Lights and shadows in Higher Education from the perspective of students with disability in the area of Health Sciences

Cómo analiza el alumnado con discapacidad del área de Ciencias de la Salud, la institución universitaria y sus aulas, en términos de barreras y ayudas, es el tema central sobre el que gira este artículo. Los resultados que se presentan pertenecen a una investigación más amplia: “Barreras y ayudas que los estudiantes con discapacidad identifican en la Universidad” (MINICO, ref. EDU 2010-16264) en la que a través de una metodología biográfico-narrativa se ha tratado de dar voz a los estudiantes con discapacidad. En concreto, se ha analizado la Enseñanza Universitaria desde diferentes perspectivas: normativa universitaria, servicio de atención al alumnado con discapacidad, servicio de bibliotecas, accesibilidad arquitectónica e infraestructuras, profesorado, proyectos docentes y compañeros de aula. Por último, en las conclusiones se lleva a cabo una discusión de los principales resultados, incorporando las aportaciones de otras investigaciones realizadas previamente.How to analyze the students with disabilities in the area of Health Sciences, the university and the classroom , in terms of barriers and aids, is the focus on turning this article. The results presented belong to a wider research which through a biographical- narrative methodology has tried to give a voice to students with disabilities. Specifically, were analyzed University Education from different perspectives: university regulations, service students with disabilities, library services, architectural accessibility and infrastructure, faculty, teaching projects and classmates. Finally, in the conclusions carried out a discussion of the main results, incorporating contributions from other research

Inclusive University Classrooms the importance of faculty training

[EN] The presence of students with disabilities in the universities is increasing. Faculty need to be trained in order to attend these students and with the objective to offer and inclusice education. The aim of this communication is to identify, describe and explain the barriers and aids that students with disabilities experience in university classroom. Forty four students with disabilitis participated in the research. A biographical narrative methodology was used. The university-life histories of the students were complied by making use of in-depth interviews, lifelines and photographs. Results indicate the important of faculty training in matters concerning disabilities and new technologies, informing to the faculty of the presence of students with disabilities in their classroom, the existence of a specific service to support the faculty and the important of iimproving a positive attitude toward the disability. These results are dicussed in line with other studies. Recommendations are maded according to inclusive education and offering keys to universities to provide training plans leading to inclusive education and learning.Morgado, B.; Melero, N.; Molina, V.; Cortés-Vega, MD. (2016). Inclusive University Classrooms the importance of faculty training. En 2nd. International conference on higher education advances (HEAD'16). Editorial Universitat Politècnica de València. 182-189. https://doi.org/10.4995/HEAD16.2016.263018218

Inclusive education in higher education: dreaming the ideal lecturer

Este artículo se centra en las recomendaciones que 44 estudiantes realizaron al profesorado para que los procesos de enseñanza y aprendizaje lleguen a ser inclusivos. Los datos analizados provienen de la investigación financiada por el Ministerio de Economía y Competitivad de España “Barreras y ayudas que los estudiantes con discapacidad identifican en la universidad” (ref. EDU 2010-16264), que se viene desarrollando desde 2011 hasta la actualidad. Para llevar a cabo esta investigación, se recurrió a la metodología biográfico-narrativa. El análisis de datos se caracterizó por ser estructural y narrativo. En los resultados de este artículo se pudo identificar que había tres aspectos en los cuales los estudiantes con discapacidad hacían especial hincapié a la hora de expresar sus deseos de mejora: las actitudes del profesorado hacia ellos, las prácticas docentes y la formación del profesorado en materia de discapacidad y nuevas tecnologías. Por último, en las conclusiones se discuten los principales resultados con otros trabajos previos.This work is centered around the suggestions that 44 students with disabilities made to lecturers in order to achieve learning-teaching processes become more inclusive. All the information was collected in the frame of a project entitled “Barriers and aids in University as identified by disabled students with disability” (ref. EDU 2010-16264) which is being completed to-date and has been financed by the Spanish Ministry of Economy and Competitiveness. A biographicalnarrative methodology has been employed for the elaboration of this project. The analysis of the data described was mostly of structural and narrative nature. The article’s conclusions reveal that there are three major areas for improvement where students participating in the study mainly placed their stress: attitude of the faculty staff towards them, teaching techniques and professors’ level of training on handicap and disability management within the University context as well as on the use of the new technologies. The study concludes with a discussion and a comparative of its results with those from previous works

Retos tecnológicos en la Educación Superior. La formación del profesorado en atención a los estudiantes con discapacidad

Esta comunicación se basa en una investigación llevada a cabo en una universidad española cuyo propósito era estudiar, desde las reflexiones de estudiantes con discapacidad, cuáles eran las barreras y ayudas identificadas en sus trayectorias universitarias. En el diseño de la investigación se utilizó la metodología biográfico-narrativa. Los resultados abordan el análisis de los apoyos y obstáculos referentes a las tecnologías, en relación a la concepción que tienen estos estudiantes sobre la tecnología educativa, al uso que se hace de la misma y al modo cómo les afectan en sus vidas académicas. En las conclusiones, se muestra la universidad como una institución que ha de hacer ejercicio de autocrítica y tomar medidas para favorecer el camino hacia la inclusión educativa.Ministerio de Economía y Competitividad de España EDU 2010-1626

Exercises using a touchscreen tablet application improved functional ability more than an exercise program prescribed on paper in people after surgical carpal tunnel release: a randomised trial

Question: In people who have undergone surgical carpal tunnel release, do sensorimotor-based exercises performed on the touchscreen of a tablet device improve outcomes more than a conventional home exercise program prescribed on paper? Design: Randomised, parallel-group trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants: Fifty participants within 10 days of surgical carpal tunnel release. Intervention: Each participant was prescribed a 4-week home exercise program. Participants in the experimental group received the ReHand tablet application, which administered and monitored exercises via the touchscreen. The control group was prescribed a home exercise program on paper, as is usual practice in the public hospital system. Outcome measures: The primary outcome was functional ability of the hand, reported using the shortened form of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Secondary outcomes were grip strength, pain intensity measured on a 10-cm visual analogue scale, and dexterity measured with the Nine-Hole Peg Test. Outcomes were measured by a blinded assessor at baseline and at the end of the 4-week intervention period. Results: At Week 4, functional ability improved significantly more in the experimental group than the control group (MD –21, 95% CI –33 to –9) on the QuickDASH score (0 to 100). Although the mean estimates of effect on the secondary outcome also all favoured the experimental group, none reached statistical significance: grip strength (MD 5.6 kg, 95% CI –0.5 to 11.7), pain (MD –1.4 cm, 95% CI –2.9 to 0.1), and dexterity (MD –1.3 seconds, 95% CI –3.7 to 1.1). Conclusion: Use of the ReHand tablet application for early rehabilitation after carpal tunnel release is more effective in the recovery of functional ability than a conventional home exercise program. It remains unclear whether there are any benefits in grip strength, pain or dexterity. Trial registration: ACTRN12618001887268

Effectiveness of vestibular training for balance and dizziness rehabilitation in people with multiple sclerosis: A Systematic Review and Meta-Analysis

Postural instability and dizziness are commonly observed in people with multiple sclerosis (PwMS). The aim of this systematic review was to evaluate the evidence for the use of vestibular rehabilitation, in comparison with other exercise interventions or no intervention, to treat balance impairments and dizziness in PwMS. An electronic search was conducted by two independent reviewers in the following databases: MEDLINE (Pubmed), Scopus, the Physiotherapy Evidence Database (PEDro), Web of Science (WOS), Lilacs, CINHAL and the Cochrane Database of Systematic Reviews (CDSR). A quality assessment was performed using the PEDro scale and the Cochrane Risk of Bias Tool. When possible, the data were pooled in a meta-analysis (95%CI). This systematic review followed the PRISMA guideline statement and was registered in the PROSPERO database (CRD42019134230). Seven studies were included, with a total of 321 participants analysed. Compared with no intervention, vestibular rehabilitation was more effective for balance development (SMD = 2.12; 95% CI = 0.49, 3.75; p = 0.01; I2 = 89%) and dizziness symptoms improvement (SMD = −17.43; 95% CI = −29.99, −4.87; p= 0.007; I2= 66%). Compared with other exercise interventions, improvements in favour of the experimental group were observed, but statistical significance for the differences between groups was not reached

Feasibility and safety of an immersive virtual reality-based vestibular rehabilitation programme in people with multiple sclerosis experiencing vestibular impairment: a protocol for a pilot randomised controlled trial

Introduction: Vestibular system damage in patients with multiple sclerosis (MS) may have a central and/or peripheral origin. Subsequent vestibular impairments may contribute to dizziness, balance disorders and fatigue in this population. Vestibular rehabilitation targeting vestibular impairments may improve these symptoms. Furthermore, as a successful tool in neurological rehabilitation, immersive virtual reality (VRi) could also be implemented within a vestibular rehabilitation intervention. Methods and analysis: This protocol describes a parallel-arm, pilot randomised controlled trial, with blinded assessments, in 30 patients with MS with vestibular impairment (Dizziness Handicap Inventory ≥16). The experimental group will receive a VRi vestibular rehabilitation intervention based on the conventional Cawthorne-Cooksey protocol; the control group will perform the conventional protocol. The duration of the intervention in both groups will be 7 weeks (20 sessions, 3 sessions/week). The primary outcomes are the feasibility and safety of the vestibular VRi intervention in patients with MS. Secondary outcome measures are dizziness symptoms, balance performance, fatigue and quality of life. Quantitative assessment will be carried out at baseline (T0), immediately after intervention (T1), and after a follow-up period of 3 and 6 months (T2 and T3). Additionally, in order to further examine the feasibility of the intervention, a qualitative assessment will be performed at T1. Ethics and dissemination: The study was approved by the Andalusian Review Board and Ethics Committee, Virgen Macarena-Virgen del Rocio Hospitals (ID 2148-N-19, 25 March 2020). Informed consent will be collected from participants who wish to participate in the research. The results of this research will be disseminated by publication in peer-reviewed scientific journals

Dropout rate in randomised controlled trials of balance and gait rehabilitation in multiple sclerosis: is it expected to be different for virtual reality-based interventions? A systematic review with meta-analysis and meta-regression

To assess and meta-analyse the pooled dropout rate from the randomised control trilas that use virtual reality for balance or gait rehabilitation in people with multiple sclerosis. A systematic review of randomised control trials with meta-analysis and meta-regressions was performed. A search was conducted in PubMed, Scopus, Web of Science, the Physiotherapy Evidence Database, the Cochrane Database, CINHAL, LILACS, ScienceDirect, and ProQuest. It was last updated in July 2022. After the selection of studies, a quality appraisal was carried out using the PEDro Scale and the Revised Cochrane risk-of-bias tool for randomised trials. A descriptive analysis of main characteristics and dropout information was performed. An overall proportion meta-analysis calculated the pooled dropout rate. Odds ratio meta-analysis compared the dropout likelihood between interventions. The meta-regression evaluated the influence of moderators related to dropout. Sixteen studies with 656 participants were included. The overall pooled dropout rate was 6.6% and 5.7% for virtual reality and 9.7% in control groups. The odds ratio (0.89, p = 0.46) indicated no differences in the probability of dropouts between the interventions. The number, duration, frequency, and weeks of sessions, intervention, sex, multiple sclerosis phenotype, Expanded Disability Status Scale score, and PEDro score were not moderators (p > 0.05). Adverse events were not reported and could not be analysed as moderators. Dropouts across the virtual reality and control comparators were similar without significant differences. Nonetheless, there is a slight trend that could favour virtual reality. Standardisation in reporting dropouts and adverse events is recommended for future trials. PROSPERO database, registration number ID CRD4202128498917 página

The immunogenetic diversity of the HLA system in Mexico correlates with underlying population genetic structure

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) allele groups and alleles by PCR-SSP based typing in a total of 15,318 mixed ancestry Mexicans from all the states of the country divided into 78 sample sets, providing information regarding allelic and haplotypic frequencies and their linkage disequilibrium, as well as admixture estimates and genetic substructure. We identified the presence of 4268 unique HLA extended haplotypes across Mexico and find that the ten most frequent (HF > 1%) HLA haplotypes with significant linkage disequilibrium (Δ’≥0.1) in Mexico (accounting for 20% of the haplotypic diversity of the country) are of primarily Native American ancestry (A*02~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*08~DQB1*04, A*68~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*14~DQB1*03:01, A*24~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*04~DQB1*03:02, A*02~B*40:02~DRB1*04~DQB1*03:02, A*68~B*35~DRB1*04~DQB1*03:02, A*02~B*15:01~DRB1*04~DQB1*03:02). Admixture estimates obtained by a maximum likelihood method using HLA-A/-B/-DRB1 as genetic estimators revealed that the main genetic components in Mexico as a whole are Native American (ranging from 37.8% in the northern part of the country to 81.5% in the southeastern region) and European (ranging from 11.5% in the southeast to 62.6% in northern Mexico). African admixture ranged from 0.0 to 12.7% not following any specific pattern. We were able to detect three major immunogenetic clusters correlating with genetic diversity and differential admixture within Mexico: North, Central and Southeast, which is in accordance with previous reports using genome-wide data. Our findings provide insights into the population immunogenetic substructure of the whole country and add to the knowledge of mixed ancestry Latin American population genetics, important for disease association studies, detection of demographic signatures on population variation and improved allocation of public health resources.Fil: Barquera, Rodrigo. Max Planck Institute For The Science Of Human History; Alemania. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Hernández Zaragoza, Diana Iraíz. Técnicas Genéticas Aplicadas A la Clínica (tgac); México. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Bravo Acevedo, Alicia. Instituto Mexicano del Seguro Social; MéxicoFil: Arrieta Bolaños, Esteban. Universitat Essen; AlemaniaFil: Clayton, Stephen. Max Planck Institute For The Science Of Human History; AlemaniaFil: Acuña Alonzo, Víctor. Instituto Nacional de Antropología E Historia, Mexico; MéxicoFil: Martínez Álvarez, Julio César. Instituto Mexicano del Seguro Social; MéxicoFil: López Gil, Concepción. Instituto Mexicano del Seguro Social; MéxicoFil: Adalid Sáinz, Carmen. Instituto Mexicano del Seguro Social; MéxicoFil: Vega Martínez, María del Rosario. Hospital Central Sur de Alta Especialidad; MéxicoFil: Escobedo Ruíz, Araceli. Instituto Mexicano del Seguro Social; MéxicoFil: Juárez Cortés, Eva Dolores. Instituto Mexicano del Seguro Social; MéxicoFil: Immel, Alexander. Max Planck Institute For The Science Of Human History; Alemania. Christian Albrechts Universitat Zu Kiel; AlemaniaFil: Pacheco Ubaldo, Hanna. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: González Medina, Liliana. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Lona Sánchez, Abraham. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Lara Riegos, Julio. Universidad Autónoma de Yucatán; MéxicoFil: Sánchez Fernández, María Guadalupe de Jesús. Instituto Mexicano del Seguro Social; MéxicoFil: Díaz López, Rosario. Hospital Central Militar, Mexico City; MéxicoFil: Guizar López, Gregorio Ulises. Hospital Central Militar, Mexico City; MéxicoFil: Medina Escobedo, Carolina Elizabeth. Instituto Mexicano del Seguro Social; MéxicoFil: Arrazola García, María Araceli. Instituto Mexicano del Seguro Social; MéxicoFil: Montiel Hernández, Gustavo Daniel. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; MéxicoFil: Hernández Hernández, Ofelia. Técnicas Genéticas Aplicadas a la Clínica ; MéxicoFil: Ramos de la Cruz, Flor del Rocío. Instituto Mexicano del Seguro Social; MéxicoFil: Juárez Nicolás, Francisco. Instituto Nacional de Pediatría; MéxicoFil: Pantoja Torres, Jorge Arturo. Instituto Mexicano del Seguro Social; MéxicoFil: Rodríguez Munguía, Tirzo Jesús. Hospital General Norberto Treviño Zapata; MéxicoFil: Juárez Barreto, Vicencio. Hospital Infantil de Mexico Federico Gomez; MéxicoFil: Gonzalez-Jose, Rolando. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentin