天津市视障学校学生视觉损害的病因及康复现状

目的：调查天津市视障学校学生视觉损害的分级及病因,分析不同类型助视器的康复效果,为儿童视觉损害的康复工作提供指导依据。

方法：于2019-08/09纳入天津市视力障碍学校学生86例。通过视力、屈光及眼部检查等方法,评估学生视觉损害的分级及主要病因。对盲和低视力学生分别验配3种远用及近用助视器,分析其康复效果。

结果：学生86例中盲49例,低视力37例,主要病因为先天性眼球发育不良26例(30%)。盲和低视力学生应用助视器后康复远视力均有所提升(F=110.59,P<0.01),低视力组远视力优于盲目组(F=184.06,P<0.01)。盲目组应用3种远用助视器脱残率及低视力组脱残率均无差异,3种近用助视器阅读成功率在盲目组无差异,低视力组电子助视器优于手持放大镜及眼镜式助视器(χ²=7.974、10.571,均P<0.01)。

结论：儿童视觉损害以先天性眼病为主,验配合适的助视器可提高其康复效果,低视力患者电子助视器康复效果优于手持放大镜及眼镜式助视器。     

Predicting three-month and 12-month post-fitting real-world hearing-aid outcome using pre-fitting acceptable noise level (ANL)

Objective: Determine the extent to which pre-fitting acceptable noise level (ANL), with or without other predictors such as hearing-aid experience, can predict real-world hearing-aid outcomes at three and 12 months post-fitting. Design: ANLs were measured before hearing-aid fitting. Post-fitting outcome was assessed using the international outcome inventory for hearing aids (IOI-HA) and a hearing-aid use questionnaire. Models that predicted outcomes (successful vs. unsuccessful) were built using logistic regression and several machine learning algorithms, and were evaluated using the cross-validation technique. Study sample: A total of 132 adults with hearing impairment. Results: The prediction accuracy of the models ranged from 61% to 68% (IOI-HA) and from 55% to 61% (hearing-aid use questionnaire). The models performed more poorly in predicting 12-month than three-month outcomes. The ANL cutoff between successful and unsuccessful users was higher for experienced (～18 dB) than first-time hearing-aid users (～10 dB), indicating that most experienced users will be predicted as successful users regardless of their ANLs. Conclusions: Pre-fitting ANL is more useful in predicting short-term (three months) hearing-aid outcomes for first-time users, as measured by the IOI-HA. The prediction accuracy was lower than the accuracy reported by some previous research that used a cross-sectional design.     

术前决策辅助对关节置换患者决策参与的影响

目的探讨术前决策辅助对关节置换患者决策参与的影响。方法将120例关节置换患者以简单随机化法分组,奇数分配到对照组,偶数分配到观察组,每组各60例,对照组按常规实施护理,观察组在常规护理基础上实施术前决策辅助干预,比较两组患者决策参与意愿和实际决策参与有无差异。结果两组决策参与意愿类型比较,差异无统计学意义(P0.05);观察组实际决策参与程度显著高于对照组(P0.01)。结论术前决策辅助能提高关节置换患者在实际临床活动中的决策参与程度。     

Audiovisual aids in primary healthcare settings’ waiting rooms. A systematic review

Background: Health promotion is part of GPs' commitments. Some waiting rooms have therefore been implemented with audiovisual aids (posters, pamphlets or screens) for health promotion purposes. Few studies have assessed the effect of audiovisual aids in primary care.

Objectives: To identify, describe and appraise studies that have investigated the effects of audiovisual aids on health promotion in primary healthcare waiting rooms. To determine which factors influence this impact through literature review.

Methods: Systematic review. Two independent researchers using predefined keywords searched databases. Additional publications were extracted from the reference lists of the selected articles. The selection of the articles was performed on the title and abstract, followed by complete reading and assessment. Bias and level of evidence were analysed.

Results: A total of 909 articles were collected. Most of them were not in primary care settings. Fourteen peer-reviewed articles fully meeting inclusion criteria were included and analysed. Good quality studies were scarce. Eight of these articles using videos or slideshows on TV screens or tablets indicated effects: three of them were significant on patient knowledge with acceptable evidence and three on health behaviour on surrogate endpoints. Audiovisual aids seem to be used or noticed by patients and can induce conversations with physicians. The relevant factors that might influence these effects (duration of exposure, conception quality, theme, target population and time spent in the waiting room) are insufficiently investigated.

Conclusion: Audiovisual aids broadcasting messages using screens (TVs, computers, tablets, and smartphones with Bluetooth^® pairing) probably enhance patients’ knowledge. A change in health behaviour remains controversial.     

我国低视力康复工作的历程回顾

低视力康复是一项系统性工作,涉及医疗、康复、教育、社会保障、家庭等多个领域。本文从我国视力残疾的患病状况与病因分析、低视力康复人才培养、辅具助视器的研发与应用、定向行走、视觉康复体系建设、公共健康教育、政策保障等方面进行了回顾总结。迄今为止,我国的低视力康复工作经历了近四十年的探索与发展,整体上逐步形成了以政府为主导、有关部门各司其责、社会广泛参与的工作格局,形成了由医疗机构、残疾人联合会、康复辅具中心和教育体系共同参与的中国特色的低视力康复服务体系,取得了瞩目成就,但仍面临较大挑战。(国际眼科纵览,2020,44:373-378)     

Determination of melatonin content in traditional Thai herbal remedies used as sleeping aids

Background

Melatonin content was screened in leaves of seven edible herbs used as sleeping aids in Thai traditional medicine. These plants are Piper nigrum L, Sesbania glandiflora (L.) Desv., Sesbania sesban (L.) Merr., Senna tora (L.) Roxb., Moringa oleifera Lam., Momordica charantia L. and Baccaurea ramiflora Lour. Dried leaves were extracted by sonication in methanol for six hours at room temperature, and then melatonin was purified by C18 solid phase extraction (SPE). Melatonin was then quantified by a validated RP-C18 HPLC method with fluorescent detection.

Findings

Melatonin contents in extracts of B. ramiflora, S. glandiflora, M. charantia, S. tora and S. sesban were 43.2, 26.3, 21.4, 10.5 and 8.7 ng/g of dry sample weight, respectively. The highest melatonin content was from P. nigrum extract (1092.7 ng/g of dry sample weight). Melatonin was not detected in the extract of M. oleifera. Melatonin identification was confirmed by ELISA.

Conclusions

Melatonin was found in six of the seven herbs in the traditional Thai sleeping recipe. One of these, P. nigrum, exhibited an encouragingly high amount of melatonin.     

Phase 2 of collaborative action around the implementation of virtual hearing aid care: Evaluation of a clinical practice guideline

Rationale

Following the onset of the COVID-19 pandemic, a clinical practice guideline (CPG) around virtual hearing aid practices was developed to fill a knowledge gap within the field of audiology. Details outlining the development and mobilization of this draft guideline were outlined as Phase 1 (described in a paired paper).

Aims and Objectives

This study describes Phase 2 of this project as part of the Knowledge-to-Action Framework, including an evaluation of the methodological quality of the guideline and the resulting tailored version of the document (v2.0).

Method

The Appraisal of Guidelines for Research and Evaluation II instrument was used to assess methodological quality and to guide revisions. Twenty-two clinicians, from a variety of clinical backgrounds, participated in the evaluation.

Results and Conclusion

Findings reported across six domains suggest high mean scores, ranging from 78% to 81%, in order of scope and purpose (highest rated), stakeholder involvement, rigour of development, applicability, clarity of presentation, and editorial independence. Specific recommendations made by in international co-creation team during the evaluation informed the final version of the CPG. Future development and evaluation efforts should aim to include greater representation from nontraditional practice contexts to strengthen global applicability.     

Classification of Upper Body Shapes Among Korean Male Wheelchair Users to Improve Clothing Fit

The upper body shape is an important factor to be considered in customized suit jacket design. The present study is intended to identify the lateral upper body shapes of wheelchair users in a sagittal plane. Anthropometric data of 144 Korean male wheelchair users were collected using a tape measure and photography. Three lateral upper body shapes were identified by cluster analysis: convex back with largely protruded abdomen (31%), convex back with flat abdomen (36%), and straight back with moderately protruded abdomen (33%). Discriminant functions were constructed for the three lateral upper body shape groups, and their overall and cross-validated classification accuracies were identified as 94.4% and 89.6%, respectively. The present study found that the wheelchair users have more convex back (67%) and protruded abdomen (64%) shapes than non-wheelchair individuals. The lateral upper body shapes and discriminant functions identified in the study can be applied to a custom production process of suit jacket design for wheelchair users.