虚拟现实技术应用于运动障碍康复的研究

概述了近年来虚拟现实技术在运动障碍康复中的应用。介绍了该技术在运动障碍康复领域的四个重点研究方向：康复机器人、虚拟人、基于触觉反馈和力反馈的虚拟现实康复平台以及游戏机Wii的应用和新进展。最后总结了虚拟现实应用于运动障碍康复的优势及面临的主要挑战。     

上海家庭病床患者对社区护理的需求调查与分析

目的 调查家庭病床患者护理服务需求情况及影响因素,为卫生管理部门制定家庭病床护理服务规范提供决策依据。方法 采用问卷调查方法,对本辖区2013年1月—2014年12月建立的160例家庭病床患者进行护理服务需求调查。结果 被调查的160名家庭病床患者中,以高龄患者为主,平均年龄（82.95±1.43）岁;疾病构成中脑血管意外后遗症康复期居首位（占58.75%）,有2种及以上慢性病者143名（占89.37%）;生活需要他人帮助的或完全不能自理146名（占91.25%）。家庭病床患者对居家护理指导、康复指导等服务项目需求较高,尤其对膀胱冲洗、居家护理指导和送药上门等存在巨大缺口,文化程度、生活自理程度、疾病了解程度和医疗保险类型为家庭病床患者对社区护理需求的影响因素。结论 要增加居家护理指导、康复指导等家庭病床护理服务项目种类,加大对患者健康知识宣教力度,增强患者的自我护理意识。     

社区康复护理对心境障碍患者康复效果的影响

目的:探究社区康复护理对心境障碍患者康复效果的影响。方法:对50例同一社区于2011年2月到2013年2月痊愈出院的心境障碍患者为研究对象,进行系统社区康复护理,选取非同一社区内同时间段出院的50例心境障碍患者组成对照组,进行传统式随访护理。结果:两组复发率比较社区护理组低于传统随访组(P<0.05)。结论:社区康复护理能降低心境障碍患者疾病复发率,能提高患者的生活质量。     

社区综合干预对老年阿尔茨海默症患者的康复效果

目的:探讨社区综合干预对老年阿尔茨海默症患者的康复效果。方法:选择本社区管理的50例阿尔茨海默症患者,随机分为对照组和研究组,每组25例。对照组患者采用常规模式进行康复训练,研究组患者在此基础上加以综合干预。观察并比较两组患者干预前后的精神症状评分(PANSS)、生活质量评分(QQL-100)、康复效果评分(MRSS)、智力评分(MMSE)以及记忆力评分(IMCT)等。结果 :两组患者接受干预前的各项指标无显著性差异(P>0.05)。与干预前比较,两组患者干预后的PANSS、QQL-100、MRSS、MMSE及IMCT均获得不同程度改善,且研究组患者显著优于对照组,差异具有统计学意义(P<0.05)。结论 :社区综合干预可改善老年阿尔茨海默症患者的生存质量,促进康复效果,值得推广。     

子宫颈癌放疗的康复护理

目的：探讨子宫颈癌放射治疗的康复护理方法。方法：采用科普宣传、康复期指导、放射治疗前康复指导、并发症护理和出院后康复指导等方法对放射治疗的患者进行护理。结果：科学的康复护理使患者均能耐受高剂量放射治疗,提高了患者的生存质量,5年生存率明显提高。结论：科学护理是宫颈癌患者放射治疗期和康复期的重要手段。     

早期康复训练及自理能力监测表在肝移植患者术后康复中的应用

目的:研究早期康复训练及监测患者自理能力对肝移植术后康复的影响。方法:选择2011年5月至2012年6月在我院接受肝移植手术的患者60例,按手术先后进行编号,使用随机排列表将患者分为实验组和对照组,每组各30例,对照组应用常规术后宣教和护理模式,室验组应用有针对性的"肝移植术后早期康复训练计划",并采用"自理能力监测表"对患者进行评估。分别比较两组患者的术后康复情况、睡眠和疼痛情况、术后第十日的自理能力以及术后早期并发症的发生。结果:两组患者康复情况比较,首次排气、排便、拔除尿管后首次排尿、首次下床和出院时间都有统计学差异(P0.05)。患者睡眠和疼痛情况比较,患者每日睡眠时间增加,安眠药物使用率明显减少(P0.05),而且术后康复训练没有增加患者术后疼痛的发生。术后第十日的自理能力比较,除自行进食(P0.05)外,自主上下床、自主如厕和自主洗漱三个方面室验组明显比对照组好(P0.05)。两组患者术后早期并发症的发生均无统计学差异(P0.05)。结论:早期康复训练和自理能力监测能有效促进肝移植术后患者的康复进程。     

针刺及电磁波照射联合康复运动训练对膝骨关节炎康复效果及不良反应的影响

目的 探讨针刺及电磁波照射联合康复运动训练对膝骨关节炎康复效果及不良反应的影响。方法 选择我院骨科2020年3月～2021年3月收治的71例膝骨关节炎患者作为研究对象,根据随机原则将患者分为观察组(n=36)和对照组(n=35)。两组患者均给予常规治疗,其中对照组采用常规康复运动训练,观察组在对照组基础上增加针刺及电磁波照射,比较两组治疗前后膝关节疼痛视觉模拟评分(VAS)、IL-1β、iNOS及SOD水平以及lysholm膝关节康复量表评分、不良反应发生情况。结果 治疗后,观察组的VAS评分、IL-1β、iNOS及SOD水平均低于对照组,差异均有统计学意义(均P<0.05)。两组的Lysholm评分比较,观察组高于对照组,差异具有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 在常规康复训练的基础上加用针刺及电磁波照射能有效改善膝骨关节炎患者的疼痛情况,提高膝关节功能,且安全性高,值得临床应用。     

康复运动对冠脉支架植入术后患者相关因素的影响

目的：研究心脏康复运动对冠脉支架植入术后患者血脂、血糖、体重指数及生活质量的影响。方法：对实施冠脉支架植入术的 146例患者进行比较分析，根据随机原则分为试验组76 例及对照组70 例。对照组患者给予常规的健康教育及冠心病二级预防指 导，给予定期随访。试验组患者在此基础上给予规律的康复运动指导。经过6 个月随访，比较两组患者血脂、HbA1C、体重指数及 生活质量情况。结果：试验组患者通过为期6 个月的规律的心脏康复运动指导，其血脂、HbA1C等冠心病危险因素控制情况优于 对照组，差异有统计学意义(P<0.05)。同时，6个月后，试验组康复运动六月后sF 量表各项评分与对照组同期比较，差异均有统计 学意义(P<0.05)。结论：规范的心脏康复运动指导能够有效改善冠脉支架植入术后患者血脂、血糖情况，提高患者生活质量。     

门诊和住院运动锻炼为核心的整体管理对慢性心力衰竭患者心脏康复治疗效果影响的临床研究

目的:探讨门诊运动康复和住院运动康复对慢性心力衰竭(CHF)患者心脏康复治疗效果的影响.方法:选择2015年9月至2018年9月间在北京康复医院临床诊断为CHF患者36例,按照随机原则和患者参与意愿分为3组:对照组(n=12):进行除运动锻炼治疗之外的常规心脏康复指导;住院运动康复组(n=12)和门诊运动康复组(n=1...     

Colles骨折手法整复后不同阶段的康复指导

目的 探讨Colles骨折手法整复后不同阶段康复的护理措施.方法 对60例Colles骨折患者手法复位及固定阶段进行心理、饮食指导,并针对不同康复阶段进行健康教育指导.结果 60例患者中,术后功能恢复为优52例,良8例.结论 Colles骨折患者手法复位后,护理上对不同康复阶段实施针对性的健康教育,可杜绝并发症的发生,有效促进患者患肢功能的恢复.     

Role of expressive behaviour for robots that learn from people

Robotics has traditionally focused on developing intelligent machines that can manipulate and interact with objects. The promise of personal robots, however, challenges researchers to develop socially intelligent robots that can collaborate with people to do things. In the future, robots are envisioned to assist people with a wide range of activities such as domestic chores, helping elders to live independently longer, serving a therapeutic role to help children with autism, assisting people undergoing physical rehabilitation and much more. Many of these activities shall require robots to learn new tasks, skills and individual preferences while ‘on the job’ from people with little expertise in the underlying technology. This paper identifies four key challenges in developing social robots that can learn from natural interpersonal interaction. The author highlights the important role that expressive behaviour plays in this process, drawing on examples from the past 8 years of her research group, the Personal Robots Group at the MIT Media Lab.     

Factors Associated with Nursing Home Placement of All Patients Admitted for Inpatient Rehabilitation in Singapore Community Hospitals from 1996 to 2005: A Disease Stratified Analysis

Objectives

To (1) identify social and rehabilitation predictors of nursing home placement, (2) investigate the association between effectiveness and efficiency in rehabilitation and nursing home placement of patients admitted for inpatient rehabilitation from 1996 to 2005 by disease in Singapore.

Design

National data were retrospectively extracted from medical records of community hospital.

Data Sources

There were 12,506 first admissions for rehabilitation in four community hospitals. Of which, 8,594 (90.3%) patients were discharged home and 924 (9.7%) patients were discharged to a nursing home. Other discharge destinations such as sheltered home (n = 37), other community hospital (n = 31), death in community hospital (n = 12), acute hospital (n = 1,182) and discharge against doctor’s advice (n = 24) were excluded.

Outcome Measure

Nursing home placement.

Results

Those who were discharged to nursing home had 33% lower median rehabilitation effectiveness and 29% lower median rehabilitation efficiency compared to those who were discharged to nursing homes. Patients discharged to nursing homes were significantly older (mean age: 77 vs. 73 years), had lower mean Bathel Index scores (40 vs. 48), a longer median length of stay (40 vs. 33 days) and a longer time to rehabilitation (19 vs. 15 days), had a higher proportion without a caregiver (28 vs. 7%), being single (21 vs. 7%) and had dementia (23 vs. 10%). Patients admitted for lower limb amputation or falls had an increased odds of being discharged to a nursing home by 175% (p<0.001) and 65% (p = 0.043) respectively compared to stroke patients.

Conclusions

In our study, the odds of nursing home placement was found to be increased in Chinese, males, single or widowed or separated/divorced, patients in high subsidy wards for hospital care, patients with dementia, without caregivers, lower functional scores at admission, lower rehabilitation effectiveness or efficiency at discharge and primary diagnosis groups such as fractures, lower limb amputation and falls in comparison to strokes.     

Cost analysis of early discharge after hip fracture.

OBJECTIVE--To ascertain the economic impact of an early discharge scheme for hip fracture patients. DESIGN--Population based study comparing costs of care for patients who had "hospital at home" as an option for rehabilitation and those who had no early discharge service available in their area of residence. SETTING--District hospital orthopaedic and rehabilitation wards and community hospital at home scheme. PATIENTS--1104 consecutively admitted patients with fractured neck of femur. 24 patients from outside the district were excluded. MAIN OUTCOME MEASURES--Cost per patient episode and number of bed days spent in hospital. RESULTS--Patients with the hospital at home option spent significantly less time as inpatients (mean of 32.5 v 41.7 days; p < 0.001). Those patients who were discharged early spent a mean of 11.5 days under hospital at home care. The total direct cost to the health service was significantly less for those patients with access to early discharge than those with no early discharge option (4884 pounds v 5606 pounds; p = 0.048). CONCLUSIONS--About 40% of patients with fractured neck of femur are suitable for early discharge to a scheme such as hospital at home. The availability of such a scheme leads to lower direct costs of rehabilitative care despite higher readmission costs. These savings accrue largely from shorter stays in orthopaedic and geriatric wards.     

典型脆弱生态区生态技术评价方法及应用专题导读

全球经济发展和日益增强的人类活动给业已脆弱的生态系统带来了巨大挑战,寻求尊重自然规律、环境友好的生态治理与恢复技术成为实现联合国可持续发展目标的重要组成部分。近年来,国内外科学家和生态治理机构研发出了一系列技术体系和技术模式,对脆弱生态区退化生态系统展开了全面的治理和恢复。然而,缺乏对这些治理技术的评价和优选方法的研发和应用在很大程度上限制了优良技术的筛选和推广应用,造成了资金和人力的浪费和损失。针对这些问题,科技部在2016年启动了国家重点研发计划项目"生态技术评价方法、指标体系与全球生态治理技术评价",其中重要的任务之一是对生态技术进行梳理、评价和优选。本文旨在对已有的评价方法和指标体系的研究进展进行系统梳理,对生态技术的特征、生态技术评价的基本步骤和原则、生态技术的三阶段评估方法等进行了界定和深入分析,对本专题收录的14篇学术文章所涵盖的评价方法和模型研发、案例应用等进行了介绍,以期为筛选优良技术、提高生态技术应用效果、促进优良技术的输出和引进提供参考。     

Iterative learning control applied to a hybrid rehabilitation exoskeleton system powered by PAM and FES

Currently upper limb exoskeleton rehabilitation robots powered by electric motors used in the hospitals are usually cumbersome, bulky and unmovable. Our developed RUPERT is a low-cost lightweight portable exoskeleton rehabilitation robot that can encourage stroke patients with high stiffness in arm flexor muscles to receive frequent intensive rehabilitation trainings in the community or home, but its joints are unidirectionally actuated by pneumatic artificial muscles (PAMs). RUPERT with one PAM of each joint is not suitable for stroke patients with weak muscles in the flaccid paralysis period. Functional electrical stimulation (FES) uses current with low frequency to activate paralyzed muscles, which can produce muscle torque and compensate the unidirectional drawbacks of RUPERT, so as to realize the two-way motion of its joints for passive reaching trainings. As both the exoskeleton robot driven by PAMs and neuromuscular skeletal system under FES possess the highly nonlinear and time-varying characteristics, which adds control difficulty to the hybrid dynamic system, iterative learning control (ILC) is chosen to control this newly designed hybrid rehabilitation system to realize repetitive task trainings.     

Current capabilities of rehabilitation robots

Predictions are often made of intelligent and independently mobile robots for the disabled, and researchers are continually improving laboratory systems. Reductions in the cost of the technology involved may lead to affordable devices by the end of the decade. Less ambitious goals must be adopted by those projects wishing to distribute robotic aids to the disabled in the next few years. A modest selling price dictates the use of existing components. Even with the advent of more advanced robots, cost considerations may still make simpler devices an attractive alternative. Excessive optimism of future capabilities should be avoided, lest unrealistic expectations of current robotic aids hamper their development. Progress at all levels of rehabilitation robotics is complementary.     

One third of a million days of care at home, 1959 to 1975.

Although articles on studies of organized home care programs are numerous, reports of long-term effectiveness of these programs are scanty. While government spokesmen appear to advocate more widespread use of alternatives to hospitalization, there has been serious criticism of the efficiency and accomplishments of home care services. A medically oriented home care program in Saskatoon (population, less than 150 000) has grown steadily over a 16-year period and is now serving a daily average of 200 individuals. All patients have required "hospital-like care" at home and most have not ordinarily been sufficiently mobile during their time in the program to attend hospital outpatient services. Many have required "concentrated care" through daily visits of professional health personnel. The program is designed for the physically ill and disabled and is administered by the major teaching hospital in the city, although it provides services to the whole community. Over one third of the patients referred in recent years had been at home. Almost one half of the patients have undergone satisfactory rehabilitation at home. The program has also proven to be an acceptable alternative to long-term institutional care for the permanently seriously disabled, a large number of whom are elderly. The program has been able to operate at considerably less cost to the public than inpatient (hospital or institutional) services would have entailed.     

SOCIAL, ECONOMIC AND CULTURAL DIMENSIONS OF SENSORY EVALUATION AND ITS POSSIBLE APPLICATIONS TO THE VARIOUS DISCIPLINES OF HOME ECONOMICS IN THE PHILIPPINES

Sensory evaluation is a scientific method that deals with precision, accuracy and sensitivity. Its basic principles are in large part anchored on the natural sciences, such as biology, chemistry, mathematics and physics. However, sensory evaluation goes beyond such platforms and has its own social, economic and cultural facets. Sensory evaluation has been extensively used in the study of consumer items such as food and clothing, and lately on behavioral and physiological reactions. It has been an integral part of the food science curriculum in various universities. However, the other disciplines of home economics, such as clothing technology, family life and child development, home economics education, hotel, restaurant and institution management, interior design and community nutrition, which deal with the needs of families and consumers, have not fully maximized the use of sensory evaluation. The multidisciplinary nature of home economics will push sensory evaluation to a more diverse level of relevance and purpose. This paper presented the social, economic and cultural dimensions of sensory evaluation along with its possible applications in the various disciplines of home economics in the Philippines.

PRACTICAL APPLICATIONS

The paper provided a wholistic view of sensory evaluation not merely as a scientific method but its important social, cultural and economic dimensions. This document can serve as a guide for students, teachers and professionals in the conduct of sensory assessments. Likewise, this will help home economists not only in the Philippines but also in other countries to maximize the use of sensory evaluation in improving the quality of life of families and consumers. Moreover, this can drive multidisciplinary undertakings utilizing sensory evaluation as the key concept and thus enrich the pool of knowledge both in the natural and social sciences and their interaction.     

A Comparison of Methods for Clustering 16S rRNA Sequences into OTUs

Recent studies of 16S rRNA sequences through next-generation sequencing have revolutionized our understanding of the microbial community composition and structure. One common approach in using these data to explore the genetic diversity in a microbial community is to cluster the 16S rRNA sequences into Operational Taxonomic Units (OTUs) based on sequence similarities. The inferred OTUs can then be used to estimate species, diversity, composition, and richness. Although a number of methods have been developed and commonly used to cluster the sequences into OTUs, relatively little guidance is available on their relative performance and the choice of key parameters for each method. In this study, we conducted a comprehensive evaluation of ten existing OTU inference methods. We found that the appropriate dissimilarity value for defining distinct OTUs is not only related with a specific method but also related with the sample complexity. For data sets with low complexity, all the algorithms need a higher dissimilarity threshold to define OTUs. Some methods, such as, CROP and SLP, are more robust to the specific choice of the threshold than other methods, especially for shorter reads. For high-complexity data sets, hierarchical cluster methods need a more strict dissimilarity threshold to define OTUs because the commonly used dissimilarity threshold of 3% often leads to an under-estimation of the number of OTUs. In general, hierarchical clustering methods perform better at lower dissimilarity thresholds. Our results show that sequence abundance plays an important role in OTU inference. We conclude that care is needed to choose both a threshold for dissimilarity and abundance for OTU inference.