New Goal To Get More People With Learning Disabilities Into Work, UK

People with a learning disability will be helped into paid jobs to close the employment gap, Jonathan Shaw, Minister for Disabled People and Phil Hope, Minister for Care Services pledged today.

The goal is set out in the new cross-government Learning Disability Employment Strategy, published today. The strategy sets out a vision to increase the number of real jobs for people with learning disabilities with appropriate support being provided.

Care Services Minister Phil Hope said:

“Two thirds of people with a learning disability would like to work. Huge progress has been made in getting physically disabled people into employment but more must be done to help people with a learning disability – we’re missing a huge talent pool which employers can tap into.

“This strategy lays out an ambitious but achievable goal – to close the employment gap, for people with learning disabilities.

“The public sector has an important role to play to deliver the strategy, which is why it commits Government departments and the NHS to increasing the number of jobs they offer to people with learning disabilities.”

Minister for Disabled People Jonathan Shaw said:

“This strategy will help thousands more people get into work. We want to make sure everyone gets the help and support they need to overcome their barriers to work, fulfil their potential and build a better life for themselves and their families.

“We have made real improvements over the last decade to the lives of disabled people but there is still more to do, which is why we have committed to do more.”

The strategy, which will focus on adults with moderate and severe learning disabilities, will seek to close the employment gap with a number of measures:

- It is crucial to promote the fact that people with learning disabilities can work and have careers. The single most important thing is to change, from an early age, expectations about work, and Government will encourage widespread culture change;

- 400 employment opportunities will be offered to people with learning disabilities across the Department for Work and Pensions, including in Jobcentre Plus;

- the Department of Health will continue to work with Strategic Health Authorities, the NHS Confederation and NHS Employers to increase the number of people with learning disabilities employed in the NHS;

- all Government departments will be issued with guidance to help them target people with learning disabilities in recruitment campaigns;

- Jobcentre Plus staff will continue to be trained to support disabled people, including people with learning disabilities, into work; and

- job coaches will be recruited to give people with learning disabilities the support they need to find and retain paid employment;

- good career and skills preparation in schools and colleges;

- the Office for Disability Issues is today inviting interested organisations to submit proposals to become Project Search sites, and take part in an evaluation of Project Search. Project Search supports people with learning disabilities into paid jobs by providing a series of internships with a host employer.

A delivery plan, to be published alongside the strategy, will set out actions with timescales and responsibilities to ensure progress.

Source
Department of Health, UK

Rheumatoid Arthritis Cardiovascular Risk Remains High In DMARD Era

The increased risk of cardiovascular disease and myocardial infarction associated with rheumatoid arthritis does not appear to have been changed by the introduction of DMARDs, according to a Swedish study.

Dr Ulf Bergstrom and colleagues, University Hospital Malmo, compared cardiovascular morbidity and mortality in 1995-2002, and in an earlier patient cohort (1978-85).

They found that the increased incidence of cardiovascular events and cardiovascular deaths in patients with RA remained unchanged over time, despite intensive treatment with newer anti-rheumatic drugs and reduced disease severity, and they call for further action to prevent cardiovascular co-morbidity (Abstract #335).

American College of Rheumatology Annual Congress (ACR)

mabthera-ra

Understanding The Basics Of Learning And Memory

A molecular “recycling plant” permits nerve cells in the brain to carry out two seemingly contradictory functions — changeable enough to record new experiences, yet permanent enough to maintain these memories over time.

The discovery of this molecular recycling plant, detailed in a study appearing early online in the journal Neuron, provides new insights into how the basic units of learning and memory function. Individual memories are “burned onto” hundreds of receptors that are constantly in motion around nerve synapses — gaps between individual nerve cells crucial for signals to travel throughout the brain.

According to the study’s leader, Duke University Medical Center neurobiologist Michael Ehlers, M.D., Ph.D., these receptors are constantly moving around the synapse and often times they disappear or escape. Ehlers discovered that a specific set of molecules catch these elusive receptors, take them to the recycling plant where they are reprocessed and returned to the synapse intact.

“These receptors constantly escape the synapse and are in a perpetual state of recycling,” said Ehlers, who is also a Howard Hughes Medical Institute investigator. “This process occurs on a time scale of minutes or hours, so the acquisition of new neurotransmitter receptors and their recycling is an on-going process. Memory loss may result from receptors escaping from the synapse.”

All this activity takes place on millions of tiny “nubs,” or protrusions in the synapses known as dendritic spines. The recycling plants are located within the body of these dendritic spines.

“We believe that the existence of this recycling ability explains in part how individual dendritic spines retain their unique identity amidst this constant molecular turnover,” Ehlers said. “The system is simultaneously dynamic and stable.”

While these findings should be able to help neurobiologists as they attempt to understand the molecular foundations of learning and memory, Ehlers believes that this knowledge could also be helpful in explaining what happens in certain neurological disorders, such as Alzheimer’s disease, schizophrenia, or learning disorders like autism.

For example, it appears that in animal models of the early phases of Alzheimer’s disease, often before any symptoms become apparent, the dendritic spines gradually lose their ability to transport and recycle the receptors.

“If the receptors don’t get recycled, you see a gradual loss of synaptic function that is associated with reduced cognitive ability,” Ehlers said. “These dendritic spines are where learning and memories reside. These are the basic units of memory.”

Other Duke members of the team were Jiuyi Lu, Thomas Helton, Thomas Blanpied, Bence Racz and Thomas Newpher. Richard Weinberg of the University of North Carolina — Chapel Hill was also a member of the team. The research was supported by the National Institutes of Health.

Source: Richard Merritt

Duke University Medical Center

Occupational Therapy Clinic Benefits Children And Students

The occupation of a child is play. Sometimes, when certain problems stand between a child and normal play, the help of an occupational therapist is needed. The University of Missouri-Columbia School of Health Professions is completing its first year of providing this type of help for children through a clinic staffed entirely by occupational therapy students, supervised by a licensed therapist. The pediatric clinic is providing early intervention for children and a place for students to get hands-on experience in their field of study.

“In the past, services were often not provided to children until they were of school age. Research shows that early intervention is best because the brain is more capable of change during that period of time. So, especially for children with long-term issues, early intervention can help address any challenges a child may be experiencing before they are set and become an even greater hurdle,” said Lea Ann Brittain, clinical instructor of occupational therapy and clinic coordinator.

The clinic provides evaluations for children of all ages, but the majority are of pre-school age. Brittain said the children could experience anything from difficulty with handwriting and dressing themselves to poor coordination and fine motor skills. The evaluation helps pinpoint the problem and the cause. Children in need of occupational therapy range from children with cerebral palsy or autism spectrum disorders to prematurity or developmental delay. Occupational therapy uses purposeful activities to promote the greatest possible function in performing daily tasks.

“If a child is a year old and not using a fork, then that is not an issue; however, if a four-year-old child is not using a fork, then that is a problem,” Brittain said. “People really underestimate the amount of stress these types of delays can cause for families. We are just one element. What really helps kids is people coming together – parents, other community and therapy supports and schools.”

The clinic also complements the work being done at the School of Health Profession’s Robert G. Combs Language Preschool. Brittain said those students involved in collaboration with other disciplines really learn the benefits of working as a team.

“Students demonstrate much better clinical reasoning and understand what is realistic to expect,” Brittain said. “These real-world scenarios also teach them how to work with families and kids with special needs.”

University of Missouri

329 Jesse Hall
Columbia, MO 65211-1280
United States
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Inflammatory Diseases Linked To Increased Cardiovascular Risk

Patients suffering from two serious autoimmune disorders which cause muscular inflammation are at increased risk of developing cardiovascular disease, says a group of Montreal researchers. Dr. Christian A. Pineau and his team at the Research Institute of the McGill University Health Centre (RI-MUHC) have linked muscular inflammation to increased cardiovascular risk for the first time. Their results were published recently in The Journal of Rheumatology.

Polymyositis (PM) and dermatomyositis (DM) are most common in women and seniors, although they can affect people of any age. Both diseases are caused by a hyperactive immune system which attacks healthy tissue, almost as if the body had become allergic to itself. This causes serious inflammation of muscle tissue in the body, leading to weakness, reduced mobility and, in the case of DM, rashes. Muscles in the heart and the lungs may also be affected.

“Inflammation has recently been recognized as a risk factor – along with hypertension and cholesterol problems – for arterial diseases that can lead to events such as heart attacks,” says Dr. Pineau. Nearly one in 5,000 people suffer from PM and DM, approximately 7,000 in Canada and 75,000 across North America.

“Our results indicate that the risk of heart attack is twice as high in these people as in the general population,” says Dr. Sasha Bernatsky, a study co-author. “Each year, one out of every 200 people with muscle inflammation, or myositis, succumbs to a stroke and one out of 75 to a heart attack.”

The researchers also noted that the immunosuppressive therapies currently used to treat PM and DM may have a preventive effect against heart attacks. “This is an extremely interesting finding for patients who are suffering from PM and DM but who may be hesitant to undergo this type of treatment,” adds Dr. Pineau, noting that some patients are concerned about the possible side-effects of immunosuppressive therapies, such as reduced immunity to infection.

“Sometimes patients do not want to undergo immunosuppressive treatment, which can last for years,” adds Dr. Bernatsky. “Knowing that it has additional preventive effects may help some people decide to opt for the treatment.”

Cardiovascular diseases are the world’s leading cause of death, and the researchers hope that their results will provide a clearer picture of the possible benefits and possibilities of immunosuppressive treatment. As a result of their encouraging findings, Dr. Pineau and his team are now turning their attention to possible benefits of immunosuppressive therapy on other health risks associated with inflammatory diseases.

Partners


This article was co-authored by Dr. Annaliese Tisseverasinghe of the MUHC, and Drs. Sasha Bernatsky and Christian A. Pineau of RI-MUHC and McGill University.

Funding


This study was funded by a grant from the Canadian Institutes of Health Research (CIHR).


Dr. Sasha Bernatsky is a researcher in the RI-MUHC Musculoskeletal Disorders Axis, and a doctor in rheumatology and epidemiology at the MUHC clinic. She is also an assistant professor in the McGill University Faculty of Medicine.


Dr. Annaliese Tisseverasinghe is a former internal medicine resident at the MUHC. She is currently pursuing her studies in rheumatology.


Dr Christian A. Pineau is a researcher in the RI-MUHC Musculoskeletal Disorders Axis, as well as co-director of the lupus and Vasculitis clinic at the MUHC. He is also the Rheumatology Program Director and associate professor in the McGill University Faculty of Medicine.

Source:
Julie Robert

McGill University Health Centre

Lotus Pharmaceuticals Enter R-Bambuterol(R) Clinical Trial I

Lotus Pharmaceuticals, Inc. (OTC Bulletin Board: LTUS) (“Lotus” or the “Company”), a growing developer, manufacturer and seller of medicine and drugs in the People’s Republic of China (the “PRC”), announced that it has entered R-Bambuterol(R) Clinical Trial I on-schedule and is on-track to complete in six months. The studies will evaluate the safety and tolerability of the new drug as well as the biological activity by measuring responses in healthy volunteers.

The studies are co-monitored by the Company and Beijing Zenith International Medical Science and Technology Development Company Limited, a mid-size full-service clinical research organization, and carried out in Peking University Third Hospital, a top-ranked AAA hospital recognized as a base adherence to the principles of good clinical practices (GCPs).

R-Bambuterol(R) Hydrochloride Tablets showed significant efficacy and less toxicity in preclinical trials as an anti-asthma drug than Bambuterol currently available in the market.

If it reaches the market, R-Bambuterol(R) Hydrochloride Tablets would address the Chinese asthma and chronic obstructive pulmonary disease (COPD) market led by AstraZeneca with a 26 percent share in 2009, according to IMS.

Safe Harbor Statement

This press release contains “forward-looking statements” within the meaning of the “safe-harbor” provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include, without limitation, any statement that may predict, forecast, indicate, or imply future results, performance or achievements, and may contain the words “estimate,” “project,” “intent,” “forecast,” “anticipate,” “plan,” “planning,” “expect,” “believe,” “will likely,” “should,” “could,” “would,” “may,” or words or expressions of similar meaning. Such statements are not guarantees of future performance and could cause the actual results of the Company to differ materially from the results expressed or implied by such statements, including, but not limited to, changes from anticipated levels of sales, future national or regional economic and competitive and regulatory conditions, changes in relationships with customers, access to capital, increased costs, difficulties in developing and marketing new products, marketing existing products, customer acceptance of existing and new products, the time to get new drugs approved by the State Food and Drug Administration and other factors. Additional information regarding risks can be found in the Company’s Annual Report on Form 10K and its other filings with the SEC. Accordingly, although the Company believes that the expectations reflected in such forward-looking statements are reasonable, there can be no assurance that such expectations will prove to be correct. The Company has no obligation to update the forward-looking information contained in this press release.

Source: Lotus Pharmaceuticals, Inc

Common Genetic Factors That Affect Autism Risk Have Been Identified

The first common genetic risk factor for autism spectrum disorder has been identified by a multi-center team of researchers that included Margaret Pericak-Vance, Ph.D., director of the Miami Institute for Human Genomics at the University of Miami Miller School of Medicine.

Dr. Pericak-Vance and her collaborator Jonathan Haines, Ph.D. at Vanderbilt University Medical Center, joined the results of their study with those of Hakon Hakonarson, Ph.D., from Children’s Hospital of Philadelphia. The findings from the breakthrough study published online April 28 by the journal Nature may implicate a gene involved in forming the connections between brain cells. .

“Until now, no common genetic variant has been identified with such overwhelming evidence to support its role in autism spectrum disorders,” said Pericak-Vance, “The identification of a common variant for autism is a monumental achievement. Researchers have been looking for clues about the genetic architecture of autism for decades. Many thought that this day would never come, but we persisted.” .

The study included investigators from more than a dozen sites and participation of more than 10,000 subjects, including individuals with autism spectrum disorder, their family members and other volunteers from across the United States. .

“Each research team conducted a genome-wide association study of individuals with autism and controls, and found a significant association between autism and a region on chromosome 5 that is near two genes known as CDH9 and CDH10,” said Dr. Haines, lead investigator of the research team from Vanderbilt and director of the Vanderbilt Center for Human Genetics Research, “Both genes encode cadherins which are cell surface proteins thought to be important for establishing connections between cells in the developing brain and are candidate genes that may contribute to autism.” .

“Although no single gene is responsible for autism, cadherin is one of several proteins that affect the stability and maturation of nerve synapses in the brain, therefore this is an intriguing candidate for this region,” said John P. Hussman, Ph.D., one of the co-investigators in the research. “This discovery is important not only in its own right, but also because it offers important clues about specific biological processes we should investigate.” .

Since individuals with autism are so diverse, some researchers believed a common risk variant would never be found, but the advent of genome wide technology changed everything. “We’ve known that technology would evolve to where identification of the hardest to find genetic risk variants would be possible,” said Pericak-Vance. .

Haines added, “We also knew that the technology would require large numbers of patient participants as well as the tools and expertise to analyze data. We stayed invested and stayed on the cutting edge; it has paid off.” .

The study published in Nature reflects the collaborative efforts of research teams from the University of Miami Miller School of Medicine, Vanderbilt, Children’s Hospital of Philadelphia, the University of Washington in Seattle, and the University of California, Los Angeles. The institutions combined resources and datasets to achieve the genome-wide significant results. .

An independent publication in the Annals of Human Genetics details all the findings from the complete genome-wide study conducted by the University of Miami and Vanderbilt Medical Center on their independent datasets. Summary results from the candidate region on chromosome 5 were included in the Nature publication as they further support the overall finding. Deqiong Ma, M.D., Ph.D. is co-first author of both publications; other key authors on both publications are Michael L. Cuccaro, Ph.D., John R. Gilbert, Ph.D., and Daria Salyakina, Ph.D. from the Miami Institute for Human Genomics at the University of Miami Miller School of Medicine. .

Autism is among a spectrum of disorders and is a neurodevelopmental disorder characterized by three primary areas of impairment: social interaction, communication, and restricted and repetitive patterns of interest or behavior. Recent prevalence studies suggest that autism spectrum disorders may affect as many as 1 in 150 children in the United States, making it one of the most common neurodevelopmental disorders. .

Funding for the autism research conducted at the Miami Institute for Human Genomics and the Center for Human Genetics Research at Vanderbilt University comes from the National Institutes of Health and specifically from the National Institute of Mental Health and the National Institute of Neurological Disorders and Stroke, from Autism Speaks, and from the Hussman Foundation. Dr. Pericak-Vance is the Dr. John T. Macdonald Professor of Human Genetics.

Source
Miller School of Medicine – University of Miami

Teaching Autistic Children To Safely Cross The Road Using Virtual Reality

Recent research conducted at the University of Haifa found that children with autism improved their road safety skills after practicing with a unique virtual reality system. “Children with autism rarely have opportunities to experience or to learn to cope with day-to-day situations. Using virtual simulations such as the one used in this research enables them to acquire skills that will make it possible for them to become independent,” said Profs. Josman and Weiss, from the Department of Occupational Therapy at the University of Haifa.

The independence of children with autism depends on their receiving treatment in natural settings. One of the main problems they face is their inability to learn how to safely cross the street, a necessary skill for independent living. While acquiring this skill could greatly improve these children’s independence, most of the methods for teaching street-crossing have been designed for use within the classroom, and they have been shown as insufficiently effective among autistic children.

The best way to teach children with autism skills is through repeated practice in natural settings, but the danger of learning to cross the street in a natural setting obviously prohibits this method. This is where virtual reality is very effective, as demonstrated by the research team which included Hadass Milika Ben-Chaim, then a student in the Occupational Therapy master’s program and Shula Friedrich, the principal of the Haifa Ofer School for Children with Autism as well as Profs. Josman and Weiss.

Six autistic children, ages 7-12, spent one month learning how to cross virtual streets, to wait for the virtual light at the crosswalk to change and to look left and right for virtual cars using a simulation programmed by Yuval Naveh. The children in the study showed substantial improvement throughout the learning process: at the beginning of the study, the average child was able to use the 2nd level of the software while by the end they mastered the 9th level, which is characterized by more vehicles traveling at a higher speed.

However, the research team was not looking to teach a virtual skill; they wanted to see if the children were able to transfer the skills they had mastered in a virtual environment to the real world. A local practice area with a street and crosswalk, complete with traffic signals, was used for this purpose. The children’s ability to cross the street safely was tested in this area evaluating, for example, whether they stopped to wait on the sidewalk or waited for a green light before crossing. The children were brought to the practice area before and after their virtual learning. Here too, the children exhibited an improvement in their skills, following the training on the virtual street, with three of the children showing considerable improvement.

One of the study participants, 16 years old, had participated in the past in a road safety program in the school, but he was not able to learn how to cross the street safely. Following learning the skill in a virtual environment, he learned how to stop on the sidewalk before stepping into the street, to look at the color of the traffic light, to cross only when the light was green and to cross without waiting too long.

“Previous studies have shown that autistic children respond well to computer learning. In this research we learned that their intelligence level or severity of their autism doesn’t affect their ability to understand the system and therefore this is an important way to improve their cognitive and social abilities,” summarized Profs. Josman and Weiss.

Source: Amir Gilat

University of Haifa

Getting Patients To Take Their Asthma Meds

Armed with the right information, physicians can play a stronger role in ensuring asthma patients don’t waver in taking drugs proven to prevent asthma attacks, according to researchers at Henry Ford Hospital in Detroit.

The study finds patients are more likely to routinely take inhaled corticosteroids (ICS) for asthma control when physicians kept close watch over their medication use and reviewed detailed electronic prescription information, including how often patients fill their prescriptions and the estimated number of days each prescription would last.

“Better inhaled corticosteroid adherence means better overall asthma control, and less hospitalization,” says lead study author L. Keoki Williams, M.D., MPH, Center for Health Services Research and Department of Internal Medicine at Henry Ford Hospital.

“Unfortunately, overall patient adherence to ICS medication is poor, accounting for an estimated 60 percent of asthma hospitalizations. So it’s important, as we move forward with health care reform, to look for more effective ways to make sure patients stay with their prescription regimens.”

The study – the first large-scale, controlled study to test the effectiveness of routinely providing patient medication adherence information to physicians – appears online in the Journal of Allergy and Clinical Immunology.

ICS, taken using an inhaler, help prevent and reduce airway swelling, and are considered the cornerstone therapy for controlling persistent asthma in patients, says Dr. Williams.

The Henry Ford scientific team set out to design an intervention that would provide physicians information on the most recent national asthma guidelines and methods for discussing medication non-adherence with their patients.

The intervention also offered physicians electronic access to patients’ medication prescription fill/refill information via Henry Ford’s ePrescribing application, part of its electronic medical record system that allows physicians to prescribe and review patient medications electronically.

The study enrolled 193 Henry Ford primary care physicians (family medicine, internal medicine, pediatrics). Eighty-eight were randomly assigned to the intervention group, while 105 were assigned to the control group (no intervention).

Physicians in the intervention group used ePrescribing to track medication fills and refills. The application also offered physicians the option to take it one step further: To review detailed adherence data, including estimates of the proportion of time that the patients took their medication.

Medication adherence for both groups was measured by using both electronic prescriptions and pharmacy claims for medication fills and refills.

Researchers found ICS adherence to be very similar among patients in the intervention group and those in the control group (21.3 percent vs. 23.3 percent).

But adherence was significantly higher in the intervention group (35 percent) when the patient’s physician elected to view detailed adherence information via the ePrescribing application.

Few physicians, however, in the intervention group accessed the detailed adherence information. “Going forward, one of the obstacles will be finding time for physicians to review and discuss this information with patients in their typically busy practices,” says Dr. Williams.

Funding: Henry Ford Hospital; National Heart, Lung and Blood Institute; National Institute of Allergy and Infectious Diseases; National Institute of Diabetes and Digestive and Kidney Disease; National Institutes of Health; and Strategic Program for Asthma Research of the American Asthma Association.

Source:
Krista Hopson
Henry Ford Health System

Diet, Obesity, And Asthma Linked

Australian researchers have identified a new protein in human airway epithelial cells that regulates allergic airway inflammation. This protein – adipocyte/macrophage fatty acid-binding protein aP2 – is known to regulate the uptake by fat cells of fatty acids and has been previously linked to insulin resistance in diabetes and the development of atherosclerosis. This new study suggests that in addition to its role in type 2 diabetes and hardening of the arteries, aP2 plays an essential role in allergic airway diseases such as asthma, and offers an additional intriguing link between the immune and metabolic systems. The study will appear online on July 13 in advance of print publication in the August issue of the Journal of Clinical Investigation.

The “hygiene hypothesis” currently dominates thinking in the medical field about the underlying causes of asthma. The hypothesis proposes that childhood infection and environmental factors such as diet and airborne pollution contribute to a predisposition to this condition. Michael Rolph and colleagues from The Garvan Institute of Medical Research, Sydney, now show for the first time that the protein aP2 is present in human epithelial cells lining the tubes that carry air from the windpipe to the lungs (bronchi), and that aP2 expression is significantly increased when these cells are stimulated with the molecules interleukin-4 and -13. This finding is very unexpected as aP2 has previously been considered to be a specific marker for fat cells. The group went on to show that mice lacking aP2 have a dramatic reduction in airway inflammation in a model of asthma. In addition, the infiltration into the airways of inflammatory molecules such as leukocytes and eosinophils was highly dependent on aP2 function in mice. The data emphasize the importance of lipids in the inflammatory response and contribute to the emerging theme that an overlap exists between the pathways that regulate inflammation and those that govern metabolism. Finally, the study suggests that blocking aP2 function may be a novel approach for the treatment of asthma and other inflammatory lung diseases.

TITLE: The adipocyte fatty acid-binding protein aP2 is required in allergic airway inflammation

AUTHOR CONTACT:

Michael S. Rolph
The Garvan Institute of Medical Research, Sydney, NSW, Australia.
E-mail: m.rolphgarvan.au.

OR

Gokhan S. Hotamisligil
Harvard School of Public Health, Boston, Massachusetts, USA.
Email: ghotamishsph.harvard.

View the PDF of this article at: https://the-jci/article.php?id=24767

Contact: Brooke Grindlinger

Journal of Clinical Investigation