Pan-American Health Organization. The so-called field of social sciences in health then took shape, especially beginning in the 1970s and 1980s. The social sciences became part of teaching and assistance activities in social medicine and public health in many countries and contributed to consolidating postgraduate programs and networks of professors, researchers, professionals, and government agents who were active in public health actions and policies. Regarding Latin American realities, the issues of inequality in incidences of sickness and death and in the healthcare delivered to populations became relevant during this time. In close dialogue with relevant social groups, these actors have been significant in constructing responses to health problems in the region. Given the profound political, social, economic, environmental, and sanitary changes that took place in the transition from the 20th to the 21st century, social thought has attempted to meet the new empirical as well as theoretical and conceptual challenges to social sciences as applied to health. The analysis of the trajectory of this regional development, its details, advancements, and limits, is an important endeavor that should help to encourage suggestions toward bettering public health as well as fairness in these times of uncertainties and of new risks for humanity, as evidenced in an unprecedented way in the handling of the Covid-19 pandemic.

Cachexia is a multifactorial syndrome related to unintentional weight loss and to loss of muscle and fat mass. In head and neck cancer (HNC) its incidence is important and not only related to a deficient intake of food due to the impact of the disease in the vital functions. A complex disturbance in the normal metabolism of the patient promotes a persistent inflammatory state and a shifting in the metabolism balance toward a catabolic predominance affecting primarily the skeletal muscle. This leads to severe impairment of the functional, emotional and social status and quality of life of the patients that will compromise response to treatment and the disease prognosis. Understanding this deleterious syndrome and mainly identifying it in early stages of the disease is of a major importance in achieving better outcomes to head and neck cancer patients. This study pretends to identify clinical aspects related to cachexia in HNC in a clinical perspective for application on the routine clinical practice. In our study, 30 HNC patients were enrolled and evaluated in terms of nutritional values (actual and loss of weight in the past 6 months, body mass index (BMI), nutritional risk index (NRI), malnutrition universal screening tool), serum biochemical markers (albumin, total proteins, cholesterol, triglycerides, urea, C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and myostatin) and health related quality of life (HRQoL) evaluation (using European Organisation for the Research and Treatment of Cancer (EORTC) quality of life questionnaires (QLQ): EORTC QLQ-C30 and EORTC QLQ-HN43). A minimum follow-up of 48 months was considered for all patients. Our results showed that NRI is a good and sensitive index to identify cachexia. This index uses two parameters, one constitutional (loss of weight) and one biochemical (level of serum albumin). According to this criterion, 16 patients were assigned to the No-cachexia group and 14 patients to the Cachexia group. Significant differences in the constitutional and nutritional values between the two groups were found: the median weight loss was 4.44 kg in the No-cachexia group and 11.29 kg in the Cachexia group, while the BMI was 21.88 and 18.33, respectively. In terms of biochemical markers, significant low values of albumin and cholesterol in the Cachexia group were encountered when compared to the No-cachexia group. Regarding the inflammatory and cachexia biomarkers studied, the results show that patients in the Cachexia group had significantly higher levels of CRP and of the proinflammatory cytokines IL-6 and TNF-α and presented significantly raised levels of the myostatin. In terms of HRQoL evaluation, the scores of the EORTC QLQ-C30 revealed that all the scales and the Summary Score showed lower scores in the Cachexia group, indicating worst quality of life evaluation. The items scores were globally higher in the Cachexia group indicating more important problems related to those items in the Cachexia group. The difference encountered between the groups was significant (p < 0.001) in all considered scales but two: Dyspnoea and Constipation. Considering the EORTC QLQ-HN43 all the scales and in all single items but one (Wound Healing) the scores were higher in the Cachexia group, indicating a worst degree of problems affecting these group of patients. The difference found between the groups was significant (p < 0.001) in all scales and items but six: Dry Mouth and Sticky Saliva, Skin problems, Problems with Teeth, Trismus, Social Contact and Wound Healing. There were no significant differences in the clinical presentation of the disease between the two groups. The median survival was of 13.5 months in the Cachexia group, significantly lower when compared to the No-cachexia group (p < 0.0001), confirming the major impact of cachexia in survival and clinical outcomes in HNC patients. These results of our study show that HRQoL evaluation and serum biochemical markers are sensitive and important tools in identifying and screening cachexia in HNC patients. The methodology followed in this study correlating HRQoL with biochemical markers supports the development of clinical protocols in HNC that include cachexia evaluation. Hopefully this new approach can help to improve prognosis of the disease.

1. Introduction Cardiovascular disease (CVD) and cancer are currently the leading causes of mortality worldwide and in Brazil.– The recent demographic and epidemiological transitions in Brazil have determined an increase in the population’s life expectancy, today around 76 years, and a change in the health profile, in which chronic diseases and their complications prevail. These factors pose important challenges and require the development of a health policy agenda for the management of the ongoing transitions. The technological advances, the shortage [...]

A gestão escolar, na perspectiva da gestão democrático-participativa, constitui-se em motriz mobilizadora para a consecução da função social da escola. Tal premissa está embasada nos processos participativos da comunidade educativa nas ações da escola, no acompanhamento e na tomada de decisões. Esses aspectos associados à finalidade da escola e seu compromisso com a formação integral do sujeito remetem ao objeto deste estudo. Nessa perspectiva, este trabalho foi realizado no contexto de três escolas da rede municipal de Criciúma. A pesquisa foi realizada por meio de abordagens qualitativas e descritivas, através de entrevistas, com vistas a responder ao seguinte problema de pesquisa: quais as contribuições da gestão escolar, na perspectiva democrático participativa, para o cumprimento da função social da escola? O objetivo geral é analisar as contribuições da gestão escolar, na perspectiva democrático-participativa, no cumprimento da função social da escola. Nesse contexto, destacam-se os seguintes objetivos específicos: verificar as funções do gestor escolar na unidade escolar; investigar a existência de estruturas democráticas na escola; identificar a função social na unidade escolar; identificar aspecto essencial para o cumprimento do papel social; reconhecer o papel da gestão escolar no cumprimento da função social da escola. O aporte teórico e investigativo foi estruturado nas seguintes seções: Gestão escolar; gestão democrático-participativa e função social da escola. Após análise do processo de pesquisa constata-se que a gestão escolar, na perspectiva da gestão democrático-participativa, contribui no cumprimento da função social da escola ao definir seu papel na construção de uma educação de qualidade social capaz de garantir, através de qualificados processos pedagógicos e administrativos, a aprendizagem e a formação cidadã dos estudantes.PALAVRAS-CHAVE: Gestão escolar; Gestão escolar democrático-participativa; Função social da escola.

Objective The purpose of this study was to determine the point prevalence of low back pain (LBP), pelvic girdle pain (PGP), and/or combination pain (COMBO pain) and period prevalence (presence or absence of any of those pains), as well as to identify risk factors at 1, 3, and 6 months postpartum in a Canadian population. Methods Participants from a previous pregnancy study participated in a postpartum survey administered over the telephone at 1, 3, and 6 months following delivery. The survey included questions about LBP, PGP, or COMBO pain during the postpartum period, as well as questions related to risk factors (Canadian Task Force Classification II-3). Results At 1, 3, and 6 months postpartum, responses from 46, 58, and 64 participants, respectively, demonstrated that 15%–21% of women experienced LBP and up to 4% of women experienced COMBO pain (point prevalence). At no time point was PGP reported to occur alone. Period prevalence of back pain for the participants returned to pre-pregnancy levels at each time point. Back pain during pregnancy was the only risk factor identified for back pain at 3 and 6 months postpartum. Conclusion This study demonstrated that 76% to 80% of respondents were pain free at 1, 3, and 6 months postpartum. Pregnancy-related back pain was the only risk factor associated with postpartum-related pain at the 1 to 3 and 3 to 6 month time interval. Identification of site-specific postpartum-related back pain may assist in determination of management and treatment plans for this population.

In this article, we address the Bolivian work in the clothing industry in the cities of São Paulo (Brazil) and Buenos Aires (Argentina) through an analysis of the social networks that allow the entry and circulation of migrants in this activity. In the light of urban sociology debate on immigrant economies, we wonder whether these activities produce ethnic economies or circulatory territories. Based on multi-site participant observation and 50 interviews with Bolivian workers, we propose the hypothesis of a hybrid economy, with a strong ethnic component associated to high mobility of workers in multiethnic contexts. We argue that this hybridity is due to the formation of two contracting network types with different logics of operation: one, from the migrant’s place of origin in Bolivia and, the other, in the migrant’s destination cities. Circumstances that allow us to see the emergence of new cosmopolitanisms in these sewing territories. However, these new cosmopolitanisms are ambivalently associated with the appeals of ethnicity, outlining a new field of political clashes, internal to the Bolivian community, around their identity belonging in the destination cities., Neste artigo, abordamos a inserção boliviana no trabalho de confecção de roupas nas cidades de São Paulo (Brasil) e Buenos Aires (Argentina) por meio de uma análise das redes sociais que permitem a inserção e circulação dos migrantes nessa atividade. À luz dos debates da sociologia urbana sobre as economias migrantes, indagamos se essa atividade constitui economias étnicas ou territórios circulatórios. A partir de observação participante multissituada e 50 entrevistas semiestruturadas com os trabalhadores migrantes, formulamos a hipótese de que se trata de uma formação híbrida, com forte componente étnico associado a uma intensa circulação de trabalhadores em espaços multiétnicos. Argumentamos que esse hibridismo se deve à coexistência de dois tipos de redes sociais de contratação, com lógicas diferenciadas: uma, desde os locais de origem dos migrantes, na Bolívia e, outra, nas cidades de destino da migração. Circunstâncias que permitem entrever a emergência de novos cosmopolitismos nesses territórios da costura. No entanto, esses novos cosmopolitismos associam-se de maneira ambivalente com os apelos da etnicidade, delineando um novo campo de embates políticos, interno à comunidade boliviana, em torno de seus pertencimentos identitários nas cidades de destino.

Spinal pain and chronic health conditions are highly prevalent, burdensome, and costly conditions, both in the United States and globally. Using cross-sectional data from the 2016 through 2018 National Health Interview Survey (n = 26,926), we explored associations between spinal pain and chronic health conditions and investigated the influence that a set of confounders may have on the associations between spinal pain and chronic health conditions. Variance estimation method was used to compute weighted descriptive statistics and measures of associations with multinomial logistic regression models. All four chronic health conditions significantly increased the prevalence odds of spinal pain; cardiovascular conditions by 58%, hypertension by 40%, diabetes by 25% and obesity by 34%, controlling for all the confounders. For all chronic health conditions, tobacco use (45–50%), being insufficiently active (17–20%), sleep problems (180–184%), cognitive impairment (90–100%), and mental health conditions (68–80%) significantly increased the prevalence odds of spinal pain compared to cases without spinal pain. These findings provide evidence to support research on the prevention and treatment of non-musculoskeletal conditions with approaches of spinal pain management.

Objective: This study aimed to identify and define which factors interfere with adherence to type 2 Diabetes Mellitus (DM2) self-care activities. Methods: A hundred three (103) adults both sexes, diagnosed with Type 2 Diabetes Mellitus, have participated in this study. They were assessed through a socioeconomic questionnaire, Diabetes Self-Care Activities Questionnaire (DSCAQ) and International Physical Activity Questionnaire. (IPAQ). The study was carried out in the city of Três Corações-MG, from August 2018 to October 2019. Results: In the DSCA questionnaire, the activity with the highest adherence was related to medication intake (6,52 days ±1,52) and the lowest adherence was the activity related to the practice of specific physical exercises (1,29 days ±2,11). The IPAQ questionnaire determined that 66.0% of the participants reached the physical activity recommendations from the American Diabetes Association. By identifying the factors that interfere with adherence to self-care activities with DM2 and physical activity recommendation it was found through the cluster analysis Pearson's chi-square that the education low level (p

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Orientador: Celso Aparecido Bertran Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Quimica Mestrado

Neste trabalho, apresenta-se um estudo experimental e numérico do comportamento de ligações entre o pilar misto e a viga de aço. O objetivo foi avaliar a contribuição do concreto de revestimento com fibras na capacidade resistente e rigidez das ligações. Quanto às ligações viga-pilar, seis tipologias de ligação foram ensaiadas em caráter exploratório, sendo duas para definição da geometria e quatro compostas por chapas de topo estendida e barras passantes com a variação do eixo de inércia do pilar misto parcialmente revestido e a presença do concreto de revestimento na ligação. Para simular pilares internos submetidos ao carregamento estático, modelos cruciformes foram ensaiados. Discutem-se os resultados experimentais, sobretudo quanto à capacidade resistente, rotações das ligações, deslocamentos e deformações nos elementos. Paralelamente, um estudo numérico foi desenvolvido para ligações viga-pilar misto sem a interrupção do concreto de revestimento com o objetivo de analisar outros parâmetros, tais como, espessura da chapa de topo, diâmetro da barra passante, carregamento do pilar e resistência do aço. A simulação numérica foi realizada nos programas DIANA versão 9.6 e Midas Fx+, baseados no método dos elementos finitos, por meio de modelos tridimensionais de ligações viga-pilar. As propriedades não-lineares dos materiais aço e concreto foram incorporadas aos modelos e as interfaces entre os elementos da ligação também foram consideradas. Os resultados da modelagem numérica mostraram-se representativos com uma pequena variação da rigidez devido a não consideração da solda, tornando-se uma ferramenta para análises paramétricas. Concluiu-se que o comportamento das ligações viga-pilar misto depende do eixo de inércia do pilar parcialmente revestido e que a presença do concreto de revestimento contribui significativamente para o aumento da capacidade resistente. Além disso, a resistência do aço da viga teve maior influência na capacidade resistente do que os outros parâmetros analisados. This work presents an experimental and numerical study on the behaviour of beam-to-column connections involving partially encased steel-concrete columns and steel beams. The main objective was to evaluate the contribution of fibre-reinforced concrete at the connections for their ultimate capacity and stiffness. In this way, six connections were tested in a short program. First two were exploratory and they were used to define the typology of the studied connection. The definitive experimental program consisted of the four remaining specimens using the adopted solution with extended end-plates and bolts. Cruciform models were used simulating internal joints. The investigated parameter was the presence of fibre-reinforced concrete at the connection, when subjected to bending moments about the highest and lowest axis of inertia. Experimental results showed the effective contribution of concrete at the connection and obtained capacities, rotations, displacements and deformations were discussed. In addition, a numerical study was carried out in order to analyse the influence of other parameters on the connection behaviour, such as thickness of the end-plate, bolt diameter, column axial load and steel strength. The numerical simulation used three-dimensional models and was performed in the Finite Element Based software DIANA version 9.6 with Midas Fx +. The nonlinear properties of steel and concrete were incorporated and the interfaces between steel and concrete were also considered. The results of the numerical modelling were consistent, with a small variation in stiffness due to the non-consideration of the welding. Therefore, a parametric analysis was performed, showing that the behaviour of the studied connection was affected by the presence of fibre-reinforced concrete and also by the direction of the bending moment. Finally, the parametric analysis showed that the strength of steel beam had the highest influence on the connection behaviour, among all tested parameters.

Orientador: Rosana Baeninger Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas Resumo: Nesta tese, abordamos a inserção boliviana na indústria de confecção de São Paulo e de Buenos Aires a partir da hipótese da "economia étnica". Argumentamos que os processos que explicam essa inserção, suas relações de trabalho e as próprias oficinas de costura nas quais trabalham os migrantes bolivianos e bolivianas não são os mesmos nos quais se inserem as costureiras brasileiras e argentinas. A pesquisa baseou-se em narrativas de vida desses migrantes sobre os seus percursos sócio espaciais e laborais anteriores e sua experiência social na indústria de confecção das cidades de destino. As entrevistas foram realizadas nos municípios de São Paulo, no Brasil, e Cochabamba, Escoma, La Paz e El Alto, na Bolívia, com bolivianos e bolivianas que, em algum momento de suas vidas, trabalharam na indústria de confecção das cidades de São Paulo e/ou Buenos Aires. A partir das narrativas, ao invés da imagem, comumente associada a essa inserção laboral, de migrantes empobrecidos que saem de suas regiões de origem sem perspectivas e, na cidade de destino, inserem-se no mercado de trabalho das oficinas de costura, encontramos trabalhadores que saem da Bolívia com um trabalho garantido na cidade de destino, que pode ser São Paulo ou Buenos Aires. Nesse sentido, invés de projetos migratórios que culminam com a inserção na indústria de confecção, encontramos "projetos costura" cuja migração, em geral, financiada (como um adiantamento) em parte ou completamente por seus futuros contratadores, é parte de um acordo de inserção laboral estabelecido na Bolívia Abstract: In this thesis, we address the Bolivian insertion in São Paulo and Buenos Aires clothing industry from the hypothesis of ethnic economy. We argue that the social process that explain this insertion, and both the work relations and the work place in which Bolivian immigrants work are not the same of the Brazilian and Argentinean sewers. The empirical research is based on life narratives of Bolivian immigrants about, on one hand, their socio-spatial pathways and previous working life, and, on another hand, their social experience in the clothing industry of their host cities. The interviews were held in the cities of São Paulo, in Brazil, and Cochabamba, La Paz, El Alto and Escoma (rural municipality of the Andean highlands) with Bolivians that, at some point in their lives, worked on São Paulo or Buenos Aires clothing industry. Instead of the image commonly associated with this labor insertion, of impoverished migrants who leave their home regions and, at the host societies, fit into de labor market of sewing workshops, we have found immigrants that leave their homes at Bolivia with a guaranteed work at São Paulo or Buenos Aires. In this sense, rather migration projects culminating in the clothing industry, we have found "sewing projects", with migration as part of a work agreement held in Bolívia Doutorado Sociologia Doutora em Sociologia

Orientador: Josue Pereira da Silva Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias Humanas Resumo: Esta dissertação aborda a imigração de bolivianos e coreanos para São Paulo, no contexto do setor de confecção. Focalizam-se as origens históricas do circuito de subcontratação transnacional de força-de-trabalho boliviana para o abastecimento de oficinas de costura informais - a princípio, de donos coreanos - e a experiência social boliviana no interior desse circuito na cidade de São Paulo. A despeito da visibilidade desse circuito, no bojo dos processos de reestruturação produtiva do setor de confecção, durante a década de 1990, argumenta-se que as determinantes históricas do circuito encontram-se nos processos de desenvolvimento e suas conseqüências nos países de origem dos fluxos migratórios de bolivianos e coreanos. E sobre a experiência social dos bolivianos são consideradas as trajetórias sócio-espaciais desses imigrantes no interior do circuito. Abstract: This work deals with the immigration of Bolivians and Koreans to São Paulo in the context of the garment industry. It focuses on the historical origins of the transnational subcontracting circuit of Bolivian labor force to supply sweatshops in the garment sector - in the beginning, owned by south Koreans - and the Bolivian social experience inside this circuit at the city of São Paulo. Despite the visibility of this circuit, in the context of processes of production restructuring in the garment sector, during the decade of 1990, I argue that the historical determinants of the circuit are in the development processes and its consequences in the origin countries of Koreans and Bolivians immigration flows. And about the Bolivians social experience are considered the socio-spaces trajectories of these immigrants inside this circuit. Mestrado Sociologia Mestre em Sociologia

Este artigo analisa a implantação da Biblioteca Infantil, como uma das iniciativas do Departamento de Cultura da Cidade de São Paulo durante as décadas de 1930 e 1940. Utilizando fontes documentais que possibilitam verificar um pouco da recepção dessas ações culturais pelo público infanto juvenil, pretendemos refletir sobre como políticas culturais pensadas para a infância podem propiciar o protagonismo infantil.

Background The COVID-19 pandemic has greatly limited patients' access to care for spine-related symptoms and disorders. However, physical distancing between clinicians and patients with spine-related symptoms is not solely limited to restrictions imposed by pandemic-related lockdowns. In most low- and middle-income countries, as well as many underserved marginalized communities in high-income countries, there is little to no access to clinicians trained in evidence-based care for people experiencing spinal pain. Objective The aim of this study is to describe the development and present the components of evidence-based patient and clinician guides for the management of spinal disorders where in-person care is not available. Methods Ultimately, two sets of guides were developed (one for patients and one for clinicians) by extracting information from the published Global Spine Care Initiative (GSCI) papers. An international, interprofessional team of 29 participants from 10 countries on 4 continents participated. The team included practitioners in family medicine, neurology, physiatry, rheumatology, psychology, chiropractic, physical therapy, and yoga, as well as epidemiologists, research methodologists, and laypeople. The participants were invited to review, edit, and comment on the guides in an open iterative consensus process. Results The Patient Guide is a simple 2-step process. The first step describes the nature of the symptoms or concerns. The second step provides information that a patient can use when considering self-care, determining whether to contact a clinician, or considering seeking emergency care. The Clinician Guide is a 5-step process: (1) Obtain and document patient demographics, location of primary clinical symptoms, and psychosocial information. (2) Review the symptoms noted in the patient guide. (3) Determine the GSCI classification of the patient’s spine-related complaints. (4) Ask additional questions to determine the GSCI subclassification of the symptom pattern. (5) Consider appropriate treatment interventions. Conclusions The Patient and Clinician Guides are designed to be sufficiently clear to be useful to all patients and clinicians, irrespective of their location, education, professional qualifications, and experience. However, they are comprehensive enough to provide guidance on the management of all spine-related symptoms or disorders, including triage for serious and specific diseases. They are consistent with widely accepted evidence-based clinical practice guidelines. They also allow for adequate documentation and medical record keeping. These guides should be of value during periods of government-mandated physical or social distancing due to infectious diseases, such as during the COVID-19 pandemic. They should also be of value in underserved communities in high-, middle-, and low-income countries where there is a dearth of accessible trained spine care clinicians. These guides have the potential to reduce the overutilization of unnecessary and expensive interventions while empowering patients to self-manage uncomplicated spinal pain with the assistance of their clinician, either through direct in-person consultation or via telehealth communication.

BACKGROUND The COVID-19 pandemic has greatly limited patients' access to care for spine-related symptoms and disorders. However, physical distancing between clinicians and patients with spine-related symptoms is not solely limited to restrictions imposed by pandemic-related lockdowns. In most low- and middle-income countries, as well as many underserved marginalized communities in high-income countries, there is little to no access to clinicians trained in evidence-based care for people experiencing spinal pain. OBJECTIVE The aim of this study is to describe the development and present the components of evidence-based patient and clinician guides for the management of spinal disorders where in-person care is not available. METHODS Ultimately, two sets of guides were developed (one for patients and one for clinicians) by extracting information from the published Global Spine Care Initiative (GSCI) papers. An international, interprofessional team of 29 participants from 10 countries on 4 continents participated. The team included practitioners in family medicine, neurology, physiatry, rheumatology, psychology, chiropractic, physical therapy, and yoga, as well as epidemiologists, research methodologists, and laypeople. The participants were invited to review, edit, and comment on the guides in an open iterative consensus process. RESULTS The Patient Guide is a simple 2-step process. The first step describes the nature of the symptoms or concerns. The second step provides information that a patient can use when considering self-care, determining whether to contact a clinician, or considering seeking emergency care. The Clinician Guide is a 5-step process: (1) Obtain and document patient demographics, location of primary clinical symptoms, and psychosocial information. (2) Review the symptoms noted in the patient guide. (3) Determine the GSCI classification of the patient’s spine-related complaints. (4) Ask additional questions to determine the GSCI subclassification of the symptom pattern. (5) Consider appropriate treatment interventions. CONCLUSIONS The Patient and Clinician Guides are designed to be sufficiently clear to be useful to all patients and clinicians, irrespective of their location, education, professional qualifications, and experience. However, they are comprehensive enough to provide guidance on the management of all spine-related symptoms or disorders, including triage for serious and specific diseases. They are consistent with widely accepted evidence-based clinical practice guidelines. They also allow for adequate documentation and medical record keeping. These guides should be of value during periods of government-mandated physical or social distancing due to infectious diseases, such as during the COVID-19 pandemic. They should also be of value in underserved communities in high-, middle-, and low-income countries where there is a dearth of accessible trained spine care clinicians. These guides have the potential to reduce the overutilization of unnecessary and expensive interventions while empowering patients to self-manage uncomplicated spinal pain with the assistance of their clinician, either through direct in-person consultation or via telehealth communication.