1.Needs for rehabilitation in China: Estimates based on the Global Burden of Disease Study 1990-2019.
Tian TIAN ; Lin ZHU ; Qingzhen FU ; Shiheng TAN ; Yukun CAO ; Ding ZHANG ; Mingxue WANG ; Ting ZHENG ; Lijing GAO ; Daria VOLONTOVICH ; Yongchen WANG ; Jinming ZHANG ; Zhimei JIANG ; Hongbin QIU ; Fan WANG ; Yashuang ZHAO
Chinese Medical Journal 2025;138(1):49-59
BACKGROUND:
As an essential part of health services, rehabilitation is of great significance to improve the health and quality of life of the whole population. Accelerating aging calls for a significant expansion of rehabilitation services in China, but rehabilitation needs remain unclear. We conducted the study to explore the rehabilitation needs in China and project the trend of rehabilitation needs from 2020 to 2034.
METHODS:
The data of health conditions that might potentially benefit from rehabilitation were obtained from Global Burden of Disease (GBD) study. Estimated annual percentage changes (EAPCs) were calculated to quantify the trends of the age-standardized rates. Projections of rehabilitation needs were made until 2034 using Bayesian age-period-cohort analysis (BAPC).
RESULTS:
Approximately 460 million persons (33.3% of the total population) need rehabilitation in China, contributing to 63 million years lived with disabilities (YLDs) in 2019. The number of prevalent cases that need rehabilitation increased from around 268 (95% uncertainty interval [UI]: 257-282) million in 1990 to almost 460 (95% UI: 443-479) million in 2019, representing an increase of 71.3%. The highest contribution to the need for rehabilitation was musculoskeletal disorders with about 322 (95% UI: 302-343) million persons in seven aggregate disease and injury categories, and hearing loss with over 95 (95% UI: 84-107) million people among 25 health conditions. Based on the projection results, there will be almost 636 million people (45% of the total population) needing rehabilitation services in China by 2034, representing an increase of 38.3%. The rehabilitation needs of neoplasms, cardiovascular diseases, and neurological disorders are expected to increase significantly from 2019 to 2034, with increases of 102.3%, 88.8% and 73.2%, respectively.
CONCLUSIONS
The need for rehabilitation in China substantially increased over the last 30 years. It is predicted that over two in five people will require rehabilitation by 2034, thus suggesting the need to develop rehabilitation services that meet individuals' rehabilitation needs.
Humans
;
China/epidemiology*
;
Global Burden of Disease
;
Female
;
Male
;
Musculoskeletal Diseases/epidemiology*
;
Rehabilitation/trends*
;
Quality of Life
;
Middle Aged
;
Aged
;
Bayes Theorem
2.Summary of International Classification of Functioning, Disability and Health core sets for individuals with attention deficit hyperactivity disorder
Yanping TIAN ; Wei LI ; Qinghong LI ; Haofan XU ; Shunbo YANG ; Yanmei LAI ; Jia′na WU ; Jindi YANG ; Sufen HU ; Zhihai LYU ; Zhimei JIANG
Chinese Journal of Applied Clinical Pediatrics 2024;39(11):831-836
Attention deficit hyperactivity disorder is a common neurodevelopmental disorder characterized by persistent attention deficit, hyperactivity, and impulsive behaviors that are not consistent with developmental age.Academic and vocational difficulties, social exclusion, and delinquent behaviors are manifested in daily life.It is also commonly accompanied by psychiatric problems.At the same time, mental problems are common, and the overall quality of life is greatly affected, placing a heavy burden on society as well as the family.International attention deficit hyperactivity disorder experts have developed a common and comprehensive International Classification of Functioning, Disability and Health core set of classifications for assessing individual functioning in attention deficit hyperactivity disorder.
3.Research progress on the self-injury behavior in children with autism spectrum disorder
Gege HU ; Yue CAO ; Zhimei JIANG
Chinese Journal of Applied Clinical Pediatrics 2023;38(8):628-632
Self-injury behavior (SIB) is a common problem behavior of children with autism spectrum disorder (ASD), which is characterized by a series of harmful reactions made by themselves causing tissue and physical damages.It seriously affects the physical and mental health in children.An early identification of SIB in children with ASD is helpful to relieve symptoms and improve the prognosis.Aiming to enrich the understanding of SIB in children with ASD and to promote early detection and intervention, this article reviews and summarizes the research on clinical characteristics, influencing factors, evaluation, detection and intervention methods of SIB in children with ASD in recent years.
4.Early screening tools for autism spectrum disorder in the past two decades: a visualized analysis
Jiaquan HU ; Liling ZHU ; Zhimei JIANG
Chinese Journal of Rehabilitation Theory and Practice 2023;29(11):1304-1315
ObjectiveTo analyze the research hotspots and frontier trends in the field of early screening tools of autism spectrum disorder (ASD) over the past two decades. MethodsThe literature on early screening tools for ASD was searched in Web of Science core collection database from 2002 to 2022. CiteSpace was used for cluster analysis of keywords, to draw knowledge mapping. Research disciplines were analyzed and comprehensively interpreted. ResultsA total of 115 articles were included. The number of researches on early screening tools for ASD had been increasing over the past two decades. The research disciplines with higher publication volume included pediatrics, neurology and neuroscience, and psychology. A total of 191 keywords were identified, and the LLR keyword clustering analysis yielded eleven clusters. ConclusionModified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) and Brief Infant-Toddler Social and Emotional Assessment (BITSEA) have been subjected to large-scale sample screening and follow-up observation for validity, demonstrating good psychometric properties and high clinical diagnostic value. The development of new early screening tools for ASD, validation of the reliability and validity of different language versions of the M-CHAT-R/F, and research on digital and networked M-CHAT-R/F are current research hotspots. Cultural adaptation of early screening tools for ASD and their application within the developmental monitoring framework may represent frontier research trends.
5.A novel biological sources consistency evaluation method reveals high level of biodiversity within wild natural medicine: A case study of Amynthas earthworms as "Guang Dilong".
Zhimei XING ; Han GAO ; Dan WANG ; Ye SHANG ; Tenukeguli TULIEBIEKE ; Jibao JIANG ; Chunxiao LI ; Hong WANG ; Zhenguo LI ; Lifu JIA ; Yongsheng WU ; Dandan WANG ; Wenzhi YANG ; Yanxu CHANG ; Xiaoying ZHANG ; Liuwei XU ; Chao JIANG ; Luqi HUANG ; Xiaoxuan TIAN
Acta Pharmaceutica Sinica B 2023;13(4):1755-1770
For wild natural medicine, unanticipated biodiversity as species or varieties with similar morphological characteristics and sympatric distribution may co-exist in a single batch of medical materials, which affects the efficacy and safety of clinical medication. DNA barcoding as an effective species identification tool is limited by its low sample throughput nature. In this study, combining DNA mini-barcode, DNA metabarcoding and species delimitation method, a novel biological sources consistency evaluation strategy was proposed, and high level of interspecific and intraspecific variations were observed and validated among 5376 Amynthas samples from 19 sampling points regarded as "Guang Dilong" and 25 batches of proprietary Chinese medicines. Besides Amynthas aspergillum as the authentic source, 8 other Molecular Operational Taxonomic Units (MOTUs) were elucidated. Significantly, even the subgroups within A. aspergillum revealed here differ significantly on chemical compositions and biological activity. Fortunately, this biodiversity could be controlled when the collection was limited to designated areas, as proved by 2796 "decoction pieces" samples. This batch biological identification method should be introduced as a novel concept regarding natural medicine quality control, and to offer guidelines for in-situ conservation and breeding bases construction of wild natural medicine.
6.Development of the Elderly Inpatient Falls Prevention Knowledge, Attitude and Practice Scale for Full-time Caregivers and its reliability and validity
Hui JIANG ; Yanan ZHU ; Fujuan CHEN ; Zhimei LIU ; Fuguo YANG
Chinese Journal of Modern Nursing 2023;29(20):2680-2686
Objective:To develop the Elderly Inpatient Falls Prevention Knowledge, Attitude and Practice Scale for Full-time Caregivers, so as to provide a measurement tool for investigating the current situation of knowledge, attitude, and practice of full-time caregivers in preventing falls in elderly inpatients.Methods:A test version of the scale was formed through literature review, expert consultation, and pre investigation. From January to April 2022, convenience sampling was used to select 312 full-time caregivers from 5 accompanying companies in 6 ClassⅢ Grade A hospitals in Qingdao as the research subject, to test the reliability and validity, and to revise the final scale. A total of 312 questionnaires were distributed, and 300 valid questionnaires were collected, with an effective response rate of 96.154% (300/312) .Results:The Elderly Inpatient Falls Prevention Knowledge, Attitude and Practice Scale for Full-time Caregivers had a total of 35 items, including 3 dimensions, including 11 items in the knowledge dimension, 10 items in the attitude dimension, and 14 items in the practice dimension. The total Cronbach's α coefficient of the scale was 0.926, with Cronbach's α coefficients of 0.914 to 0.944 for each dimension, 0.998 for test-retest reliability coefficient, and 0.681 for split half reliability coefficient of the scale. The content validity index of the scale level was 0.984, and the cumulative variance contribution rate was 59.688%.Conclusions:The reliability and validity of the Elderly Inpatient Falls Prevention Knowledge, Attitude and Practice Scale for Full-time Caregivers are good, and can be used as a tool to evaluate the full-time caregiver knowledge, attitude and practice for preventing falls in elderly inpatients.
7.Interventions to improve physical function for children and young people with cerebral palsy: interpretation by Chinese experts
Jin GUO ; Xiaojie LI ; Jianguo CAO ; Wei PANG ; Zhimei JIANG ; Pei ZENG ; Xinping HUANG ; Yanping FAN
Chinese Journal of Applied Clinical Pediatrics 2022;37(7):502-509
This review aims to interpret the interventions to improve physical function for children and young people with cerebral palsy, thus providing relevant suggestions.Relevant literatures published before November 2018 were systematically searched in Cochrane library, CINAHL, and Embase MEDLINE using the Grading of Recommendations Assessment, Development and Evaluation method.Consult with international experts and patients to assess evidence and recommend it.Based on 3 systematic reviews, 30 randomized clinical trials, and 5 pre-and post-treatment studies, a total of 13 recommendations were given.The guidelines recommend that, in order to achieve functional stan-dards, intervention measures should include, patient-selected goals, full-task practice in real-life settings, support for family empowerment, and a team approach.The age, ability, and child/family preferences were all needed to be considered.In order to improve walking ability, ground walking and treadmill training can be carried out.Various methods can promote the realization of hand use goals hand use, including the two-hand exercise training, constraint-induced moverment therapy, goal-oriented training and cognitive therapy.In terms of patient self-care, the guideline proposed that, the combination of full-task practice and auxiliary equipment can improve the independence of self-care and reduce the burden of care givers.Leisure goals could be achieved by the combination of the practice of the entire task with strategies to address environmental, personal, and social barriers.The intervention of children and adolescents with cerebral palsy should take into consideration of patient selection and the goal of full-task practice.The child/family preference, age and ability should be considered when clinical workers selecting specific interventions.
8.Research progress of autism spectrum disorder comorbid with obsessive compulsive disorder
Yue CAO ; Zhimei JIANG ; Gege HU
Chinese Journal of Applied Clinical Pediatrics 2022;37(16):1273-1277
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication and interaction, restricted and repetitive behaviors, interests and activities, and abnormal perception.Obsessive compulsive disorder (OCD) is one of the common comorbid mental diseases of ASD.Accurate identification of the obsessive-compulsive symptoms and OCD comorbidity of ASD and early intervention are essential for the prognosis of patients.However, there are few domestic studies on comorbid OCD in ASD.Based on previous studies abroad, the progress of research on the epidemiology, etiology and neural mechanism, clinical characteristics, evaluation, diagnosis, intervention and treatment of comorbid OCD in ASD was reviewed in this paper.It aims to identify the manifestations of OCD in ASD patients in the early stage and improve the prognosis of patients.
9.Feasibility study on developing clinical pediatrics curriculum for medical students engaged in long schooling system in the pre-clinical stage
Cui SONG ; Zhiyong ZHANG ; Gaofu ZHANG ; Zhimei YANG ; Leyuan JIANG ; Feng CHEN ; Ziyu HUA
Chinese Journal of Medical Education Research 2022;21(5):550-555
Objective:To analyze the feasibility of developing clinical pediatrics curriculum for pediatric students at the pre-clinical stage, and to provide a basis for the subsequent curriculum construction.Methods:A total of 90 pediatric medical students were enrolled, including pre-clinical group (G1, third semester of the second year, n=47) and the clinical clerkship group (G2, seventh semester of the fourth year, n=43). A questionnaire survey was conducted to compare the two groups from three aspects: clinical interest, learning methods and learning ability. And 24 and 20 students were randomly selected from the two groups to participate a clinical course respectively. Both of the formative evaluation and in-class test were carried out to compare the learning performance and learning effect between G1 and G2. SPSS 22.0 was used for data analysis. The counting data were described by case number and rate, and the frequency between groups was compared by chi-square test. When the chi-square test condition is not met, Fisher's exact test was performed. Normal distribution test was carried out for measurement data. Two independent sample t test was conducted for the comparison between groups of normal distribution data and Mann-Whitney U test for the comparison between groups of skewed distribution respectively. Results:There was no significant difference in clinical interest and pre-clinical interest between the two groups (Fisher's exact probability method, P=0.252, 1.000). There were partial differences in learning methods: G1 spent more time learning after class ( Z=-2.36, P=0.018), learned more in spare time ( Z=2.53, P=0.011), learned more on the homework ( P=0.020), and had a higher preview rate ( Z=-5.07, P < 0.001). There were also partial differences in learning ability: G2 had better literature retrieval ability ( χ2=10.57, P=0.001); G2 had higher scores on class and extended class performance ( t=-3.18, P=0.004; t=-10.14, P<0.001). In terms of learning effect, G2 scored higher scores on only one multiple choice question ( t=-2.46, P=0.022). Conclusion:The pediatrics students at the pre-clinical stage have certain interest and ability to receive clinical pediatrics courses. Sufficient pre-class preparation and appropriate curriculum design are helpful to the early cultivation of student's clinical thinking.
10.Interpretation of effectiveness of paediatric occupational therapy in children with disabilities: a systematic review(2019)
Ruixue SUN ; Lei XU ; Yijing CHEN ; Jiaqin WANG ; Jianguo CAO ; Zhimei JIANG
Chinese Journal of Applied Clinical Pediatrics 2021;36(2):81-88
Occupational therapy can not only promote the development of motor and cognitive functions in children with developmental or other disabilities, but also improve their self-care ability, learning ability, participation skills and other activities.In 2019, the Aust Occup Ther J published a systematic review on the effects of occupational therapy interventions on disabled children, aiming to summarize the best evidence of occupational therapy and help occupational therapists and families to choose the effective treatment regimens.In this article, the systematic review was interpreted in light of the current status of domestic child occupational therapy, so as to allow clinicians to compare the pros and cons of different treatment methods and improve the efficacy.

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