The diagnosis of autism spectrum disorder (ASD) brings a lifetime of considerations for individuals and their families. The core symptoms of ASD vary in severity and influence behavior and function ...across all environments. Co-occurring medical, mental health, cognitive, language, learning, and behavioral differences add challenges to those associated with core symptoms. Navigating the preschool, school, and transition ages in the educational setting requires continual reassessment of the strengths, weaknesses, and needs of the student to provide appropriate placement and services.
A laboratory evaluation was undertaken to assess the shoulder range of motion and distal strength after oncologic resection and reconstruction involving the shoulder joint and to compare these ...functional parameters based on potentially important variables. Inclusion in the study was limited to 32 patients with bone tumors of the proximal humerus or scapula treated surgically by resection of the shoulder joint including the proximal humerus from 1976 through 1992. Active shoulder range of motion and isometric elbow extension and forearm supination strength are significantly less after surgery in patients with greater amounts of bony resection and with resection of the deltoid. Patients who had a modified Tikhoff-Linberg resection were able to achieve 10 degrees to 15 degrees greater shoulder motion in each direction than were patients who had the classic procedure including complete scapulectomy. However, elbow flexion and extension strength and forearm pronation strength were greater for the patients with the classic resection. Osteoarticular allografts as a reconstructive alternative provide as a group the best shoulder motion and overall distal upper extremity strength, but these reconstructions were performed only when the rotator cuff muscles and deltoid were able to be reconstructed. Diminishing elbow strength was seen with longer followup in the patients with osteoarticular reconstructions, corresponding temporally to subchondral collapse observed on radiographs. Range of shoulder motion except rotation was just as good for allograft vascularized fibular arthrodeses as for the osteoarticular allografts, but strength was significantly less with the arthrodeses.
Functional outcomes of patients with arthrodesis after resection of a shoulder girdle neoplasm are only sparsely reported. Fusion of the shoulder can be done as a primary reconstruction or ...secondarily for salvage of a failed limb-sparing procedure. We retrospectively reviewed 21 patients at a mean followup of 11 years. In eight patients, arthrodesis was done as the primary reconstruction and in 13 patients as the secondary procedure. There were no local recurrences, and no patient had metastatic disease develop. The overall Toronto extremity salvage and Musculoskeletal Tumor Society scores were 81% (range, 46-97) and 23 points (range, 17-26), respectively. There was no difference with respect to function between patients who had their arthrodesis as a primary or secondary procedure. Eight of 21 patients (43%) had a complication that required major surgical intervention. Shoulder arthrodesis as a limb salvage procedure after tumor resection provides good function independent of whether the procedure is done primarily or secondarily. Because of the high complication rate, future efforts must be directed at surgical methods to decrease such complications.
Therapeutic study, Level IV (case series--no, or historical control group). See the Guidelines to Authors for a complete description of levels of evidence.
Hip Pain - Adolescent Surfer Shannon, Robert P.; Mills, Wes; O??Connor, Mary ...
Medicine and science in sports and exercise,
05/2005, Letnik:
37, Številka:
Supplement
Journal Article
"Revoicing" by teachers in classroom group conversations creates participant frameworks that facilitate students' "alignment" with academic tasks and their socialization to roles and identities in ...intellectual discourse. Three examples demonstrate the potential of "revoicing" to: (1) position students in differing alignments with propositions and allow them to claim or disclaim ownership of their position; (2) share reformulations in ways that credit students with teachers' warranted inferences; (3) scaffold and recast problem-solution strategies of non-native-language students.
Hip Pain - Cross Country Shapiro, Shane A.; Dorsher, Peter T.; O??Connor, Mary I. ...
Medicine and science in sports and exercise,
05/2005, Letnik:
37, Številka:
Supplement
Journal Article
Background. Non‐adherence to human immunodeficiency virus (HIV) medications often results in irreparable drug resistance and poor outcomes. Hence, care providers generally think that treatment of ...HIV disease should be delayed until a person is ‘ready’ to adhere. However, little research has focused on understanding the process that results in readiness for successful adherence.
Aim. The aim of this phenomenological study was to describe and understand the experience and decision‐making processes of people who became adherent to their HIV medication regimens after previously failing treatment because of non‐adherence.
Method. A Husserlian phenomenological approach was taken, and in‐depth interviews were analysed using Giorgi's method of phenomenological description and analysis.
Findings. Thirteen HIV‐positive men and women who had previously failed two or more treatment regimens because of non‐adherence were purposefully selected from two infectious diseases clinics in the Midwest region of the United States. They had achieved and sustained adherence to their HIV medications for 1 year or longer without formal intervention. All participants experienced a ‘trigger’ event preceding the process that led to the ability to incorporate lifestyle and health behaviour changes necessary for successful adherence. Factors associated with the process leading to adherence were: changing attitudes towards HIV medication, finding the right health care provider, creating the right support system, getting control of life and having goals.
Conclusions. This study demonstrated that HIV‐positive individuals who had been non‐adherent and had been viewed as ‘difficult to treat’ nonetheless successfully adhered to treatment once they became ‘ready’. Findings from this study implicate that readiness may be a necessary component for successful adherence, particularly in HIV‐positive individuals who have previously failed treatment. Understanding the relationship between the phenomenon of readiness and subsequent HIV treatment adherence has implications for clinical decision‐making and for development of interventions that enhance adherence and prevent HIV drug resistance.
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