187例精神疾病患者劳动能力鉴定分析

目的：探讨精神疾病患者劳动能力鉴定状况及与其相关问题。方法：分析1998至2002年共187例精神疾病患者的劳动能力鉴定资料，并进行不同年代、不同诊断、不同级别的组问比较。结果：除1998年外，其余各年度基本资料相似；诊断以精神分裂症为主，精神发育迟滞为次；前者的平均年龄最大、病期最短、累计病休时间最长、残疾级别最低，后者反之。结论：劳动能力鉴定应按有关标准执行，但目前仍存在一些有待进一步完善的问题。     

Lesbians with disabilities

There is a severe lack of information on sexuality for any woman with a disability. Often, what is available is limited to material on birth control and child delivery. For women who are disabled and lesbian, virtually no written information exist and health care workers seldom feel comfortable discussing the topic. Lesbians with disabilities have the responsibility to discuss sexual preference with their health care workers. Yet, there is much to lose. This paper discusses the issues of being lesbian and disabled as well as the unique problems faced by their partners. Finally, the article discusses negative attitudes of health care workers toward both disability and homosexuality.     

Dysphagia,an unrecognized handicap

The aim of this study was to examine whether esophageal dysphagia can be described as a handicap and to grade the severity of handicap as the discrepancy between the subject's own eating goals and his or her eating disability. The severity of the disability-goal-handicap (DGH) regarding dysphagia was expressed on a scale ranging from 0 to 48 points. Nineteen patients with dysphagia of differing causes were selected from a patient register at a laboratory for diagnostic procedures of the esophagus. The severity of handicap for the 19 patients was, on average, 33 points (range, 20–44). The DGH score correlated significantly with the patients' own evaluation of the severity of their dysphagia (p=0.008). The DGH scores did not differ markedly based on patient's sex, age, or cause of dysphagia. Patients who were operated upon because of dysphagia had significantly more points on the DGH scale prior to operation than patients who were not (p=0.001). Denial of dysphagia (N=18), concealment of dysphagia (N=18), and lack of confirmation by the patient's physician (N=15) were common but did not influence the severity of handicap as assessed by the DGH scale. It was shown that dysphagia affects all aspects of life as expressed by reduction in self-esteem (N=13), security (N=16), work capacity (N=8), exercise (N=7), and leisure time (N=6). Esophageal dysphagia may therefore be regarded as a handicap when assessed using the DGH code described in this study.     

496例精神分裂症残疾评定分析

目的：了解精神分裂症致残情况。方法：收集我院1998年1月至2003年7月进行残疾评定的精神分裂症502例，采用中国实用残疾人评定标准评定精神残疾及等级。结果：502例中496例(98．8％)评定为精神残疾，其中Ⅰ级、Ⅱ级、Ⅲ级分别为12．1％、54．8％、33．1％。结论：精神分裂症致残率较高，其程度受性别、婚姻状况、药物依从性及社会支持系统的影响。     

Relationship of knee joint proprioception to pain and disability in individuals with knee osteoarthritis.

Proprioception plays an integral role in neuromotor control of the knee joint and deficits in knee joint proprioception are well documented in individuals with knee osteoarthritis (OA). However, the functional relevance of these deficits is not clear. This cross-sectional study evaluated the relationship between knee joint proprioception and pain and disability in a large cohort of individuals with knee OA. Two hundred and twenty participants (145 F, 75 M) with symptomatic knee OA were recruited from the community. Five non-weight bearing active tests with ipsilateral limb matching responses were performed at 20 degrees and 40 degrees flexion to measure knee joint position sense. Pain and disability were assessed by self-reported questionnaires and objective measures of balance and gait. Results showed little association between knee joint position sense variables and measures of pain and disability (r values <0.24, most p>0.05). When comparing participants with the worst and best joint position sense, no significant differences in pain and disability could be found (p>0.05). While our study design does not allow causality to be established, these results suggest that deficits in joint position sense may be due to factors other than pain and that deficits are not large enough to impact upon disability.     

Colonic Motility in Profoundly Disabled People: A comparison of massage and laxative therapy in the management of constipation

This pilot study compared abdominal massage with laxative treatment in the management of constipation in 32 profoundly disabled, institutionalised adults. A randomised cross-over design was used. After an initial 16-day baseline measurement phase without any treatment, there followed two seven-week treatment phases separated by a one-week washout period. Each subject received seven weeks of massage and seven weeks on his or her previous laxative regimen. Primary outcome measures were gastro-intestinal and segmental transit times, measured at the end of the baseline phase and of each treatment phase. Secondary measures included stool frequency, size and consistency, the requirement for enemas and an assessment of patient well-being.The median value of total colonic transit time was 183 hours for the baseline phase and 159 hours for all treatment phases. There was no evidence of any statistically significant treatment differences between laxative and massage therapy for right, left or rectosigmoid segments either separately or in total. Analysis of secondary outcome measures also failed to find any treatment preferences.These results reveal the grossly abnormal colonic transit times of the study population at all times. The effects of laxative and massage therapy within this environment were not demonstrably different.     

conference report: Mental health and intellectual disability: an international perspective

The present paper reports on the inaugural meeting of the Mental Health Special Interest Research Group (SIRG) of the International Association for the Scientific study of Intellectual disability which was held at Fitzwilliam College, Cambridge, UK, in March 1998. The meeting was organized in conjunction with the Ninth Annual SIRG on ageing and intellectual disability. Representatives from North America, several European and Scandinavian countries, Australia, and Israel attended. Two broad themes had been determined prior to the meeting: ‘Improving the detection of mental health problems’ and ‘Research strategies for identifying risk factors for mental health problems’. In the presentations and subsequent discussions, it was apparent that there were extrenely diverse perspectives both across and within the different countries represented. Not only were individuals' experiences very different, but most strikingly, the theoretical frameworks were very diverse. This was partly a function of there being understandable differences in perspectives across disciplines, but at its most marked, there were fundamental differences in the way both intellectual disability and mental health were conceptualized.     

Loneliness,social support,social isolation and wellbeing among working age adults with and without disability: Cross-sectional study

BackgroundLoneliness is significantly related to health and wellbeing. However, there is little information on the prevalence of loneliness among people with disability or the association between disability, loneliness and wellbeing.Objective/hypothesisFor a nationally representative sample of adults (age 16–64) with/without disability, to examine exposure to three indicators of low social connectedness (loneliness, low perceived social support, social isolation), and to evaluate the association between low social connectedness and wellbeing. To test whether disability status moderated the relationship between low social connectedness and wellbeing.MethodsSecondary analysis of data from three annual rounds of the cross-sectional English Community Life Survey (CLS) 2016–19.ResultsPeople with disability experienced loneliness, low perceived social support and social isolation at significantly higher rates than people without disability. Effect sizes were significantly greater for loneliness. Disability was associated with lower wellbeing. With one exception, low social connectedness was associated with lower wellbeing. Again, effect sizes were significantly greater for loneliness. The prevalence of loneliness was highest among adults with disability who were younger, economically inactive, living in rented or other accommodation, living alone and with low levels of access to environmental assets. There was no evidence that disability status moderated the association between exposure to low social connectedness and low wellbeing.ConclusionsLoneliness was a particularly significant driver of poor wellbeing among people with disability. The relative independence between different indicators of social connectedness suggests that interventions to reduce loneliness will need to do more than simply increase rates of social contact or social support.