Determinants of students'' attitudes towards peers with disabilities

Aim  To explore factors associated with students' attitudes towards their peers with disabilities.
Method  All 7th grade students (aged 12−13y) from 12 schools in the Toulouse area were invited to participate ( n =1509). Attitudes were measured using the Chedoke-McMaster Attitudes Towards Children with Handicaps (CATCH) questionnaire (affective, behavioural, cognitive, and total scores). Personal characteristics, including KIDSCREEN quality of life scores, were recorded. Data regarding information about disabilities received from parents and the media and acquaintance with people with disabilities constituted the 'disability knowledge' factors. The characteristics of the schools were obtained from the local education authority. Multivariate multilevel linear regression analyses were conducted to explore the associations between CATCH scores and these three groups of factors.
Results  Responses from 1135 students (612 females, 523 males; mean age 12y 8mo SD 7mo; age range 10y 8mo–15y) were studied (75.2% of the students approached). Factors independently associated with more positive attitudes were being a female, having a good quality of life, being friends with a child with disabilities, or having received information about disabilities from parents and the media. Presence in the school of a special class for children with cognitive disabilities was independently associated with more negative attitudes.
Interpretation  This cross-sectional study identified different personal and environmental factors upon which interventions aimed at improving students' attitudes towards their peers with disabilities could be based.     

Construct validity of the Capacity Profile in preschool children with cerebral palsy

The Capacity Profile (CAP) classifies additional care needs, subdivided into five domains of body functions (physical health, motor, sensory, mental, and voice/speech) of children with stable conditions. Construct validity of the CAP was established in 72 children (56 males, 16 females) with cerebral palsy (CP); median age 2 years 7 months, range 2 years 6 months to 3 years; 34 unilateral and 37 bilateral spastic-type CP, one dyskinetic-type CP. Gross Motor Function Classification System (GMFCS) classification was 24 in level I, eight in level II, 18 in level III, 14 in level IV, and eight in level V. All CAP domains were significantly associated ( p <0.001) with the Functional Skills (rho=−0.42 to −0.85) and Caregiver Assistance scales (rho=−0.42 to −0.82) of the Dutch Paediatric Evaluation of Disability Inventory. The CAP-motor domain and GMFCS were strongly correlated (rho=0.91, p <0.001). Stepwise regression analysis demonstrated that the CAP domains contributed 74% to mobility (CAP-motor 66%, mental 6%, voice 2%); 75% to self-care (CAP-voice 61%, mental 12%, physical 2%); and 70% to social functionality (CAP-mental 68%, voice 2%). CAP demonstrated good construct validity in young children with CP. The independent contribution of CAP domains to daily function underscores the importance of comprehensive assessment with regard to all domains of body functions in heterogeneous conditions like CP.     

From the brain to bad behaviour and back again: Neurocognitive and psychobiological mechanisms of driving while impaired by alcohol

Issues. Driving while impaired by alcohol (DWI) is responsible for substantial mortality and injury. Significant gaps in our understanding of DWI re‐offending, or recidivism, reduce our ability to practically assess recidivism probability and to match interventions to individual risk profiles. These shortcomings reflect the baffling heterogeneity in the DWI population and the limited focus of much existing DWI recidivism research to psychosocial, psychological and substance use correlates. Approach. This narrative review summarises the evidence for the contribution of neurocognitive and psychobiological mechanisms to DWI behaviour and recidivism. Given the nascent nature of this literature, insight into the putative contribution of these mechanisms to DWI is also drawn from other experimental literatures, particularly those on alcohol use disorders and cognitive and behavioural neuroscience. Key Findings. Alcohol‐related neurotoxicity and dysregulation of hypothalamic–pituitary–adrenal axis and serotonergic systems may underlie certain offender characteristics consistently correlated with heightened DWI risk, persistence and intervention resistance. Their markers are less vulnerable to sources of bias than subjective psychosocial indices and are more far‐reaching than alcohol abuse in explaining DWI behaviour and recidivism. Implications. The investigation of neurocognitive and psychobiological mechanisms in DWI research is a promising avenue for discerning clinically meaningful subgroups within the DWI population. This can lead to research and development in alternative assessment and more targeted intervention technologies. Conclusion. Multidimensional research in DWI and recidivism offers novel avenues for increasing road safety.[Brown TG, Ouimet MC, Nadeau L, Gianoulakis C, Lepage M, Tremblay J, Dongier M. From the brain to bad behaviour and back again: Neurocognitive and psychobiological mechanisms of driving while impaired by alcohol. Drug Alcohol Rev 2009;28:406–418]     

Induced abortions in Bulgaria: Trends during the period 1986-1996

Background: Bulgaria is in a state of socioeconomic transition.Along with the political, economic and social system, the currentchanges affect the health care sector. The present article focuseson the issue of induced abortions. Bulgaria has one of the highestabortion rates in Europe, and this poses an important publichealth concern. Methods: Data were collected from the BulgarianMinistry of Health, the Bulgarian National Statistical Institute,articles and the reports of WHO, UNDP, UNICEF, and AIHA. Thedata was analysed by stratifying abortion rates according toage, marital status, parity, socio-economic status, level ofeducation, and ethnicity. In addition, possible contributingfactors were reviewed. The main factors included were demographiccharacteristics of the country; legislation related to inducedabortions; financing of the health care system; organizationof family planning services; and data on contraceptive prevalenceand practices. Results: Abortion rates show a general trendof shift towards younger age groups, as well as to single nulliparawomen. Definite associations with ethnicity, level of educationand socio-economic status could not be established, maily becausesufficient data was not available. The observed cases of multipleabortions indicate the inadequacy of the post-abortion counselling.The new financing system is expected to make the family planningservices more effective. The objective of this review is tocontribute to a better understanding of the problem of highrates of induced abortions in Bulgaria. Detailed analysis ofassociations between different factors related to the problemwould be important for developing adequate strategies for intervention,i.e. reduction of the number of induced abortions. This wouldundoubtedly be of social, financial and public health benefitfor Bulgaria.     

Improved Survival in Multiple Myeloma with Renal Failure

ABSTRACT. Forty-four myeloma patients with large tumour cell mass and impairment of renal function (S-creatinine >2 mg/dl, stage III B) were studied. Seven patients, who received no active treatment, neither cytostatics nor plasmapheresis, survived for >1 month (median). Twenty-one patients who were treated with chemotherapy combination (M-2 protocol: melphalan, vincristine, BCNU, cyclophosphamide, prednisone) plus plasma exchanges for three days at the start of each 5-week cycle survived longer (median 17 months, p<0.01) than 16 pateints who were treated with melphalan-prednisolone alone (median 2 months). However, better supportive care, dialysis, and improved antibiotic treatment may also have contributed to the improved results. It is concluded that intensive chemotherapy in full dosage, plasmapheresis, and active uremia treatment including dialysis should be considered in patients with advanced myeloma and renal failure.     

Salivary gland extract from Ixodes ricinus ticks inhibits production of interferon-γ by the upregulation of interleukin-10

Tick saliva has been shown to modulate host immunity by a so far unknown mechanism. We have demonstrated an inverted effect of salivary gland extract (SGE), derived from partially fed Ixodes ricinus females, on the production of two cytokines, interferon (IFN)-gamma and interleukin (IL)-10, in vitro. While SGE markedly suppressed the elaboration of IFN-gamma by mouse splenocytes stimulated with lipopolysaccharide (LPS), the production of IL-10 was increased in comparison with SGE-untreated cultures. The suppressive effect of SGE could be abolished by the addition of an IL-10 neutralizing monoclonal antibody to splenocyte cultures. Similar results were obtained when live Borrelia afzelii spirochetes, which are transmitted in Europe by I. ricinus ticks, were used for the cytokine induction. These results suggest that tick saliva can upregulate the IL-10 production at the tick feeding site, which consecutively inhibits the elaboration of pro-inflammatory cytokines, for example IFN-gamma. This immunosuppression may facilitate the establishment of tick-transmitted pathogens in the host.     

Infantile seborrhoeic dermatitis and Pityrosporum ovale

Twenty children (mean age 9 weeks) with infantile seborrhoeic dermatitis (ISD) were investigated with cultures for bacteria, Pityrosporum ovale and other fungi, and 20 healthy children served as controls. P. ovale and Staphylococcus aureus were the dominant organisms. P. ovale was cultured in 18 of 20 infants with ISD as compared to 4 of 20 controls. S. aureus was cultured in 14 of 20 infants with ISD as compared to 1 of 20 controls. The role of S. aureus in ISD is not known, but it could be a secondary invader as is supposed in atopic dermatitis (AD). Even if P. ovale may be suspected as the aetiological agent of ISD further studies are needed to clarify the exact role of the organism in ISD.     

Incidence of Deep Vein Thrombosis in Bedridden Non-surgical Patients

ABSTRACT. In order to detect deep vein thrombosis (DVT), 101 patients with acute medical or infectious disorders were examined with the ¹²⁵I-fibrinogen uptake test. All patients were bedridden on admission and were scanned daily from the second to the eighth day. Thirteen patients developed a positive fibrinogen uptake test. Thus, if a positive test is interpreted as DVT, the incidence of DVT was 13% in our bedridden patients. Of the patients admitted because of heart disease or pneumonia 20% had DVT, but only 4% of those admitted with other diagnoses. Other clinical “risk factors” studied, could not identify patients who developed DVT.     

Short-Term and Long-Term Changes of Left Ventricular Volumes During Rate-Adaptive and Single-Rate Pacing

To evaluate the adaptation of the heart to exercise during pacing, 15 patients with permanent endocardial pacemakers were studied; nine patients had atrioventricular universal (DDD) pacemakers (Symbios 7005) and six patients had activity detecting rate-responsive ventricular (VVIR) pacemakers (Activitrax 8403). Left ventricular function in each patient during rate variable pacing was compared to ventricular function during VVI single-rate pacing. End-systolic and end-diastolic volume changes during exercise were measured by radionuclide angiography and the amount of volume change was used to assess left ventricular function. Both short-term (within 4 hours) and long-term measurements (after at least 4 weeks) were made at rest and at 50% of the maximal exercise capacity in DDD or VVIR mode and were compared with VVI single-rate pacing. All patients, when changed from DDD or VVIR mode to VVI single-rate pacing showed a significant increase of the end-diastolic volume during exercise, which increased even more after long-term VVI pacing. During long-term rate variable pacing, there was no increase of the end-diastolic volume during exercise. DDD or VVIR pacing initially showed a substantial increase of the end-systolic volume during exercise combined with a decrease of left ventricular ejection fraction, suggesting a decrease of the left ventricular contractility. After 4 weeks, contractility improved both with DDD and VVIR pacing. We conclude that short-term DDD and VVIR pacing induces a temporary impairment of left ventricular function that improves after 4 weeks, whereas long-term VVI pacing is associated with left ventricular dilatation even at moderate levels of exercise.     

Noise Reversion of a Dual Chamber Pacemaker without Noise

Three patients are reported whose DDD pacemakers reverted to the asynchronous mode in the absence of skeletal muscle or electromagnetic (EMI) interference. In all three cases, the basic cardiac rhythm was atrial fibrillation with fast ventricular response due to intrinsic AV conduction. Noise reversion was triggered by the patients' own ventricular activity at cycle lengths shorter than the ventricular refractory period of the pulse generator. In one patient, asynchronous AV sequential pacing during atrial fibrillation was noted shortly after resuscitation from ventricular fibrillation; however, the initiation of the malignant ventricular arrhythmia by the pacemaker remains unproven. The mechanism of noise reversion by rapid cardiac activity and possible solutions to the problem by adequate pacemaker design are discussed.