Effect of joint mobilization on the H Reflex amplitude in people with spasticity

Objective: To determine the effect of ankle joint mobilization on the H reflex amplitude of thesoleus muscle in people with spasticity. Materials and methods: A quasi-experimental study withcrossover design and simple masking was conducted in 24 randomized subjects to initiate thecontrol or experimental group. Traction and rhythmic oscillation were applied for five minutesto the ankle joint. H wave amplitude changes of Hoffmann reflex (electrical equivalent of themonosynaptic spinal reflex) was assessed, stimulating the tibial nerve at the level of the poplitealfossa and recording in the soleus muscle. In each subject 12 measurements were taken: basalrate, during and after mobilization. Changes in H reflex amplitude were calculated in relationto basal measurement. For each measurement a hypothesis test was performed (Student t test).Results: In groups of patients with brain injury and incomplete spinal cord injury, a significantdifference was found between measurements of both studies, concerning variation in H reflexamplitude during the application of joint mobilization techniques, with a decrease in the experimentalgroup and an increase in the control group. In contrast, no significant differences werefound after mobilization therapy. Patients with complete spinal cord injury showed no significantdifferences in any measurements. Conclusion: We demonstrate the effectiveness of jointmobilization in the decrease of H reflex amplitude in patients with brain injury or incompletespinal cord injury during the mobilization maneuver, but no residual effect after completion ofthe trial. This research showed no evidence regarding excitability reduction in complete spinalcord injury. We suggest that therapeutic interventions to decrease muscle tone based on the jointmobilization should be reconsidered.

'To get somewhere in life' : marginalized youth people with successful trajectories of education in Rio Grande do Sul, Brazil. ''Llegar a algún lugar en la vida' : jóvenes marginados con éxito en sus trayectorias de educación en Río Grande del Sur, Brasil'.

Monográfico con el título: 'Desde la diversidad hacia la desigualdad: ¿destino inexorable de la globalización?'. Resumen basado en el de la publicación

Some indicators of satisfaction with the support system for students with disabilities in Secondary Education in Croatia

Resumen basado en el de la publicaci??n

As atitudes dos professores face à inclusão de alunos com deficiência : o contacto com a deficiência

RESUMO: Actualmente as práticas de exclusão evoluíram para uma perspectiva de inclusão, assim como para a consciencialização dos direitos e deveres de cada um, como forma de dar resposta à sociedade heterogénea existente. A visão baseada nos sistemas de identificação e classificação dos sujeitos em várias categorias de deficiências era algo muito usual, mas que foi abolida, dando assim lugar ao conceito de Necessidades Educativas Especiais, com uma óptica mais abrangente, tendo em conta o contexto em que o sujeito está envolvido (Nunes, 2000). As atitudes dos professores face aos alunos com deficiência têm melhorado significativamente (Ribeiro, 1999), no entanto o processo de inclusão destas crianças no ensino regular não está isento de problemas. Neste sentido, e para que este desafio seja ultrapassado com sucesso, torna-se essencial que os professores modifiquem as suas atitudes e passem a desempenhar um papel mais activo nas suas funções, devendo para isso, começar por adaptar o currículo, e posteriormente repensar as suas estratégias e métodos de trabalho, como forma a responder às necessidades de todos os alunos (Ainscow, 1997). O objectivo principal deste estudo é verificar se o contacto com a deficiência (a nível da experiência no ensino, formação inicial e contacto na infância/juventude), por parte dos professores, influencia as suas atitudes em relação à formação necessária para a inclusão de alunos com deficiência, bem como às vantagens que esta representa para esses mesmos alunos. A amostra foi constituída por 672 professores do ensino regular, todos estão actualmente no activo e leccionam níveis de ensino do Pré-Escolar ao Ensino Secundário, de Norte a Sul do país. (N = 482 do género feminino e N =190 do género masculino). O instrumento de avaliação aplicado foi o questionário APIAD – Atitude dos Professores face à Inclusão de Alunos com Deficiência (Leitão, 2011). Concluiu-se que a experiência no ensino de alunos com deficiência influencia significativamente a atitude dos professores face à formação necessária (deficiência motora: p<0,001; deficiência auditiva: p<0,001; deficiência visual: p<0,001; deficiência mental: p=0,004) e face às vantagens da inclusão para os alunos com deficiência (deficiência motora: p=0,005; deficiência auditiva: p<0,001; deficiência visual: p<0,001; deficiência mental: p=0,022). No que se refere ao contacto com pessoas com deficiência durante a formação inicial, concluiu-se que existem diferenças significativas na atitude dos professores face às vantagens da inclusão para os alunos com deficiência (deficiência motora: p<0,001; deficiência auditiva: p<0,001; deficiência visual: p<0,001; deficiência mental: p<0,001). No entanto, no que respeita à formação, a atitude dos professores não difere, independentemente de terem tido esse contacto (deficiência motora: p=0,393; deficiência auditiva: p=0,456; deficiência visual: p=0,055; deficiência mental: p=0,342). Relativamente ao contacto com pessoas com deficiência durante a infância/juventude conclui-se que não existem diferenças na atitude dos professores em relação à formação necessária (deficiência motora: p=0,893; deficiência auditiva: p=0,667; deficiência visual: p=0,459; deficiência mental: p=0,918). Por sua vez, no que respeita às vantagens da inclusão para os alunos com deficiência, esta variável só influencia significativamente a atitude dos professores no caso da deficiência visual (deficiência motora: p=0,154; deficiência auditiva: p=0,100; deficiência visual: p=0,045; deficiência mental: p=0,149). ABSTRACT: Currently the exclusionary practices evolved to an inclusion perspective, as well as the awareness of rights and duties of each one as a way to reply to the existing heterogeneous society. The vision-based systems for identification and classification of subjects into various categories of disabilities was very unusual, but it was abolished, giving way to the concept of Special Educational Needs, with a broader perspective, considering the context in which the subject is involved (Nunes, 2000). The teachers attitude face to the students with disabilities have improved significantly (Ribeiro, 1999), however the process of inclusion of these children in regular education isn't exempt of problems. In this direction and so this challenge is exceeded successfully, it is essential that teachers change their attitudes and start to perform a more active role in their functions, and to do so, start by adapting the curriculum and then rethink their strategies and working methods, in order to meet the needs of all students (Ainscow, 1997). The main purpose of this study is to verify that the contact with the disability (educational level of experience, initial formation and contact in childhood/youth), among teachers, influences their attitudes towards the needed formation for the inclusion of students with disabilities as well as the benefits that this represents for them. The sample consisted by 672 regular educational teachers, all currently in employment and teaching from Preschool to High school, from North to South. (N = 482 females and N = 190 males). The evaluation instrument used was the survey APIAD - Teachers attitude towards the inclusion of students with disabilities (Leitão, 2011). It was concluded that the experience in teaching students with disabilities influences significantly the teachers attitude faced to the necessary formation (motor disability: p<0,001; hearing impairment: p<0,001; visual impairment: p<0,001; mental disability: p=0,004) and faced to the inclusion benefits for students with disabilities (motor disability: p=0,005; hearing impairment: p<0,001; visual impairment: p<0,001; mental disability: p=0,022).Concerning to the contact with people with disabilities during the initial formation, it was concluded that there are significant differences in the teachers attitude face to the inclusion benefits for students with disabilities (motor disability: p<0,001; hearing impairment: p<0,001; visual impairment: p<0,001; mental disability: p<0,001). In relation to the formation, the teachers attitude is the same, regardless of whether or not they have had such contact (motor disability: p=0,393; hearing impairment: p=0,456; visual impairment: p=0,055; mental disability: p=0,342). Regarding to the contact with people with disabilities during childhood/youth, it was concluded that there is no difference in the teachers attitude in relation to the formation needed (motor disability: p=0,893; hearing impairment: p=0,667; visual impairment: p=0,459; mental disability: p=0,918). On the other way, regarding to the inclusion benefits for students with disabilities, this influences significantly the teachers attitude just in the visual impairment. (motor disability: p=0,154; hearing impairment: p=0,100; visual impairment: p=0,045; mental disability: p=0,149).

Survey of hearing-impaired adults and parents of hearing-impaired children and their knowledge of the Americans with Disabilities Act

This paper discusses the results of a survey about awareness of the American with Disabilities Act.

A shift to randomness of brain oscillations in people with autism

BACKGROUND: Resting-state functional magnetic resonance imaging (fMRI) enables investigation of the intrinsic functional organization of the brain. Fractal parameters such as the Hurst exponent, H, describe the complexity of endogenous low-frequency fMRI time series on a continuum from random (H = .5) to ordered (H = 1). Shifts in fractal scaling of physiological time series have been associated with neurological and cardiac conditions. METHODS: Resting-state fMRI time series were recorded in 30 male adults with an autism spectrum condition (ASC) and 33 age- and IQ-matched male volunteers. The Hurst exponent was estimated in the wavelet domain and between-group differences were investigated at global and voxel level and in regions known to be involved in autism. RESULTS: Complex fractal scaling of fMRI time series was found in both groups but globally there was a significant shift to randomness in the ASC (mean H = .758, SD = .045) compared with neurotypical volunteers (mean H = .788, SD = .047). Between-group differences in H, which was always reduced in the ASC group, were seen in most regions previously reported to be involved in autism, including cortical midline structures, medial temporal structures, lateral temporal and parietal structures, insula, amygdala, basal ganglia, thalamus, and inferior frontal gyrus. Severity of autistic symptoms was negatively correlated with H in retrosplenial and right anterior insular cortex. CONCLUSIONS: Autism is associated with a small but significant shift to randomness of endogenous brain oscillations. Complexity measures may provide physiological indicators for autism as they have done for other medical conditions.

Under-investigation of older people with abnormal chest radiographs

Background: Whilst many authors have previously suggested that older people are under-represented in the investigation and management of lung cancer, few data are available as to the effect of age on the subsequent investigation and management of a patient with an abnormal chest radiograph. Methods: During a 3-month period in a university teaching hospital, all abnormal chest radiographs suggestive of a possible diagnosis of lung cancer were identified, and patients subsequently followed to determine investigation, management and date of death over a 5-year period. Results: Thirty-seven younger (less than or equal to69 years, median age 62 years) and 43 older patients ( 670 years, median age 80 years) were identified. Of the 80 patients with a possible bronchial carcinoma only 59% had a further chest radiograph performed. Bronchoscopy was performed in 34% of patients, but a biopsy of the lesion was undertaken in only 24% of patients. Sixteen of the 80 patients, irrespective of what investigations had been undertaken, were referred for an oncological or surgical opinion. During the study period ( 3 months), 24% of the patients died. At 6, 24 and 60 months, respectively, the total deaths were 40, 78 and 88%. Conclusion: Older patients compared with those aged less than 70 years were less likely to be investigated, further, were more likely to be managed differently (i.e., less aggressively) and more likely to die within each time interval. In more of the older group a presumed death certificate diagnosis of pneumonia was made. When an abnormal chest radiograph raises the possibility of an underlying bronchial carcinoma, the finding of this study suggests that an ageist attitude influences the subsequent management of some patients. Copyright (C) 2005 S. Karger AG, Basel.

A review of instruments developed to measure outcomes for carers of people with mental health problems

Objective: Community-based care for mental disorders places considerable burden on families and carers. Measuring their experiences has become a priority, but there is no consensus on appropriate instruments. We aimed to review instruments carers consider relevant to their needs and assess evidence for their use. Method: A literature search was conducted for outcome measures used with mental health carers. Identified instruments were assessed for their relevance to the outcomes identified by carers and their psychometric properties. Results: Three hundred and ninety two published articles referring to 241 outcome measures were identified, 64 of which were eligible for review (used in three or more studies). Twenty-six instruments had good psychometric properties; they measured (i) carers' well-being, (ii) the experience of caregiving and (iii) carers' needs for professional support. Conclusion: Measures exist which have been used to assess the most salient aspects of carer outcome in mental health. All require further work to establish their psychometric properties fully.