Deficits in the perception of time and processing of changes across time are commonly observed in individuals with autism. This pilot study evaluated the efficacy of the use of the software tool Tic-Tac, designed to make time visual, in three adults with autism and learning difficulties. This research focused on applying the tool in waiting situations where the participants exhibited anxiety-related behaviour. The intervention followed a baseline and intervention (AB) design, and a partial interval recording procedure was used to code the presence of stereotypes, nervous utterances, wandering or other examples of nervousness during the selected waiting situations. The results showed that the use of Tic-Tac resulted in lower levels of anxiety-related behaviour in all three participants, compared to the baseline, suggesting that this software may be an effective technology for helping people with autism with organisation and predictability during waiting periods. The results are discussed in terms of limitations and implications for further study.

This paper explores disparities in health care access for undocumented immigrants in the United States. Using the case of California, we find that less than half of undocumented immigrants in this state report having health insurance. Additionally, our estimates show that, among the insured, US-born and naturalized citizens are significantly more likely to have a doctor visit in the previous year when compared to undocumented immigrants (aOR = 1.53%; 95% CI 1.15 -2.04, aOR = 1.40%; 95% CI 1.05 -1.87, respectively). Further, we find that US-born citizens are significantly more likely to use the ER in the previous year than undocumented immigrants, independent of insurance status. Our findings suggest that undocumented immigrants not only face barriers to obtain health insurance, but even with health insurance they face barriers to access health care services.

Efecto del pedaleo de brazos sobre el sistema cardiorrespiratorio de las Efecto del pedaleo de brazos sobre el sistema cardiorrespiratorio de las personas con tetraplejia personas con tetraplejia Effect of armcrank pedaling on the cardiorespiratory system of the Effect of armcrank pedaling on the cardiorespiratory system of the people with tetraplegia people with tetraplegia G a b r i e l B r i z u e l a C o s t a S a n d r a S i n z R a f a e l A r a n d a M a l a v é s I g n a c i o M a r t í n e z N a v a r r o U n i v e r s i d a d d e V a l e n c i a Objetivos: Determinar el efecto de un programa de entrenamiento de pedaleo de brazos (PB) estacionario sobre el sistema cardiorrespiratorio de personas con tetraplejia. Método: Se estudiaron 11 participantes con tetraplejia por lesión medular (LM) de origen traumático a niveles entre C4 y C6. Se midieron variables espirométricas (VC, FVC y MVV) y de Variabilidad de la Frecuencia Cardíaca VFC (HR, STDHR, RMSSD, LF, HF y HRVPOWER), antes y después de 8 semanas de entrenamiento. Resultados: Todas las variables mostraron cambios significativos (p < 0,05) después del programa de entrenamiento aumentando su valor, excepto la FC que disminuyó. Las personas con las LM más bajas mostraron valores mayores en todos los parámetros espirométricos. Conclusiones: Un entrenamiento de PB a corto plazo es suficiente para mejorar de modo relevante tanto los parámetros respiratorios como los de VFC, en personas con tetraplejia, incrementando probablemente su calidad de vida.Palabras clave: pedaleo de brazos; tetraplejia; variabilidad de la frecuencia cardíaca; espirometría. R e s u m e nGabriel Brizuela Costa Universidad de Valencia, España E-mail: Gabriel.Brizuela@uv.es Objective: The aim of the study was to determine the effect, in subjects with tetraplejia, of a stationary armcrank pedaling (AP) training program on their cardiorespiratory system. Method: 11 participants with tetraplegia, originated by traumatic spinal cord injury (SCI) at levels between C4 and C6, were included in the study. Spirometric (VC, FVC and MVV) and Heart Rate Variability (HRV) indexes (HR, STDHR, RMSSD, LF, HF, HRVPOWER) were measured before and after an 8 weeks of armcrank pedaling training program. Results: Spirometric and HRV variables showed changes (p < 0.05) after the training program, all the variables increased their value after the program, except HR which was decreased. People with lower SCI showed higher respiratory parameters. Conclusions: A short term AP training program is sufficient to meaningfully improve both respiratory and HRV parameters in people with high tetraplegia, and probably increasing their quality of life.Key words: armcrank pedaling; tetraplegia; heart rate variability; spirometry. A b s t r a c tRecibido el 16 de abril 2010; aceptado el 17 de septiembre de 2010

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