社区居家失能老人口腔吞咽现状及其对心理健康的影响研究

目的 调查社区居家失能老人口腔吞咽现状,并分析其对心理健康的影响。方法 采用方便抽样法,对207名社区居家失能老人进行问卷调查。结果 社区居家失能老人口腔健康状况得分（8.45±3.51）分,前3位口腔问题为天然齿缺如、口腔卫生状况不佳、义齿破损或未正确佩戴;吞咽功能得分3（1,9）分,功能正常94名（45.4%）,功能异常113名（54.6%）;心理健康状况得分（18.26±7.41）分,良好102名（49.3%）,异常105名（50.7%）;失能老人口腔健康、吞咽功能、心理健康三者间呈正相关（P<0.001）;口腔健康状况不佳（OR=1.155,P<0.05）、吞咽功能异常（OR=4.155,P=0.001）是失能老人心理健康的独立危险因素。结论 社区居家失能老人口腔吞咽现状不容乐观,应重视社区层面上的失能老人口腔健康及吞咽功能评估,以尽早筛查并识别口腔疾病及吞咽安全风险,维持或促进其心理健康。     

Oral health care for patients with Alzheimer's disease: An update

Alzheimer's disease and related disorders (ADRD) are among the age‐associated chronic conditions that are most challenging to health care systems around the globe, as patients with dementia require full‐time, intensive care for multiple years. Oral health care is negatively impacted by cognitive decline, and consequently poor oral health is common among people with ADRD. Poor oral health status is linked with many undesirable consequences for the well‐being of people with ADRD, from excruciating local pain to life‐threatening conditions, as aspiration pneumonia. In this paper, the authors provide an update on the most current concepts about Alzheimer's disease epidemiology, etiology, and management, current oral health care for patients with Alzheimer's disease, oral health promotion strategies for this population, as well as current research and future direction for improving oral health care for patients with Alzheimer's disease. It concludes that oral health care should be included in the patient's routine health care as early as possible in the progression of Alzheimer's disease for preventing rapid oral health deterioration. Establishing oral hygiene routines and providing dental treatment that is customized to the patients’ individual needs and disease stage are important to achieve good oral health outcomes and prevent quality of life decline.     

Palliative care for disabled children and young people

Palliative care for disabled children and young people embraces holistic, high quality, evidence-based care, recognition and timely management of symptoms, recognition and discussion with the multidisciplinary team and with families about the possibility of dying and care and support through life, death and bereavement.Systems are being piloted across the UK to collect data about who and where children and young people with palliative care needs are and to ensure robust funding mechanisms are established for provision of care in an equitable way.Decision-making within a legal and ethical framework is paramount in this area of clinical practice, along with clinical networking within care pathways to ensure care delivered is of the highest standard.     

The delivery of oral care services to elderly people living in a noninstitutionalized setting

Advances in medical science are enabling people to survive more illness and disability. As people live longer, their mobility and/or ability for self-care often are reduced by physical or mental disability and other chronic diseases. It may become unreasonable or impractical for them to access mainstream dental services. Increasing numbers of dentate elderly people with expectations of oral health higher than earlier cohorts of elderly people are likely to bring increasing demands to the dental profession for their continuing care. Thus, the oral care for disabled elderly people in noninstitutionalized settings may pose a challenge. The oral care options available to this group of people include the dental surgery/operatory, a mobile dental service, home-based or domiciliary dental care, a mix-and-match combination of surgery-based and domiciliary care, and cyberspace. Noninstitutionalized, disabled elderly people may have to rely on domiciliary care services for their oral health care. This paper explores the training implications, the necessary knowledge and skills base, the benefits and limitations to both the service provider and user, the equipment available, and the cost/funding of domiciliary dentistry. Domiciliary dental care services need to be developed by improving pre- and postdoctoral training programs and by establishing realistic remuneration for dental teams providing this care so that noninstitutionalized, disabled elderly people can access oral health care.     

An Analysis of Four Sexual Offenders' Arousal in the Natural Environment Through the Use of a Portable Penile Plethysmograph

We report the development of a technology for measuring sexual arousal in the natural environment. Experiment 1 demonstrated that levels of sexual arousal obtained in the laboratory when a participant was wearing underwear and trousers were similar to arousal levels obtained without underwear and trousers. In Experiment 2, four sexual offenders' arousal was measured in the natural environment using a portable penile plethysmograph. Measures were taken in three different settings: a setting in which only adults were present, a setting with children present, and a setting with no person other than the data collector present. In each setting, arousal was measured when the data collector was both near and away from the offender. For three of four offenders, patterns of arousal were consistent with previous laboratory assessments and/or previous offenses. Moreover, arousal was greatest when the data collector was away from the participant.     

康复医院残疾患者医疗欠费状况的研究

目的：分析康复医院残疾患者住院欠费的情况，为减少或杜绝医疗欠费提供资料。方法：112例脊髓损伤、脑卒中、脑瘫出院的康复患者欠费个案作为调查研究对象进行统计分析。结果：康复残疾患者拖欠医疗费用总金额为1231829．82元，人均欠费10998．48元。欠费人员多为外地国有中小企业职工、农民工，欠费方式因经济困难无力支付费用占总欠费用的78．0％，逃费占12．9％，医疗纠纷占9．1％。结论：康复医疗机构应加强医疗欠费的管理；政府部门应建立并完善医疗法制管理制度和社会救助基金制度，切实维护医患双方合法权益。