Objective To evaluate the effectiveness and safety of Botulinum toxin-A (BTX-A) injection into detrusor to treat neurogenic detrusor overactivity in patients with spinal cord injury (SCI).Methods A total of 78 patients with SCI were treated with transurethral injection of BTX-A (300 IU dissolved in 15 ml of saline) into 30 different points of detrusor with 15 ml in every patients. Urodynamic parameters and voiding diary were assessed at baseline and 3 weeks and 3 months after the injections. Adverse events were recorded after the injection if present.Results After the first injection, 78 patients showed that the mean frequencies of incontinence decreased from 13.5 to 2.7 times per day, the mean volume of intermittent catheterization (IC) increased from 131 ml to 389 ml per time, the mean volume of incontinence decreased from 1 690 ml to 281 ml per day, the mean getting effect time was 7.6 days. 10 patients received second injection at 8.9 months after first injection, the results showed that the mean frequencies of incontinence decreased from 9.7 to 3.7 times per day, the mean IC volume increased from 108 ml to 387 ml. 6 patients received third injection at 5.8 months after second injection, the results showed that the mean frequencies of incontinence decreased from 9.2 to 3.9 times per day, the mean IC volume increased from 116 ml to 364 ml. No side effects were observed during the follow-up.Conclusion BTX-A injection into detrusor to treat neurogenic detrusor overactivity in patients with SCI seems to be an effective, safe and miniinvasive solution.

The goals of videofluoroscopy are visualization of oropharyngeal swallow physiology in the lateral and anterior/posterior plane, visualization of symptoms of swallowing disorders and assessment of efficacy of various selected treatment strategies.Analyzing videofluoroscopic evaluation results can provide the foundation for treatment planning. The session will include: Overview of normal anatomy and physiology, X-ray landmarks of structures involved in oropharyngeal swallowing, videofluorographic view of normal swallow physiology, identification of symptoms and disorders representing swallowing problems, and overview of treatment planning.

Objective To improve communication between patients with communication disorders and their health care providers. Methods A communication training session and a communication toolkit for health care workers in long-term care facilities (L-TCFs) were used before. A control group and experimental group were used to assess the effectiveness of the communication training and a toolkit. Results and Conclusion There was little benefit to the training and toolkit. However, anecdotal observations showed there were some benefits, especially with the increased use of amplifiers for patients with hearing impairment. In addition, the L-TCF is inherent with structural obstacles to successful communication that need to be taken into account when interpreting the results. More research is needed in this area.

Autism is a perplexing developmental disorder that presents itself in a variety of behavioral disorders. Research indicates that through early intervention and appropriate treatment these behaviors can be improved. This article reviews and critiques several of the current treatment programs for children with autism. These include Applied Behavioral Analysis (ABA), TEACCH,Sign Language, Facilitated Communication, Piture Exchange Comminication System (PECS), Object Exchange, Auditory Integration Therapy (AIT), and augmentative communication. When appropriate, the treatments were reviewed for their abilities to increase attention, imitation and initiation, social interaction and intentional communication, language development, and emotional regulation. The article, hopefully, provides parents and professionals a clearer choice as to what treatment is most appropriate for which child and when to use them.

In this article, I will discuss disability issues as a second and a half generation American of Chinese descent who has worked with persons with disabilities, has taught rehabilitation counseling as well as having been a rehabilitation psychologist for more than 35 years in the U.S. and Australia. I am pleased to be able to share some of my thoughts and experiences in this article that is a bit less formal than what you may expect in a professional journal. Though I hope that what I share will provoke some thinking and action from those who read these words.

The article is intended to introduce the readers to the concept and background of Web accessibility in the United States. I will first discuss different definitions of Web accessibility. The beneficiaries of accessible Web or the sufferers from inaccessible Web will be discussed based on the type of disability. The importance of Web accessibility will be introduced from the perspectives of ethical, demographic, legal, and financial importance. Web accessibility related standards and legislations will be discussed in great detail. Previous research on evaluating Web accessibility will be presented. Lastly, a system for automated Web accessibility transformation will be introduced as an alternative approach for enhancing Web accessibility.

Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of life. Current American societal expectations are that individuals who identify they are involved in substance abuse will go to treatment, eventually recover, get off public assistance straightaway, and return to work. Most rehabilitation professionals also maintain the same expectations. The reality is that efforts of prevention do not appear to diminish the number of people with substance abuse. Traditional treatment appears to have minimal, if any, influence upon the cessation of substance abuse, and traditional vocational rehabilitation practices appear unsuited for the unique problems and types of symptoms experienced by substance abusers. Creative, yet sound, alternatives that combine effective treatment strategies and non-traditional vocational rehabilitation methods need to be explored and tested for effectiveness, and applied.

Objective To discuss the key problem of medical device supervision of orthoses and its effect on orthoses market. Methods The meaning of orthoses was discriminated, the status of regulation was revealed, the generic names of orthoses was designed, and the effect of supervision on different body of orthoses market was analyzed. Results Difficulties are brought to the medical device regulation because of different meanings of orthoses in the fields of assistive devices and medical devices. Scientific classification and naming was the right way to solve the problem. Conclusion All the organizations on chains of orthoses are within the category of medical device supervision. Fit-ting organizations of orthoses should also accept regulation of China Food and Drug Administration, at the same time gaining qualification from China Ministry of Civil Affairs. The problem of personalized orthoses supervision needs to be solved properly.

Objective To explore the correlation between left ventricular hypertrophy (LVH) and dynamic parameters of blood pressure as well as blood pressure variation in patients with essential hypertension (EH). Methods From January to September, 2013, 581 patients with EH were divided into hypertrophy group (n=161) and non-hypertrophy group (n=420) according to the left ventricular mass index (LV-MI). The clinical data, biochemical indexes and dynamic parameters of blood pressure were compared, and the multiple factors regression was used to analyze the risk factors of LVH. Results The incidence of LVH was higher in women than in men (χ2=4.836, P=0.03), the level of blood uric acid was higher in the hypertrophy group than in the non-hypertrophy group (t=-11.540, P<0.001). The clinic systolic blood pressure was higher in the non-hypertrophy group (t=-3.805, P<0.001). There was significantly difference in 24-hour systolic blood pres-sure load, systolic blood pressure drops at night and average systolic blood pressure between two groups (t>2.770, P<0.05). Multi-factor Lo-gistic regression analysis showed that gender (OR=1.674, P=0.044) and 24-hour systolic blood pressure load (OR=1.021, P=0.003) associat-ed with LVH. Conclusion The occurrence of LVH in patients with EH was closely related to the 24-hour systolic blood pressure load, and was higher in women than in men.

Objective To explore the effect of unsupported arm exercise (UAE) on dyspnea, exercise endurance of upper limbs and qual-ity of life in patients with chronic obstructive pulmonary disease (COPD). Methods From May to October, 2014, totally 70 patients with COPD were recruited and were randomly assigned to control group and intervention group. Both groups received routine care, and the inter-vention group performed UAE for six weeks additionally. The COPD Assessment Test (CAT), baseline dyspnoea index (BDI) and six-min-ute Pegbord and Ring Test (6PBRT) were recorded. Results The scores of CAT and BDI, and the number of turns in six minutes were better in the intervention group than in the control group (P<0.05). Conclusion UAE can increase the exercise endurance of upper limbs, relieve the dyspnea, and improve the quality of life in patients with COPD.