煤矿工人工伤所致精神障碍赔偿行为分析

目的探讨煤矿工人工伤与非工伤精神障碍赔偿行为。方法采用自拟的煤矿工人工伤后及非工伤精神障碍待遇调查表对75例工伤和80例非工伤精神障碍矿工进行精神残疾鉴定后的赔偿行为进行对比分析。结果工伤组70.7%尚能胜任工作的患者中重返工作岗位者只有4.0%,76%长期住院或多次住院的患者中有29.3%的患者长期假出院在家;诈病率显著高于非工伤组,1～3级精神残疾率显著低于非工伤组（P〈0.01）;工伤组患者有意扩大病情的比例显著高于非工伤组,医疗费用及工资待遇显著优于非工伤组。结论煤矿工人工伤后有严重的赔偿行为;工人价值观、道德标准低,工作劳动强度大,卫生条件差,危险性大,矿区对工伤待遇优厚等是赔偿行为产生的主要原因。     

视力残疾的病因分析及预防

目的：了解重庆市渝中区近5年来视力残疾的状况、特点及致残病因，提出相应的预防措施。方法：由指定眼科医师进行多次常规及特殊检查，分析403例806只眼的调查资料。结果：0～14岁儿童组人群的主要致残因素是先天遗传、屈光不正／弱视、斜视／弱视、角膜病和视神经病变；60岁以上老年人群为青光眼、白内障、角膜病、视网膜病变和视神经病变；其他人群依次为高度近视网脱及黄斑变性、眼外伤、角膜病、青光眼和视网膜病变。结论：对不同年龄段的人群应制定相应的预防视残措施。重点开展孕期保健工作及遗传咨询，加大眼部疾病预防知识宣传，预防眼部感染和外伤，积极治疗原发病。     

Hypertension and Associated Risk Factors among Children with Intellectual Disability: A Cross-Sectional Study

To investigate the prevalence of hypertension and associated risk factors in Chinese children with intellectual disability, a cross-sectional study was conducted in a sample of 558 children with intellectual disability aged 6–18 years in Hong Kong, and 452 (81.0%) with valid data were included in the data analysis. Blood pressure was measured according to a standard protocol. Hypertension was defined using the age-, gender-, and height-specific classification criteria recommended by the 2018 Chinese Guidelines for Children. Multivariate and hierarchical logistic regression was fitted to examine the associations of hypertension with potential risk factors. Overall, 31.4% of the participants were classified as having hypertension. Obese children were more likely to develop hypertension than non-obese children (adjusted OR = 2.77, 95% CI: 1.28, 5.99, p = 0.010). A paternal education of college or above and a paternal occupation of clerks, sales representatives, and workers were also associated with an increased risk of hypertension. The prevalence of hypertension is high among Chinese children with intellectual disability. Obesity was the strongest risk factor. Further longitudinal studies are warranted to confirm our findings. Nevertheless, preventions against obesity are promising to receive doubled benefits in reducing both obesity and hypertension, given its strong relationship with hypertension in this special population.     

癫痫儿童认知学习能力的研究

目的:探讨癫痫儿童的认知学习状况。方法:采用学习障碍筛查量表(PRS)测量60例癫痫儿童和60例健康对照,并用丹麦维迪Keypoint诱发电位仪检测其事件相关电位P300。结果:①癫痫儿童PRS量表总分、言语得分及非言语得分均较正常儿童降低,差异有显著性(P<0.01);②癫痫儿童P300潜伏期较正常儿童延长,差异有显著性(P<0.01);③全面性发作组与部分性发作组比较,P300与PRS量表均未见显著性差异(P>0.05)。结论:本研究表明癫痫儿童存在学习障碍,PRS量表与P300可从不同角度反映癫痫儿童的认知学习状况。     

Prevalence of intellectual disability among eight-year-old children from selected communities in the United States, 2014

BackgroundChildren with intellectual disability (ID), characterized by impairments in intellectual functioning and adaptive behavior, benefit from early identification and access to services. Previous U.S. estimates used administrative data or parent report with limited information for demographic subgroups.ObjectiveUsing empiric measures we examined ID characteristics among 8-year-old children and estimated prevalence by sex, race/ethnicity, geographic area and socioeconomic status (SES) area indicators.MethodsWe analyzed data for 8-year-old children in 9 geographic areas participating in the 2014 Autism and Developmental Disabilities Monitoring Network. Children with ID were identified through record review of IQ test data. Census and American Community Survey data were used to estimate the denominator.ResultsOverall, 11.8 per 1,000 (1.2%) had ID (IQ ≤ 70), of whom 39% (n = 998) also had autism spectrum disorder. Among children with ID, 1,823 had adaptive behavior test scores for which 64% were characterized as impaired. ID prevalence per 1,000 was 15.8 (95% confidence interval [95% CI], 15.0–16.5) among males and 7.7 (95% CI, 7.2–8.2) among females. ID prevalence was 17.7 (95% CI, 16.6–18.9) among children who were non-Hispanic black; 12.0 (95% CI, 11.1–13.0), among Hispanic; 8.6 (95% CI, 7.1–10.4), among non-Hispanic Asian; and 8.0 (95% CI, 7.5–8.6), among non-Hispanic white. Prevalence varied across geographic areas and was inversely associated with SES.ConclusionsID prevalence varied substantively among racial, ethnic, geographic, and SES groups. Results can inform strategies to enhance identification and improve access to services particularly for children who are minorities or living in areas with lower SES.     

福建同安主要恶性肿瘤死亡率分析与趋势预测

[目的]分析福建省同安恶性肿瘤死因及死亡率变化趋势，为预防控制提供依据。[方法]计算标化死亡率、早死所致生命损失年，并采用灰色模型预测，对1990—2001年同安恶性肿瘤死亡资料统计分析。[结果]1990—2001年同安恶性肿瘤死亡率呈上升趋势。恶性肿瘤标化死亡率126．72／10万，食管癌、肝癌、胃癌和肺癌标化死亡率分别为39．12／10万、36．59／10万、12．82／10万和12．60／10万。肺癌死亡率上升趋势明显，女性肺癌标化生命损失年YLLs率上升18．18％。以灰色模型GM(1，1)预测2005年同安恶性肿瘤死亡率为142．06／10万。[结论]肝癌、食管癌、肺癌、胃癌是同安肿瘤研究与防治的重点。     

对接大健康产业发展的康复治疗学人才培养体系的构建

在大健康产业发展背景下,康复服务产业发展模式和服务理念逐步转变。康复人力资源是康复服务产业发展的基石,文章基于《国际功能、残疾和健康分类》(international classification of functioning,disability and health,ICF)康复科学理论体系,切合康复服务产业化和专业化需求,重构康复治疗学专业人才培养的课程体系,强化实践教学,探讨构建康复治疗学专业人才培养新模式。     

Assessment of functioning in Dutch primary care: Development study of a consultation tool for patients with chronic conditions and multimorbidity

BackgroundIn primary care, a shift from a disease‐oriented approach for patients with multimorbidity towards a more person‐centred approach is needed.AimTo transform a self‐report questionnaire for patients with chronic conditions in primary care, the Primary Care Functioning Scale (PCFS), into an understandable, visually attractive and feasible consultation tool for patients and health care providers. The consultation tool consists of a web‐based version of the PCFS, which is filled in by the patient and is processed to a feedback report that summarizes and visualizes the main findings. The feedback report can be discussed with the patient to facilitate a more person‐centred conversation for patients with chronic conditions and multimorbidity in general practice.Design and SettingIn this qualitative study, we developed the consultation tool by using design thinking in a participatory developmental process.MethodsIn the first phase, we constructed five different feedback report templates to summarize and display the results of a completed PCFS questionnaire in a series of two expert meetings with patients and general practitioners (GPs). In the second phase, we performed an exploratory qualitative interview study involving dyads of patients with chronic conditions and their practice nurses. In an iterative process, we explored their experiences with the consultation tool.ResultsPatients, as well as GPs, preferred a clear manner of presenting the results of the questionnaire in a feedback report. In 18 interviews with patients and practice nurses during three different interview rounds, we adjusted the feedback report and consultation tool based on the input from patients and practice nurses. After the final interview round, patients and practice nurses consented that the consultation tool was useful for having a more in‐depth consultation about functioning and patients'' preferences when integrated into the regularly scheduled consultations.ConclusionWe were able to develop an understandable and feasible consultation tool that is applicable in already existing chronic disease management programmes in general practice in the Netherlands.Patient or Public ContributionTo increase the understandability and feasibility of the consultation tool, we collaborated with end‐users and actively involved patients, GPs and practice nurses in a participatory development process.     

精神分裂症精神残疾影响因素的研究进展

精神残疾指各类精神障碍持续一年以上未痊愈,存在认知、情感和行为障碍,影响日常生活和社会参与的状态［1］。精神分裂症是引发精神残疾的主要原因,83％的精神分裂症患者最终会出现精神残疾［2］。有研究证实,精神分裂症患者在前驱期已经表现出明显的社会功能缺陷,缺陷程度随着病程进展不断加重,最终出现严重的精神残疾［3］。患者不同程度的精神残疾和治疗费用给家庭和社会带来沉重的心理和经济负担。因此,积极探索精神分裂症患者的精神残疾的影响因素已成为研究热点。现就目前国内外精神分裂症精神残疾影响因素的研究进行归纳总结,将影响因素加以提炼,分为保护性和危险性因素,以期为强化保护性因素、降低危险性因素,改善患者的社会功能,延缓精神残疾提供新的视角。