An intervention in the Halliwick Method procedures (swimming) for a group of individuals with Downs syndrome

The purpose of this study was to intervene in the process of the Halliwick Method (swimming), in order to improve the method, or some of its aspects, for a sample of 14 individuals with Downs syndrome (aged six to 21 years), using both an individualized educational setting approach and a differentiation of the elements of the Halliwick Method. The pre-intervention phase included medical examination, IQ, measurement of the behaviour according to the Rutter Scale and a Test of Physical Performance for each subject. Next, the subjects were assigned to seven pairs of case studies, where each individual following a Halliwick Methods swimming programme was paired with an individual following a modified swimming programme based on the same method, on physical health variables, IQ, behaviour and motor abilities. The duration of each swimming programme was 24 weeks for each individual, at a frequency of once per week, for 40 minutes. In the light of the findings of this study, further recommendations for the improvement of Halliwick Method procedures were made, common factors that affected the performance of each individual were identified and their relation with performance was explored.     

Discriminating Quantity: New Points for Teaching Children with Down Syndrome About Number?

ABSTRACT

The focus of much mathematics teaching has been on the acquisition of counting, an area where children with Down syndrome can experience particular difficulties. Research with typically developing children has highlighted how early awareness of quantity provides a strong platform for the acquisition of later mathematical skills and programmes of early intervention have been introduced. Many of these studies are embedded in the work and traditions of developmental and cognitive psychology and can be difficult to access. Consequently, this is an area that has been largely ignored in the curricula of children with Down syndrome. This paper seeks to make this literature more available. It systematically reviews previous research with children with Down Syndrome on these early foundations. It considers seemingly contradictory findings in the light of differences in tasks, their presentation and instructions, and the responses required, in order to draw conclusions and reflect on the implications for teaching and learning. Some of these propositions are in contrast to existing practices and call for further research to test their effectiveness.     

Relationship between hyperuricemia and metabolic syndrome

Objective: To investigate the relationship between metabolic syndrome and hyperuricemia. Methods: A total of 2 374 subjects who received health examination in our hospital from Jan. 2004 to Dec. 2006 were enrolled in our study. Hyperuricemia is defined as ≥7 mg/dl (in men) or ≥6.0 mg/dl (in women). Metabolic syndrome was defined using AHA/NHLBI (American Heart Association/National Heart, Lung, and Blood Institute) criteria. Results: (1) The overall prevalence of hyperuricemia was 13.10%. The condition was more common in men than in women (19.07% vs 3.42%). (2) Among men, uric acid concentration is statistically significantly positively correlated with waist circumference, blood pressure, and triglyceride. Uric acid is negatively correlated with serum high-density lipoprotein-cholesterol (HDL-C). Uric acid concentration is most strongly correlated with serum triglyceride (r=0.379) and waist circumference (r=0.297). Among women, statistically significant positive correlations were noted for the serum uric acid concentrations with waist circumference, triglyceride and fasting plasma glucose. Serum triglyceride (r=0.329) and waist circumference (r=0.234) are most strongly correlated with uric acid concentrations. (3) Men with hyperuricemia had a 1.634-fold increased risk of metabolic syndrome as compared with those without hyperuricemia odds ratio (OR)=1.634, P=0.000. Women with hyperuricemia had a 1.626-fold increased risk of metabolic syndrome (OR=1.626, P=0.000) as compared with those without hyperuricemia. Conclusion: Hyperuricemia is prevalent among Chinese population. Additionally, serum uric acid is positively associated with metabolic syndrome.     

The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) – A systematic review of 796 cases

IntroductionLittle is known about the perpetrators of medical child abuse (MCA) which is often described as “Munchausen’s syndrome by proxy” or “factitious disorder imposed on another”. The demographic and clinical characteristics of these abusers have yet to be described in a sufficiently large sample. We aimed to address this issue through a systematic review of case reports and series in the professional literature.MethodA systematic search for case reports and series published since 1965 was undertaken using MEDLINE, Web of Science and EMBASE. 4100 database records were screened. A supplementary search was then conducted using GoogleScholar and reference lists of eligible studies. Our search yielded a total sample of 796 perpetrators: 309 from case reports and 487 from case series. Information extracted included demographic and clinical characteristics, in addition to methods of abuse and case outcomes.ResultsNearly all abusers were female (97.6%) and the victim’s mother (95.6%). Most were married (75.8%). Mean caretaker age at the child’s presentation was 27.6 years. Perpetrators were frequently reported to be in healthcare-related professions (45.6%), to have had obstetric complications (23.5%), or to have histories of childhood maltreatment (30%). The most common psychiatric diagnoses recorded were factitious disorder imposed on self (30.9%), personality disorder (18.6%), and depression (14.2%).ConclusionsFrom the largest analysis of MCA perpetrators to date, we provide several clinical recommendations. In particular, we urge clinicians to consider mothers with a personal history of childhood maltreatment, obstetric complications, and/or factitious disorder at heightened risk for MCA. Longitudinal studies are required to establish the true prognostic value of these factors as our method may have been vulnerable to publication bias.     

从蓝棣之症候式分析看重写文学史中“人”的维度

在重写文学史中重新确立的新的文学规范,试图把过去作为政治依附品的文学解放出来,让文学成为具有其个性的独立个体。人作为其中重要的一环,人在文学作品评价中的"主体性"是一个十分重要的关键词,而蓝棣之的症候式批评方法,正是通过探析作者的深层精神世界,完成对作品的再评价,是在强调主体性前提下以一种极具个性眼光进行的一种重写文学史的实践。     

有氧运动强度监测指标特征分析与研究

研究了运动指标中的心率、代谢当量、主观感觉程度与运动能量消耗等指标特征,首先,从心率对运动负荷的基本应答特征、运用目标心率安排锻炼负荷强度、心率测量的特征、心率的运动强度监测等方面分析了心率指标特征;其次,阐述了代谢当量指标与主观感觉程度特征及其分级指标;再次,从气体代谢分析仪与心率测试法等方面分析了运动能量消耗测定方法;最后进行了总结与建议。     

肾综合征出血热病后残留损害的研究(Ⅱ)

在1988年5月对HFRS病后1～10年148例调查的基础上,对其中的77例进行了第二次调查.结果:全身乏力占68.83％,头昏痛占48.05％,腰痛占41.55％,背胀占37.66％,心悸气短占20.77％.19例血清和/或尿液β_2-MG异常的患者,此次仍有6例血清β_2-MG大于3000ng/ml,9例尿β_2-MG大于150ng/ml,4例尿Alb,5例尿IgG,3例尿NAG异常.     

Diagnosis of Major Organic Acidurias in Children: Two Years Experience at a Tertiary Care Centre

Organic acid disorders are inherited metabolic disorders in which organic acids accumulate in tissues and biological fluids of affected individuals. Classical organic acidurias include methylmalonic aciduria, propionic aciduria, isovaleric aciduria and maple syrup urine disease (MSUD). They are considered the most frequent metabolic disorders among severely ill children. Patients frequently present with acute symptoms early in life. 420 cases clinically suspected to have organic aciduria, with upper age limit of 12 years for a 2-year period (January 2007–December 2008) were enrolled into this study. Metabolic acidosis and neurological symptoms were the most common signs. Screening tests and thin layer chromatography were done for detection of organic acidurias. Identification and quantitation of organic acids in urine and quantification of amino acids in blood were done by high performance liquid chromatography. Out of 420 patients, 45 patients (10.7%) were found to have organic acidurias. 15 cases of methylmalonic aciduria, 16 cases of propionic aciduria, 13 cases of MSUD, and one case of isovaleric aciduria were diagnosed. Results demonstrate the importance of testing for organic acidurias. Since organic aciduria may cause irreversible brain damage if not treated, we recommend selective screening amongst severely ill children despite implied extra costs.     

Relation of uric acid levels to aortic root dilatation in hypertensive patients with and without metabolic syndrome

Objective:Uric acid(UA) is considered to be a powerful predictor of cardiovascular risk and hyperuricemia might be involved in the metabolic syndrome(MS).This study aims to investigate the relation between UA levels and aortic root dilatation.Methods:A total of 348 hypertensive patients [age(67.5±9.8) years] with or without MS were included in the study.The aortic root diameters at the aortic annulus,the sinuses of Valsalva,the sinotubular junction,and the proximal part of the ascending aorta were measured using a two-dimensional(2D) echocardiography.Serum UA levels were also measured for all patients.Results:A high UA level is independently associated with aortic root diameters at the sinuses of Valsalva(P=0.001) and the proximal ascending aorta(P0.0001) in the hypertensive patients without MS.In contrast,aortic root diameters were not significantly related to UA levels in the hypertensive patients with MS.Furthermore,increased UA levels were associated with an increased risk for aortic root dilatation in the patients without MS(sex-adjusted hazard ratio 1.75,95% confidence intervals(CI) 1.27-2.41),but not in those with MS.Conclusions:This study demonstrated an independent relationship between the aortic root dimensions and increased levels of serum UA in the hypertensive patients without MS.Further understanding of the mechanisms underlying these associations may allow a clearer interpretation of the potential value of specific urate-lowering treatment on cardiovascular disease.