江苏省老年医院江苏省省级机关医院

江苏省老年医院(江苏省省级机关医院、江苏省老年医学研究所)始建于1952年11月,2004年10月参与组建江苏省人民医院集团,是一所集医疗、教学、科研、康复、保健为一体,具有老年特色的综合性医院,承担着省、市领导、公务员、社区居民的医疗服务,以及省内高级干部和中央来苏领导的日常医疗保健任务。医院坚持以医疗为基础,     

保健医学研究与实践杂志成功承办第二届全国社区养老服务创新发展高峰论坛

正2019年4月11—14日,由西南大学及中国康复医学会医养结合专委会联合主办,西南大学医院老年康复研究所、四联优侍科技养老产业有限公司、保健医学研究与实践杂志承办的"第二届全国社区养老服务创新发展高峰论坛"在重庆北碚顺利举行。论坛开幕式由西南大学医院老年康复研究所所长、西南大学医院院长、我刊主编吴宗辉教授主持,西南大学党委常委、副校长崔延强教授、重庆市卫健委老龄健康处处长吴长文、重     

老年骨质疏松性骨折的影响因素及社区康复效果

目的探讨老年骨质疏松性骨折的影响因素及社区康复治疗对患者的治疗效果。方法选取2015年1月—2017年1月同济大学附属杨浦医院收治的老年骨质疏松症患者300例,根据患者是否出现骨折分为对照组(n=150,非骨折组)和观察组(n=150,骨折组),对比分析老年骨质疏松性骨折的影响因素,同时给予社区康复治疗,探讨社区康复治疗效果。结果经骨折的影响因素分析结果显示,年龄、TC、LDL、总髋部BMD水平及阳光照射情况均为老年骨质疏松患者骨折发生的影响因素(P0.05);经logistic回归分析显示,女性、年龄较大、缺乏阳光照射和总髋部BMD水平低均为老年骨质疏松患者发生骨折的独立危险因素(P0.05);老年骨质疏松性骨折患者经社区康复治疗其前屈后伸痛、翻身痛、负重痛及总髋部BMD水平均有所改善(P0.05)。结论女性、年龄较大、缺乏阳光照射及总髋部BMD水平低均为老年骨质疏松患者发生骨折的独立危险因素,临床医生应根据患者的实际情况有针对性地实施社区康复。     

在老年慢性病社区康复中开展医疗体育的理论探讨

慢性病对老年人身心健康和生活质量影响巨大,人口老龄化带来的医疗保健问题也日益突出。文章调查老年慢性病流行现状,分析医疗体育对老年慢性疾病康复的重要性,探讨依托社区开展慢性病医疗体育康复的必要性和可行性,提出慢性病社区康复(community-based rehabilitation,CBR)服务流程的理论框架,包括健康调查、康复对象确定、医疗体育运动处方的定制、实施、监督与调整等环节。为老年慢性病康复以及健康生活质量的提高提供理论与实践参考。     

南京金陵骨质增生研究中心

江苏省省级机关医院坐落于南京著名的颐和路民国公馆区．地理位置优越,环境优美。医院始建于1952年,1991年成立江苏省老年医学研究所．1992年挂牌江苏省老年医院,2004年参与组建江苏省人民医院集团。是一所集医疗、教学、科研、康复,保健为一体,具有老年特色的综合性医院。承担着省、市党政领导、公务员、社区居民的医疗服务．以及省内高级干部和中央来苏领导的日常医疗保健等任务。     

老年脑卒中患者社区康复护理的探讨

目的 了解老年脑卒中患者社区康复护理需求，对其影响因素进行分析，为其针对性制订有效的社区康复护理对策提供依据。方法 选取2021年10月—2022年2月天津市河西区友谊路街社区240例老年脑卒中患者，通过多阶段分层随机抽样的方法，对其常规资料、患病情况和社区康复护理方面进行调查。结果 老年脑卒中患者社区康复护理服务需求为（22.22±4.32）分，康复护理技术（23.15±4.56）分，健康教育（26.45±3.79）分，总体需求（73.02±11.41）分。236例患者社区康复护理服务项目需求依次是血压监测、病情观察、针灸按摩、照顾者指导、饮食和营养知识、保健知识、急救对策、心理康复、心电图检查、健康咨询、静脉输液、睡眠和休息指导、康复练习的需求。将老年脑卒中患者进行多因素分析，经回归方程分析后结果显示，独处时间、经济收入、年龄和就医距离均是老年脑卒中患者康复护理需求的影响因素，差异均有统计学意义（P<0.01）。结论 老年脑卒中患者对社区康复护理需求较高，其中独处时间、经济收入、年龄和就医距离均是老年脑卒中患者康复护理需求的影响因素。     

康复治疗对社区老年脑卒中后日常生活能力的影响

目的探讨康复治疗对社区老年脑卒中患者日常生活能力的影响。方法选择2007年1月～2008年10月社区内新发老年脑卒中患者74例,分对照组和康复组,康复组采用良肢位的设计,BoBath疗法心理疏导等,对照组常规药物治疗。康复评定采用Barthel指数评定患者的日常生活能力。结果经6个月康复训练后,康复组BI指数评定值从治疗前22．79±17．33提高到38．26±22．24,与对照组相比,差异有统计学意义（P〈0．001）。结论社区早期康复治疗是脑卒中患者人人享有康复服务的有效途径。     

我国城市社区老年医疗保健服务

为了探索城市社区老年医疗保健服务的有效途径,特介绍两种城市社区老年医疗保健服务模式,供各地参考。①社区老年医疗保健的三级监护。即将社区内的全部老年人,根据其生活自理能力、年龄、患病情况,划分为一、二、三级监护对象,分别提供不同的医疗保健服务。②社区老年医疗保健的三段服务。即根据疾病发展的过程。在患病阶段提供医疗服务,对疾病的恢复期、慢性病的迁延期和残疾患者提供康复服务,对预后不良的重危患者和老年多器官衰竭患者提供临终关怀服务。搞好社区老年医疗保健必须得到街道办事处和有关部门的支持,必须得到市、区两级政府和有关部门的支持,必须健全三级医疗保健网,充分发挥地段医院的作用。     

老年患者下呼吸道酵母样真菌感染的临床分析

目的探讨老年患者酵母样真菌社区与医院感染临床特点。方法对288例老年住院患者下呼吸道酵母样真菌感染进行回顾性分析。结果社区和医院感染均以白色假丝酵母菌多见,社区感染愈后较好;医院感染多伴有发热和侵入性操作,住院时间较长,与性别、年龄、抗菌药物使用、白细胞等差异无统计学意义;各种真菌对多种抗真菌药物敏感率较高,社区感染的光滑假丝酵母菌对氟康唑和伊曲康唑的敏感性高于医院感染。结论认识老年患者下呼吸道真菌社区与医院感染特点,有助于指导临床。     

老年医院护理单元疗愈性空间环境设计研究

通过梳理老年医院护理单元的相关理论,依据老年患者的一般特征和对护理单元空间环境的需求,提出老年医院护理单元疗愈性空间环境的设计框架.在此基础上,通过实地调研总结出我国老年医院护理单元空间的问题,并对其疗愈性空间环境提出设计策略.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.