健康寿命年——一个新的测量疾病负担的指标

介绍一种新的测量疾病负担的指标——健康寿命率（ＨｅａＬＹ）。我们用此指标对１９９０～１９９３年北京ＭＯＮＩＣＡ资料进行了重新估算和分析,并将其与几年前ＷＨＯ和世界银行提出的另一个测量疾病负担的指标ＤＡＬＹ进行了比较。     

学习障碍儿筛检测试的应用研究

目的：为在我国开展学习障碍的研究提供筛查工具,对日本PRS在江苏省进行标准化研究。方法：采用PRS测试江苏省12市城乡5～15岁普通学校中小学生和幼儿园儿童6676名,进行标准化研究。结果：PRS项目测试具有较高的可靠性,言语性以及非言语性领域Cronbach’sa系数均大于093,全项目则达到096;因子分析则间接提示本次测试的有效性;各项目得分比日本样本更接近正态分布,各项目以及各领域得分均略高于日本。作为筛查学习障碍界值是合适的。结论：PRS在江苏省可用于筛俭学习能力障碍,需进一步加强应用研究。     

人眼眩光失能测定及其临床意义

目的:观察国产仪器测定眩光失能的性能与规律,并讨论其临床意义。方法:采用MGT—1多功能视觉眩光测试仪(海军医学研究所研制),按规定方法操作。测定正常人30名56眼(矫正视力全部≥1.0,晶体透明,无其他明显眼病),晶体混浊患者15人27眼。测定目标亮度及眩光亮度设置为中—中及弱—中两档分别模拟白天及夜间眩光失能。结果:中—中状态下,眩光失能值正常人均值为9.22%(全距0～31),低于晶体混浊者(24.05%,全距9～67),两者差异显著。正常眼在弱—中状态眩光失能值较中—中状态明显(均值20.12%,全距0～56)。不同频率条件对正常及晶体混浊眼眩光失能的影响不同,低频及中频较高频区的影响明显。结论:作为视功能评论指标,眩光失能检查是一种实用方法。在眼科临床及人体工效学上具有重要的意义。     

The functional restoration approach for chronic spinal disability

The functional restoration approach to treating chronic spinal disability consists of a medically directed, interdisciplinary team approach to physical reconditioning and a cognitive-behavioral crisis intervention procedure for dealing with related psychosocial problems. One- and two-year follow-up studies have demonstrated the clinical efficacy of this approach. The present article describes this approach and summarizes the research documenting its success in treating patients with chronic spinal disability. This article also highlights the pitfalls in misunderstanding and misrepresenting the components of the functional restoration approach when evaluating treatment efficacy.     

Thoughts about encounters between nondisabled and disabled peers: Situational constraints,states-of-mind,valenced thought categories

This study explores three issues: thoughts and feelings of individuals with and without physical disabilities concerning encounters in different situations, ways of grouping self-statements into valenced categories, and use of states-of-mind (SOM) ratios as an alternative to positive and negative thought frequencies. Data from 127 able-bodied and 46 physically disabled college students indicate that, in everyday social encounters, nondisabled individuals' thoughts and feelings were more negative, while those of disabled individuals were more negative when helping was involved and when encounters centered on the impairment. Thus, problematic encounters between people with and without disabilities may be due to the reactions of individuals with disabilities in situations which involve help, and to reactions of able-bodied persons in everyday contexts. The data also confirm the utility of SOM ratios as an alternative to valenced frequencies in cognitive assessment: SOM scores discriminated groups when situational demands were manipulated and scores were linearly related to criterion measures. However, SOM ratios differed dramatically, depending on the attentional focus of thoughts. The findings illustrate types of thoughts which occur during interaction between people with and without disabilities, demonstrate a simple technique for grouping thoughts into valenced categories on an empirical basis, and highlight the relative contribution of cognitive and affective elements to overall valenced scores. Implications for research on assessment of self-statements are discussed and recommendations are made concerning programming to facilitate the social integration of people with disabilities.This research was supported by grants to the first author from the Social Sciences and Humanities Research Council of Canada and from Fonds F.C.A.R. pour l'aide et le soutien à la recherche. Thanks are due to Meribah Aikens, Maria Barile, Leo Bissonette, Bosco Daude, Jim Dubois, Lillian Fox, Evelyn Gold, Naomi Goodz, Darlene Judd, André Leblanc, John Martos, Sue McKenzie, Irwin Slopak, and Joan Wolforth for their assistance with various stages of this investigation.     

Sexuality and people with intellectual disabilities: A historical perspective

Until the 1960s, the sexuality of people with mental retardation was handled by denial and suppression. The eugenics movement of 1880–1940 led to forced mass sterilization and the segregation of these members of our society. The civil rights movement and the sexual revolution were among the catalysts for change as was the move toward normalization and deinstitutionalization of people with mental retardation. In the last 25 years, parents and professionals have begun to work together to find ways to help mentally handicapped individuals to understand their sexuality and to engage in appropriate self-affirming sexual behaviors. We have established goals, guidelines, and curricula for sexuality education. We have trained parents and staff and developed policies for handling sensitive issues, such as sterilization and problematic sexual expression. The AIDS epidemic has provided new impetus for improving education and training in this emerging field.A.C.S.W.Private practice (as a consultant, lecturer, and trainer in sexuality and mental retardation).     

Planum temporale, planum parietale and dichotic listening in dyslexia

A reduction or reversal of the normal leftward asymmetry of the planum temporale (PT) has been claimed to be typical of dyslexia, although some recent studies have challenged this view. In a population-based study of 20 right-handed dyslexic boys and 20 matched controls, we have measured the PT and the adjacent planum parietale (PP) region in sagittal magnetic resonance images. For the PT, mean left and right areas and asymmetry coefficients were compared. Since a PP area often could not be identified in one or both hemispheres, a qualitative comparison was used for this region. The total planar area (sum of PT and PP) was also compared between the two groups. A dichotic listening (DL) test with consonant–vowel syllables was administered to assess functional asymmetry of language. The results showed a mean leftward PT asymmetry in both the dyslexic and the control group, with no significant difference for the degree of PT asymmetry. Planned comparisons revealed however, a trend towards smaller left PT in the dyslexic group. In control children, but not in the dyslexic children, a significant correlation between PT asymmetry and reading was observed. A mean leftward asymmetry was also found for the total planar area, with no difference between the groups for the degree of asymmetry. Significantly fewer dyslexic children than control children showed a rightward asymmetry for the PP region. Both groups showed a normal right ear advantage on the DL task, with no significant difference for DL asymmetry. No significant correlation was observed between PT asymmetry and DL asymmetry. The present population-based study adds to recent reports of normal PT asymmetry in dyslexia, but indicates that subtle morphological abnormalities in the left planar area may be present in this condition.     

Impairments, disabilities and handicaps in children and adolescents with epilepsy

The patterns of motor and sensory impairments, disabilities and handicap were assessed in 217 children and adolescents with epilepsy. Motor and sensory dysfunctions were found to be common even in children without major additional neurodisorders such as cerebral palsy and mental retardation. Handicap was most severe in the dimensions of physical independence and orientation and increased significantly with duration of epilepsy. It was more severe when the onset of seizures was early and when secondary generalized seizures were present. Handicap was significantly reduced after epilepsy surgery.     

A follow-up study of infants ≤ 2000 g birthweight treated in central Queensland

This follow-up study was undertaken in an effort to ascertain the morbidity in the survivors of infants ≤2000 g birthweight cared for in the two Rockhampton intensive care nurseries.

Methodology:

The records of all infants ≤2000 g delivered in or transferred to Rockhampton during the 11 year period 1979 through 1989 inclusive were extracted. Efforts were made to contact and examine all of these children. Those found to be disabled were assessed as being mildly, moderately or severely affected.

Results:

Of the 482 infants of birthweight ≤2000 g treated in the period under review, 393 survived to be discharged from hospital. Eight were known to have died subsequently. Of the remaining 385 children, 288 (74.8%) were able to be contacted and their health status determined. A total of 36 infants were found to have significant disabilities. Twenty-four were mildly affected, five moderately and seven severely affected. Severe disability in infants of ≤1000 g was 16% (3/19).

Conclusions:

The incidence of disability was established in 74.8% of the surviving population, It was not dissimilar to the incidence of disability in similar birthweight groups in some Australian tertiary centres for the years under study. It is emphasized that the follow-up was incomplete and recognized that the survival rates and incidence of disability in survivors has improved in tertiary centres since the time frame of this study.     

Effects of Pediatric Chronic Physical Disorders on Child and Family Adjustment

Research conducted primarily over the past 5–8 years on the psychosocial effects of pediatric chronic physical disorders on children and their families is reviewed. A large body of studies show that both children and their mothers, as groups, are at increased risk for psychosocial adjustment problems compared to peers, but that there is considerable individual variation in outcome. Since the last review on this topic (Eiser, 1990a), many studies have been conducted to identify risk and resistance factors associated with differences in adjustment among these children and their mothers. Improvements are noted in the theoretical basis for this work, programmatic nature of some of the research, and efforts at producing clinically relevant information. Evaluations of interventions, however, are lagging. Critical issues and future directions regarding developmental approaches, theory, method, measurement and intervention are discussed.