The Participation of Disabled Children and Young People: A Social Justice Perspective

There is an increasing expectation that children, young people and their parents should participate in decisions that affect them. This includes decisions about their health and social care and collective or public decisions about the way in which such services are designed, delivered and evaluated. Indeed this has become a policy priority across the United Kingdom. The participation of disabled children and young people, however, has been slow to develop in the United Kingdom and concerns have been expressed about progress in this area. Drawing on the results of an Economic and Social Research Council-funded, mixed-methods study, the aim of this article is to explore the participation of disabled children and young people through a social justice lens. Participants, recruited by purposeful sampling, included 18 disabled children and young people, 77 parents and 90 professionals from one health and social care trust in Northern Ireland. There were four phases of data collection: surveys to parents and professionals, parent interviews, interviews with children and young people using creative and participatory techniques, and a focus group with professionals. Results showed that for most disabled children and young people, decision-making was firmly grounded in a family-centred model. However, when children and young people were drawn into participatory processes by adults and recognised as partners in interactions with professionals, they wanted more say and were more confident about expressing their views. Choices, information and resources were at times limited and this had a key impact on participation and the lives of these children, young people and their parents. The article concludes by exploring implications for further research and practice. The need for a two-pronged, social justice approach is recommended as a mechanism to advance the participation agenda.     

中华人民共和国卫生部/全球疫苗和免疫联盟合作项目地区乙型肝炎疫苗纳入免疫规划效果评估

目的评价2002年以后,中华人民共和国卫生部（MInistry Of Health Of the People’s Republic of China,MOH）/全球疫苗和免疫联盟（Global Alliance for Vaccine and Immunization,GAVI）合作项目乙型肝炎（乙肝）疫苗（Hepatitis B Vaccine,HepB）纳入免疫规划的效果。方法在全国68个项目县（区、市）,采用多阶段随机抽样方法,抽取2002～2005年出生的儿童作为调查对象。通过调查问卷收集基本情况、HepB接种史等信息,同时采集血清标本2～4ml,现场分离血清后,用酶联免疫吸附试验检测乙肝病毒表面抗原（Hepatitis B Surfance Antigen,HBsAg）、抗乙肝病毒表面抗原抗体、抗乙肝病毒核心抗原抗体。结果MOH/GAVI合作项目地区2002～2005年出生的儿童,HepB3剂全程免疫接种率为80.02%,HepB首剂及时接种率为60.06%;出生越晚,接种率越高,农村接种率低于城市;在家出生儿童接种率低于在医院出生儿童。项目地区2002～2005年出生儿童HBsAg携带率〈2%。结论MOH/GAVI合作项目实施后,加快了HepB纳入免疫规划进程,HepB接种率显著提高,起到了良好的预防作用。     

Prevalence of Psychoactive Substance Consumption in People With Obesity

Objective: The aim of this study was to evaluate the prevalence and the kind of psychoactive substances consumed by people with obesity. Methods: Patients were included at their first visit for bariatric surgery. Socio-demographic characteristics, anxiety, depressive disorders and psychoactive substance consumption were assessed. The prevalence of psychoactive substance consumption was compared to that of the general population reported by the French National Institute of Prevention and Health Education. Results: One hundred (100) patients were consecutively recruited: 60 women (mean age 41 ± 14 years) and 40 men (mean age 46 ± 13 years). Sixty-seven percent of subjects consumed alcohol. Consumption rates of cannabis (21% vs. 10%), cocaine (7.0% vs. 0.8%) and amphetamine (6.0% vs. 0.3%) were significantly (p < .0001) higher in people with obesity than in the general population. Conclusions: People with obesity have an excess risk of amphetamine, cocaine and cannabis consumption. This consumption may increase the risk of cardiovascular and psychiatric morbidity and should therefore be detected before surgery.     

Assessing the feasibility of hepatitis C virus vaccine trials: Results from the Hepatitis C Incidence and Transmission Study-community (HITS-c) vaccine preparedness study

Efficacy trials of preventive hepatitis C virus (HCV) vaccine candidates raise challenging scientific and ethical issues. Based on data from the first 3 years of a community-based prospective observational study – the Hepatitis C Incidence and Transmission Study-community (HITS-c) – this paper examines the feasibility of conducting trials of candidate HCV vaccines with people who inject drugs (PWID) in Sydney, Australia. Of the 166 PWID confirmed HCV antibody negative and eligible for enrolment, 156 (94%) completed baseline procedures. Retention was high, with 89% of participants retained at 48 weeks and 76% of participants completing at least 75% of study visits within 2 weeks of schedule. The rate of primary HCV infection was 7.9/100 py (95% CI 4.9, 12.7). Of the 17 incident cases, 16 completed at least one follow-up assessment and 12 (75%) had evidence of chronic viraemia with progression to chronic HCV infection estimated to be 6/100 py. Power calculations suggest a chronic HCV infection rate of at least 12/100 py (primary HCV infection rate 16/100 py) will be required for stand-alone trials of highly efficacious candidates designed to prevent chronic infection. However, elevated primary HCV infection was observed among participants not receiving opioid substitution therapy who reported heroin as the main drug injected (26.9/100 py, 95% CI 14.5, 50.0) and those who reported unstable housing (23.5/100 py, 95% CI 7.6, 72.8), daily or more frequent injecting (22.7/100 py, 95% CI 12.2, 42.2) and receptive syringe sharing (23.6/100 py, 95% CI 9.8, 56.7) in the 6 months prior to baseline. These data suggest that it is possible to recruit and retain at-risk PWID who adhere to study protocols and that modification of eligibility criteria may identify populations with sufficiently high HCV incidence. Results support the feasibility of large multi-centre HCV vaccine trials, including in the Australian setting.     

Post-adoption beliefs and continuance intention of smart device use among people with physical disabilities

BackgroundThere has been a continuous increase of smart device use among people with physical disabilities in Korea. In spite of previous research on those people’s motives to adopt smart devices, little investigation has been conducted to scrutinize post-adoption behaviors of using smart devices among people with physical disabilities.Objective/Hypothesis: Based on the post-adoption model, this study examined the relationship between post-adoption beliefs regarding smart devices and behavioral intentions toward continued use of smartphones among people with physical disabilities. Moreover, this study investigated the moderating effects of self-efficacy on the relationships among the main study variables.MethodsBoth online and paper-pencil surveys were conducted, resulting in a total of 108 questionnaires collected from people with physical disabilities.ResultsA path analysis showed that, with the exception of perceived ease of use, all variables (confirmation, perceived usefulness, and satisfaction of smart device use) had significant effects on continuance intention to use smart devices. Another main finding of this study was the significant moderating effects of general self-efficacy on the relationships among the three variables of confirmation, perceived usefulness, and continuance intention of smart devices. The relationships among the three variables were significantly stronger among people with lower levels of general self-efficacy.ConclusionsThis study’s main findings will aid the thorough comprehension of the mechanisms that lead people with physical disabilities to continue to use smart devices.     

院前急救担架员配置及社会化服务方式探索

承担院前急救搬抬服务的担架员是院前急救医疗服务的重要组成部分,因各种各样的原因全国大部分急救单元不配备或少配备担架员,影响了院前急救工作效率。该文以青岛市院前急救为例,通过分析院前急救担架员的配置现状、存在问题及分析,提出合理配备院前急救担架员的必要性,并积极调研其他地市急救中心的做法,探索院前急救担架员社会化服务方式。     

2010 - 2018年成都市50岁及以上人群HIV/AIDS疫情特点分析

目的 了解成都市2010 - 2018年50岁及以上人群艾滋病病毒感染者和艾滋病病人（简称HIV/AIDS）流行现状,分析其疫情特点。方法 整理成都市近9年新报告50岁及以上HIV/AIDS病例的基本信息,对其地区分布、人口学特征、感染途径、样本来源及相关信息进行统计和描述性分析。结果 成都市2010 - 2018年新报告50岁及以上人群病例逐年增多。病例数在地区上分布不均,以远郊县最多,构成比为50.52%,近年来增长极为明显;近郊区次之,构成比为29.71%,增长较中心城区明显;中心城区相对最少,构成比为19.77%,呈逐年增长,但增长缓慢。男女比例为3.04∶1,职业分布构成以农民为主,61.85%婚姻状况为已婚有配偶,文化程度中小学占49.35%。感染途径以异性传播为主,占94.88%;同性传播占3.27%;样本来源以其他就诊者检测为主。结论 成都市50岁及以上人群艾滋病疫情呈上升趋势,流行特征具有自身特色,应当针对该人群制定有针对性的适合于该人群艾滋病防控措施。     

Effectiveness of the COVID-19 vaccines on preventing symptomatic SARS-CoV-2 infections and hospitalizations in Southwestern Alaska,January–December 2021

The population in rural southwest Alaska has been disproportionately affected by COVID-19. To assess the benefit of COVID-19 vaccines, we analyzed data from the regional health system. We estimated vaccine effectiveness (VE) during January 16–December 3, 2021, against symptomatic SARS-CoV-2 infection after a primary series or booster dose, and overall VE against hospitalization. VE of a primary series against symptomatic infection among adult residents was 91.3% (95% CI: 85.7, 95.2) during January 16–May 7, 2021, 50.3% (95% CI, 41.1%–58.8%) during July 17–September 24, and 37.0% (95% CI, 27.8–45.0) during September 25–December 3, 2021; VE of a booster dose during September 25–December 3, 2021, was 92.1% (95% CI: 87.2–95.2). During the overall study period, VE against hospitalization was 91.9% (95% CI: 85.4–95.5). COVID-19 vaccination offered strong protection against hospitalization and a booster dose restored protection against symptomatic infection.     

Predictors of serological non-response to the 13-valent pneumococcal conjugate vaccine followed by the 23-valent polysaccharide vaccine among adults living with HIV

BackgroundPeople living with HIV (PLWH) have higher incidence of pneumococcal disease compared to people without HIV. Immunization with pneumococcal vaccines is recommended, but serological non-response to pneumococcal vaccination is common for largely unknown reasons.MethodsPLWH on antiretroviral treatment and no prior pneumococcal vaccination received the 13-valent pneumococcal conjugate vaccine (PCV13) followed 60 days later by the 23-valent polysaccharide vaccine (PPV23). Serological response was evaluated 30 days post-PPV23 by antibodies against 12 serotypes covered by both PCV13 and PPV23. Seroprotection was defined as a ≥2-fold rise to a level above 1.3 µg/ml in geometric mean concentration (GMC) across all serotypes. Associations with non-responsiveness were evaluated by logistic regression.ResultsFifty-two virologically suppressed PLWH (median age of 50 years (IQR 44–55) and median CD4 count of 634 cells/mm³ (IQR 507–792)) were included. Forty-six percent (95 % CI 32–61, n = 24) achieved seroprotection. Serotypes 14, 18C and 19F had the highest, and serotypes 3, 4 and 6B the lowest GMCs. Pre-vaccination GMC levels less than 100 ng/ml were associated with increased odds of non-responsiveness compared to levels above 100 ng/ml (adjusted OR 8.7, 95 % CI 1.2–63.6, p = 0.0438).ConclusionLess than half of our study population achieved anti-pneumococcal seroprotective levels following PCV13 and PPV23 immunization. Low pre-vaccination GMC levels were associated with non-response. Further research is required to optimize vaccination strategies that achieve higher seroprotection in this high-risk group.     

《中华人民共和国药典（2015年版）》中中药部分的增、修订情况简介

本文简要介绍《中华人民共和国药典（2015年版）》中中药部分的增、修订情况及技术特点。本版药典不仅中药收载品种数大幅增加,而且进一步加强了多药味（成分）的检测、活性成分的控制和杂质（有害物质）的检查,更注重现代分析技术的应用,包括广泛应用了指纹（特征）图谱技术,对提高中药的安全性及其质量整体控制水平具有重要作用。