Impact of enjoyment on physical activity and health among children with disabilities in schools

Background

Enjoyment in school-based physical activity (PA) programs, such as recess or physical education may be important for promoting children's health, but there is a lack of evidence explaining how enjoyment affects health in children with disabilities.

侧隐窝注射与大推拿整复术治疗腰椎间盘突出症的疗效分析

目的评价侧隐窝注射与大推拿整复术治疗腰椎间盘突出症的效果。方法腰椎间盘突出症患者,观察组48例采用侧隐窝注射与大推拿整复术治疗;对照组67例采用后正中人路硬膜外注射与大推拿整复术治疗。两组住院期间均行一次性麻醉下大推拿整复术治疗。结果两组患者平均住院10d,随访时间6个月。观察组麻醉效果的优良率为100％、治愈率为58．3％均优于对照组（P〈0．05）。观察组麻醉平面〉T10的病例为12．5％,低于对照组的52．2％（P〈0．05）。结论侧隐窝注射联合大推拿整复术治疗腰椎间盘突出症更有优势。     

Elementary school practices and children's objectively measured physical activity during school

Objective

To examine the relation of physical activity practices covering physical education (PE), recess, and classroom time in elementary schools to children's objectively measured physical activity during school.

Methods

Participants were 172 children from 97 elementary schools in the San Diego, CA and Seattle, WA USA regions recruited in 2009–2010. Children's moderate-to-vigorous physical activity (MVPA) during school was assessed via accelerometry, and school practices were assessed via survey of school informants. Multivariate linear mixed models were adjusted for participant demographics and unstandardized regression coefficients are reported. The 5 practices with the strongest associations with physical activity were combined into an index to investigate additive effects of these practices on children's MVPA.

Results

Providing ≥ 100 min/week of PE (B = 6.7 more min/day; p = .049), having ≤ 75 students/supervisor in recess (B = 6.4 fewer min/day; p = .031), and having a PE teacher (B = 5.8 more min/day; p = .089) were related to children's MVPA during school. Children at schools with 4 of the 5 practices in the index had 20 more min/day of MVPA during school than children at schools with 0 or 1 of the 5 practices (p < .001).

Conclusions

The presence of multiple school physical activity practices doubled children's physical activity during school.     

Peer mediation to increase communication and interaction at recess for students with autism spectrum disorders

Recess plays an integral role in the social and emotional development of children given the time provided to engage in interactions with others and practice important social skills. Students with ASD, however, typically fail to achieve even minimal benefit from recess due to social and communication impairments as well as a tendency to withdraw. Implementation of evidence-based interventions such as peer-mediated social skills groups, are necessary to ensure recess is an advantageous learning environment for students with ASD. A multiple-baseline design across participants was used to determine if a functional relationship exists between a social skills instructional program combined with peer networks with school staff as implementers and increases in level of communicative acts for participants with ASD at recess. Results indicate all participants demonstrated an immediate increase in the number of communicative acts with the introduction of the intervention. Implications for practice are discussed.     

应用椎间盘镜手术治疗合并侧隐窝狭窄的腰椎间盘突出症

目的观察经后路椎间盘镜（MED）手术治疗合并有侧隐窝狭窄的腰椎间盘突出症的手术技巧及临床疗效。方法对73例腰椎间盘突出症伴侧隐窝狭窄患者,在持硬膜外麻醉下,床旁C臂机定住,MED下行推板间隙开窗,摘除突出椎间盘髓核组织,通过调整手术通道以及采用特殊器械对增生内聚的关节突进行有限切除,对侧隐窝、神经根管潜行扩大,对神经根进行彻底减压,并对病人术后疗效进行分析。结果73例患者,平均住院9．7天,平均手术出血量58毫升,平均手术时间73分钟。术后65例得到随访,按Nakai标准,优55例,良7例,可3例,优良率95．4％。结论该术式较常规手术创伤小,出血少,保持了脊柱后柱完整性与稳定性,适用于单节段腰椎间盘突出症合并相同节段侧隐窝狭窄症。     

侧隐窝注射加牵引治疗腰椎间盘突出症疗效观察

目的观察侧隐窝注射加牵引治疗腰椎间盘突出症的效果。方法用7号腰麻针穿刺到腰椎侧隐窝后,注射消炎镇痛液,完毕平卧1h后,行床头骨盆牵引。治疗后经3～6个月复查,随访16个月,以VAS法评定疗效。结果196例患者中优92例,良69例,差27例,无效8例,总有效率为95.9%（188例）,优良率为82.1%（161例）。结论腰椎侧隐窝注射加牵引治疗腰椎间盘突出症,疗效肯定,方法简单,副作用少。     

Is the Frequent Sonographic Anechoic Area Distally in Metacarpophalangeal Joints a Sign of Arthritis?

In clinical practice, ultrasonography (US) often reveals, in the dorsal scan, a small anechoic area distally in both inflamed and clinically non-inflamed metacarpophalangeal joints. This “distal anechogenicity in the metacarpophalangeal joint” (DAEM) might thus be scored false positively as arthritis. We aimed to investigate whether the DAEM is a sign of arthritis. We evaluated the prevalence of DAEMs in 24 non-arthritic subjects. We then compared the dimensions of the DAEM in 10 non-arthritic subjects with a DAEM and 7 consecutive rheumatoid arthritis (RA) outpatients, using 2-D and 3-D ultrasound. Furthermore, we dissected two fresh-frozen postmortem hand specimens after US. A DAEM was observed in the metacarpophalangeal 2 (MCP2) joints of 54% of the 24 non-selected non-arthritic individuals; in none of those did the joint exhibit a power Doppler signal. A DAEM was observed in 86% of the 7 RA patients. Dimensions of DAEMs did not statistically significantly differ between these groups. At 3-D imaging and dissection, the DAEM was found to be an extension of the metacarpophalangeal joint capsule. In conclusion, DAEMs occur frequently and are not a sign of arthritis, but are distal joint recesses. This should be taken into account when using current sensitive ultrasonographic scoring systems grading arthritis.     

鼻内镜下泪前隐窝入路治疗上颌窦良性病变

目的经鼻内镜下泪前隐窝入路治疗上颌窦良性病变,并探讨其适应证、并发症及手术方式。方法回顾性分析43例经鼻内镜下泪前隐窝入路治疗上颌窦良性病变的病例,其中术前及术后病理确诊的上颌窦内翻性乳头状瘤15例,窦内病变镜下检出菌丝或孢子的真菌性上颌窦炎8例,上颌窦囊肿12例,上颌窦后鼻孔息肉6例,上颌窦异物2例。所有病例手术前均行鼻窦冠状位或水平位CT扫描。患者在局麻下以下鼻甲前缘为中心切口,解剖内移鼻泪管-下鼻甲瓣经泪前隐窝进入上颌窦腔处理上颌窦内病变,复位鼻泪管-下鼻甲瓣,缝合手术切口并行下鼻道开窗。结果 43例患者术中均完全清除窦内病变,术后随访6～24个月,下鼻甲形态愈合良好,术腔上皮化,无溢泪、面部麻木等并发症。2例上颌窦内翻性乳头状瘤术后6个月局部复发,原手术入路切除,随访1 8个月无复发。3例术后鼻腔粘连,局部分离,随访12个月无复发。结论经鼻内镜下泪前隐窝入路进入上颌窦是一种微创、安全、有效的处理上颌窦良性病变的手术方式,可作为鼻内镜下经中鼻道行上颌窦自然口开窗无法彻底切除窦内病变组织的首选治疗方法。