耶鲁抽动症整体严重度量表在儿科临床的初步应用

目的 为量化评估儿童抽动障碍症状的严重程度,翻译并初步应用耶鲁抽动症整体严重度量表（Ｙale Ｇic Ｓeverity Ｓcale,ＹＧＴＳＳ）。方法 对７２例抽动障碍病儿分别于 治疗前和治疗２周后作ＹＧＴＳＳ抽动评分,同时由病儿或监护人按显效、有效和无效自行评定疗效。比较７２例患儿中三种不同类型（暂时性抽动,慢性抽动和抽－秽语综合征）之间的积分差别,比较三组不同疗效病儿之间ＹＧＴＳＳ积分变化的差别。结果 治疗开始前     

Review Article: Normal science? Texts for teaching the sociology of health and illness

Ellen Annandale, The Sociology of Health and Medicine
Rob Baggott, Health and Health Care in Britain
David Field and Steve Taylor (eds), Sociological Perspectives on Health,Illness and Health Care
John Germov (ed), Second Opinion: an Introduction to Health Sociology
Ron Iphofen and Fiona Poland, Sociology in Practice for Health CareProfessionals
Lesley Mackay, Keith Soothill and Kath Melia (eds), Classic Texts inHealth Care
Alan Petersen and Charles Waddell (eds), Health Matters: a Sociology ofIllness, Prevention and Care     

Creative versus repetitive dance therapies to reduce the impact of fibromyalgia and pain: A systematic review and meta-analysis

Background and purposePhysical exercise is one of the most effective interventions to reduce fibromyalgia symptoms. Previous studies have reported benefits of dance-based intervention on the fibromyalgia impact, health-related quality of life and pain, regardless the interventions were based on creative- or repetitive dance. This study aimed to compare the effectiveness of creative and repetitive dance interventions.MethodsPRISMA guidelines were followed in this systematic review. The Cochrane Library, PubMed, Trip, Google Scholar, Web of Science (WOS), Embase and Scopus databases were selected to identify potential articles. Studies were included if they met the following inclusion criteria: to be a clinical trial or a randomized controlled trial, include people with fibromyalgia, have a comparison group and evaluate the impact of the disease, pain or quality of life. Fifteen articles fulfilled the inclusion criteria. The methodological quality of the studies was assessed using the Cochrane Collaboration's tool.ResultsDance-based interventions significantly reduced fibromyalgia impact (standardized mean difference = −0.69), pain (standardized mean difference = −0.70 and increased quality of life (standardized mean difference = 0.43) of people with fibromyalgia. The effectiveness of dance interventions is increased when a creative component is added, since it can lead to higher improvements in pain, impact of the disease and improving quality of life.ConclusionDance-based interventions are significantly effective in reducing the impact of fibromyalgia, pain as well as increasing health-related quality of life. Subgroup analyses suggest that creative dance-based interventions could be more effective than repetitive dance-based interventions to reduce pain and fibromyalgia impact. However, results must be taken with caution due to the large heterogeneity and the small number of articles.     

Efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization: A randomized,single-blind,controlled trial

BackgroundThe best physiotherapeutic approach in shoulder pathology that generates prolonged immobilization is still uncertain. Kinesitherapy remains the most widely used option. Myofascial therapy is a therapeutic approach in which the aim is to release fascial tension and regain mobility although its efficacy in shoulder pathology has not been sufficiently studied. This Prospective, single-blind randomized controlled trial in a university hospital setting aimed to compare the efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization.MethodsPatients were randomly assigned to a control group or to the intervention group.Both groups completed a therapeutic exercise program. Main Outcome Measures: The QuickDash questionnaire was the primary outcome, Pain Visual Analog Scale and the Range Of Motion of the shoulder were the secondary outcomes. The outcomes were evaluated at baseline (T0), at 4 (T2), 8 (T2), and 12 weeks (T3)Results44 participants were included. In the analysis of evolution over time, a significant improvement in functionality and range of motion measurements was observed in both groups (p < 0.05), although at 12 weeks only Myofasical Group achieved a clinically and statistically significant reduction in pain. Comparative analysis at 12 weeks revealed no statistically significant differences between the two therapies in the variables explored.ConclusionsBoth, myofascial therapy and kinesitherapy can improve function, mobility, and pain in patients with painful shoulder associated with prolonged immobilization, with no significant differences between therapies, although in the medium term only myofascial therapy achieves a clinically and statistically significant improvement in pain.Trial registrationTrial registration: ClinicalTrials.gov NCT04944446.     

Feasibility,acceptability and effects of dance therapy in stroke patients: A systematic review

IntroductionStroke is the leading cause of non-traumatic disability in adults, with balance and gait disturbances representing the main limitations of body functions. Dance therapy (DT) has shown positive effects in older adults and in patients with neurological pathologies. This systematic review aims to examine the feasibility, acceptability and effects of DT in stroke rehabilitation, specifically on functional gains of gait and balance.MethodsA systematic search was carried out for articles published in the MEDLINE, PEDro, Web of Science, Scopus and CINHAL in February 2021 and updated in April 2021. Results: Eight studies were included (2 clinical cases, 5 case series and 1 randomized controlled trial), 7 of them in patients with chronic stroke and only 1 in subacute stroke phase. The most widely used dance modality was tango and ballet, with sessions ranging from 30 to 110 min. DT seems to show positive effects on post-stroke body functions and activities such as gait and balance. Reported dropout rates are inconsistent, no adverse effects were reported, and participant satisfaction was high.ConclusionGiven the heterogeneity and uneven quality of the included studies, strong conclusions cannot be put forward on the effectiveness of DT in post-stroke body function and activities. Nevertheless, DT seems to be safe and acceptable therapy for patients, and no adverse effects have been reported. More studies with a high level of evidence and feasibility are needed to determine the patient profile, the characteristics of the intervention, the participation rate and the role of the rehabilitation professional most likely to generate optimal benefit.     

Vineland Adaptive Behavior Scale Scores as a Function of Age and Initial IQ in 210 Autistic Children

Human growth modeling statistics were utilized to examine how Vineland Adaptive Behavior Scale (VABS) scores changed in individuals with autistic disorder as a function of both age and initial IQ. Results revealed that subjects improved with age in all domains. The rate of growth in Communication and Daily Living Skills was related to initial IQ while rate of growth in Social Skills was not. Results should provide hope for parents and further support for the importance of functional social-communication skills in the treatment of autism.     

伽玛刀的医学技术评估

伽玛刀是世界上最昂贵的医疗设备之一,我国从１９９２年开始引进。１９９５年卫生部等联合发文暂缓装备。为了规范提供方和患方的行为,以及为卫生行政部门提供决策依据,我们开展了伽玛刀的技术评估。在评估前拟定评估步骤,然后确定评估内容与方法。评估结果,国外１９９４年有５６台伽玛刀,平均每台治疗１９０例,治疗病种是：动静脉畸型病人占３２％,肿瘤病人占６５％,功能性疾病占２％。我国１３台伽玛刀到１９９５年底共治病人７０００例,前６位病种是转移瘤等,虽然比例和顺位与世界有差异,但病例分析结果完全一致。     

转轨时期医院经营管理效益量化评价方法研究

效益评价是医院经营管理中的一项重要工作。医院经营管理的效益分为社会效益和经济效益。两个效益的人为脱节和社会效益指标的虚化,形成了效益评价的难点。本文采取层次分析法,将医院的社会效益、经济效益与医院的投入、消耗和产出的１９个指标有机结合起来,使两个效益在有机统一的前提下指标量化,这样既增强了两个效益评价工作的可操作性,也增强了效益评价结果对医院经济工作指导的操作性。     

护理质量评价体系的改进及其软件开发

通过对《军队医院护理质量主要评价指标》在运用过程中存在不足之处的分析,结合实际对原评价体系的评价方法,评价内容进行了补充和完善,形成了一套既能从宏观上全面反映医院护理质量达标情况。又能从微观上具体反映各临床科室护理质量达标程度及名次排列的评价体系,使护理质量管理更具针对性。在此基础上又介绍了研制出的适合医院护理工作特点的《护理质量综合评价》软件。     

Neurological soft signs in schizophrenia: Assessment and correlates

A German version of the Neurological Evaluation Scale (NES) was administered to 143 schizophrenic patients, 45 of them being severly chronic and disabled. Seventy-eight alcohol-dependent inpatients and 57 healthy volunteers were tested as control groups. Neurological soft signs (NSS) were rated with convincing agreement. Schizophrenic patients are more impaired on all scales than healthy controls. The chronic, severly disabled schizophrenic patients are more impaired compared with the main group of schizophrenic patients and both control groups. A significant patients and alcohol-dependent patients was only found for the subscale Motor Coordination. Compared with healthy controls the alcohol-dependent patients show a higher NES total score. The NES total score was related to the relative width of the third ventricle. Total score and subscales were correlated consistently with the level of cognitive functioning as measured by the Raven Standard Progressive Matrices and various neuropsychological tests presumably sensitive to dysfunctions of the prefrontal cortex. The NSS were related to positive as well as to negative symptoms, the correlations with negative symptoms being confined to items of Cognitive Disorganization. This close association of psychomotor and cognitive dysfunctions may be seen as related to the frequently discussed dysfunctions of the prefrontal cortex or the neurointegrative deficit postulated by Meehl.