Using participatory action research in community-based rehabilitation for people with acquired brain injury: from service provision to partnership with Aboriginal communities

Purpose.?Community-based rehabilitation (CBR) developed in response to delivery of rehabilitation services to people with disability in developing countries, and appears appropriate to address rehabilitation needs of rural and remote populations, including Australian Aboriginal People with acquired brain injury (ABI). This article will describe participatory action research (PAR) as a vehicle for exploring and translating the CBR model within a mainstream brain injury rehabilitation service in Queensland, Australia.

Method.?PAR was conducted with two self-selected remote Aboriginal communities in Far North Queensland. Key components to this project were the employment of a local Aboriginal worker, facilitating community engagement and consultation. PAR elements of planning, action and review were conducted through individual and group meetings and activities within the communities across a 3-year period.

Results.?The project has facilitated expansion and change within the current brain injury rehabilitation service model in line with CBR philosophical foundations, including community development and partnership as a desirable way of engaging with key stakeholders.

Conclusions.?The focus on community consultation through PAR and the development of community partnerships has increased the cultural competency of the rehabilitation service, the capacity of participating communities and of the sector to respond in ways that are valued and owned by Aboriginal People with brain injury, their families and communities.     

城市低保与非低保对象社会支持现状分析

目的 为探讨低保对象与非低保对象之间社会支持的差异,了解低保对象低保措施之外的社会支持,以更好地提高对低保对象的全方位支持.方法 采用系统和整群抽样相结合的方法抽取445名低保对象,并选取445名非低保对象进行1∶1配对,对890名调查对象进行入户调查.结果 调查对象平均年龄为51.21士14.86岁,男性占40.00%.相对于非低保对象,低保对象收入低、文化程度低、社会保障低、待业失业率高、高危家庭比例偏高、慢性病患病率高.结论 相对于非低保对象,低保对象具有"三低三高"特点,社会支持较差.     

老年人心房颤动并发脑卒中40例临床分析

目的探讨老年人心房颤动并发脑卒中的危险因素及防治。方法将2002-2007年收治的216例老年心房颤动患者,分为脑卒中组40例、对照组（无脑卒中组）176例,采用病例对照研究的方法,分析病史、体征、辅助检查及合并疾病、用药情况。结果脑卒中组与对照组中,其脑卒中危险因素差异有统计学意义（P〈0.05）。结论年龄≥70岁、持续性房颤、高血压、糖尿病、左心房增大、未抗栓治疗是老年房颤并发脑卒中的高危危险因素。控制危险因素,合理应用抗凝、抗血小板药,可减少老年人心房颤动并发脑卒中的发生。     

安徽省不同地区自然人群无形体病血清流行病学调查

目的了解安徽省南北不同地区自然人群无形体病感染状况和分布特点,为科学防治无形体病提供依据。方法 2010年5~6月在怀远、明光、庐江、枞阳、广德和太湖县共采集自然人群血清603份,采用间接免疫荧光法(IFA)检测无形体抗体IgG,并进行不同地区、年龄、性别比较。结果 603份人血清中,无形体抗体阳性血清98份,阳性率16.25%,(存在性别差异)。结论安徽省部分农村地区自然人群中均有无形体感染,需加强无形体病的预防宣传及诊断能力。     

中医临床处方饮片用量调研报告(妇科)

目的：调研中医妇科临床处方饮片用量，为制定中药饮片用量标准提供依据。方法：在全国不同区域，选取18个省市的21家医院，采用分层抽样和简单随机抽样相结合的方法，收集门诊中医妇科内服汤剂处方41 226张，构建中药饮片用量数据库，基于Weka数据挖掘软件进行统计分析。结果：明确了300味药物的中医妇科临床用药频次、相应的用量区间、及其与《中国药典》规定用量不相符合的155味药物具体的用量，大多数药物的临床用量区间为(36］，(912］，(1215］ 3个区间，具体集中在9，10，12，15 g等几个用量上。结论：《中国药典》部分中药的规定用量与中医妇科临床实际用量严重不符，需要修订，并为制定用量新标准提供了依据。     

Dissociation between recognition and recall in developmental amnesia

Developmental amnesia (DA) is a memory disorder due to hypoxia/ischaemia-induced damage to the hippocampus early in life. To test the hypothesis that this disorder is associated with a disproportionate impairment in recall vis-à-vis recognition, we examined a group of 10 patients with DA on the Doors and People test, which affords a quantitative comparison between measures of the two memory processes. The results supported the hypothesis in that the patients showed a sharp, though not complete, recall-recognition dissociation, exhibiting impairment on both measures relative to their matched controls, but with a far greater loss in recall than in recognition. Whether their relatively spared recognition ability is due to restriction of their medial temporal lobe damage to the hippocampus or whether it is due instead to their early age at injury is still uncertain.     

河南口岸出境人员酒精性肝病的患病调查

目的 了解河南口岸出境人员酒精性肝病的患病率及其发病的相关因素。方法 随机抽取4358名出境人员作为调查对象，调查酒精性肝病史及其相关的发病因素，无菌抽取静脉血5ml进行相关酶学检查。结果 酒精性肝病的检出率为4．84％，调查发现酒精性肝病的发生与饮酒的剂量、饮酒的时间有关。结论 加强河南地区人群的健康教育，少饮酒或不饮酒，有益于提高出境人员的整体素质。     

Individual- and community-level determinants of social acceptance of people living with HIV in Kenya: Results from a national population-based survey

Using the 2003 Kenya Demographic and Health Survey, we investigated the influence of individual- and community-level factors on accepting attitudes toward people living with HIV (PLHIV) using three outcomes: (1) willingness to care for an infected household member, (2) willingness to buy vegetables from an infected vendor, and (3) willingness to allow an infected female teacher to continue teaching. In multilevel logistic regression models, we found that individuals who expressed greater acceptance of PLHIV were more likely to be male, older, more educated, high AIDS knowledge, and exposed to mass media. At the community level, differences in accepting attitudes were associated with community AIDS knowledge, community education, and community AIDS experience, but not for region, or place of residence. The findings suggest the important role of community factors in determining social acceptance of PLHIV. Programmatic strategies aimed at increasing these accepting attitudes should consider both individual- and community-level factors.     

Identifying need in care homes for people with dementia: The relationship between two standard assessment tools

Considerable effort has been invested in improving assessment processes for older people, some of the most vulnerable of whom live in care homes. The paper compares two well-known assessment tools used in care homes, the CANE and the Minimum Data Set/Resident Assessment Instrument. There was poor agreement between the tools in terms of domains of need covered. Nineteen pairs of items could be compared, with agreement greater than 60% found on 11 items. Of the 15 items where κ could be computed, seven significant values were found. High levels of agreement existed in relation to behaviour, psychological wellbeing, mood state, psychotic symptoms, incontinence, mobility and inadvertent self-harm (risk). The study suggests that tools commonly used for assessment are not interchangeable and that the selection of assessment tool should be determined by the setting in which it is used, the needs of the population being assessed, the skills and knowledge of those undertaking the assessment and the purpose of the assessment itself.