ABSTRACT
Parkinson's disease (PD) is a neurodegenerative movement disorder characterized by motor symptoms that initially manifest unilaterally. Whilst some studies indicate that right-side onset is associated with greater symptom severity, others report no differences between right-side and left-side onset patients. The present meta-analysis was thus designed to reconcile inconsistencies in the literature and determine whether side of onset affects PD symptom severity. Following the PRISMA guidelines 1013 studies were initially identified in database and grey literature searches; following title and abstract, and full text, screening 34 studies met the stringent inclusion criteria (n = 2210). Results of the random-effects meta-analysis indicated no difference in symptom severity between PD patients with left-side (n = 1104) and right-side (n = 1106) onset. As such, the meta-analysis suggests that the side of onset should not be used to predict symptom trajectory or to formulate prognoses for PD patients. The current meta-analysis was the first to focus on the relationship between the side of onset and symptom severity in PD. However, the studies included were limited by the common exclusion of left-handed participants. Future research would benefit from exploring other factors that may influence symptom severity and disease progression in PD, such as asymmetric loss of nigrostriatal dopaminergic neurons.
ABSTRACT
Contemporary reform efforts pose numerous challenges for students and their teachers, especially in the context of inclusion classrooms that serve students with diverse academic and social profiles. The research reported in this article was conducted for the purpose of closely studying the engagement and learning of students who have learning disabilities as they participate in a particular approach to guided inquiry called Guided Inquiry supporting Multiple Literacies (GIsML). Questions guiding the research included (a) What are the opportunities and challenges that GIsML instruction presents students with special needs? (b) How do students with special needs respond to these opportunities and challenges? and (c) What hypotheses emerge from the data that will usefully guide subsequent research investigating the means of mediating these students' participation in GIsML for the purpose of enhancing their engagement and learning? The research was conducted using an array of ethnographic methods. The findings were summarized in a set of claims concerning the engagement and learning of these students. Finally, cases of individual students were constructed to illustrate these claims. The article concludes with the case of one fourth-grade student as he engaged in a program of study investigating why objects float and sink. The case revealed (a) the ways in which, in the context of guided inquiry, the student achieved a number of positive outcomes; (b) how his learning problems, principally with regard to print literacy, revealed themselves in his activity; and
