舌面散刺联合金津、玉液点刺出血治疗脑卒中后吞咽困难临床疗效观察

目的 探讨舌面散刺联合金津、玉液点刺出血治疗脑卒中后吞咽困难的临床疗效。方法 将60例脑卒中后吞咽困难患者,采用随机数字表法按患者入院先后顺序随机分为对照组30例,治疗组30例。两组均给予神经内科常规西药治疗及吞咽功能康复训练,对照组采用常规针刺,取廉泉、风府、哑门穴,治疗组在对照组基础上采用舌面散刺联合金津、玉液点刺出血,2周为1个疗程。2周后采用洼田饮水试验量表、改良曼恩吞咽能力评估（Mann assessment of swallowing ability,MASA）量表、改良Barthel指数（modified Barthel index,MBI）量表评价并比较两组的疗效。结果 治疗后两组患者洼田饮水试验量表评级比较,差异有统计学意义（Z=－4.026,P=0.000）;且治疗后治疗组的洼田饮水试验量表评级在Ⅰ级、Ⅱ级分布占比较多;广义估计方程统计结果表明,两组治疗方法产生的疗效不同,治疗组吞咽功能恢复情况优于对照组（P<0.05）,治疗后吞咽功能疗效优于治疗前（P<0.05）。两组患者治疗后MBI量表评分、MASA评分均较治疗前显著升高（P<0.05）,且治疗组MBI量表评分升高程度大于对照组（P<0.05）。结论 舌面散刺联合金津、玉液点刺出血治疗脑卒中后吞咽困难疗效确切,该治疗方法可促进神经功能恢复,减轻患者脑卒中后吞咽困难症状,提高患者生活质量。     

中国智慧和中国方案 ：就业优先的阶段性内涵与生发机制

作为中国特色的经济社会战略名词,就业优先惟有明晰其阶段性和针对性才能充分彰显中国智 慧和中国方案的魅力。结合低中高收入水平及其各自所处阶段的发展均衡陷阱,以反贫困、反对不平等、实现 充分就业与体面就业等阶段性主要任务为媒介,可探究就业优先的阶段性内涵与生发机制。总体上就业优先的 内涵变迁可拾级而上形成三个阶段,即努力实现市场化就业优先的低等水平就业,追求就业数量优先的中等水 平就业,致力于就业质量优先的高等水平就业。就业优先由低到高的三个阶段性内涵依次对应收入水平的低等、 中低等、中高等不同阶段,但并非绝对。进入中国特色社会主义新时代,更要坚持就业优先战略,并把握好就 业质量优先这一新的阶段性内涵,进一步推动相关领域的深化改革。     

银发浪潮下的中国老年人力资源开发

人口老龄化是中国当前及今后很长时期都必须面临的重要问题,充分认识到老年人力资源开发的重要意义,挖掘老年人口红利将成为经济社会发展的新动力。中国拥有规模庞大的老年人力资源,但老年人口实际就业率并不高。影响老年人力资源开发和利用的因素既有社会观念、强制的退休年龄制度等宏观因素,也有老年人的就业意愿、健康状况、受教育程度等微观因素。促进老年人就业,实现老有所为是中国积极应对人口老龄化的重要举措。研究提出如下政策建议:转变社会观念,营造老年人力资源价值观念;重点开发低龄健康老年人力资源;加强对老年人的教育和培训;重视对老年就业的法律保护;改革现有的强制退休年龄制度,实行弹性退休制度。     

Status of Mandibular Third Molar Development as Evidence in Legal Age Threshold Cases

The completion of the third molar roots has played an important role in ascertaining whether individuals may be at or over a legal threshold of age, often taken as 18 years. This study demonstrates that root apex completion in the third molar is relatively uninformative regarding the threshold of age 18 years in a sample of 1184 males, where mean age‐of‐attainment of root apex completion for third mandibular molars is about 19.4 years. This paper also considers the legal age threshold problem for cases where the third mandibular molar is not completely formed, and outlines the use of parametric models and Bayes’ factors to evaluate dental evidence in statistically appropriate ways. It attempts to resolve confusion over age‐within‐stage versus age‐of‐attainment, likelihood ratios versus other diagnostic tests, and prior odds for a case versus the prior density for an age distribution.     

Bone Area Histomorphometry

Quantifying the amount of cortical bone loss is one variable used in histological methods of adult age estimation. Measurements of cortical area tend to be subjective and additional information regarding bone loss is not captured considering cancellous bone is disregarded. We describe whether measuring bone area (cancellous + cortical area) rather than cortical area may improve histological age estimation for the sixth rib. Mid‐shaft rib cross‐sections (n = 114) with a skewed sex distribution were analyzed. Ages range from 16 to 87 years. Variables included: total cross‐sectional area, cortical area, bone area, relative bone area, relative cortical area, and endosteal area. Males have larger mean total cross‐sectional area, bone area, and cortical area than females. Females display a larger mean endosteal area and greater mean relative measure values. Relative bone area significantly correlates with age. The relative bone area variable will provide researchers with a less subjective and more accurate measure than cortical area.     

Severity of neurocognitive impairment in women who have experienced intimate partner violence in Spain

This study examines neuropsychological impairment in women who have experienced intimate partner violence using DSM 5 criteria for mild and severe cognitive impairment. A total of 108 females in Spain were included in one of three groups: psychological abuse (n = 24), physical and psychological abuse (n = 45), and no-abuse (n = 39). There were differences between the control and IPV groups in attention and executive functioning. Furthermore, approximately 25% of women experiencing IPV suffer mild neuropsychological alterations and 5% severe, mostly in memory and executive function domains. This evidence supports the growth in research that suggests psychological violence on its own to be as strongly related to poor health outcomes as physical violence in intimate partner relationships.     

A New Approach of Juvenile Age Estimation using Measurements of the Ilium and Multivariate Adaptive Regression Splines (MARS) Models for Better Age Prediction

Juvenile age estimation methods used in forensic anthropology generally lack methodological consistency and/or statistical validity. Considering this, a standard approach using nonparametric Multivariate Adaptive Regression Splines (MARS) models were tested to predict age from iliac biometric variables of male and female juveniles from Marseilles, France, aged 0–12 years. Models using unidimensional (length and width) and bidimensional iliac data (module and surface) were constructed on a training sample of 176 individuals and validated on an independent test sample of 68 individuals. Results show that MARS prediction models using iliac width, module and area give overall better and statistically valid age estimates. These models integrate punctual nonlinearities of the relationship between age and osteometric variables. By constructing valid prediction intervals whose size increases with age, MARS models take into account the normal increase of individual variability. MARS models can qualify as a practical and standardized approach for juvenile age estimation.     

Exploring the trend of violence against women in India

ABSTRACT

India is witnessing growing violence against women including horrific rapes even in major metropolitan areas that have attracted considerable media attention. Insecurity and physical threat to women is real and a major concern. Justice Verma Commission that examined the Delhi rape case has recommended several measures including changes in laws involving crimes against women, yet little has changed. In this paper we conduct a variety of qualitative and quantitative analyses using open source data to understand the nature and extent of crimes against women in India. Police records indeed suggest a growing escalation in serious crimes against women. The paper also critically examines the efforts of the police and others, particularly non-governmental groups to combat such crimes. A number of policy recommendations are made for prevention including comparative efforts in Korea where crimes against women are similarly serious.     

Towards identifying and ranking selected types of violence against women in North India

ABSTRACT

The paper is aimed at identifying and ranking different types of violence against women (VAW) in states of Delhi and Haryana in Northern India. Examples of gender-specific violence were selected through an extensive review of the literature. The types of VAW reviewed include the lower economic value of daughters at birth (females being considered a liability rather than an asset), rampant female feticides aided by proliferation of often illegal prenatal diagnoses, maternal morbidity, and mortality rates, physical and emotional abuse and neglect of female children, “honour” killing of women, exclusion and deprivation of women from medical treatment and nutrition, their subjection to assaults and rape (including marital rape), insufficient compliance to women’s legal rights of inheritance, arranging early marriages of girls, dowry deaths, female sexual harassment, and intimidation in community and workplace, female trafficking and prostitution, and so forth.

The conceptual frame of reference used for the study was provided by the culturally sanctioned legitimation of the patriarchal system of Indian family as well as by people’s perceptions and attitudes. Data were collected through the survey method in two phases. A preliminary survey was conducted during the first phase for developing the questionnaire items to be used for data collection in the phase two of the study. The findings of the study are presented and reveal participants’ rankings of selected types of VAW by degree of relative importance. Data, based on secondary sources as well as a non-random sample of respondents, were analysed to assess the various areas which demand immediate redress. We also interpret data based on selected criteria and suggest few optimistic future trends in regard to addressing and preventing VAW.     

上颌中切牙牙根直径及根管管径与年龄的关系

目的探讨汉族人上颌中切牙牙根直径及根管管径与年龄的关系。方法 2014年11月~2015年11月间,在一家三甲医院数据库中选择420例汉族人的口腔锥形束CT资料,根据年龄将所有研究对象分为6个组别(8~12岁、13~17岁、18~22岁、23~27岁、28~32岁、33~37岁,每组70例,男女各15例。对所有研究对象上颌中切牙牙根直径及根管管径进行测量,取釉牙骨质界距根尖3/4处,分析上颌中切牙牙根直径及根管管径与年龄的关系,比较男女上颌中切牙牙根直径。结果男性与女性上颌中切牙牙根直径比较具有差异显著性(P0.05);男性与女性上颌中切牙牙根管径比较具有差异显著性(P0.05);男性与女性上颌中切牙牙根直径与牙根管径之比比较具有差异显著性(P0.05);不同性别间上颌中切牙牙根直径与牙根管径之比与年龄具有一定的相关性(R~2=0.623,P0.05)。结论汉族人上颌中切牙牙根直径及根管管径与年龄的变化具有相关性,且男性根管管径减小趋势比女性更高。