In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and quali...In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.展开更多
BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is ...BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.展开更多
Netrin-G2 is a membrane-anchored protein known to play critical roles in neuronal circuit development and synaptic organization.In this study,we identify compound heterozygous mutations of c.547delC p.(Arg183Alafs*186...Netrin-G2 is a membrane-anchored protein known to play critical roles in neuronal circuit development and synaptic organization.In this study,we identify compound heterozygous mutations of c.547delC p.(Arg183Alafs*186)and c.605G>A,p.(Trp202X)in NTNG2 causing a syndrome exhibiting developmenta delay,intellectual disability,hypotonia,and facial dysmorphism.To elucidate the underlying cellular and molecular mechanisms,CRISPR-Cas9 technology is employed to generate a knock-in mouse mode expressing the R183Afs and W202X mutations.We report that the Ntng2^(R183Afs/W202X)mice exhibit hypo tonia and impaired learning and memory.We find that the levels of CaMKII and p-GluA1^(Ser831)are decreased,and excitatory postsynaptic transmission and long-term potentiation are impaired.To increase the activity of CaMKII,the mutant mice receive intraperitoneal injections of DCP-LA,a CaMKII agonist,and show improved cognitive function.Together,our findings reveal molecular mechanisms of how NTNG2deficiency leads to impairments of cognitive ability and synaptic plasticity.展开更多
Introduction: Lumbar disc herniation (LDH) refers to the rupture of the fibrous annulus of the intervertebral discs. Lumbar curvature may lead to the occurrence of lumbar disc degeneration. Fear of movement may worsen...Introduction: Lumbar disc herniation (LDH) refers to the rupture of the fibrous annulus of the intervertebral discs. Lumbar curvature may lead to the occurrence of lumbar disc degeneration. Fear of movement may worsen their disc herniation and cause further pain and injury. LDH conditions impact the individuals’ quality of life, to explore the relationship between lumbar curve, muscle strength, fear of movement and functional disability among patients with LDH. Methods: An electronic search was conducted on PubMed, Medline, Science Direct, Springerlink, Google Scholar and a hand search from reference lists was reviewed. Publications were included in human studies, patients 25 - 85 years of age, original studies and published in English language journals from January 2002 to December 2023. Result: In total, 64 articles were researched through the online search engines, and 9 papers were found through manual searches of reference lists. As a result, a total of 11 articles were included for the purpose of this review. The comprehensive analysis revealed the presence of eight cross-sectional studies, two retrospective studies and one experimental study. A minimum of 25 participants and a maximum of 360 participants were included. Ten studies included both genders, only one studies included healthy adults and patients with LDH but these studies didn’t mention gender. Results showed that the factors influencing LDH can be categorized into non-modifiable factors, such as gender, age, height or others. Modifiable factors included increased BMI, DM, smoking, alcohol, employment status, lifestyle and health problems or psychology. Conclusion: Females with greater VASC may be at risk of LDH. The lumbar extensor muscles indicated a localized disc herniation or nerve root pathology in patients with LDH. The fear of movement may lead to psychological consequences and reduce functional disability among patients with LDH.展开更多
BACKGROUND There is little data on physical activity(PA),organized PA(OPA),and sedentary behaviors in autism spectrum disorders(ASD)and other neurodevelopmental disorders in developing countries.AIM To examine OPA,non...BACKGROUND There is little data on physical activity(PA),organized PA(OPA),and sedentary behaviors in autism spectrum disorders(ASD)and other neurodevelopmental disorders in developing countries.AIM To examine OPA,non-OPA,and sedentary behaviors and their associated factors in children and adolescents with ASD,cerebral palsy(CP),and intellectual disability(ID).METHODS A total of 1020 children and adolescents with ASD,CP,and ID were assessed regarding the child and family information as well as the Children’s Leisure Activities Study Survey.RESULTS The results showed that the OPA level was significantly lower than non-OPA in all groups.Furthermore,the OPA level was significantly lower in the CP group compared to ASD and ID groups(P<0.001).Also,moderate(P<0.001),vigorous(P<0.05),and total(P<0.001)physical activity levels were significantly different between all three groups,with the values being higher in the ASD group compared to the other two.The mean of the total sedentary behavior duration in the ASD group(1819.4 min/week,SD:1680)was significantly lower than in the CP group(2687 min/week,SD:2673)(P=0.007)but not ID group(2176 min/week,SD:2168.9)(P=0.525).CONCLUSION Our findings remark on the participation rate of PA,OPA,and sedentary behaviors of children and adolescents with ASD,CP,and ID in a developing country.In contrast,the need for developing standards of PA/OPA participation in neurodevelopmental disorders is discussed.展开更多
The main characteristics of potential smart cities in the future, smart citizens, smart energy, smart buildings, smart mobility, smart technology, smart healthcare, smart infrastructure, smart governance and education...The main characteristics of potential smart cities in the future, smart citizens, smart energy, smart buildings, smart mobility, smart technology, smart healthcare, smart infrastructure, smart governance and education, and finally smart security are the aspects of smart cities. In the smart city, smart accessible infrastructure creates an inclusive environment for people with disabilities, in which they can integrate into the community and enjoy their civil, cultural, political, social and economic rights and entitlements. The aim of this study is to integrate disabled people into society so that they can actively participate in society and lead to a normal life. An integrated approach is needed to ensure that people with disabilities are not left alone. A combination of mainstreaming and targeted action is required for all interventions. People with disabilities have the same basic needs as everyone else: health protection and treatment, basic services, housing and income. Targeted intervention measures need to complement disability mainstreaming by addressing specific needs identified by general responses, including such interventions need not add materially to the overall cost, especially if the requirements of the maximum number of users are considered in the initial planning. This paper recommends how we can use an appropriate design checklist as a guide for our initial architectural concept and smart city planning to facilities reasonably accessible for people with disabilities in private and public buildings, making our cities smarter and more inclusive and helping to improve the quality of life for all people, especially people with disabilities.展开更多
<strong>Purpose</strong>: People with disabilities represent a major objective, a global public health issue. This disadvantaged category needs protection and integration into society by implementing an im...<strong>Purpose</strong>: People with disabilities represent a major objective, a global public health issue. This disadvantaged category needs protection and integration into society by implementing an improved legislative framework. The effectiveness of the policy making, consolidating the benefit programs and enhancing equity of the social insurance system represent the key of The Governments strategy. <strong>Methods</strong>: The paper highlights comparable data and research related to disability and social insurance system from Romania and other Member States of the European Union. Internationally, a proper measurement of disability may lead to a successful removal of barriers which increase the vulnerability of people with disability. <strong>Results</strong>: According to official data, in Romania the number of disabled people decreased gradually one year to another (in the last 5 years). In the EU Member States, musculoskeletal disorders leading to disability were one of the most common compared to Romania where it ranked last. From the point of view of the share in the total number of people with disabilities, according to the degree of disability, both in the EU Member States and in Romania, the number of moderately disabled people was double, respectively triple compared to the number of those with severe disability. <strong>Conclusion</strong>: The Romania Government promotes social-professional integration of people with disabilities, being responsible for the guidance, vocational counselling and employment. In accordance with our law, “any person with disabilities, fit and included in the labor market in Romania is entitled to a reasonable accommodation of the workplace.”展开更多
The Autism Spectrum Rating Scale(ASRS) and the Social Responsiveness Scale(SRS) have been widely used for screening autism spectrum disorder(ASD) in the general population during epidemiological studies, but studies o...The Autism Spectrum Rating Scale(ASRS) and the Social Responsiveness Scale(SRS) have been widely used for screening autism spectrum disorder(ASD) in the general population during epidemiological studies, but studies of individuals with intellectual disability(ID) are quite limited. Therefore, we recruited the parents/caregivers of 204 ASD cases, 71 ID cases aged 6–18 years from special education schools, and 402 typically developing(TD) children in the same age span from a communitybased population to complete the ASRS and SRS. The results showed that the ID group scored significantly lower on total and subscale scores than the ASD group on both scales(P \ 0.05) but higher than TD children(P \ 0.05).Receiver operating characteristic analyses demonstrated a similar fair performance in discriminating ASD from ID with the ASRS(area under the curve(AUC) = 0.709,sensitivity = 77.0%, specificity = 52.1%, positive predictive value(PPV) = 82.2%) and the SRS(AUC = 0.742,sensitivity = 59.8%, specificity = 77.5%, PPV = 88.4%).The results showed that individuals with ID had clear autistic traits and discriminating ASD from ID cases was quite challenging, while assessment tools such as ASRS and SRS, help to some degree.展开更多
Background Cardiac arrhythmias are common conditions in older people.Unfortunately,there is limited literature on associations between cardiac arrhythmias and physical performance or disability.We therefore aimed to p...Background Cardiac arrhythmias are common conditions in older people.Unfortunately,there is limited literature on associations between cardiac arrhythmias and physical performance or disability.We therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up,using data from the Italian Longitudinal Study on Aging(ILSA).Methods Cardiac arrhythmias diagnosis was posed through a screening phase,confirmed by a physician.The onset of disability in activities of daily living(ADL)and the changes in several physical performance tests during follow-up were considered as outcomes.Fully-adjusted and propensity-score Cox Proportional Hazard models and mixed models were used for exploring associations between cardiac arrhythmia and the outcomes of interest.Results The prevalence of cardiac arrhythmia at baseline was 23.3%.People reporting cardiac arrhythmia at the baseline were significantly older,more frequently male,smokers and reported a higher presence of all medical conditions investigated(hypertension,heart failure,angina,myocardial infarction,diabetes,stroke),but no difference in dementia,Parkinsonism,cognitive or mood disorder.Cardiac arrhythmia at baseline was significantly associated with the incidence of disability in ADL(HR=1.23;95%:CI:1.01–1.50;P=0.0478 in propensity score analyses;HR=1.28;95%CI:1.01–1.61;P=0.0401 in fully adjusted models).Cardiac arrhythmia at baseline was also associated with a significant worsening in balance test(P=0.0436).Conclusions The presence of cardiac arrhythmia at baseline was associated with a significant higher risk of disability and of worsening in some physical performance tests,particularly those relating to balance.Screening and frequently assessing physical performance in older people affected by cardiac arrhythmia can be important to prevent a loss of physical performance,with further,potential,complications of medical management.展开更多
OBJECTIVE: To culturally translate the cardiff acne disability index(CADI) into Korean, and to examine its relationship with clinical acne severity,pathological patterns, and general quality of life(Qo L).METHODS: The...OBJECTIVE: To culturally translate the cardiff acne disability index(CADI) into Korean, and to examine its relationship with clinical acne severity,pathological patterns, and general quality of life(Qo L).METHODS: The CADI was culturally and lin-guistically translated into Korean via translation,back-translation, and face validity test process. Two hundred and fifty-four Korean adolescents were asked to complete the Korean version of the CADI(K-CADI), the Phlegm Pattern, the Cold-Heat Pattern, and the Korean version of the General Health Questionnaires. A clinician estimated acne severity for the adolescents, using the Korean Acne Grading System. Finally, reliability and validity of the K-CADI was examined, and the relationships between acne severity, Phlegm, Cold, and Heat patterns, and Qo L level were examined via pathway analysis.RESULTS: The K-CADI had satisfactory internal consistency(α = 0.827). The examination of construct validity indicated that the K-CADI had one factor(explaining 59.6% of the total variance). Pathway analysis showed satisfactory model fit(normal fit index = 0.960 and comparative fit index = 0.983),and acne-related Qo L was determinant to Phlegm,Heat, and Cold patterns(0.13-0.27 of β), and Phlegm and Heat patterns lowered one's Qo L level(0.17-0.34 of β).CONCLUSION: The K-CADI is a valid and reliable instrument. Phlegm and Heat patterns should be managed when treating acne since they have a moderating effect on general Qo L aggravation.展开更多
AIM:To investigate the correlation of facet joint osteoarthritis(FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of ...AIM:To investigate the correlation of facet joint osteoarthritis(FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years.The MRIs of the lumbar spine were performed on a 1.5 Tesla scanner(Magnetom Avanto,Siemens AG,Erlangen,Germany) using a dedicated receive only spine coil.After initial blinding,each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging.In total 2364 facet joints were graded.Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI.The index is scored from 0 to 100 and interpreted as follows:0%-20%,minimaldisability; 20%-40%,moderate disability; 40%-60%,severe disability; 60%-80%,crippled; 80%-100%,patients are bedbound.Spearman’s coefficient of rank correlation was used for statistical analysis,with significance set at P 【 0.05.RESULTS:In total 2364 facet joints at lumbar levels L4/5 and L5/S1 were analysed in 591 individuals.FJOA was present in 97%(L4/L5) and 98%(L5/S1).At level L4/5(left/right) 17/15(2.9%/2.5%) were described as grade 0,146/147(24.7%/24.9%) as grade 1,290/302(49.1%/51.1%) as grade 2 and 138/127(23.4%/21.5%) as grade 3.At level L5/S1(left/right) 10/11(1.7%/1.9%) were described as grade 0,136/136(23.0%/23.0%) as grade 1,318/325(53.8%/55.0%) as grade 2 and 127/119(21.5%/20.1%) as grade 3.Regarding the ODI scores,patients’ disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%.The majority of patients(48.39%) had moderate functional disability(21%-40%).There was no significant correlation between FJOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1.A weak positive correlation was evaluated between ODI and FJOA on the right side of lumbar level L5/S1.CONCLUSION:The missing correlation of FJOA and ODI confirms our clinical experience that imaging alone is an insufficient approach explaining low back pain.Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain.展开更多
AIM To determine the prevalence of work disability in inflammatory bowel disease(IBD),and to assess risk factors associated with work disability.METHODS For this retrospective cohort study,we retrieved clinical data f...AIM To determine the prevalence of work disability in inflammatory bowel disease(IBD),and to assess risk factors associated with work disability.METHODS For this retrospective cohort study,we retrieved clinical data from the Dutch IBD Biobank on July 2014,containing electronic patient records of 3388 IBD patients treated in the eight University Medical Centers in the Netherlands.Prevalence of work disability was assessed in 2794 IBD patients and compared with the general Dutch population.Multivariate analyses were performed for work disability(sick leave,partial and full disability)and long-term full work disability(>80%work disability for>2 years).RESULTS Prevalence of work disability was higher in Crohn's disease(CD)(29%)and ulcerative colitis(UC)(19%)patients compared to the general Dutch population(7%).In all IBD patients,female sex,a lower education level,and extra-intestinal manifestations,were associated with work disability.In CD patients,an age>40 years at diagnosis,disease duration>15 years,smoking,surgical interventions,and anti-TNFαuse were associated with work disability.In UC patients,an age>55 years,and immunomodulator use were associated with work disability.In CD patients,a lower education level(OR=1.62,95%CI:1.02-2.58),and in UC patients,disease complications(OR=3.39,95%CI:1.09-10.58)were associated with long-term full work disability.CONCLUSION The prevalence of work disability in IBD patients is higher than in the general Dutch population.Early assessment of risk factors for work disability is necessary,as work disability is substantial among IBD patients.展开更多
AIM To investigate whether minority ethnicity and the duration of education influence preoperative disability and expectations in patients undergoing total knee arthroplasty.METHODS We prospectively included 829 patie...AIM To investigate whether minority ethnicity and the duration of education influence preoperative disability and expectations in patients undergoing total knee arthroplasty.METHODS We prospectively included 829 patients undergoing primary unilateral total knee arthroplasty(TKA) from April 2013 to December 2014 at a single centre. Patients filled in pre-operative questionnaires with information regarding place of birth, duration of education, expectations for outcome of surgery and baseline characteristics. Patients were stratified based on ethnicity. Majority ethnicity was defined as born inthe study country and minority ethnicity was defined as born in any other country. Similarly, patients were stratified based on duration of education in groups defined as < 9 years, 9-12 years and > 12 years, respectively.RESULTS We found that 92.2% of patients were of majority ethnicity. We found that 24.5%, 44.8% and 30.8% of patients had an education of < 9 years, 9-12 years and > 12 years, respectively. The mean preoperative(preOP) oxford knee score(OKS) in the total population was 23.6. Patients of minority ethnicity had lower mean pre-OP OKS(18.6 vs 23.9, P < 0.001), higher pain levels(VAS 73.0 vs 58.7, P < 0.001), expected higher levels of post-OP pain(VAS 14.1 vs 6.1, P = 0.02) and of overall symptoms(VAS 16.6 vs 6.4, P = 0.006). Patients with > 12 years education had lower mean pre-OP OKS(21.5 vs 23.8 and 24.6, P < 0.001) and higher pre-OP VAS pain(65.4 vs 59.2 and 56.4, P < 0.001) compared to groups with shorter education. One year post-operative(post-OP) patients of minority ethnicity had lower mean OKS, higher pain and lower QoL. One year post-OP patients with > 12 years education reported higher pain compared to patients with shorter educations. However, the response-rate was low(44.6%), and therefore post-OP results were not considered to be significant.CONCLUSION Minority ethnicity and the duration of education influ-ence preoperative disability and expectation in patients undergoing TKA. This should be taken into account when patients are advised pre-operatively.展开更多
AIM:To evaluate the reliability of an instrument that measures disability arising from episodic abdominal pain in patients with suspected sphincter of Oddi dysfunction(SOD).METHODS:Although several treatments have bee...AIM:To evaluate the reliability of an instrument that measures disability arising from episodic abdominal pain in patients with suspected sphincter of Oddi dysfunction(SOD).METHODS:Although several treatments have been utilized to reduce pain and associated disability,measurement tools have not been developed to reliably track outcomes.Two pilot studies were conducted to assess test-retest reliability of a newly developed instrument,the recurrent abdominal pain intensity and disability(RAPID) instrument.The RAPID score is a 90-d summation of days where productivity for various daily activities is reduced as a result of abdominal pain episodes,and is modeled after the migraine disability assessment instrument used to measure headache-related disability.RAPID was administered by telephone on 2 consecutive occasions in 2 consenting populations with suspected SOD:a pre-sphincterotomy population(Pilot Ⅰ,n = 55) and a post-sphincterotomy population(Pilot Ⅱ,n = 70).RESULTS:The average RAPID scores for Pilots Ⅰ and Ⅱ were:82 d(median:81.5 d,SD:64 d) and 48 d(median:0 d,SD:91 d),respectively.The concordance between the 2 assessments for both populations was very good:0.81 for the pre-sphincterotomy population and 0.95 for the post-sphincterotomy population.CONCLUSION:The described pilot studies suggest that RAPID is a reliable instrument for measuring disability resulting from abdominal pain in suspected SOD patients.展开更多
AIM: To investigate the association between socioeconomic status(SES) and visual disability(VD) among older Chinese adults. METHODS: We obtained data from the Second National Sample Survey on Disability, conducted in ...AIM: To investigate the association between socioeconomic status(SES) and visual disability(VD) among older Chinese adults. METHODS: We obtained data from the Second National Sample Survey on Disability, conducted in China in 2006. A total number of 192 375 older adults(aged≥65 y) were screened for suspected VD via interviews with trained examiners. Those who screened positively for VD were referred to ophthalmologists to obtain a final diagnosis. RESULTS: VD was prevalent among 7.29% of Chinese adults aged 65 and older, and was higher in rural areas(8.71%) than in urban areas(4.82%). After adjusting for SES indicators and covariates, we found that lesseducated older adults were more likely to suffer from VD, with an odds ratio(OR) of 2.50(95%CI: 2.26-2.82) for illiterates, compared with those who graduated from senior high school or above. Older adults who were in the lowest income quintile were more at risk of VD, with an OR of 1.81(95%CI: 1.68-2.95), compared with adults in the highest income quintile. In urban areas, when compared with adults who graduated from senior high school or above, those who did not continue their education after junior high school, primary school, or those who were illiterate, were more likely to suffer from VD, with an OR of 1.35(95%CI: 1.51-1.59), 1.84(95%CI: 1.60-2.12), and 2.63(95%CI: 2.27-3.04), respectively. Lower levels of income were statistically significant when associated with VD. In rural areas, adults who were illiterate had an OR of 2.21(95%CI:1.75-2.79) when compared to adults with senior high school or above education level. Per capita, household income remained significantly associated with VD. Older adults who were ≥85, female, single, and residing in rural areas were associated with higher risks of VD. CONCLUSION: Individual-level SES among the elderly, in the form of education and income, is associated with VD among elderly Chinese adults in both urban and rural areas; however, the association is stronger in rural areas. Further studies are still required to explore the mechanism behind the relationships.展开更多
The estimate of dental caries among Chinese children at the microscale level using standard methodology remains unclear. In this study, we assessed and analyzed the disease burden of childhood dental caries in China b...The estimate of dental caries among Chinese children at the microscale level using standard methodology remains unclear. In this study, we assessed and analyzed the disease burden of childhood dental caries in China by extracting data from the Global Burden of Disease, Injuries, and Risk Factors Study 2016 （GBD 2016）. In 2016, the number of cases, prevalence, years lived with disability （YLD）, and age-standardized YLD rate of dental caries was 93.0 million, 43.0%, 32,200 person years, and 14.8 per 100,000, respectively. Across 33 provincial units, the disease burden was highest in Hubei （YLD rate 28.6 per 100,000）, lowest in Macao （9.1 per 100,000）, while geographical clustering was not observed. Compared with 1990, the prevalence in 2016 decreased from 46.8% to 43.0%, and the YLD rate decreased from 16.5 per 100,000 to 14.8 per 100,000. Given the slight decrease in dental caries burden, the prevalence and disease burden remained high among Chinese children. Strategies for addressing the spatial inequity of childhood dental caries require geographical targeting.展开更多
AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint condition...AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.展开更多
The growing diabetic epidemic has created a substantial burden,not only on the people with diabetes but also on society at large.This mini-review discussed the limitations and patterns of disability in type 2 diabetes...The growing diabetic epidemic has created a substantial burden,not only on the people with diabetes but also on society at large.This mini-review discussed the limitations and patterns of disability in type 2 diabetes mellitus and put forward a case for the moderating effects of physical activity(PA)in the management of diabetes.The limitations and impairments associated with diabetes include vascular,neurological,cardiac,and renal impairments.Moreover,individuals participate less in their daily lives and in their instrumental activities of daily living,which negatively impacts the quality of life of individuals with diabetes.This often leads to a loss of quality of life due to disabilities,resulting in an increased rate of disability-adjusted life years among people with type 2 diabetes mellitus.Moreover,there are psychosocial sequelae of diabetes mellitus.This necessitates looking for moderating factors that may reduce the burden of the disease.PA has been shown to be one of the factors that can mitigate these burdens.PA does this in several ways,including through the benefits it confers,such as a reduction of hemoglobin A1c,a reduction of excess fat in the liver and pancreas,and the reduction of cardiovascular risk factors,all of which favorably affect glycemic parameters.Specifically,PA regulates or moderates diabetes disability through two mechanisms:The regulation of glucolipid metabolism disorders and the optimization of body mass index and systemic conditions.Therefore,efforts should be directed at PA uptake through identified strategies.This will not only prevent diabetes or diabetes complications but will reduce its burden.展开更多
In this paper, we will address common psychological reactions to disability such as anxiety, depression, denial, and anger in the framework of a stage model. In addition, this paper will discuss specific societal aspe...In this paper, we will address common psychological reactions to disability such as anxiety, depression, denial, and anger in the framework of a stage model. In addition, this paper will discuss specific societal aspects that can impact reaction and adjustment to disability. In this vein, we will examine the specific effects of societal attitudes and stigma upon individuals with disabilities. Strategies for changing attitudes and facilitating adjustment to disability will also be discussed.展开更多
文摘In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.
文摘BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.
基金National Key R&D Program of China(2022YFC2703400 to Y.G.Y.)National Natural Science Foundation of China(82001209 to S.S.D.,82271904 and 82070914 to Y.G.Y.)+2 种基金Shanghai Municipal Commission of Health and Family Planning(20204Y0451 to S.S.D.)Shanghai Scientific and Technological Innovation Action Plan(20YF1440600 to S.S.D.)Shanghai Natural Science Foundation of China(21ZR1452700 to Y.K.Z.)。
文摘Netrin-G2 is a membrane-anchored protein known to play critical roles in neuronal circuit development and synaptic organization.In this study,we identify compound heterozygous mutations of c.547delC p.(Arg183Alafs*186)and c.605G>A,p.(Trp202X)in NTNG2 causing a syndrome exhibiting developmenta delay,intellectual disability,hypotonia,and facial dysmorphism.To elucidate the underlying cellular and molecular mechanisms,CRISPR-Cas9 technology is employed to generate a knock-in mouse mode expressing the R183Afs and W202X mutations.We report that the Ntng2^(R183Afs/W202X)mice exhibit hypo tonia and impaired learning and memory.We find that the levels of CaMKII and p-GluA1^(Ser831)are decreased,and excitatory postsynaptic transmission and long-term potentiation are impaired.To increase the activity of CaMKII,the mutant mice receive intraperitoneal injections of DCP-LA,a CaMKII agonist,and show improved cognitive function.Together,our findings reveal molecular mechanisms of how NTNG2deficiency leads to impairments of cognitive ability and synaptic plasticity.
文摘Introduction: Lumbar disc herniation (LDH) refers to the rupture of the fibrous annulus of the intervertebral discs. Lumbar curvature may lead to the occurrence of lumbar disc degeneration. Fear of movement may worsen their disc herniation and cause further pain and injury. LDH conditions impact the individuals’ quality of life, to explore the relationship between lumbar curve, muscle strength, fear of movement and functional disability among patients with LDH. Methods: An electronic search was conducted on PubMed, Medline, Science Direct, Springerlink, Google Scholar and a hand search from reference lists was reviewed. Publications were included in human studies, patients 25 - 85 years of age, original studies and published in English language journals from January 2002 to December 2023. Result: In total, 64 articles were researched through the online search engines, and 9 papers were found through manual searches of reference lists. As a result, a total of 11 articles were included for the purpose of this review. The comprehensive analysis revealed the presence of eight cross-sectional studies, two retrospective studies and one experimental study. A minimum of 25 participants and a maximum of 360 participants were included. Ten studies included both genders, only one studies included healthy adults and patients with LDH but these studies didn’t mention gender. Results showed that the factors influencing LDH can be categorized into non-modifiable factors, such as gender, age, height or others. Modifiable factors included increased BMI, DM, smoking, alcohol, employment status, lifestyle and health problems or psychology. Conclusion: Females with greater VASC may be at risk of LDH. The lumbar extensor muscles indicated a localized disc herniation or nerve root pathology in patients with LDH. The fear of movement may lead to psychological consequences and reduce functional disability among patients with LDH.
基金Supported by the Sports Medicine Research Center,No.57842.
文摘BACKGROUND There is little data on physical activity(PA),organized PA(OPA),and sedentary behaviors in autism spectrum disorders(ASD)and other neurodevelopmental disorders in developing countries.AIM To examine OPA,non-OPA,and sedentary behaviors and their associated factors in children and adolescents with ASD,cerebral palsy(CP),and intellectual disability(ID).METHODS A total of 1020 children and adolescents with ASD,CP,and ID were assessed regarding the child and family information as well as the Children’s Leisure Activities Study Survey.RESULTS The results showed that the OPA level was significantly lower than non-OPA in all groups.Furthermore,the OPA level was significantly lower in the CP group compared to ASD and ID groups(P<0.001).Also,moderate(P<0.001),vigorous(P<0.05),and total(P<0.001)physical activity levels were significantly different between all three groups,with the values being higher in the ASD group compared to the other two.The mean of the total sedentary behavior duration in the ASD group(1819.4 min/week,SD:1680)was significantly lower than in the CP group(2687 min/week,SD:2673)(P=0.007)but not ID group(2176 min/week,SD:2168.9)(P=0.525).CONCLUSION Our findings remark on the participation rate of PA,OPA,and sedentary behaviors of children and adolescents with ASD,CP,and ID in a developing country.In contrast,the need for developing standards of PA/OPA participation in neurodevelopmental disorders is discussed.
文摘The main characteristics of potential smart cities in the future, smart citizens, smart energy, smart buildings, smart mobility, smart technology, smart healthcare, smart infrastructure, smart governance and education, and finally smart security are the aspects of smart cities. In the smart city, smart accessible infrastructure creates an inclusive environment for people with disabilities, in which they can integrate into the community and enjoy their civil, cultural, political, social and economic rights and entitlements. The aim of this study is to integrate disabled people into society so that they can actively participate in society and lead to a normal life. An integrated approach is needed to ensure that people with disabilities are not left alone. A combination of mainstreaming and targeted action is required for all interventions. People with disabilities have the same basic needs as everyone else: health protection and treatment, basic services, housing and income. Targeted intervention measures need to complement disability mainstreaming by addressing specific needs identified by general responses, including such interventions need not add materially to the overall cost, especially if the requirements of the maximum number of users are considered in the initial planning. This paper recommends how we can use an appropriate design checklist as a guide for our initial architectural concept and smart city planning to facilities reasonably accessible for people with disabilities in private and public buildings, making our cities smarter and more inclusive and helping to improve the quality of life for all people, especially people with disabilities.
文摘<strong>Purpose</strong>: People with disabilities represent a major objective, a global public health issue. This disadvantaged category needs protection and integration into society by implementing an improved legislative framework. The effectiveness of the policy making, consolidating the benefit programs and enhancing equity of the social insurance system represent the key of The Governments strategy. <strong>Methods</strong>: The paper highlights comparable data and research related to disability and social insurance system from Romania and other Member States of the European Union. Internationally, a proper measurement of disability may lead to a successful removal of barriers which increase the vulnerability of people with disability. <strong>Results</strong>: According to official data, in Romania the number of disabled people decreased gradually one year to another (in the last 5 years). In the EU Member States, musculoskeletal disorders leading to disability were one of the most common compared to Romania where it ranked last. From the point of view of the share in the total number of people with disabilities, according to the degree of disability, both in the EU Member States and in Romania, the number of moderately disabled people was double, respectively triple compared to the number of those with severe disability. <strong>Conclusion</strong>: The Romania Government promotes social-professional integration of people with disabilities, being responsible for the guidance, vocational counselling and employment. In accordance with our law, “any person with disabilities, fit and included in the labor market in Romania is entitled to a reasonable accommodation of the workplace.”
基金supported by the National Health and Family Planning Commission of China (201302002 ClinicalTrials.gov Number NCT 02200679)
文摘The Autism Spectrum Rating Scale(ASRS) and the Social Responsiveness Scale(SRS) have been widely used for screening autism spectrum disorder(ASD) in the general population during epidemiological studies, but studies of individuals with intellectual disability(ID) are quite limited. Therefore, we recruited the parents/caregivers of 204 ASD cases, 71 ID cases aged 6–18 years from special education schools, and 402 typically developing(TD) children in the same age span from a communitybased population to complete the ASRS and SRS. The results showed that the ID group scored significantly lower on total and subscale scores than the ASD group on both scales(P \ 0.05) but higher than TD children(P \ 0.05).Receiver operating characteristic analyses demonstrated a similar fair performance in discriminating ASD from ID with the ASRS(area under the curve(AUC) = 0.709,sensitivity = 77.0%, specificity = 52.1%, positive predictive value(PPV) = 82.2%) and the SRS(AUC = 0.742,sensitivity = 59.8%, specificity = 77.5%, PPV = 88.4%).The results showed that individuals with ID had clear autistic traits and discriminating ASD from ID cases was quite challenging, while assessment tools such as ASRS and SRS, help to some degree.
基金The Italian National Research Council(CNR)supported the ILSA project from 1991 to 1998 as part of the“Progetto Finalizzato Invecchiamento”Since 1999,the Italian CNR,the“Biology of Aging”Strategic Project and the Ministero della Sanità,through the program“Epidemiology of the Elderly”of the Istituto Superiore di Sanitàand the“Estimates of Health Needs of the Elderly”Special Programme of the Tuscany Region have been supporting the ILSA project.
文摘Background Cardiac arrhythmias are common conditions in older people.Unfortunately,there is limited literature on associations between cardiac arrhythmias and physical performance or disability.We therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up,using data from the Italian Longitudinal Study on Aging(ILSA).Methods Cardiac arrhythmias diagnosis was posed through a screening phase,confirmed by a physician.The onset of disability in activities of daily living(ADL)and the changes in several physical performance tests during follow-up were considered as outcomes.Fully-adjusted and propensity-score Cox Proportional Hazard models and mixed models were used for exploring associations between cardiac arrhythmia and the outcomes of interest.Results The prevalence of cardiac arrhythmia at baseline was 23.3%.People reporting cardiac arrhythmia at the baseline were significantly older,more frequently male,smokers and reported a higher presence of all medical conditions investigated(hypertension,heart failure,angina,myocardial infarction,diabetes,stroke),but no difference in dementia,Parkinsonism,cognitive or mood disorder.Cardiac arrhythmia at baseline was significantly associated with the incidence of disability in ADL(HR=1.23;95%:CI:1.01–1.50;P=0.0478 in propensity score analyses;HR=1.28;95%CI:1.01–1.61;P=0.0401 in fully adjusted models).Cardiac arrhythmia at baseline was also associated with a significant worsening in balance test(P=0.0436).Conclusions The presence of cardiac arrhythmia at baseline was associated with a significant higher risk of disability and of worsening in some physical performance tests,particularly those relating to balance.Screening and frequently assessing physical performance in older people affected by cardiac arrhythmia can be important to prevent a loss of physical performance,with further,potential,complications of medical management.
文摘OBJECTIVE: To culturally translate the cardiff acne disability index(CADI) into Korean, and to examine its relationship with clinical acne severity,pathological patterns, and general quality of life(Qo L).METHODS: The CADI was culturally and lin-guistically translated into Korean via translation,back-translation, and face validity test process. Two hundred and fifty-four Korean adolescents were asked to complete the Korean version of the CADI(K-CADI), the Phlegm Pattern, the Cold-Heat Pattern, and the Korean version of the General Health Questionnaires. A clinician estimated acne severity for the adolescents, using the Korean Acne Grading System. Finally, reliability and validity of the K-CADI was examined, and the relationships between acne severity, Phlegm, Cold, and Heat patterns, and Qo L level were examined via pathway analysis.RESULTS: The K-CADI had satisfactory internal consistency(α = 0.827). The examination of construct validity indicated that the K-CADI had one factor(explaining 59.6% of the total variance). Pathway analysis showed satisfactory model fit(normal fit index = 0.960 and comparative fit index = 0.983),and acne-related Qo L was determinant to Phlegm,Heat, and Cold patterns(0.13-0.27 of β), and Phlegm and Heat patterns lowered one's Qo L level(0.17-0.34 of β).CONCLUSION: The K-CADI is a valid and reliable instrument. Phlegm and Heat patterns should be managed when treating acne since they have a moderating effect on general Qo L aggravation.
文摘AIM:To investigate the correlation of facet joint osteoarthritis(FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years.The MRIs of the lumbar spine were performed on a 1.5 Tesla scanner(Magnetom Avanto,Siemens AG,Erlangen,Germany) using a dedicated receive only spine coil.After initial blinding,each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging.In total 2364 facet joints were graded.Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI.The index is scored from 0 to 100 and interpreted as follows:0%-20%,minimaldisability; 20%-40%,moderate disability; 40%-60%,severe disability; 60%-80%,crippled; 80%-100%,patients are bedbound.Spearman’s coefficient of rank correlation was used for statistical analysis,with significance set at P 【 0.05.RESULTS:In total 2364 facet joints at lumbar levels L4/5 and L5/S1 were analysed in 591 individuals.FJOA was present in 97%(L4/L5) and 98%(L5/S1).At level L4/5(left/right) 17/15(2.9%/2.5%) were described as grade 0,146/147(24.7%/24.9%) as grade 1,290/302(49.1%/51.1%) as grade 2 and 138/127(23.4%/21.5%) as grade 3.At level L5/S1(left/right) 10/11(1.7%/1.9%) were described as grade 0,136/136(23.0%/23.0%) as grade 1,318/325(53.8%/55.0%) as grade 2 and 127/119(21.5%/20.1%) as grade 3.Regarding the ODI scores,patients’ disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%.The majority of patients(48.39%) had moderate functional disability(21%-40%).There was no significant correlation between FJOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1.A weak positive correlation was evaluated between ODI and FJOA on the right side of lumbar level L5/S1.CONCLUSION:The missing correlation of FJOA and ODI confirms our clinical experience that imaging alone is an insufficient approach explaining low back pain.Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain.
基金Supported by the Netherlands Organisation for Scientific Research,VIDI grant No.016.136.308 to Weersma RKCareer Development grant of the Dutch Digestive Foundation,No.CDG 14-04 to Festen EAM
文摘AIM To determine the prevalence of work disability in inflammatory bowel disease(IBD),and to assess risk factors associated with work disability.METHODS For this retrospective cohort study,we retrieved clinical data from the Dutch IBD Biobank on July 2014,containing electronic patient records of 3388 IBD patients treated in the eight University Medical Centers in the Netherlands.Prevalence of work disability was assessed in 2794 IBD patients and compared with the general Dutch population.Multivariate analyses were performed for work disability(sick leave,partial and full disability)and long-term full work disability(>80%work disability for>2 years).RESULTS Prevalence of work disability was higher in Crohn's disease(CD)(29%)and ulcerative colitis(UC)(19%)patients compared to the general Dutch population(7%).In all IBD patients,female sex,a lower education level,and extra-intestinal manifestations,were associated with work disability.In CD patients,an age>40 years at diagnosis,disease duration>15 years,smoking,surgical interventions,and anti-TNFαuse were associated with work disability.In UC patients,an age>55 years,and immunomodulator use were associated with work disability.In CD patients,a lower education level(OR=1.62,95%CI:1.02-2.58),and in UC patients,disease complications(OR=3.39,95%CI:1.09-10.58)were associated with long-term full work disability.CONCLUSION The prevalence of work disability in IBD patients is higher than in the general Dutch population.Early assessment of risk factors for work disability is necessary,as work disability is substantial among IBD patients.
基金Supported by the Danish Rheumatism Association,No.R111-A2587
文摘AIM To investigate whether minority ethnicity and the duration of education influence preoperative disability and expectations in patients undergoing total knee arthroplasty.METHODS We prospectively included 829 patients undergoing primary unilateral total knee arthroplasty(TKA) from April 2013 to December 2014 at a single centre. Patients filled in pre-operative questionnaires with information regarding place of birth, duration of education, expectations for outcome of surgery and baseline characteristics. Patients were stratified based on ethnicity. Majority ethnicity was defined as born inthe study country and minority ethnicity was defined as born in any other country. Similarly, patients were stratified based on duration of education in groups defined as < 9 years, 9-12 years and > 12 years, respectively.RESULTS We found that 92.2% of patients were of majority ethnicity. We found that 24.5%, 44.8% and 30.8% of patients had an education of < 9 years, 9-12 years and > 12 years, respectively. The mean preoperative(preOP) oxford knee score(OKS) in the total population was 23.6. Patients of minority ethnicity had lower mean pre-OP OKS(18.6 vs 23.9, P < 0.001), higher pain levels(VAS 73.0 vs 58.7, P < 0.001), expected higher levels of post-OP pain(VAS 14.1 vs 6.1, P = 0.02) and of overall symptoms(VAS 16.6 vs 6.4, P = 0.006). Patients with > 12 years education had lower mean pre-OP OKS(21.5 vs 23.8 and 24.6, P < 0.001) and higher pre-OP VAS pain(65.4 vs 59.2 and 56.4, P < 0.001) compared to groups with shorter education. One year post-operative(post-OP) patients of minority ethnicity had lower mean OKS, higher pain and lower QoL. One year post-OP patients with > 12 years education reported higher pain compared to patients with shorter educations. However, the response-rate was low(44.6%), and therefore post-OP results were not considered to be significant.CONCLUSION Minority ethnicity and the duration of education influ-ence preoperative disability and expectation in patients undergoing TKA. This should be taken into account when patients are advised pre-operatively.
基金Supported by The development of the RAPID instrument was supported in part by the National Institute of Diabetes and Digestive and Kidney Diseases, No R03 DK069328-01
文摘AIM:To evaluate the reliability of an instrument that measures disability arising from episodic abdominal pain in patients with suspected sphincter of Oddi dysfunction(SOD).METHODS:Although several treatments have been utilized to reduce pain and associated disability,measurement tools have not been developed to reliably track outcomes.Two pilot studies were conducted to assess test-retest reliability of a newly developed instrument,the recurrent abdominal pain intensity and disability(RAPID) instrument.The RAPID score is a 90-d summation of days where productivity for various daily activities is reduced as a result of abdominal pain episodes,and is modeled after the migraine disability assessment instrument used to measure headache-related disability.RAPID was administered by telephone on 2 consecutive occasions in 2 consenting populations with suspected SOD:a pre-sphincterotomy population(Pilot Ⅰ,n = 55) and a post-sphincterotomy population(Pilot Ⅱ,n = 70).RESULTS:The average RAPID scores for Pilots Ⅰ and Ⅱ were:82 d(median:81.5 d,SD:64 d) and 48 d(median:0 d,SD:91 d),respectively.The concordance between the 2 assessments for both populations was very good:0.81 for the pre-sphincterotomy population and 0.95 for the post-sphincterotomy population.CONCLUSION:The described pilot studies suggest that RAPID is a reliable instrument for measuring disability resulting from abdominal pain in suspected SOD patients.
文摘AIM: To investigate the association between socioeconomic status(SES) and visual disability(VD) among older Chinese adults. METHODS: We obtained data from the Second National Sample Survey on Disability, conducted in China in 2006. A total number of 192 375 older adults(aged≥65 y) were screened for suspected VD via interviews with trained examiners. Those who screened positively for VD were referred to ophthalmologists to obtain a final diagnosis. RESULTS: VD was prevalent among 7.29% of Chinese adults aged 65 and older, and was higher in rural areas(8.71%) than in urban areas(4.82%). After adjusting for SES indicators and covariates, we found that lesseducated older adults were more likely to suffer from VD, with an odds ratio(OR) of 2.50(95%CI: 2.26-2.82) for illiterates, compared with those who graduated from senior high school or above. Older adults who were in the lowest income quintile were more at risk of VD, with an OR of 1.81(95%CI: 1.68-2.95), compared with adults in the highest income quintile. In urban areas, when compared with adults who graduated from senior high school or above, those who did not continue their education after junior high school, primary school, or those who were illiterate, were more likely to suffer from VD, with an OR of 1.35(95%CI: 1.51-1.59), 1.84(95%CI: 1.60-2.12), and 2.63(95%CI: 2.27-3.04), respectively. Lower levels of income were statistically significant when associated with VD. In rural areas, adults who were illiterate had an OR of 2.21(95%CI:1.75-2.79) when compared to adults with senior high school or above education level. Per capita, household income remained significantly associated with VD. Older adults who were ≥85, female, single, and residing in rural areas were associated with higher risks of VD. CONCLUSION: Individual-level SES among the elderly, in the form of education and income, is associated with VD among elderly Chinese adults in both urban and rural areas; however, the association is stronger in rural areas. Further studies are still required to explore the mechanism behind the relationships.
文摘The estimate of dental caries among Chinese children at the microscale level using standard methodology remains unclear. In this study, we assessed and analyzed the disease burden of childhood dental caries in China by extracting data from the Global Burden of Disease, Injuries, and Risk Factors Study 2016 （GBD 2016）. In 2016, the number of cases, prevalence, years lived with disability （YLD）, and age-standardized YLD rate of dental caries was 93.0 million, 43.0%, 32,200 person years, and 14.8 per 100,000, respectively. Across 33 provincial units, the disease burden was highest in Hubei （YLD rate 28.6 per 100,000）, lowest in Macao （9.1 per 100,000）, while geographical clustering was not observed. Compared with 1990, the prevalence in 2016 decreased from 46.8% to 43.0%, and the YLD rate decreased from 16.5 per 100,000 to 14.8 per 100,000. Given the slight decrease in dental caries burden, the prevalence and disease burden remained high among Chinese children. Strategies for addressing the spatial inequity of childhood dental caries require geographical targeting.
基金National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health,No.U01AR067138.
文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.
文摘The growing diabetic epidemic has created a substantial burden,not only on the people with diabetes but also on society at large.This mini-review discussed the limitations and patterns of disability in type 2 diabetes mellitus and put forward a case for the moderating effects of physical activity(PA)in the management of diabetes.The limitations and impairments associated with diabetes include vascular,neurological,cardiac,and renal impairments.Moreover,individuals participate less in their daily lives and in their instrumental activities of daily living,which negatively impacts the quality of life of individuals with diabetes.This often leads to a loss of quality of life due to disabilities,resulting in an increased rate of disability-adjusted life years among people with type 2 diabetes mellitus.Moreover,there are psychosocial sequelae of diabetes mellitus.This necessitates looking for moderating factors that may reduce the burden of the disease.PA has been shown to be one of the factors that can mitigate these burdens.PA does this in several ways,including through the benefits it confers,such as a reduction of hemoglobin A1c,a reduction of excess fat in the liver and pancreas,and the reduction of cardiovascular risk factors,all of which favorably affect glycemic parameters.Specifically,PA regulates or moderates diabetes disability through two mechanisms:The regulation of glucolipid metabolism disorders and the optimization of body mass index and systemic conditions.Therefore,efforts should be directed at PA uptake through identified strategies.This will not only prevent diabetes or diabetes complications but will reduce its burden.
文摘In this paper, we will address common psychological reactions to disability such as anxiety, depression, denial, and anger in the framework of a stage model. In addition, this paper will discuss specific societal aspects that can impact reaction and adjustment to disability. In this vein, we will examine the specific effects of societal attitudes and stigma upon individuals with disabilities. Strategies for changing attitudes and facilitating adjustment to disability will also be discussed.
