BR-bombesin: a novel bombesin-related peptide from the skin secretion of the Chaco tree frog (Boana raniceps) with physiological gastric effects.

Bombesin mediates several biological activities in the gastrointestinal (GI) tract and central nervous system in mammals, including smooth muscle contraction, secretion of GI hormones and regulation of homeostatic mechanisms. Here, we report a novel bombesin-like peptide isolated from Boana raniceps. Its amino acid sequence, GGNQWAIGHFM-NH2, was identified and structurally confirmed by HPLC, MS/MS and 454-pyrosequencing; the peptide was named BR-bombesin. The effect of BR-bombesin on smooth muscle contraction was assessed in ileum and esophagus, and its anti-secretory activity was investigated in the stomach. BR-bombesin exerted significant contractile activity with a concentration-response curve similar to that of commercially available bombesin in ileum strips of Wistar rats. In esophageal strips, BR-bombesin acted as an agonist, as many other bombesin-related peptides act, although with different behavior compared to the muscarinic agonist carbachol. Moreover, BR-bombesin inhibited stomach secretion by approximately 50% compared to the untreated control group. This novel peptide has 80% and 70% similarity with the 10-residue C-terminal domain of human neuromedin B (NMB) and human gastrin releasing peptide (GRP10), respectively. Molecular docking analysis revealed that the GRP receptor had a binding energy equal to - 7.3 kcal.mol-1 and - 8.5 kcal.mol-1 when interacting with bombesin and BR-bombesin, respectively. Taken together, our data open an avenue to investigate BR-bombesin in disorders that involve gastrointestinal tract motility and acid gastric secretion.

Função sexual e qualidade de vida em mulheres climatéricas / Climacteric women's sexual function and quality of life

Introdução: O climatério é um período marcado por transformações no corpo feminino, desse modo, diversos problemas como: redução da lubrificação vaginal, anorgasmia e dispareunia podem surgir ou se agravar e, como consequência, há uma diminuição na qualidade de vida. Objetivo: Analisar a relação da função sexual e a qualidade de vida em mulheres climatéricas. Métodos: Trata-se de um estudo observacional, de corte transversal, analítico. A coleta de dados foi realizada com 20 mulheres climatéricas com faixa etária de 38 a 60 anos. Como instrumentos foram utilizados questionários contendo dados sociodemográficos, o Female Sexual Function Index para avaliar a função sexual e o World Health Organization Quality of Life (WHOQOLBREF) para analisar a qualidade de vida. Resultados: Foi observado que nas mulheres que possuem disfunção sexual no domínio excitação, a média está abaixo do ponto de corte, o que não ocorre com mulheres que não possuem disfunção (p = 0,03), o mesmo ocorre com os domínios orgasmo e satisfação. Na correlação da função sexual com a qualidade de vida, há significância estatística nos domínios físico (p = 0,023) e meio ambiente (p = 0,049). Conclusão: Constatou-se que nas mulheres que possuem uma qualidade de vida reduzida os impactos da disfunção sexual são maiores. (AU)

Introduction: The climacteric period is a stage characterized by changes in women's bodies this way, numerous issues such as the decrease of vaginal lubrication, anorgasmia and dyspareunia may come up and be aggravated consequently promoting a reduction in the quality of life. Objective: To assess the relation between sexual functioning and life's quality in climacteric women. Methods: It is an observational and analytical study, with a cross-sectional design. The data collection was carried with 20 climacteric women aged from 38 to 60 years old. As instruments were used questionnaires that comprised sociodemographic data, the Female Sexual Function Index to examine the sexual function and the World Health Organization Quality of Life WHOQOL-BREF to assess life's quality. Results: It was noted that for women who have had sexual dysfunction in the excitation domain, the mean was below the cutoff point what does not happen with women who did not have dysfunction (p = 0,03), the same happens with orgasm and satisfaction domains. Correlating sexual function with life's quality, the physical (p = 0,023) and environmental (p = 0,049) present statistical significance. Conclusion: It was determined that for women who have a reduced quality of life the sexual dysfunction impacts are larger. (AU)

EFFECT OF CHRONIC RENAL DYSFUNCTION ON THE PERMEABILITY OF THE COLON TO WATER AND ELECTROLYTES: EXPERIMENTAL STUDY IN RATS.

BACKGROUND: Renal insufficiency is a disease that affects several organs by provoking hypervolemia and uremia. The disease reaches more than 500 million people worldwide and few studies bring their influence on the gastrointestinal tract. AIM: To evaluate the influence of 5/6 nephrectomy-induced hypervolemia on colonic permeability to water and electrolytes. METHOD: Sixty male Wistar rats weighing between 280-300 g were divided into three groups: 3, 7 and 14 days after nephrectomy, each one having a false-operated/control and partially nephrectomized. For colonic permeability they were submitted to colonic perfusion with a solution of Tyroad containing phenolphthalein. Differences among the concentrations of Na+, K+ and Cl- were used to calculate the rate of colonic permeability for the electrolytes. Phenolphthalein concentrations were used to evaluate the rate of secretion and water absorption. RESULTS: The colonic secretion of water and electrolytes occurred expressively in the group seven days after nephrectomy. Hemodynamic and biochemical assessments determined the progression of renal failure in all three groups and polyethylene glycol was shown to be effective in reversing the secretory capacity of the colon. CONCLUSION: Hypervolemia established after 7 days post-nephrectomy 5/6 caused marked colonic secretion for water and electrolytes. The organism presents progressive colonic secretion as the blood volume increases; on the other hand, polyethylene glycol was able to revert this secretory framework of the colon to water and electrolytes by reversing the hypervolemia.

Protective effect of Platymiscium floribundum Vog. in tree extract on periodontitis inflammation in rats.

Periodontitis is an immuno-inflammatory disease, which can lead to tooth loss. This study aimed to investigate the efficacy of Platymiscium floribundum Vog., a Brazilian tree which has been used in folk medicine as an anti-inflammatory agent, in a pre-clinical trial of periodontitis in rats. Periodontitis was induced by placing a sterilized nylon (3.0) thread ligature around the cervix of the second left upper molar of the rats, which received (per os) P. floribundum extract (0.1, 1 or 10 mg/kg) or vehicle 1h before periodontitis-challenge and once daily during 11 days. Treatment with P. floribundum (10mg/kg) decreased alveolar bone loss, MPO activity nitrite/nitrate levels, oxidative stress, TNF-α, IL1-ß, IL-8/CINC-1, and PGE2 gingival levels, and transcription of TNF-α, IL1-ß, COX-2, iNOS, RANK, and RANKL genes, while elevated both BALP serum levels and IL-10 gingival levels. The animals did not show signs of toxicity throughout the experimental course. These findings show that P. floribundum has anti-inflammatory and anti-resorptive properties in a pre-clinical trial of periodontitis, representing an interesting biotechnological tool.

O ser mãe de uma criança com microcefalia / Being mother of a child with microcephaly

Essa pesquisa objetiva analisar o impacto de ser mãe de uma criança com microcefalia, identificando as mudanças ocorridas no seu cotidiano após o nascimento do filho. Participaram desse estudo cinco mães, com faixa etária de 21 a 45 anos, todas atendidas na atenção básica, que tinham filhos de qualquer idade e sexo, com diagnóstico de Microcefalia, residentes no município de Jequié/BA. Trata-se de um estudo de caráter descritivo e abordagem qualitativa. Foram realizadas 5 entrevistas, que foram gravadas e transcritas na íntegra para a análise de conteúdo, usando a metodologia de Bardin. Após análise foram geradas categorias e subcategorias: 1. Conhecimento prévio da microcefalia; 2. Diagnóstico da microcefalia (Descoberta do diagnóstico, Cuidado do profissional de saúde ao passar o diagnóstico e Falta de conhecimento dos profissionais de saúde para o diagnóstico); 3. O pai diante da microcefalia; 4. Alterações na rotina da mãe (Interferência no sono e Impacto na rotina) 5. Acolhimento dos serviços de saúde e profissionais de saúde. Com os resultados percebeu-se que são diversas as dificuldades enfrentadas pelas mães que mudam totalmente suas rotinas, abandonam emprego, abdicam de momentos de lazer, vivenciam a separação dos seus parceiros no momento de dificuldade e a abdicação de si para cuidar do filho. Quanto aos profissionais de saúde, os resultados apontaram que não dominam o conhecimento sobre a microcefalia e demonstram pouca sensibilidade ao passar o diagnóstico as mães. Conclui-se assim que as mães de filhos microcefálicos mudam totalmente sua rotina e se veem negligenciadas pela Rede de Assistência em relação a sua própria saúde e de seus filhos. (AU)

This study aimed to analyze the impact of being mother of a child with microcephaly, identifying the changes that occurred in their daily life after the child birth. Five mothers, aged between 21 and 45 years, all attended in primary care, who had children of any age and sex, with diagnosis of Microcephaly, living in the municipality of Jequié in Bahia, Brazil, took part of this study. This is a descriptive study with qualitative approach. Five interviews were carried out, which were recorded and transcribed in full for the content analysis, using Bardin's methodology. After analysis, categories and subcategories were generated: 1. Previous microcephaly knowledge; 2. Microcephaly Diagnosis (Diagnosis discovery, Health professional care when informing the diagnosis and health professionals lack of knowledge for the diagnosis); 3. The father facing microcephaly; 4. Changes in the mother's routine (Sleep interference and Impact in the routine) 5. Reception of health services and health professionals. We observed several difficulties faced by mothers who totally change their routines, abandon their jobs, give up leisure time, experience separation from their partners at the difficulty moment, and abdicate themselves to care for their child. Regarding health professionals, the results indicated that they do not dominate microcephaly knowledge and show little sensitivity when informing the diagnosis to the mothers. We concluded that mothers of children with microcephalic change their routine completely and are neglected by the Care Network in relation to their own health and their children. (AU)

Função sexual e qualidade de vida em mulheres climatéricas / Climacteric women's sexual function and quality of life

Introdução: O climatério é um perí­odo marcado por transformações no corpo feminino, desse modo, diversos problemas como: redução da lubrificação vaginal, anorgasmia e dispareunia podem surgir ou se agravar e, como consequência, favorece uma diminuição na qualidade de vida. Objetivo: Analisar a relação da função sexual e a qualidade de vida em mulheres climatéricas. Métodos: Trata-se de um estudo observacional, de corte transversal, analí­tico. A coleta de dados foi realizada com 20 mulheres climatéricas com faixa etária de 38 a 60 anos. Como instrumentos foram utilizados questionários contendo dados sociodemográficos, o Female Sexual Function Index para avaliar a função sexual e o World Health Organization Quality of Life WHOQOL-BREF para analisar a qualidade de vida. Resultados: Foi observado que nas mulheres que possuem disfunção sexual no domí­nio excitação, a média está abaixo do ponto de corte, o que não ocorre com mulheres que não possuem disfunção (p = 0,03), o mesmo ocorre com os domí­nios orgasmo e satisfação. Na correlação da função sexual com a qualidade de vida, há significância estatí­stica nos domí­nios fí­sico (p = 0,023) e meio ambiente (p = 0,049). Conclusão: Constatou-se que nas mulheres que possuem uma qualidade de vida reduzida os impactos da disfunção sexual são maiores. (AU)

Introduction: The climacteric period is characterized by changes in women's bodies, and numerous issues like decrease of vaginal lubrication, anorgasmia and dyspareunia may come up and be aggravated, promoting a reduction in the quality of life. Objective: To assess the relation between sexual functioning and quality of life in climacteric women. Methods: This is an observational and analytical study, with a cross-sectional design. The data were carried out with 20 climacteric women 38 to 60 years old. We used questionnaires including sociodemographic data, the Female Sexual Function Index to examine the sexual function and the World Health Organization Quality of Life WHOQOL-BREF to assess quality of life. Results: We noted that for women who have had sexual dysfunction in the excitation domain, the mean was below the cutoff point what does not happen with women who did not have dysfunction (p = 0,03), the same happens with orgasm and satisfaction domains. Correlating sexual function with quality of life, the physical (p = 0,023) and environmental domains (p = 0,049) present statistical significance. Conclusion: In women with a reduced quality of life the sexual dysfunction impacts are larger. (AU)

Effect of chronic renal dysfunction on the permeability of the colon to water and electrolytes: experimental study in rats / Efeito da disfunção renal crônica sobre a permeabilidade do cólon para água e eletrólitos: estudo experimental em ratos

ABSTRACT Background: Renal insufficiency is a disease that affects several organs by provoking hypervolemia and uremia. The disease reaches more than 500 million people worldwide and few studies bring their influence on the gastrointestinal tract. Aim: To evaluate the influence of 5/6 nephrectomy-induced hypervolemia on colonic permeability to water and electrolytes. Method: Sixty male Wistar rats weighing between 280-300 g were divided into three groups: 3, 7 and 14 days after nephrectomy, each one having a false-operated/control and partially nephrectomized. For colonic permeability they were submitted to colonic perfusion with a solution of Tyroad containing phenolphthalein. Differences among the concentrations of Na+, K+ and Cl- were used to calculate the rate of colonic permeability for the electrolytes. Phenolphthalein concentrations were used to evaluate the rate of secretion and water absorption. Results: The colonic secretion of water and electrolytes occurred expressively in the group seven days after nephrectomy. Hemodynamic and biochemical assessments determined the progression of renal failure in all three groups and polyethylene glycol was shown to be effective in reversing the secretory capacity of the colon. Conclusion: Hypervolemia established after 7 days post-nephrectomy 5/6 caused marked colonic secretion for water and electrolytes. The organism presents progressive colonic secretion as the blood volume increases; on the other hand, polyethylene glycol was able to revert this secretory framework of the colon to water and electrolytes by reversing the hypervolemia.

RESUMO Racional: A insuficiência renal é doença que afeta diversos órgãos por provocar hipervolemia e quadro urêmico ao organismo. A doença atinge mais de 500 milhões de pessoas em todo o mundo, e poucos estudos trazem sua influência sobre o trato gastrointestinal. Objetivo: Avaliar a influência da hipervolemia induzida pela nefrectomia 5/6 sobre a permeabilidade colônica para água e eletrólitos. Método: Foram utilizados 60 ratos machos Wistar, pesando entre 280-300 g divididos em três grupos: 3, 7 e 14 dias de pós-nefrectomia. Cada grupo foi formado por um controle e outro parcialmente nefrectomizado. Para os estudos de permeabilidade colônica, os animais foram submetidos à perfusão colônica com solução de Tyroad contendo fenolftaleína por 60 min. Diferenças entre as concentrações de Na+, K+, e Cl- foram utilizadas para calcular a taxa de permeabilidade colônica para os eletrólitos e as de fenolftaleína para avaliar a taxa de secreção e absorção de água. Resultados: A secreção colônica de água e eletrólitos ocorreu de forma expressiva no grupo 7 dias pós-nefrectomia. Avaliações hemodinâmicas e bioquímicas determinaram a evolução da insuficiência renal nos três grupos e o polietilenoglicol mostrou-se eficaz na reversão da capacidade secretora do cólon. Conclusão: O quadro de hipervolemia estabelecido a partir dos sete dias pós-nefrectomia 5/6 provocou acentuada secreção colônica para água e eletrólitos. O organismo apresenta secreção colônica progressiva a medida que aumenta a volemia sanguínea; por outro lado, o polietilenoglicol foi capaz de reverter esse quadro secretor do cólon para água e eletrólitos por reverter o quadro hipervolêmico.

Antidiarrheal activity of a novel sulfated polysaccharide from the red seaweed Gracilaria cervicornis.

ETHNOPHARMACOLOGICAL RELEVANCE: The use of marine seaweeds as a source of natural compounds with medicinal purposes is increasing in Western countries in the last decades, becoming an important alternative in the traditional medicine of many developing countries, where diarrhea still remains a severe public health problem, with high rates of mortality and morbidity. Sulfated polysaccharides (PLS) extracted from red seaweeds can exhibit therapeutic effects for the treatment of gastrointestinal disorders. Thus, the pharmacological properties of the PLS from Gracilaria cervicornis, an endemic seaweed found in the Brazilian northeast coast, was evaluated as an alternative natural medication for diarrhea. AIM OF THE STUDY: This study aimed to evaluate the antidiarrheal activity of sulfated polysaccharides (PLS) extracted from the red seaweed G. cervicornis in Swiss mice pre-treated with castor oil or cholera toxin. MATERIALS AND METHODS: The seaweed Gracilaria cervicornis was collected at Flecheiras beach (city of Trairí, State of Ceará, Brazil) and the PLS was obtained through enzymatic extraction and administered in mice (25-30 g) before diarrhea induction with castor oil or cholera toxin. For the evaluation of the total number of fecal output and diarrheal feces, the animals were placed in cages lined with adsorbent material. The evaluation of intestinal fluid accumulation (enteropooling) on castor oil-induced diarrhea in mice occurred by dissecting the small intestine and measuring its volume. The determination of Na+/K+-ATPase activity was measured in the small intestine supernatants by colorimetry, using commercial biochemistry kits. The gastrointestinal motility was evaluated utilizing an activated charcoal as a food tracer. The intestinal fluid secretion and chloride ion concentration were evaluated in intestinal closed loops in mice with cholera toxin-induced secretory diarrhea. The binding ability of PLS with GM1 and/or cholera toxin was evaluated by an Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: The G. cervicornis PLS showed antidiarrheal effects in both acute and secretory diarrhea, reducing the total number of fecal output, diarrheic stools, intestinal fluid accumulation, and increasing small intestine Na+/K+-ATPase activity on castor oil-induced diarrhea. However, the PLS did not affect gastrointestinal motility, indicating that this compound has a different action mechanism than loperamide. In secretory diarrhea, the PLS decreased intestinal fluid secretion and small intestine chloride excretion, binding with GM1 and/or cholera toxin and blocking their attachment to the enterocyte cell surface. CONCLUSIONS: In conclusion, PLS has a significant antidiarrheal effect in acute and secretory diarrhea. Further investigation is needed towards its use as a natural medicine to treat diarrhea.

Antidiarrheal effects of water-soluble proteins from Plumeria pudica latex in mice.

The water-soluble protein fraction obtained from Plumeria pudica (LPPp) latex has previously been demonstrated to have anti-inflammatory and antinociceptive effects. In the present study, LPPp was tested for activity against diarrhea induced by castor oil, prostaglandin E2 (PGE2) or cholera toxin. Different doses of LPPp (10, 20 or 40mg/kg) significantly inhibited the percentage of diarrheal stools (31.18%, 42.97% and 59.70%, respectively) induced by castor oil. This event was followed by significant reduction of both intestinal fluid accumulation (31.42%; LPPp 40mg/kg) and intestinal transit (68.4%; LPPp 40mg/kg). The pretreatment of animals with LPPp (40mg/kg) prevented glutathione and malondialdehyde alterations induced by castor oil. The effects of LPPp against diarrhea induced by castor oil were lost when the fraction was submitted to protein denaturing treatment with heat. LPPp (40mg/kg) also inhibited the average volume of intestinal fluid induced by PGE2 (inhibition of 46.0%). Furthermore, LPPp (40mg/kg) prevented intestinal fluid secretion accumulation (37.7%) and chloride ion concentration (50.2%) induced by cholera toxin. In parallel, colorimetric assays demonstrated that proteinases, chitinases and proteinase inhibitors were found in LPPp. Our data suggest that the antidiarrheal effect of LPPp is due to its protein content and is probably associated with its anti-inflammatory properties.

Percepções de mães acerca da inclusão escolar de crianças com lesão medular por mielomeningocele / Perceptions of mothers concerning the school inclusion of children with spinal cord injury by meningomyelocele / Percepciones de madres sobre la inclusión escolar de niños con lesiones en la médula espinal por mielomeningocele

O educando com deficiência física necessita de maior qualidade na vida escolar, independência na realização de tarefas, ampliação de sua mobilidade, comunicação e habilidades em seu aprendizado. Nesta perspectiva, este estudo tem como objetivo identificar os aspectos da inclusão escolar de crianças com lesão medular por mielomeningocele segundo as percepções de suas mães. Para tanto, resgatou-se a história de vida de duas crianças com base nos relatos orais de suas mães, com aplicação de entrevistas semiestruturadas. A abordagem deste estudo é de caráter descritivo, qualitativo e exploratório, cuja estratégia metodológica foi a história de vida. Do ponto de vista dos resultados, identificaram-se alguns obstáculos que precisam ser transpostos: ausência da comunicação entre professoras e profissionais da saúde e falta de informação das mães. Concluiu-se que a ausência de comunicação entre pais, professoras, profissionais da saúde e a falta de informação das mães é um grande inimigo na integração desses deficientes na sociedade, na escola, no trabalho e no lazer.

The student with physical disabilities needs more quality in school life,independence in performing tasks, increasing its mobility, communication and skills in his/her learning. Within this perspective, the objective of the present study is to identify the aspects pertaining to school inclusion of children with spinal cord injury by Myelomeningocele, according to their mothers? perception. Thus, the life story of two children ws rescued from the oral reports of their mothers, with the application of semi-structured interviews. The approach of this study is of a descriptive, qualitative and exploratory character, the methodological strategy of which was the life history. In terms of results, some obstacles were identified which need to be overcome: lack of communication between teachers and health professionals, and lack of information by the mothers. It may be concluded that the lack of communication between parents, teachers, health professionals and lack of information by the mothers is a major enemy to the integration of disabled people into society, school, work and leisure.

El estudiante con discapacidad física, requieren de una mayor calidad de vida en la escuela, independencia en la realización de tareas, ampliación de su movilidad, comunicación y habilidades en su aprendizaje. Desde esta perspectiva, este estudio tiene como objetivo identificar los aspectos de la inclusión educativa de los niños con lesión en la médula espinal por mielomeningocele en la percepción de sus madres. Para ello, se rescató la historia de vida de dos niños con base en relatos orales de sus madres, con la aplicación de entrevistas semiestructuradas. El enfoque de este estudio es de carácter descriptivo, cualitativo y exploratorio, cuya estratégia metodológica fue la historia de vida. Desde el punto de vista de los resultados, se identificaron algunos obstáculos que necesitan superarse: falta de comunicación entre profesores y profesionales de la salud y falta de información de las madres. Se concluyó que la falta de comunicación entre padres, maestras, profesionales de la salud y la falta de información de sus madres es una gran enemiga em la integración de esos discapacitados en la sociedad, en la escuela, en el trabajo y el ocio.

Desafios à inclusão de pessoas com deficiência: aspectos da trajetória escolar de crianças com lesão medular por mielomeningocele. / Challenges for inclusion of people with disabilities: aspects of school trajectory of children with spinal cord injury in meningomyelocele.

O objetivo geral desse trabalho é descrever os aspectos da trajetória de escolarização de crianças com lesão medular por mielomeningocele segundo a percepção de seus pais e professoras. Esse objetivo desdobrou-se nos seguintes objetivos específicos: destacaras peculiaridades da deficiência física no que diz respeito ao encaminhamento para inclusão escolar /social, descrever suas tentativas de retorno/ingresso a escola e analisar as variáveis da ordem dos comportamentos das professoras e dos pais dos alunos. Para tanto, resgatou-se a história de vida de duas crianças a partir dos relatos orais de suas mães e professoras. Esta abordagem metodológica foi triangulada com observação participante e com aplicação de entrevistas semi-estruturadas. Desta forma, este estudo evidenciou o caráter problemático da inclusão escolar de crianças com deficiência física assim como possibilitou, do ponto de vista dos resultados, a identificação de alguns obstáculos que precisam ser transpostos para garantir a qualidade da inclusão, tais como: compreensão da mielomeningocele conceitualmente equivocada por parte das professoras e ausência da comunicação entre pais, professoras e profissionais da saúde, de modo que o turno da fisioterapia seja oposto ao da aula. Finalmente, essa pesquisa pretende colaborar com o desenvolvimento da Educação Inclusiva/ Educação Especial, o que representa uma iniciativa no sentido de mobilizar mais estudos que preencham a lacuna existente no tocante à investigação de um tipo específico de deficiência física.

The general objective of this study is to describe aspects of the history of education of children with spinal cord injury by meningomyelocele according to the perception of their parents and teachers. This objective was deployed in the following specific objectives: to highlight the peculiarities of disability with regard to referral to school/ social inclusion, describing their attempts to return/enter the school and analyse the variables of the order of the behaviors of teachers and parents of students. Thus, it rescued the life story of two children from oral reports of their mothers and teachers. This methodological approach was triangulated with participant observation and application of semi-structured interviews. Thus, this study highlighted the problematic nature of school inclusion of children with physical disabilities as well as made possible, in terms of results, the identification of some obstacles that need to be overcome to ensure the quality of inclusion, such as: understanding of meningomyelocele conceptually mistaken by the teachers and lackof communication among parents, teachers and health professionals, so the physical therapy shift is opposite to the classroom. Finally, this research aims to collaborate with the development of Inclusive/Special Education, which represents an initiative to mobilize more studies that meet the gap concerning the investigation of a specific type of disability.