残疾儿童青少年身体活动及其健康效果：系统综述的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF)构建身体活动对残疾儿童青少年健康效果的范畴及研究架构,系统分析残疾儿童青少年的主要残疾类型、身体活动处方及其健康效果。     

适用于残疾儿童青少年运动功能和运动能力测量工具的结构、内容和心理测量特性的系统综述

目的 基于《国际功能、残疾和健康分类(儿童和青少年版)》(ICF-CY)对4种残疾儿童青少年运动功能和运动能力评估工具的主要结构和内容特征及其心理测量特性进行评估。方法 检索PubMed、Medline、Web of Science数据库，收集建库至2023年5月发表的有关残疾儿童青少年身体活动的测量/报告工具的文献。运用ICF-CY对残疾儿童青少年运动功能和运动能力的评估工具的主要结构和内容特征进行分析，采用基于共识的健康测量工具选择标准(COSMIN)对评估工具的心理测量特性进行质量评估。结果 最终纳入9篇文献，确定4项工具，包括粗大运动功能测试(GMFM-88)、Peabody发育性运动量表2(PDMS-2)、 Bruininks-Oseretsky运动能力测试2(BOT-2)和儿童运动评估成套测验第二版(MABC-2)。GMFM-88由A区(卧位与翻身)、B区(坐位)、C区(爬行与跪)、D区(站立位)、E区(行走于跑跳)5个维度88个项目组成；涉及身体功能和结构中的关节活动功能(b710)、随意运动控制功能(b760)等，活动与参与的改变身体的基本姿保持(d410)、保持一种身...     

基于WHO-FICs架构智力残疾儿童青少年身体活动与运动康复的健康结局：系统综述的系统综述

目的 基于世界卫生组织国际分类家族(WHO-FICs)构建智力残疾儿童青少年参与身体活动和运动康复的健康和功能结局的研究架构,系统分析智力残疾儿童青少年的主要健康与功能障碍表现、参与身体活动的方案以及健康和功能结局。 方法 运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF),对智力残疾儿童青少年身体活动干预方案以及健康与功能结局进行系统分析,构建智力残疾儿童青少年健康与功能状况、身体活动干预方案以及健康与功能结局架构。检索Scopus、PubMed、Embase、Web of Science、中国知网、维普、万方数据,收集建库至2022年8月18日公开发表的智力残疾儿童青少年参与身体活动与运动康复的健康及功能结局的系统综述,进行系统综述。 结果 最终纳入系统综述8篇,来自5个国家,包括190项随机对照试验和7 011例参与者,研究领域主要涉及智力障碍、儿童神经病学、康复科学、残疾与健康、适应性体育、特殊教育等,发表时间集中在2018年至2022年。常见的健康状况主要有唐氏综合征、孤独症谱系障碍、脆性X综合征、Prade-Willi综合征、智力障碍、认知障碍;身体活动干预形式分为体适能类、技能类和活动类3类,活动频率每周1~5次,活动强度为中-高强度,持续时间1周~1.5年;健康结局体现在智力功能和适应性行为、身体活动、心理行为健康与社会适应、整体生活质量和福祉方面。 结论 基于WHO-FICs构建了智力残疾儿童青少年参与身体活动和运动康复的健康效果的理论架构。智力残疾儿童青少年主要功能障碍表现为智力功能和适应性行为、活动和心理健康、生活质量和福祉3个层面。其中智力功能和适应性行为层面涉及概念性技能、社交性技能和实践性技能,活动和参与层面表现为低体育活动参与度、久坐和肥胖,活动能力低,没有发展基本运动能力和身体素质。生活质量和福祉层面涉及情绪和情感、自尊、一般自我概念、幸福感、友谊、与他人的关系或社会成熟度、生活质量和福祉等。身体活动方式可以分为体适能类、技能类和运动项目类。主要健康和功能结局主要表现在三个领域：智力功能与适应性行为,活动和参与以及心理行为健康与社会适应、生活质量和福祉。在智力功能和适应性行为领域,主要健康结局涉及认知功能(执行功能、认知可塑性、工作记忆等)、心理功能(情绪自我控制、自我价值和自尊)。在活动和参与领域,主要健康结局涉及体适能(肌力和肌耐力、速度、灵敏性)和动作技能(基本动作技能、平衡、核心稳定性),提高体育活动参与度,促进其更好地适应与赋能(社交、亲社会行为等),达成健康目标(降低疾病风险、缓解焦虑和抑郁、肥胖管理)。在心理行为健康与社会适应、生活质量和福祉领域,参与身体活动与运动康复可以提升儿童青少年整体的生活质量和福祉。     

不同身体活动对脑性瘫痪儿童青少年健康效益的系统综述

目的 系统综述不同身体活动对脑瘫儿童青少年的健康效益。方法 采用主题词和自由词相结合的检索策略,检索建库至2023年12月在Web of Science、PubMed、EBSCO、Cochrane、中国知网数据库中发表的脑瘫儿童青少年参与身体活动干预后健康和功能结局的随机对照试验,并进行系统综述。结果 共纳入10项研究,涉及402例参与者(3～24岁),物理治疗证据数据库量表评分6～8分,来自澳大利亚、美国、巴西和荷兰,主要来源于康复医学、神经科学、残疾研究、物理治疗等领域,发表日期集中在2013年至2020年。身体活动类型包括体适能类(体能体适能、技能体适能)、运动技能类(粗大运动技能、精细运动技能)和适应性身体活动类(移动技能、休闲类)。每次20～60 min,每周1～5次,持续7～26周;干预强度为中等至高强度,干预场所涉及社区和家庭、学校、康复机构。有3种指导和支持模式：运动康复,适应性体育活动,以及运动康复与适应性体育活动相结合。健康效益体现在身体活动相关的健康行为、身体功能、活动和参与以及生活质量4个方面,包括提升身体活动水平,减少久坐行为;增强肌肉力量,提高心肺功能,改善...     

智力和发展性残疾儿童青少年身体活动效益：基于ICF的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF)构建智力和发展性残疾儿童青少年身体活动效益系统综述的范畴和PICO架构，探讨智力和发展性残疾儿童和青少年参加身体活动的健康效益。     

适用于残疾儿童青少年身体活动测量报告工具结构、内容及心理测量特性的系统综述

目的 综述适用于残疾儿童青少年的身体活动测量报告工具的结构、内容和心理测量特性。方法 检索PubMed、Medline、EBSCO、Web of Science、中国知网，收集建库至2023年6月发表的有关残疾儿童身体活动的测量报告工具的文献，运用《国际功能、残疾与健康分类(儿童青少年版)》(ICF-CY)对工具的主要结构和内容特征进行分析，采用基于共识的健康测量工具选择标准(COSMIN)的方法对测量工具的心理测量特性进行评估。结果 确定6种工具，最终纳入9篇文献。两种为全球化标准工具：儿童和青少年身体活动全球报告矩阵卡4.0(Global Matrix 4.0)、残疾儿童和青少年身体活动全球报告矩阵卡(Para Report Card)，测量内容包括b455运动耐受功能，b7神经肌肉骨骼和运动有关功能；d4活动，d450步行，d470利用交通工具，d820学校教育，d910社区生活，d920娱乐和休闲；e310直系亲属家庭，e320朋友，e460社会的态度，e575全社会支持的服务、体制和政策等。该类测量工具具有完整的结构，测量工具的信度、效度和适用性高，测量方式可以是残疾学生自我...     

基于ICF-CY孤独症儿童青少年参与身体活动功能效果的系统综述

目的 基于《国际功能、残疾和健康分类(儿童青少年版)》(ICF-CY)的理论与方法，建立孤独症儿童青少年身体活动的范畴和结构，对孤独症儿童青少年的参与身体活动的功能效果文献进行系统综述。     

基于ICF-CY儿童青少年身体活动指南的内容分析与比较

目的 比较国内外儿童青少年身体活动指南的政策背景和理论依据、活动方式和活动量、收益以及影响因素,为相关指南的制定和实施提供理论依据和方法指导。 方法 运用《国际功能、残疾和健康分类(儿童和青少年版)》(ICF-CY)的分类架构对世界卫生组织、中国、美国、澳大利亚、加拿大(2套)等颁布的6套儿童青少年身体活动指南进行内容解析和编码。对指南的政策背景、理论依据、循证方法、推荐活动方式、活动量、收益以及影响因素进行内容分析。 结果 6套指南均依据相关国家的健康政策和身体活动与健康的理论;推荐的主要活动方式包括体适能、技能和运动项目三大类,推荐的活动量为每天至少60 min中等强度或高强度活动,每周至少3次高强度或增强骨骼肌肉功能的活动。身体活动有助于发展和改善身体功能,提升活动和参与水平,同时有助于形成良好的生活习惯,建立健康的生活方式,并改善相关环境因素。 结论 ICF-CY的理论架构、术语和编码是儿童青少年身体活动指南内容分析的有效工具。国内外儿童青少年身体活动指南均有其健康发展的政策背景和健康相关的理论依据。儿童青少年的身体活动有体适能、技能和运动项目三大类,且各指南推荐了中、高强度的活动量。身体活动有助于形成良好的运动习惯,形成积极的生活方式。为了促进儿童青少年的身体活动,需要建立适宜的环境,包括：产品和技术;自然环境和对环境的人为改变;支持和相互联系;态度;服务、体制和政策。     

基于ICF-CY残疾儿童青少年运动功能评价量表内容和心理测量指标的Scoping综述

目的 基于《国际功能、残疾和健康分类(儿童青少年版)》(ICF-CY)的理论与方法,分析儿童青少年常用运动功能评估工具的内容和心理测量指标。方法 基于ICF-CY分类架构和编码系统,应用ICF编码规则、匹配原则,选择4种儿童青少年常用的功能评估工具,分析其运动功能测量方法和心理测量指标。结果 最终纳入11篇文献,其中英文9篇,中文2篇,来自韩国、西班牙、中国、巴西,主要发表在临床医学、神经科学、公共健康、康复科学等领域期刊,发表时间为2011年至2021年。研究对象的年龄为0～16岁,涉及的总样本量为987,健康情况为痉挛型脑瘫、神经发育障碍等。纳入文献中,采用粗大运动功能测试(GMFM-88) 6篇,精细运动功能测试(FMFM) 2篇,Peabody运动发育评定量表(PDMS-2) 2篇,残疾儿童能力评定量表-功能技能量表(PEDI-FSS) 2篇,残疾儿童能评定量表(PEDI) 3篇;测量方式为客观评估、主观评估、主试观察等;测量次数为2～6次。运动功能测量指标主要涉及两个层面,其中身体活动层面包括粗大运动、精细运动和运动控制能力;活动功能层面主要为日常生活活动能力和功能独立性等。...     

北京市智力残疾儿童康复影响因素的Logistic回归分析

目的 了解智力残疾儿童康复的社会和家庭影响因素.方法 对2004年北京市残疾儿童调查中确定的237例智力残疾儿童进行问卷调查,对数据进行列联分析和Logistic回归分析.结果 Logistic回归分析显示,2004年的残疾程度( P<0.001)、现是否接受教育( P<0.05)、社区对儿童的态度( P<0.05)是智力残疾儿童康复的影响因素.结论 智力残疾儿童能否康复成功,首先取决于残疾程度,轻度残疾或中度残疾儿童在较好的社会和家庭环境中,通过正常的教育体系可以较好地康复,社会环境中社区对儿童的态度也对智力残疾儿童的康复有明显影响.     

探讨儿童慢性顽固性咳嗽与支原体感染的关系及临床治疗观察

Objective To explore the relation between chronic and persistent cough of children and MP infection and clinical observation and treatment.Methods Retrospective Study of the 55 children chronic and persistent cough cases, with a clinical features as pneumonia MP infection, in my hospital from March 2005 to March 2008.Results ①Clinical Feature:major symptom of these 55 children chronic cough cases is chronic and persistent cough.58%(32/55)of the cases showed no symptoms in their lungs.②Peripheral Blood:85％(47/55)cases showed no obvious changes in peripheral blood, with their WBC ranging from(4～10)×109/Land their eosinophile granulocyte increased.③Special Test:47.27%(26/55)IgM (MP-IgM)antibody positive,83.64%(46/55)cased showed pneumonia MP DNA specificity after PcR Test.④X-Rate Report:Results varied.Conclusion Pneumonia MP Infection is one of the pathogeny causing chronic and persistent cough of children.Treating the infection is a very important solution in curing chronic and persistent cough of children.     

Complementary and integrative medicine: An observational study on pediatric clinicians’ knowledge,beliefs and practices

ObjectiveComplementary and Integrative Medicine (CIM) is a group of diverse health care therapies that often serve as adjuncts to conventional medical treatments. Our aim for this study was to evaluate the current knowledge, beliefs and practices of pediatric clinicians regarding CIM.MethodsClinicians from the pediatric unit of a large US based teaching hospital in Connecticut were surveyed, through self-administered questionnaires.ResultsWe sampled 70 participants with a response rate of 99 %. Of the 70, 32 were Registered Nurses, 9 were Attendings, 7 were Fellows, 15 were Residents and 4 were Nurse Practitioners. Regarding use, 24 % had referred a patient to a CIM practitioner, 43 % reported using CIM while 47 % had a family member who had used CIM in the past year. Respondents were most familiar with massage (70 %) and yoga (69 %) least familiar with Ayurvedic medicine (20 %) and Qi Gong (24 %). Regarding attitude, 67 % believed that some CIM therapies hold promise for the treatment of symptoms while 59 % believed that incorporation of CIM would increase patient satisfaction. Most of the respondents indicated that they did not have easy access to clinical information on many CIM treatment modalities. Nurses were more familiar (p = 0.024), had more positive attitudes and beliefs (p = 0.001) and thought CIM therapies had a higher impact (p = 0.002) on patient care compared to physicians, even when controlled for gender.ConclusionThis study highlights the need to bridge the gap in evidence based medicine and clinician’s knowledge with the rise in CIM use. It also stresses the need for standardized learning competencies in the field of PIM.     

Primary and community care workforce planning and development

AIM: This article reports a study that provided primary and community care managers with information, allowing them to: (a) evaluate the size and mix of their workforce; and (b) develop knowledgeable and skilled teams to meet the demands of growing and changing services. BACKGROUND: Primary and community care services are growing in the United Kingdom, but workforce planning and development, despite their wide-ranging cost and quality implications, have not received the same attention. Indeed, most primary and community care workforce planning and development issues are universal. Demand 1-1 side workforce planning is concerned not only with the number, but also with staff mix; but how these autonomous and isolated practitioners spend their time is unique. The other side of the equation, workforce supply, raises many recruitment and retention challenges for managers in many countries. Any country's main workforce planning methods apply equally well to primary care, but each is flawed. A second, main problem is that the methods lead to fragmented services, whereas modern workforce planning methods should be multidisciplinary. Consequently, it has never been more important for managers to have data and algorithms to develop appropriate care teams. METHOD: A large and versatile workforce database, profiling 304 English primary care trusts using demographic, socio-economic, mortality, morbidity, staffing and performance workforce-related variables, compiled in 2002 and updated yearly, is described. Data were supplemented with a systematic literature review leading to a 340-item annotated bibliography; and qualitative interviews with managers. RESULTS: Workforce size and mix are historical and irrational at best. Moreover, the number of variables that influence staffing is growing, thereby complicating workforce planning. CONCLUSION: Evaluating and adjusting the size and mix of teams using empirically determined community demand and performance variables based on the area's socio-economic characteristics is feasible.     

加强对人类健康影响重大的内分泌代谢病防治

以联合国名义直接作出决议的疾病只有艾滋病和糖尿病,国际糖尿病联盟(IDF)发表的新的糖尿病防治指南,展现了在糖尿病预防与诊治方面的最新进展。甲状腺疾病流行病学、临床及实验室研究和长期随访,填补了我国在世界卫生保健数据库中的空白。     

介入放射技术在妇产科临床运用探讨

目的探讨介入放射技术在妇产科临床诊断与治疗的应用可行性与安全性．方法临床34例患者，16例为剖宫产术后反复大出血者，3例为顽固性功能性子宫出血者，10例为晚期官颈癌者，5例为子宫肌瘤者。34例经Scldinger介入放射技术诊断与治疗。结果经介入放射技术诊断与治疗，34倒不同的患者得到及时、准确、有效的诊断与治疗，未见并发症和后遗症。结论介入放射技术在妇产科临床运用安全、有效。     

Drugs and Medical Devices: Adverse Events and the Impact on Women’s Health

A large number of medications and medical devices removed from the market by the US Food and Drug Administration over the past 4 decades specifically posed greater health risks to women. This article reviews the historical background of sex and gender in clinical research policy and describes several approved drugs and devices targeted for use in women that have caused major morbidity and mortality. The intended population for the medications and devices, population affected, approval process, and the basic and legal actions taken against the medication/drug company are also discussed. It is recognized that women are still at risk for harm from unsafe medications and devices, and continued improvements in legislation that promotes inclusion of sex and gender into the design and analysis of research will improve safety for both men and women.     

头体针治疗脑卒中临床观察

目的观察头体针结合治疗脑卒中的临床疗效。方法 183例脑卒中患者分头针、体针、头体针 3组进行治疗 ,疗程满2个月后比较疗效。结果头针组与体针组之间、体针组与头体针组之间无显著性差异 ,但头体针组与头针组之间有显著性差异 (P<0 .0 5 )。结论头体针结合较单纯的头针或体针治疗能获得更好的临床疗效     

Molecular and point-of-care diagnostics for Ebola and new threats: National POCT policy and guidelines will stop epidemics

Introduction: US hospitals that admitted Ebola virus disease (EVD) patients mitigated risk by using point-or-care testing (POCT) for critical support in isolation units. Success proved unequivocally the need for POCT. Additionally, molecular diagnostics have been used to help stop new outbreaks, and even handheld diagnostic solutions are emerging.

Areas covered: This update of ‘Molecular detection and point-of-care testing in Ebola virus disease and other threats’ [Expert Reviews 2015;15(10):1249–1255], assesses the impact of EVD epidemics, documents insights from recent reviews, summarizes evolving POC molecular technologies, presents General Accountability Office (GAO) recommendations, identifies the role of POC Coordinators, and casts a vision for national POCT policies and guidelines. Factual updating comprised summarizing EVD outbreaks including 2017–2018, analyzing reviews and evidence-based publications since the 2014–2016 epidemic, and tabulating published technical and molecular diagnostics. New graphics illustrate POC error mitigation/risk reduction, a framework for national POCT policy and guidelines, modular adaptations for country-specific solutions, and a logic diagram for future progress embedding artificial intelligence.

Expert commentary: The USA is still not prepared for highly infectious diseases. Key is lack of community rapid response and resilience, which must be enhanced not via mechanisms distant, but instead by molecular diagnostics directly at critical points of need.     

婴幼儿流动注射车的研制与临床应用

目的 为了提高婴幼儿头皮静脉穿刺成功率，减轻护士的体力消耗。方法 根据儿科临床实际的需要，经过二年来的设计及二次改进，研制出实用新型的“婴幼儿流动注射车”，并应用于儿科临床操作过程中。结果 经统计学处理，表明应用“婴幼儿流动注射车”对提高婴幼儿头皮静脉穿刺成功率具有显著意义，对缩短婴幼儿头皮静脉注射时间具有非常显著的意义。结论 在流动车上实施头皮静脉穿刺，能充分利用自然光线，提高头皮静脉穿刺成功率并减轻护士体力消耗。