Impact of COVID-19: Nursing challenges to meeting the care needs of people with developmental disabilities

BackgroundPeople with developmental disabilities (DD) are a population at high-risk for poor outcomes related to COVID-19. COVID-19-specific risks, including greater comorbidities and congregate living situations in persons with DD compound existing health disparities. With their expertise in care of persons with DD and understanding of basic principles of infection control, DD nurses are well-prepared to advocate for the needs of people with DD during the COVID-19 pandemic.ObjectiveTo assess the challenges faced by nurses caring for persons with DD during the COVID-19 pandemic and how the challenges impact people with DD.MethodsWe surveyed 556 DD nurses, from April 6–20, 2020. The 35-item mixed-method survey asked nurses to rate the degree of challenges faced in meeting the care needs of people with DD. We analyzed responses based on presence of COVID-19 in the care setting and geographically. One open-ended question elicited challenges not included in the survey, which we analyzed using manifest content analysis.ResultsStartlingly, nurses reported being excluded from COVID-19 planning, and an absence of public health guidelines specific to persons with DD, despite their high-risk status. Obtaining PPE and sanitizers and meeting social-behavioral care needs were the most highly ranked challenges. COVID-19 impacted nurses’ ability to maintain adequate staffing and perform essential aspects of care. No significant geographic differences were noted.ConclusionsDD nurses must be involved in public health planning and policy development to ensure that basic care needs of persons with DD are met, and the disproportionate burden of COVID-19 in this vulnerable population is reduced.     

医院档案管理工作基于新形势的开展途径分析

医院是为人类提供公共卫生服务的一个单位,其存在具有至关重要的影响意义,是人们医疗卫生事业的主要承担场所,医院所提供的公共卫生服务水平主要受到两个方面因素的影响,其一是医疗卫生发展水平,其二是人们生活水平;而这两种因素均受到人类社会经济发展水平的影响,由此可见,医院可以直接反映人类社会的发展水平,医院管理治疗会对其实际运行水平产生直接性影响,同时也侧面体现了我国公共卫生服务质量。因此,基于此种社会现实下,结合新形势要求,分析医院档案管理工作存在的弊端,并探讨创新途径具有至关重要的影响意义,这不仅是国家发展、社会发展的要求,同时也是医院实现可持续运行的根本条件,是当前医院刻不容缓需要解决的主要问题。     

新型医疗体制改革后我国卫生人力资源现状分析

目的对新型医疗体制改革十年以来,我国卫生人力资源数量、学历、职称及分布等现状进行分析并提出建议。方法以2010、2019年国家卫生统计年鉴数据为依据,对相关数据进行描述统计和比较分析。结果我国卫生人力资源数量不断增长,学历水平持续提升,职称结构得到一定改善,其中,注册护士增长速度最快,年均增长率为9.21%,到2018年,卫生技术人员、执业(助理)医师、注册护士本科以上学历人员占比分别为36.2%、55.4%、21.0%。卫生人力资源数量呈东部地区>中部地区>西部地区分布,城市卫生人力资源优于农村。结论建议通过教育培训、政策激励、人才合理规划等措施,加强人才队伍建设,促进人力资源均衡、持续发展。     

湘潭市5起新型冠状病毒肺炎聚集性疫情调查分析

目的 对湘潭市5起新型冠状病毒肺炎(简称新冠肺炎)聚集性疫情开展流行病学调查,分析病例的感染来源,并探讨其传播模式,提出针对性预防控制建议。 方法 应用现场流行病学方法调查病例及其密切接触者,描述流行特征,采集患者鼻咽拭子,利用反转录聚合酶链式反应技术进行病毒核酸检测。 结果 截至2020年3月5日,湘潭市累计报告42例新冠肺炎病例(其中6例为无症状感染者),重症及危重症病例8例。涉及5起新冠肺炎聚集性疫情,共发病19人(包括无症状感染者),占总病例数45.24%;其中4起因武汉返湘潭(简称潭)人员引起,1起因本地病例引起;男性8例、女性11例,年龄为1岁3月～84岁;临床表现出现咳嗽症状比例最高(占70.59%),病例从发病到就诊隔离间隔时间在0～10 d之间,中位数为2 d,发病时已住院隔离观察的病例占比最高为42.11%(8/19),从就诊隔离到确诊的间隔时间在0～7 d 之间,中位数为2 d。 结论 新型冠状病毒具有极强的传染性和隐匿性,人员密集、聚餐/会、家庭内传播是聚集性疫情的高危因素,应做好重点场所、重点人群新冠肺炎疫情防控工作,减少聚集性疫情的发生。     

新型冠状病毒肺炎的流行及公众关注度研究

目的 通过对北京市2020年6月11日—7月20日新型冠状病毒肺炎(简称新冠肺炎)疫情流行情况及网络关注点进行分析,为疫情防控提供参考。 方法 利用北京市卫生健康委员会官方网站新冠肺炎疫情通报和互联网搜索引擎,回顾性搜集整理疫情数据和网络搜索指数数据,并采用描述性统计和Spearman秩相关分析方法进行数据分析。 结果 6月11日—7月20日北京市新冠肺炎累计确诊335例,累计发病率为1.56/10万;累计确诊病例主要集中在丰台区(230例,占68.66%)。网络搜索指数研究显示,“北京疫情最新情况”和“新发地”搜索指数均与疫情数据存在相关关系(r=0.711,P＜0.05;r=0.861,P＜0.05); “北京疫情”搜索指数最高,并与日新增确诊病例数呈高度正相关(r=0.919,P＜0.05)。 结论 北京市新型冠状病毒肺炎疫情已取得阶段性成效。网络搜索指数与疫情发展高度相关,应加强网络搜索指数在疫情防控中的应用。     

Child developmental and special education service receipt: The intersection of health and poverty

BackgroundChildren born of low birth weight (LBW) and/or premature may have developmental delays and difficulties. The vulnerability, without early intervention, would have detrimental lifelong effects.ObjectivesThis study examined 1) the relationship between LBW and prematurity and the occurrence and timing of children's receipt of developmental and special education services; and 2) whether poverty intersects with LBW and prematurity affecting service receipt.MethodsThis population-based study used cross-sectional data from the National Survey of Children's Health which consisted of approximately 52,000 participants aged 1–17 between 2017 and 2018 in the United States. We conducted logistic regression to analyze the predictive relationship of LBW/prematurity and the occurrence of receiving developmental and special education services. We then conducted ordered logistic regression to examine whether LBW and prematurity predicted the timing of receiving developmental and special education services. Further, we conducted moderating analyses to examine whether the predictive relationships above varied with poverty. The analyses listed above were weighted to reflect the population drawn.ResultsChildren born with LBW and prematurity were more likely to receive developmental and special education services and they tended to receive services earlier than those born at normal weight and term. Educational disparities were evident among children in low-income families. Children of LBW in low-income families were less likely to receive earlier services than those in affluent families.ConclusionsThis study indicates developmental and special education needs of children born LBW and/or premature. With restrained assets, low-income families may need more assistance to promote optimal development for their children.     

Matching Special Olympics registration data with administrative health databases: Feasibility and health status differences in children and youth with IDD

BackgroundChildren and youth with intellectual and developmental disabilities (IDD) experience health disparities. What is unknown is if data collected from children and youth with IDD who participate in Special Olympics is representative of children and youth with IDD who do not.ObjectivesAim 1: determine the feasibility of matching a database of registrants from Special Olympics Ontario (SOO), with population-based health services databases in Ontario, Canada housed at ICES. Aim 2: evaluate the differences between the database sources with regards to demographic variables and clinical status.MethodsUsing deterministic and probabilistic matching, registration data from SOO were matched to administrative health databases. Established algorithms were used to determine the prevalence of asthma, diabetes, and mental disorder in addition to demographic variables.ResultsThe matching rate was over 90%; 8404 were attributed to children and youth between the ages of 0–19 years. When comparing SOO participants with IDD to non-SOO participants with IDD, children and youth who participate in SOO were, on average, older with no further differences between groups on clinical or demographic variables. When comparing those previously not identified in the health services databases (from SOO) to those with IDD identified by ICES, the SOO participants appear to use the health system less, possibly indicating a better health status.ConclusionsResearch conducted on child and youth who participate in Special Olympics Ontario can be generalized to the broader population of children and youth with IDD in Canada when adjusted for age; however, care should be taken when comparing levels of overall morbidity.     

COVID-19 vaccine perceptions in New York State's intellectual and developmental disabilities community

BackgroundPeople with intellectual and developmental disabilities (IDD) are at disproportionate risk for severe COVID-19 outcomes, particularly those living in congregate care settings. Yet, there is limited data on vaccine perceptions in the disability community.ObjectiveTo explore COVID-19 vaccine perceptions in individuals with IDD, their family members, and those who work with them, to inform a statewide vaccine information and messaging project.MethodsA national survey, adapted in five languages for the IDD community, was distributed to a convenience sample of IDD organizations throughout New York State. Constructs included vaccine intention, reasons for vaccine hesitancy, and trusted sources of vaccine information. Zip code data were used to map respondent location and vaccine preferences.ResultsOf n = 825 respondents, approximately 75% intended to or had received the vaccine across roles (i.e., people with developmental disabilities, family members, direct care workers) and racial/ethnic groups. Greater vaccine hesitancy was reported in younger individuals and those making decisions on behalf of a person with IDD. Concerns included side effects and the swiftness of vaccine development. Black and Hispanic participants had heightened concerns about being an “experiment” for the vaccine. Trusted sources of information included healthcare providers and family members. Respondents who intended to/received the vaccine were dispersed throughout the state.ConclusionsVaccine preferences in this New York State disability community sample align with national data. Identified concerns suggest the need for community education that addresses misperceptions. Age and race differences in perspectives highlight the need for tailored education, delivered by trusted messengers.     

应用CiteSpace软件对腹腔镜肝切除术文献行可视化分析报告

Visual analysis of laparoscopic hepatectomy by CiteSpace software        LIU Yao*,CAO Kuan,ZHANG Bin,et al. *Graduate School of Xuzhou Medical University, Xuzhou 221004,China Corresponding author：WANG Ren-hao, E-mail:wangrenhao@xzhmu.edu.cn Abstract    Objective    To analyze the papers,research hotspots and research trends in the research field of laparoscopic hepatectomy,so as to provide references for relevant personnel in this field to carry out the academic research of laparoscopic hepatectomy.  Methods    In the web of Science（WOS）,take " laparoscopic liver resection " as the subject word, "August 20,2021" as the time node,and "paper or review" as the source to limit the type of journals. Use Excel to sort out the retrieved documents,and get the basic overview of the annual number of documents,countries or regions,periodicals,institutions and authors. Use CiteSpace to perform keyword cluster analysis,and obtain the research hotspot and development trend. Results    A total of 2792 articles were retrieved,the total number of publications was small,  but the annual publication volume showed an increasing trend. Literature sources were highly concentrated in a few countries or regions. More than 100 articles in this field were published by 3 journals. More than 100 documents issued by 3 issuing institutions. More than 50 articles issued by 10 people. The research hotspots in this field focused on radiofrequency ablation,liver surgery,cholecystectomy,liver transferase and surgical management. From the evolution trend of research topics from 2002 to 2021,partial hepatectomy,ultrasonography,cancer cells,malignant tumors,liver tumors,laparoscopic cholecystectomy,bile duct injury,radiofrequency ablation of liver metastasis,surgical management,diagnostic laparoscopy,single center,meta-analysis and outcm are the frontier topics in this field,it may become the focus of scholars' attention in the next few years. Conclusion    Laparoscopic hepatectomy has been widely used all over the world because of its advantages of small trauma and rapid recovery. In the future,it is necessary to pay attention to the cutting-edge research in this field and explore new surgical methods on the existing basis.