Weeks Of Inclusion Research Articles

Formation of positive relationships of peers to children with special educational needs in inclusive education

This study aimed to establish a positive relationship between peers and children in need of special education in inclusive education. The research was carried out in the 2021–2022 spring academic year, and the study was carried out with the participation of 142 students in the quantitative research model. In the study, 3 weeks of inclusion and peer training were given to the participant group. In the study, a data collection tool called ‘inclusion and peer’ was used to collect data developed by the researchers. The data collection tool used in the research was delivered to the participant groups by online method and collected. The analysis of the data was made by using the Statistical Package for the Social Sciences programme, frequency analysis and t-test, and the results were added to the research in the presence of tables. As a result of the research, it was seen that the students participating in the research understood how to approach children in need of special education and also had high values as they expected this relationship to be established.
 Keywords: Inclusive education, special education, distance education, peer to peer;

Update on pubertal development in France. PROSPEL – Observational study. Preliminary feasibility study

IntroductionRecent publications report a decrease in the age of onset of pubertal changes in the United States and Europe. The PROSPEL study (PRemier Observatoire des Stades Pubertaire en Libéral) will provide the first French data on the age at which pubertal signs appear. Before considering this work at the national level, we wanted to assess its feasibility. Materials and methodsPrivate pediatricians and general practitioners were recruited in Bordeaux and Toulouse. Before participating in the study, they had been trained in pubertal assessment and then evaluated. Each physician completed 1–4 weeks of inclusion during which children aged 5–18 years seen in consultation were included, except children who were adopted or had a chronic condition. Pubertal stages were assessed according to Tanner's classification and using an orchidometer for testicular volume. The causes of non-realization were documented where appropriate. Inter-individual reproducibility was analyzed by a double examination for a number of children who had previously given their consent. ResultsIn total, 63 physicians participated in the study (35 pediatricians and 28 general practitioners). All were certified at the end of the training session. A total of 2646 children were included (1318 girls, 1328 boys) with a homogeneous age distribution. The study was carried out in 83.5% of cases. The main reason for non-realization was that physicians did not propose the study to patients who met the criteria (10.1%). Lack of time was the main reason. Inter-individual reproducibility was excellent. Discussion and conclusionOur results attest to the good feasibility of the PROSPEL study. They allowed us to validate our methodology, the training and certification of the participating physicians, and to consider extending the study to the national level.

A Case-control Study of Risk Sources for Severe Fever with Thrombocytopenia Syndrome in Hubei Province, China

BackgroundSevere fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease caused by a novel bunyavirus, was discovered in rural areas of Central China in 2009. MethodsA case-control study based on hospital data was applied to detect the potential risk sources for SFTS in SFTS-endemic counties in Hubei Province. Cases were defined as hospitalized SFTSV confirmed patients. Controls were randomly selected from non-SFTSV patients in the same hospital ward within 2 weeks of inclusion of the cases, and they were matched by age (+/− 5 years) and gender according to 1:2 matching condition. Results68 cases and 136 controls participated in this study. In multivariate analysis, “Contact with cattle tick” was the major risk source (Conditional Logistic Regression OR-MH=8.62, 95% CI=1.79-41.51), outdoor activities and working in weeds or hillside fields could increase risk of cattle tick contact and SFTS infection (Conditional Logistic Regression OR-MH=8.82, 95% CI=1.69-46.05, P value=0.01). ConclusionOur results suggested cattle might be dominant hosts in SFTS-endemic regions in Hubei Province, which provided clues to transmission mechanism of “vectors, host animals, and humans”, thus more effectively preventing and controlling the disease.

Cordance derived from REM sleep EEG as a biomarker for treatment response in depression – a naturalistic study after antidepressant medication

ObjectiveTo evaluate whether prefrontal cordance in theta frequency band derived from REM sleep EEG after the first week of antidepressant medication could characterize the treatment response after 4 weeks of therapy in depressed patients. Method20 in-patients (15 females, 5 males) with a depressive episode and 20 healthy matched controls were recruited into 4-week, open label, case–control study. Patients were treated with various antidepressants. No significant differences in age (responders (mean ± SD): 45 ± 22) years; non-responders: 49 ± 12 years), medication or Hamilton Depression Rating Scale (HAM-D) score (responders: 23.8 ± 4.5; non-responders 24.5 ± 7.6) at inclusion into the study were found between responders and non-responders. Response to treatment was defined as a ≥50% reduction of HAM-D score at the end of four weeks of active medication. Sleep EEG of patients was recorded after the first and the fourth week of medication. Cordance was computed for prefrontal EEG channels in theta frequency band during tonic REM sleep. ResultsThe group of 8 responders had significantly higher prefrontal theta cordance in relation to the group of 12 non-responders after the first week of antidepressant medication. This finding was significant also when controlling for age, gender and number of previous depressive episodes (F1,15 = 6.025, P = .027). Furthermore, prefrontal cordance of all patients showed significant positive correlation (r = 0.52; P = .019) with the improvement of HAM-D score between the inclusion week and fourth week of medication. ConclusionsThe results suggest that prefrontal cordance derived from REM sleep EEG could provide a biomarker for the response to antidepressant treatment in depressed patients.

Knee arthroscopic surgery is beneficial to middle-aged patients with meniscal symptoms: a prospective, randomised, single-blinded study

There is no evidence that a knee arthroscopy is more beneficial to middle-aged patients with meniscal symptoms compared to other treatments. This randomised controlled trial aimed to determine whether an arthroscopic intervention combined with a structured exercise programme would provide more benefit than a structured exercise programme alone for middle-aged patients with meniscal symptoms that have undergone physiotherapy. 150 out of 179 eligible patients, aged 45 to 64 (mean:54±5), symptom duration more than 3 months and standing X-ray with Ahlbäck grade 0, were randomised to: (1) a physiotherapy appointment within 2 weeks of inclusion that included instructions for a 3-month exercise programme (non-surgery group); or (2) the same as (1) plus, within 4 weeks of inclusion, knee arthroscopy for resection of any significant meniscal injuries (surgery group). The primary outcome was change in pain at 12 months, assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOSPAIN). In the Intention-To-Treat analysis, pain at 12 months was significantly lower in the surgery than in the non-surgery group. The change in KOOSPAIN was significantly larger in the surgery than in the non-surgery group (between-group difference was 10.6 points of change; 95% CI: 3.4 to 17.7, P=0.004). The As-Treated analysis results were consistent with the Intention-To-Treat analysis results. Middle-aged patients with meniscal symptoms may benefit from arthroscopic surgery in addition to a structured exercise programme. Patients' age or symptom history (i.e., mechanical symptoms or acute onset of symptoms) didn't affect the outcome. NCT01288768.

Adjustment and social support at work early after breast cancer surgery and its associations with sickness absence

As half of the women with breast cancer are of working ages and usually survive, knowledge is needed on how to support them early regarding work-related problems caused by treatments. Most previous studies have focused on individual and disease-related factors, whereas few have focused on work-related factors such as work adjustment and social support. The aim of this study was to investigate received and perceived social support from supervisor and colleagues as well as work adjustments, and their associations with sickness absence, among women who recently had had breast cancer surgery. Inclusion criteria were as follows: women aged 20-63 years, living in Stockholm County, treated surgically for a first diagnosis of breast cancer, literate in Swedish, without pre-surgical chemotherapy or known distant metastases. Included in the study were 605 women who worked at diagnosis and that had answered a questionnaire within eight weeks of inclusion. Descriptive statistics, univariate, and multivariable logistic regression analyses were applied to estimate odds ratios (OR) with 95% confidence intervals (CI) for the likelihood of being sickness absent. Most women perceived and received social support and work adjustment after breast cancer surgery. Low adjustment (OR = 2.14; 95% CI, 1.45-3.18) and less social support (OR = 1.80; 95% CI, 1.16-2.78) were significantly associated with being sickness absent. Adjusting for sociodemographics, strenuous work posture, and treatment did not attenuate these associations. Adjustment at work and social support from employer are associated with sickness absence and needs to be explored in discussions on return to work after breast cancer surgery.

Specificity and sensitivity of transcranial sonography of the substantia nigra in the diagnosis of Parkinson's disease: prospective cohort study in 196 patients

ObjectiveNumerous ultrasound studies have suggested that a typical enlarged area of echogenicity in the substantia nigra (SN+) can help diagnose idiopathic Parkinson's disease (IPD). Almost all these studies were retrospective...

The Decision to Limit or Withdraw Specific Therapies for Advanced Cancer and Hematological Malignancies: Physicians and Patients Points of View and Interactions.

Abstract 2076 Context:The decision to limit or withdraw specific therapies (DLWT) in patients with advanced cancer is a complex process that is always painful for patients, relatives and professionals. For more than 10 years, shared decision making has been more and more emphasized. However, few data in the literature rely on clinical research. In order to understand their difficulties and issues, this study explores the determinants and modalities of DLWT and analyses the feasibility of different methods for investigating this decision making process. Method:We conducted a multi-center pilot study in oncology and hematology units of 5 institutions: 2 university hospitals, 1 general hospital, 1 cancer center and 1 private hospital. The study included two different approaches: an epidemiological section to identify the prevalence of these situations in different institutions and a qualitative study section exploring factors influencing the decision process. The epidemiological analysis included all hospitalized patients identified with advanced cancer for whom the question of DLWT was raised in a given week or during the two weeks preceding the investigation. The qualitative analysis was based on interviews with the referent oncologist (or hematologist) and his patient (conducted by a physician and a psychologist respectively) as well as interviews with other partners involved in the situation (care staff and relatives) depending on the center. Researchers also participated in multidisciplinary meetings and monitored changes in the decision over a three month period. Results:Of the 839 patients hospitalized in the inclusion week, the question of DLWT was raised in 3.5% of cases (no=30) and in 14.3% (no=27 of 188 patients) when excluding outpatients. All primary care physicians and 70% (no=21) of patients were questioned in interviews. Subjective determinants related to the physician/patient relationship, and their respective experiences seemed predominant in DLWT. Futility and poor general condition were the most frequently cited reasons to limit or withdraw specific therapies. The complexity of the DLWT was linked primarily to the uncertainty of benefit-risk balance, emotional aspects, communication issues and possible discrepancies between physician and patients' expectations. A mirror analysis of the two points of view indicated that the personal experience of physicians and patients, pertaining to the withdrawal of specific therapies, was often discerned as a failure or an abandonment of care. Patients' involvement in DLWT was often hindered by the complex communication in the end of life period. Communication training of health professionals, involvement of care staff and relatives, and early palliative care were factors facilitating the decision process. Discussion and Conclusions:This study demonstrates the feasibility of a multi-disciplinary qualitative approach to explore the DLWT process that is acceptable for physicians and patients. It shows the frequency of this type of questioning in hospitalized patients (about 15%) and proposes a pertinent analysis to understand these difficult and poorly investigated situations, in which uncertainty brings the subjectivity of each person to the heart of major ethical issues. This preliminary work prompts us to build a prospective study to develop and evaluate tools and training programs which could support the ethical questioning and decisions in these situations. Disclosures:No relevant conflicts of interest to declare.

Lipid-lowering drug atorvastatin as an adjunct in the management of diabetic macular edema

Purpose To determine the efficacy of the lipid-lowering drug atorvastatin in reducing retinal hard exudates and subfoveal lipid migration after focal/grid laser photocoagulation in clinically significant macular edema in patients with diabetes with elevated serum lipids. Design Randomized case trial. Methods Thirty patients with type 2 diabetes with clinically significant macular edema, dyslipidemia, and hard exudates of grade 4 and above were assessed in an institutional setting. All patients were subjected to strict metabolic control within 4 to 6 weeks of enrollment. In addition, 15 patients in group A received atorvastatin, a 3-hydroxy-3-methylglutaryl coenzyme A inhibitor; 15 members of group B did not receive any lipid-lowering therapy. All received laser photocoagulation after a metabolic control period and were followed up for a minimum of 18 weeks. The outcome measures were reduction in hard exudates, subfoveal lipid migration, status of macular edema, and visual acuity. Results The study included 21 men and nine women with noninsulin-dependent diabetes mellitus who could achieve good metabolic control within 4 to 6 weeks of inclusion in the study. All patients had elevated serum lipids at baseline. Ten (66.6%) of 15 patients in treatment group A and two (13.3%) of 15 patients in control group B showed reduction in hard exudates ( P = .007). None of the patients in group A and five (33.3%) of 15 in group B showed subfoveal lipid migration after laser photocoagulation ( P = .04). Regression of macular edema was seen in nine eyes in group A and five in group B ( P = .27). None of the eyes in group A and three eyes in group B showed worsening of visual acuity ( P = .22). Conclusion Oral atorvastatin therapy in patients with type 2 diabetes with dyslipidemia reduces the severity of hard exudates and subfoveal lipid migration in clinically significant macular edema and could be an important adjunct in the management of clinically significant macular edema.

Correlations between cognitive, behavioural and psychological findings and levels of vitamin B12 and folate in patients with dementia.

Associations between low levels of folate and vitamin B12 and cognitive impairment in patients with dementia have been reported. Some studies revealed correlations between low levels of vitamin B12 and behavioural and psychological signs and symptoms of dementia (BPSD) in Alzheimer's disease (AD) patients. Given the lack of studies in frontotemporal dementia (FTD) and on folate and given the methodological shortcomings of former publications, we set up a prospective study. At inclusion, AD (n=152) and FTD (n=28) patients underwent a neuropsychological examination. Behaviour was assessed using a battery of behavioural assessment scales. Determination of serum vitamin B12 and red cell folate levels were performed within a time frame of two weeks of inclusion. In both patient groups, significantly negative correlations between levels of serum vitamin B12 and red cell folate and the degree of cognitive deterioration were found. No correlations with BPSD were found in the AD patient group. In FTD patients, levels of vitamin B12 were negatively correlated with both hallucinations (p=0.022) and diurnal rhythm disturbances (p=0.036). The observed negative correlations between levels of vitamin B12 and folate and cognitive impairment in both AD and FTD patients, raise the possibility of a non-specific etiological role. Although levels of vitamin B12 and folate did not correlate with BPSD in AD patients, negative correlations between serum vitamin B12 levels and BPSD in FTD patients were revealed. Decreased serum vitamin B12 levels may predispose FTD patients to develop hallucinations and diurnal rhythm disturbances.