Implementation of Educational Provision for Children with Severe to Profound Intellectual Disability in the Western Cape: From Rights to Reality

Children with severe to profound intellectual disability have been excluded from education on the basis that their impairment makes them ‘ineducable’. The Western Cape Forum for Intellectual Disability challenged this notion through litigation against the South African Government. The ensuing judgement asserts the right to education of these children and outlines action steps for government to this end. We describe the actions taken by the Western Cape Education Department in responding to the requirements of the court by means of a document review. We then reflect on the implementation process, highlighting key learning points of relevance for others engaged in implementation. We note critical factors to be considered for the child, their families, special care centres, and the broader educational and legal systems. We conclude by outlining important considerations for the inclusion of these children within the education system in South Africa.     

Children with Down Syndrome Sharing Past Personal Event Narratives with Their Teacher Aides: A Pilot Study

Personal narrative ability is crucial for social–emotional well-being and classroom participation. This study investigated the ability of 10 school-age participants with Down syndrome to share past personal experiences with their teacher aides in their school environment. To participate, children were required to speak in short sentences and be largely intelligible to unfamiliar listeners. Personal narratives were elicited using photo prompts, comprising a set of the child’s own photographs and a standard set of photographs and accompanying verbal prompts, utilising a clinical language sampling protocol. Personal narratives were analysed on quality, syntactic complexity, verbal fluency and intelligibility. Examiner behaviour was evaluated for measures of syntactic complexity, mean turn length in utterances and number of utterances. Results indicated significant difficulties in producing quality personal narratives in both photo conditions. Examiner behaviour was negatively correlated to the participants’ spoken language performance. Clinical implications are highlighted.     

A new mutation （1062 del 16） of iduronate-2-sulfatase gene from a Chinese patient with Hunter syndrome

Objective: To identify the mutations of iduronate-2-sulfatase (IDS) gene, to reveal its mutation features, and to establish a basis for genetic counseling and prenatal gene diagnosis of Hunter syndrome. Methods: Urine glycosaminoglycans (GAGs) assay, PCR and DNA sequencing were performed to detect mutation of IDS gene of the patient and his parents. Results: The result showed that the patient was: DS( ), HS( ), KS(-), CS(-), and that both of his parents were negative. A frame-shift deletion mutation (1062 del 16) was identified in exon 7 of the patient's IDS gene. His parents' genotypes were normal. Conclusion:The patient's mutation was not inherited by his parents but a novel one. The mutation probably altered the primary structure and tertiary structure of IDS enzyme protein remarkably and lowered the activity of IDS enzyme greatly. Therefore it is supposed to be the direct cause of the disorder.     

Relationship between resistin level in serum and acute coronary syndrome or stable angina pectoris

Objective To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP). Methods Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroupsacute myocardial infarction (AMI), unstable angina pectoris (UAP) and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA (enzyme-linked immunosorbent assay), and WBC (white blood cell count), hsCRP (high sensitive C-reaction protein), CKmax (maximum ofcreatinkinase), CK-MBmax (maximum of isozyme of creatinkinase) and cTnImax (maximum oftroponin) were measured by standard laboratory methods. Results The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and 1.12 folds in SAP patients than in the healthy controls (P＜0.05). The resistin levels were also significantly different between AMI [(8.16±0.79) ng/ml], UAP [(5.59±0.75) ng/ml]and SAP [(3.45±0.56) ng/ml] groups (P＜0.01); WBC, hsCRP, CKmax, CK-MBmax and cTnImax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC (r=0.412, P=0.046), hsCRP (r=0.427, P=0.037), CKmax, CK-MBmax and cTnImax (r=0.731, 0.678, 0.656; P＜0.01). ConclusionSerum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.     

护理干预重症胰腺炎患者急性反应期强化治疗阶段作用效果分析

探讨护理干预在重症胰腺炎患者急性反应期强化治疗阶段中的作用效果。将46例重症急性胰腺炎患者随机分为观察组(21例)和对照组(25例)。对照组采用临床常规治疗和护理,观察组在对照组的基础上行综合护理干预包括早期监测、准确记录出入量、加强脏器支持及营养支持等。比较两组患者的死亡率、生存质量。结果显示综合的护理干预可以使患者及时接受治疗和护理,减少并发症,降低死亡率,促进患者康复和提高生存质量。     

茶与人体健康：茶叶活性组分的生物医学效应和当前关注的若干问题

饮茶有益于健康的观念在我国已沿传多个世纪,并在很大程度上为全世界所接受。本文简述了茶叶的药用历史以及从中国传播到世界各地的历史进程,重点对国内外关于饮茶预防癌症、代谢综合症、心血管疾病以及神经退行性疾病等人体重要疾病的最新研究成果进行了综述。在此基础上,针对当前在动物实验和人体流行病学调查结果上存在差异的原因,特别是对茶叶中儿茶素类化合物在人体组织中生物可利用度低的问题、高剂量绿茶提取物对人体可能存在毒性等安全性问题进行了讨论。此外,还介绍了近几年在提高儿茶素类化合物生物可利用度和对癌症的预防和治疗效果上的最新进展。     

Correlations of Insulin Resistance and Serum Testosterone Levels with LH:FSH Ratio and Oxidative Stress in Women with Functional Ovarian Hyperandrogenism

Functional ovarian hyperandrogenism (FOH) is a form of polycystic ovary syndrome (PCOS) characterized by elevated circulating levels of androgens derived from the ovary. Insulin resistance (IR) is the most common etiological factor in women with FOH. IR causes the generation of increased oxidative stress (OS) and diminished antioxidant status. OS is directly correlated with both IR and testosterone levels, which consequently contribute to endocrine and biochemical alterations in FOH women. In the current study, elevations in total testosterone, free testosterone and luteinizing hormone (LH) levels accompanied by a decrease in follicle stimulating hormone (FSH) level leading to higher LH:FSH ratio were the prominent endocrine changes observed in women with FOH. A significant increase in fasting blood levels of glucose and insulin, as well as an elevated IR were also seen in FOH women, as compared to their age matched controls. Women with FOH have higher pro-oxidant and lower anti-oxidant levels in blood than their age matched controls. In FOH women, elevations in LH:FSH ratio and OS are correlated more with hyperandrogenemia than with IR. Of the androgens, free rather than total testosterone has better positive correlations with elevated LH:FSH ratio and OS, and hence, the former is a better predictive marker for the development of biochemical PCOS in women with FOH.     

加味柴芍六君颗粒加减治疗腹泻型肠易激综合征80例临床疗效观察

目的:临床观察中药加味柴芍六君颗粒治疗腹泻型肠易激综合征(irritable bowel syndrome-diarrhea predomina nt,IBS-D)的临床疗效。方法:将80例IBS-D患者随机分为加味柴芍六君颗粒中药组和培菲康西药组,分别给予加味柴芍六君颗粒及口服培菲康治疗。疗程均为4周,疗程结束后随访3个月,观察疗效。结果:(1)治疗2、4周后、治疗结束后第1个月及第3个月随访时,结果两组的证候总积分改善明显优于治疗前,差异有统计学意义(p0.05);(2)治疗4周后,中药组总有效率为81.1%,西药组为70.4%,2组总体疗效差异无统计学意义(p=0.194);在单项症状方面排便次数和大便性状等改善情况中药组要优于西药,差异具有统计学意义(p0.05);(3)在第1、第3个月随访中药组证候积分改善优于西药组,差异具有统计学意义(p0.05)。结论:临床应用加味柴芍六君颗粒治疗IBS-D具有较好的临床疗效。     

针对手足口病的SICR模型

根据2008年至2009年中国传染病调查资料,手足口病在我国也有流行趋势.将研究非典型性肺炎的数学模型SEIJR修正为SICR模型,并根据目前医学研究报告的结论：手足口病的患者痊愈后,痊愈者对其病毒能永久免疫,分析并讨论SICR模型找到能控制手足口病并发重症患者累积人数的理论依据,并且作为现实情形中控制疫情的参考依据.