Using a 4:1 conversion ratio for Dysport and Botox, similar results were obtained for the two treatments in an appropriately powered study, suggesting that this conversion factor is a good estimate of their comparative clinical potencies.

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T his paper reviews a work project that uses illiteracy as a tool to understand the way the brain adapts to information. The project follows the exploration of certain targets that can be identified with the functions of reading and writing, both from the functional and from the anatomical points of view. Results concerning visual processing, cross-modal operations (audiovisual and visuotactile), and interhemispheric crossing of information are reported. Studies with magnetoencephalography, with positron emission tomography, and with functional magnetic resonance provided evidence that the absence of school attendance at the usual age constitutes a handicap for the development of certain biological processes that serve behavioural functioning. Differences between groups of literate and illiterate subjects were found in several areas: while dealing with phonology a complex pattern of brain activation was only present in literate subjects; the corpus callosum in the segment where the parietal lobe fibres cross was thinner in the illiterate group; the parietal lobe processing of both hemispheres was different between groups; and the occipital lobe processed information more slowly in cases that learned to read as adults compared to those that learned at the usual age. Some behavioural studies suggest that there are other operations that can be explored from the image point of view.C et article fait la revue d'un projet d'étude qui utilise l'analphabétisme comme outil pour comprendre la façon dont le cerveau s'adapte à l'information. Le projet poursuit l'exploration de certaines cibles qui peuvent être identifiées avec les fonctions de lecture et d'écriture, à la fois du point de vue fonctionnel et anatomique. Les résultats concernant le traitement visuel, les opérations trans-modales (audiovisuelles et visuotactiles) et le passage inter-hémisphérique de l'information sont rapportés. Les études utilisant la magnéto-encéphalographie, la tomographie avec émission de positrons et la résonance magnétique fonctionnelle ont démontré que l'absence de scolarisation à l'â ge adéquat constitue un handicap pour le développement de certains processus biologiques servant au fonctionnement comportemental. Des différences entre les groupes de participants alphabètes et analphabètes furent soulevées : lorsque les participants font des tâ ches de phonologie, un patron complexe d'activation cérébrale est présent seulement chez les alphabètes; chez le groupe analphabète, le corps calleux est plus mince dans le segment où traversent les fibres du lobe pariétal; le traitement du lobe pariétal des deux hémisphères est différent entre les groupes; et le lobe occipital traite l'information plus lentement dans les cas de l'apprentissage de la lecture à l'â ge adulte comparativement à l'apprentissage de la lecture à l'â ge adéquat. Des études comportementales suggèrent que d'autres opérations pourraient être explorées du point de vue de l'image.E ste estudio revisa una línea de investigació n que ha utilizado al analfabetismo como una herrami...

The epidemiology of traumatic brain injury (TBI) was studied in Portugal, using data of hospital admissions and total mortality, in 1994, 1996 and 1997. A rate of incidence of 151/100,000 for 1994 and of 137/100,000, for 1996 and 1997, was observed. Although in the last two years the incidence was the same, the mortality has decreased. The global rate of mortality for 1997 was of 17/100,000, with highest risk in age groups of 20 to 29 years (20/100,000) and after the age of 80 years (54/100,000). About 95% of deaths occur outside hospital and 5% after hospital admission. The incidence rate ratio of TBI was 1.8:1 in hospital admissions and of 3.4:1 in mortality, comparing men to women. This last difference is a constant throughout the life span but much more enhanced between 20 and 39 years of age.

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As estratégias de coping face a acontecimentos adversos são multidimensionais e articulam os campos comportamental, cognitivo e afetivo. O conhecimento das estratégias utilizadas pelos adolescentes proporciona informação para uma intervenção mais e caz. OBJETIVO: Adaptar e avaliar as propriedades psicométricas da Escala Toulousiana de Coping numa amostra de 291 adolescentes portugueses que frequentam o 3º Ciclo dos Ensinos Básico e Secundário, em dois Agrupamentos de Escolas; e analisar a in uência do género e idade no Coping. METODOLOGIA: Realizamos um estudo transversal, quantitativo. Para aferir as propriedades psicométricas do instrumento veri camos a con abilidade e validade dos resultados, através duma análise fatorial de componentes principais com rotação Varimax dos itens da escala e do cálculo do coe ciente Alpha de Cronbach. Recorremos à análise estatística inferencial para estudar a relação entre variáveis. RESULTADOS: A Escala Toulousiana de Coping apresenta caraterísticas psicométricas adequadas para este grupo de adolescentes (α Cronbach .85). O estudo da dimensionalidade identi cou cinco subescalas: Controlo; Suporte Social; Retraimento, Conversão e Aditividade; Distração Social e Recusa. O Coping Global é, em média, ligeiramente mais elevado nos rapazes. No entanto, as estratégias de controlo, suporte e distração social são utilizadas de forma idêntica por rapazes e raparigas. Por sua vez, as estratégias de retraimento, conversão e aditividade são tendencialmente mais utilizadas pelas raparigas e a recusa pelos rapazes. CONCLUSÕES: A Escala Toulousiana de Coping é um instrumento ável e útil para os enfermeiros, com vista à implementação de cuidados preferencialmente proativos, personalizados e direcionados para os problemas detetados em adolescentes.

Introduction:The satisfactory symptomatic control of the axial symptoms of Parkinson's disease (PD) remains challenging. As these symptoms are an important cause of disability, new therapeutic strategies should be developed and evaluated. To do this, it is necessary to select the outcomes to be measured and reported in a clinical trial. In this study, we sought to identify the most responsive outcome measures for assessing the efficacy of a multidisciplinary intervention on the axial symptoms of PD.Methods: An exploratory prospective clinical study was conducted. PD patients engaged in a pre-defined multidisciplinary intervention program for parkinsonian patients were assessed at admission and discharge by a multidisciplinary team. The responsiveness to intervention was evaluated and the smallest sample size needed to enable statistically significant results for an expected 30% change from baseline for each outcome was calculated.Results: Twenty-two patients were included in the study. The effect size detected varied between 0.04 and 0.83. The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) total score and each subsection, the N-FOG questionnaire, the 10-m walk test, and Frenchay Dysarthria Assessment-2 Edition (FDA-2) showed a medium to large effect size. Sample size calculations for 90% power and assuming 30% change from baseline ranged from eight to 180 participants. The outcome measures that require a small number of participants to enable statistically significant results were the FDA-2 rating scale (n = 4 participants), the MDS-UPDRS total score (n = 9), the 10-m walk test (n = 9), and the MDS-UPDRS motor examination (n = 10). Conclusions:The MDS-UPDRS part III and total score and the 10-m walk test were the outcomes with the best responsiveness to a multidisciplinary intervention and required a small number of participants to enable statistically significant results. Further studies are needed to clarify the suitability of the Timed Up and Go test.

Aims: Unilateral hopping (UH) is one of the common tests for footedness assessment. Inter-limb differences between vertical stiffness (KVERT), ankle dynamic joint stiffness (ADJS) and knee dynamic joint stiffness (KDJS) are expected to exist between the dominant and non-dominant limb. Thus the objective of the present study is to verify those differences, denoting KVERT, ADJS and KDJS as indicators of footedness. Study Design: Comparative study.