Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study.

HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white matter hyperintensities. METHODS: In the Leukoaraiosis And DISability in the elderly (LADIS) study, we investigated the relationships between DM, hypertension, blood pressure and MTA in 582 subjects, stratified by white matter hyperintensity severity, using multinomial logistic regression. MTA was visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95% CI: 1.1-7.8) compared with an MTA score of 0 (no atrophy). The odds ratio for MTA score 2 was not significantly increased (OR 1.8; CI: 0.9-4). Systolic and diastolic blood pressure and a history of hypertension were not associated with MTA. There was no interaction between DM and hypertension. Stratification on white matter hyperintensities (WMH) did not alter the associations. CONCLUSION: Our study strengthens the observation that MTA is associated with DM, independently of the amount of small vessel disease as reflected by WMH.     

400例独生子女病残儿鉴定分析与二胎儿随访

１９８１年１１月－１９９４年１２月，我院共鉴定独生子女病残儿４００例。除１０例未发现明显异常外，余下的疾病有百余种，大致分了七类，神经系统疾病２００例（５０％），其中智力低下（ＭＲ）１７４例，又占神经系统疾病中的８７％，说明ＭＲ已是当前引致小儿残疾的主要疾患。先天性遗传性疾病２１５例，占了总数的５３．７５％，说明加强优生与孕期保健工作的重要性。作者对可生育二胎者随机随访了５４例，３６例（６６．７％）已生育了二胎，大部小儿生长健康，仅２例异常，１例６个月死于心肌炎，另一例为出生低体重（２２５０ｇ），似乎与第一胎之残疾关系不大。说明病残儿医学鉴定小组的监护对第二胎的出生质量是至关重要的。     

1336例病残儿医学鉴定结果分析

目的探讨泰安市病残儿的病因及优生对策。方法对泰安市连续四年经医学鉴定确诊的1336例病残儿进行分析。结果病残儿重出现最高的为神经系统疾病，为613例，占病残儿总数的45．88％，其次为五官疾病222例，第三为心血管畸形146例。造成以上病残的原因有遗传因素、环境因素及产时因素。结论必须大力开展优生优育咨询，加强孕期保健，提高产科质量，做好婴幼儿监护。     

107例在院伤残军人抑郁自评量表调查研究及多因子分析

目的了解伤残军人伤残后的心理健康状况。方法用zung’s抑郁自评量表(self rating depressionscale，SDS)为工具，对在院107例特、一等伤残军人进行调查研究。并选择年龄、病程、伤残种类、文化程度、伤残严重度、婚姻等14个因子作自变量，SDS部分作因困变量进行逐步回归分析。结果伤残军人SDS与我国SDS常模比较显示伤残军人分明显增高，二者有极显著统计学意义，并且受X2病程、X12康复疗效、X13参与社会工作等因素影响(P＜0．01)。结论伤残军人伤残后存在有明显的心理健康问题，针对性开展一些康复措施，有利于全面康复。     

Perceptions of severely and multiply disabled persons

Data from studies of rankings of acceptability and severity of various disabilities were converted to a common metric of percentile equivalent ranks. A total of 1331 data points from 53 studies yielded the following overall percentile equivalent ranks for 24 disabilities: diabetes (most acceptable), ulcer, arthritis, asthma, heart condition, speech problems, crippled, orthopedic disability, physical disability, amputation, emotional disturbance, appearance disability, deafness, learning disability, stroke, cancer, paraplegia, blindness, epilepsy, tuberculosis, cerebral palsy, mental retardation, mental illness, and multiple disabilities (least acceptable). Rankings of the severity of seven disabilities yielded a somewhat different order that correlated 0.55 with the total data. Rankings of a mild disability were, on average, 40 percentile points higher than rankings for the same disability labeled severe or profound.     

照料失能配偶对老年女性抑郁程度的影响--基于CHARLS数据的实证分析

目的:研究照料失能配偶对老年女性抑郁程度的影响。方法:利用“中国健康与养老追踪调查”2015年全国数据,通过工具变量回归进行分析。结果:相比于没有照料配偶的女性,参与配偶照料的女性抑郁得分更高(P<0.01)。结论:提供长期照料会增加老年女性的抑郁程度。制定老年长期照料政策时应关注女性照料者的心理健康。     

建立残疾儿童社区康复网络

由医疗单位为主体的残疾儿童社区网络,对智残及脑瘫患儿如何进行社区家庭康复训练受到各阶层人士的高度重视。自2003年6月起,我们在这方面进行了探索,现将有关资料总结如下。1对象与方法1.1对象所在地总共13个街道的122250名0～18岁户籍少年儿童。1.2方法由区卫生局直接领导,区所在地残联及区妇幼保健所组成残疾儿童网络领导层,并由其各自所辖的街道及地段医院组成网络成员,见表1。参加调查的相关人员先集中进行筛查和诊断方法的应用培训,然后于2003年6月1日～30日对13个街道户籍儿童逐一入户调查,调查表由残联和妇幼保健所统一制定。残疾的…     

Pay less,consume more? The price elasticity of home care for the disabled elderly in France

Little is known about the price sensitivity of demand for home care of the disabled elderly. We partially fill this knowledge gap by using administrative data on the beneficiaries of the main French home care subsidy program in a department and exploiting interindividual variation in provider prices. We address the potential endogeneity of prices by taking advantage of the unequal spatial coverage of providers and instrumenting price by the number of municipalities served by a provider. We estimate a price elasticity of around ?0.4 that is significantly different from both 0 and ?1. This less than proportionate response of consumption to price has implications for the efficiency and redistributive impact of variation in the level of copayments in home care subsidy schemes.     

Could a national oral health promotion program improve the oral hygiene of persons attending special care establishments in France? Evaluation of a pilot program

This study aimed to investigate the effectiveness of an oral health promotion intervention implemented in special care establishments by dentists trained online. Twenty‐six dentists intervening in 27 French special care establishments undertook a standardised oral health promotion intervention, including a conference presentation for care staff and hands‐on toothbrushing workshops. Oral hygiene status of the residents was performed at baseline and at 6 months, and were compared using the McNemar test. Mixed logistic regression was performed to identify the factors associated with an improvement of dental plaque removal. The oral health intervention was completed by 890 residents: 445 children, 373 adults and 72 elderly adults. At baseline, dental plaque was observed for 79.8% of the 797 dentate residents. Among the 691 dentate residents included in the final analysis, dental plaque removal was improved for 34%. Improvement in dental plaque removal was recorded more often for the group of 13 to 20‐year‐old residents (OR = 1.97; 95% CI = 1.15–3.38). The results indicate that this programme failed to significantly improve the dental plaque removal of the residents. More research is needed to understand the limiting factors of such interventions.