The Role of Music Therapy in Supporting Intellectually Disabled Youth in Senegal

Introduction: Music therapy is a practice for helping and supporting people with intellectual and relational difficulties. This study illustrated the benefits of music therapy for young people living with intellectual disabilities (YLID) in an African context. Methodology: This study investigated six young individuals with intellectual disabilities who had undergone three years of music therapy. They were participants in the inclusive non-academic training program at the National School of Arts in Dakar from 2017 to 2019. Data collection utilized individual interviews with the youths, evaluation grids from teachers and psychiatrists. Guardians provided informed consent along with the assent of the young participants. Results: The six young were aged between 18 and 30 years old, with an average age of 24.6 years. Four of the YLID were male. Three young people with intellectual disabilities had delayed psychomotor development. Observations revealed the beneficial influence of music therapy on the health and well-being of young individuals. Music played a role in alleviating stress and anxiety among youth with intellectual disabilities (YLID), enhancing their mood and mental health. It assisted in navigating challenging situations and heightened alertness among YLID. Additionally, music therapy contributed to improvements in dyslexia, fine and gross motor skills, and memory development among intellectually disabled youth, ultimately facilitating their integration into society. Conclusion: In light of our results, music therapy makes a major contribution to the empowerment of YLID. Engaging in musical activities helps young people connect with others through instrumental expression and a sense of accomplishment. By facilitating music therapy, it becomes possible to combat discrimination and stigmatization, thus promoting the social inclusion of intellectually disabled youth. Therefore, it is important to promote music therapy in Senegal to meet the needs of YLID.

Associated Factors of Dental Caries among Intellectually Disabled Persons in Specialized Centers of Ouagadougou

Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated with it, we conducted a study in specialized centers welcoming subjects with intellectual disabilities in Ouagadougou (Burkina Faso). Objectives: The objective of this study was to identify the factors associated with it among intellectually disabled in the specialized centers of Ouagadougou. Methods: The study was cross-sectional analytical. The survey took place between November 2020 and January 2021 among people with intellectual disabilities in reception centers receiving a grant from the Ministry of Women, National Solidarity, Family and Humanitarian Action. Data collection was done with a questionnaire adapted from the World Health Organization (WHO) and dental caries was recorded according to WHO criteria in decayed, missing or filled teeth generating a DMF index. Logistic regression was used to identify factors associated with the presence of dental caries. Results: A total of 193 participants were included in the study with an average age of 12.4 years ± 7.9. The overall prevalence of caries measured with the DMF index was 58.6% 95% CI [51.2 - 65.8]. It was significantly associated with female gender (OR = 4.2;95% CI [1.4 - 12.5], p = 0,01), the clinical form of mental illness (epilepsy OR = 3.8 95%;CI [1.2 - 12.7], p = 0,02, trisomy OR = 5.0;95% CI [1.1 - 22.9], p = 0,03, motor autonomy OR = 0.2 95%;CI [0.1 - 0.7], p = 0,01) and at use of toothpaste OR = 9.33;95% CI [1.05 - 82.7], p = 0,04. Conclusion: Dental caries remains a very present pathology in most people living with an intellectual disability. Also, it is necessary to put in place prevention strategies to reduce its prevalence and improve access to oral care for these people.

Oral candidiasis and potential risk factors among disabled and nondisabled in Al-Baha region, Saudi Arabia

BACKGROUND Oral candidiasis(OC)is an oral health disease that could influence patients’oral health quality of life.AIM To estimate prevalence of OC among disabled and non-disabled individuals and its potential risk factors in the Al-Baha region,Saudi Arabia.METHODS An observational cross-sectional study was carried out among 148 disabled and non-disabled participants.The technique of concentrated oral rinse employing the Sabouraud Dextrose Agar medium accompanied with 0.05%chloramphenicol was conducted to assess and isolate candida.Oral examination using the World Health Organization guidelines was conducted to examine participants’oral hea-lth status.A pre-designed questionnaire was also used to evaluate sociodemo-graphic,medical history,and oral hygiene habits of the studied population.RESULTS Out of 148 participants(n=57,38%)had colonized candida.None of the studied population had visible Candida lesions.However,Candida was found in the oral rinses without the subject presenting any lesions or issues caused by Candida(asymptomatic colonization).The most common prevalent OC among participants were Candida albicans,Candida glabrata,Candida dubliniensis,Candida krusei,Candida tropicalis,and Candida parapsilosis(n=35,61%;n=8,14%;n=6,10%;n=5,9%;n=2,4%;and n=1,2%)respectively.Diabetes,smoking,poor plaque,and gingival status were key potential risk factors that significantly associated with candida’s density and presence(P=0.001,P=0.001,P=0.01,and P=0.01)respectively.Disability status had no statistically significant effect on presence and density of Candida.CONCLUSION The prevalence of OC is almost third of the studied population;thus,may provoke a need to develop preventive strategies to reduce the OC rate and establish solid treatment plans.

Effectiveness of Extended Care in Preventing Falls in Disabled Elderly and Its Impact on Quality of Life

Objective:To analyze the value of extended care interventions for disabled elderly in preventing falls and optimizing quality of life.Methods:A sample of 60 cases of disabled elderly in a tertiary hospital from May 2022 to May 2023 was selected and grouped by the random number table method.The observation group received extended care,while the control group adopted routine care.The differences in complication rate,fall rate,36-Item Short Form Health Survey(SF-36)score,health knowledge awareness score,and nursing satisfaction were compared.Results:The complication rate and fall rate of the disabled elderly in the observation group were lower than those in the control group,P<0.05;the SF-36 score,health knowledge score,and nursing satisfaction of the observation group were higher than those of the control group,P<0.05.Conclusion:Extended care for the disabled elderly can reduce the risk of falls and complications related to disability,as well as optimize their cognition and improve their quality of life,which is efficient and feasible.

基于《国际功能、残疾和健康分类》评价中国智能化辅盲设备的补偿功能

背景:辅盲设备及技术的应用是当今视力障碍人群常用的干预手段,可提高日常生活活动的参与及工作学习能力,帮助其回归家庭、回归社会。数字信息和智能化时代下辅盲设备的形式、技术和功能各有不同,其分类目前暂未能得到有效统一的讨论和评价。目的:基于《国际功能、残疾和健康分类》评价国内视力障碍人群智能化辅盲设备的补偿功能。方法:通过计算机检索中国知网、维普和万方数据库2013-01-01/2023-12-31收录的相关文献。基于《国际功能、残疾和健康分类》理论模式和框架结构,应用术语结构和编码程序归纳相关视力障碍评估类目,整理与分析国内视力障碍的智能化辅盲设备补偿功能研究与分类。结果与结论:①共纳入197篇文献:其中身体功能1篇,包含b2(b210);身体结构1篇,包含s2(s220);活动与参与共119篇,包含d1(10篇,d110、d115、d120、d140、d166),d3(4篇,d315、d325、d345、d360),d4(102篇,d465、d470),d8(3篇,d820、d825);环境因素共76篇,包含e1(72篇,e115、e120、e125、e130、e140、e150、e155、e160),e2(4篇,e210、e240);②基于《国际功能、残疾和健康分类》的视力障碍智能化辅盲设备补偿功能研究分类包含4个部分、8个分类、25个类目,领域涉及身体补偿类、生活用品类、教育学习类、出行导盲类、布局规划类。

CNKSR2 interactome analysis indicates its association with the centrosome/microtubule system

The protein connector enhancer of kinase suppressor of Ras 2(CNKSR2),present in both the postsynaptic density and cytoplasm of neurons,is a scaffolding protein with several protein-binding domains.Variants of the CNKSR2 gene have been implicated in neurodevelopmental disorders,particularly intellectual disability,although the precise mechanism involved has not yet been fully understood.Research has demonstrated that CNKSR2 plays a role in facilitating the localization of postsynaptic density protein complexes to the membrane,thereby influencing synaptic signaling and the morphogenesis of dendritic spines.However,the function of CNKSR2 in the cytoplasm remains to be elucidated.In this study,we used immunoprecipitation and high-resolution liquid chromatography-mass spectrometry to identify the interactors of CNKSR2.Through a combination of bioinformatic analysis and cytological experiments,we found that the CNKSR2 interactors were significantly enriched in the proteome of the centrosome.We also showed that CNKSR2 interacted with the microtubule protein DYNC1H1 and with the centrosome marker CEP290.Subsequent colocalization analysis confirmed the centrosomal localization of CNKSR2.When we downregulated CNKSR2 expression in mouse neuroblastoma cells(Neuro 2A),we observed significant changes in the expression of numerous centrosomal genes.This manipulation also affected centrosome-related functions,including cell size and shape,cell proliferation,and motility.Furthermore,we found that CNKSR2 interactors were highly enriched in de novo variants associated with intellectual disability and autism spectrum disorder.Our findings establish a connection between CNKSR2 and the centrosome,and offer new insights into the underlying mechanisms of neurodevelopmental disorders.

Peripheral blood RNA biomarkers can predict lesion severity in degenerative cervical myelopathy

Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.

Reevaluating health metrics:Unraveling the limitations of disabilityadjusted life years as an indicator in disease burden assessment

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.

肺癌组织中Atonal homolog 1与Disabled-2的表达及其临床意义

目的:分析Atonal homolog 1(Atoh1)和Disabled-2(Dab2)在肺癌组织中的表达及其与临床病理因素间的关系。方法:采用免疫组化方法检测Atoh1和Dab2在100例非小细胞肺癌中的表达情况。结果:在100例非小细胞肺癌中,Atoh1的细胞质和细胞核的平均阳性表达率分别为82.70%±19.06%和43.10%±27.16%,明显高于Atoh1在癌旁正常组织中的细胞质和细胞核的平均阳性表达率(71.80%±19.14%,18.77%±10.54%)。Atoh1在细胞核内的表达与肺癌的低分化(P=0.026)负相关,并且在肺腺癌(P=0.002)和女性患者(P=0.042)中阳性率较高。Dab2在细胞核内的表达与肺癌的原发灶T分期负相关(P=0.025),并且与肺癌的TNM分期相关(P=0.002)。Atoh1在肺癌中的细胞质表达与Dab2的细胞质表达显著相关(P<0.001)。结论:Atoh1在细胞核内的表达与肺癌的低分化负相关,Dab2在细胞核内的表达与肺癌患者TNM分期负相关。Atoh1和Dab2在肺癌组织中可能具有协同表达的现象。

中国老年慢性病患者失能状况的Meta分析

背景随着人口老龄化加深,失能成为老年人较突出的健康问题之一。我国老年慢性病群体庞大,且有多病共存特点,存在巨大的失能风险,而既往失能率研究结果不一。目的系统评价中国老年慢性病患者失能状况。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、Scopus、中国知网(CNKI)、万方数据知识服务平台、维普中文科技期刊库(VIP)、中国生物医学文献数据库(CBM)、中华医学期刊全文数据库共计10个数据库中关于中国老年慢性病患者失能状况的观察性研究,检索时限截至2023年8月。由2名研究者独立进行文献筛选、数据提取及质量评价,采用Stata 16.0软件对纳入文献进行Meta分析。结果共纳入32篇文献(34项研究),样本量为221~16566例,失能率为6.9%~82.8%。Meta分析结果表明,老年慢性病患者失能率为43.2%(95%CI=32.9%~53.5%)。亚组分析结果表明,女性失能率(36.6%,95%CI=27.0%~46.2%)高于男性(33.9%,95%CI=23.9%~43.9%);年龄越大,失能率越高(60~69岁:24.2%,95%CI=14.3%~34.0%;70~79岁:34.9%,95%CI=24.1%~45.7%;≥80岁:47.7%,95%CI=36.3%~59.1%);患慢性病种类失能率位列前3的为痴呆/帕金森病(56.3%,95%CI=40.9%~71.7%)、精神疾病(53.9%,95%CI=46.0%~61.7%)、脑血管疾病(49.2%,95%CI=33.5%~64.8%);老年人群失能率随合并慢性病种数增多而增高(1种:33.1%,95%CI=20.8%~45.3%;2种:36.3%,95%CI=22.6%~50.0%;≥3种:49.7%,95%CI=31.3%~68.0%)。结论我国老年慢性病人群失能率较高,慢性病种类和患病数量均对失能率有影响。建议加强对老年慢性病人群的监测和管理,以预防和减少失能的发生,促进健康老龄化。

MyosinⅥ和Disabled-2表达水平对小鼠内毛细胞胞吞和胞饮作用的影响

目的:研究肌球蛋白Ⅵ(MyosinⅥ)和Disabled-2(Dab2)对小鼠内毛细胞(IHC)胞吞和胞饮的影响。方法:分离BALB/C小鼠基底膜,进行IHC原代培养,构建MyosinⅥ、Dab2基因重组过表达及RNAi载体并转染至IHC内。采用实时荧光定量PCR(qPCR)法检测各组细胞MyosinⅥ、Dab2 mRNA的表达水平,Western blotting法检测MyosinⅥ、Dab2蛋白的表达水平,划痕实验检测各组IHC迁移能力,并检测各组IHC胞饮和胞吞情况。结果:过表达联合组MyosinⅥ、Dab2mRNA及其蛋白表达水平,转染12 h、24 h、48 h、72 h后迁移距离、胞吞荧光颗粒数量均最高,而RNAi联合组上述指标均为最低(均P<0.05);胞饮实验显示,RNAi联合组IHC胞饮作用最弱,过表达联合组IHC胞饮作用最强(P<0.05)。结论:MyosinⅥ、Dab2均具有促进IHC胞吞和胞饮的作用,并具有协同作用。

老年人群慢性病共病模式与失能状况的关联研究:基于四川省抽样调查

背景随着人口老龄化的进展,慢性病共病和失能老年人的数量与日俱增,给社会带来沉重的医疗负担。共病和失能联系紧密,但目前关于共病模式和失能状况的相关性研究较少。目的本研究旨在以四川省为例识别我国老年人群中常见的慢性病共病模式,并从个体层面探讨不同共病模式与失能状况之间的相关性。方法于2022年8—11月采用定额随机抽样方法在四川省抽取501例60岁及以上的老年人群样本,收集其慢性病患病状况、失能状况及一般人口学等信息。通过自组织映射神经网络和K-Means相结合的二次聚类方法,识别老年人群的常见共病模式。基于2021年国家医疗保障局首个《长期护理失能等级评估标准(试行)》判定样本的失能等级,应用逻辑回归模型探究慢性病共病模式与失能等级之间的关系。结果501例样本中,共病患病率为62.3%(312/501),失能率为74.3%(372/501);最终确定6种共病模式:关节炎或风湿病-高血压模式;血脂异常-高血压模式;肾脏疾病-关节炎或风湿病模式;癌症-关节炎或风湿病模式;哮喘-高血压-消化系统疾病模式;情感精神-记忆相关疾病模式。二分类逻辑回归分析结果显示,共病人群的失能风险是无共病人群的6.3倍(OR=6.3,95%CI=3.9~10.3,P<0.05)。多因素多分类逻辑回归分析结果显示,6种共病模式的失能风险均增加(P<0.05);其中情感精神-记忆相关疾病模式的共病人群失能风险最大,是无共病人群的10.7倍(OR=10.7,95%CI=1.7~63.6),其次是癌症-关节炎或风湿病模式(OR=7.8,95%CI=2.4~24.8)。结论四川省老年人共病患病率较高,多种共病模式均与失能的发生显著相关,尤其是情感精神-记忆相关疾病模式和癌症-关节炎或风湿病模式。医疗卫生保健系统应重点关注患有共病的老年群体,基于不同共病模式制定精准有效的长期护理政策和策略,预防延缓失能的发生、发展,提高老年人健康福祉,节约社会医疗卫生资源。

Oswestry功能障碍指数评分中久坐和体力活动水平与椎间盘退变的因果关系

背景:观察性研究表明,椎间盘退变会影响久坐和体力活动水平,然而Oswestry功能障碍指数评分中久坐和体力活动水平与椎间盘退变之间的因果关系尚不明确。目的:通过孟德尔随机化方法探讨Oswestry功能障碍指数评分中久坐和体力活动水平与椎间盘退变的因果关系。方法:从大规模人群全基因组关联分析中选择5个与Oswestry功能障碍指数评分中行为学相关的特征:看电视的时间、用电脑的时间、轻度/中度/剧烈体力活动,分别提取这些行为学相关特征的工具变量。结合Finn Gen最新第9版数据库中提取椎间盘退变作为结局,进行孟德尔随机化分析。使用逆方差加权法、MR-Egger回归、简单中位数法、加权中位数法、加权中值法等回归模型OR值和95%CI评估Oswestry功能障碍指数评分中久坐和体力活动水平与椎间盘退变的因果关系。使用Cochran’s Q检验异质性、MR-Egger截距检验多效性、“留一法”检验单核苷酸多态性观察暴露因素和椎间盘退变因果关系的敏感性。结果与结论:孟德尔随机化逆方差加权法结果显示,看电视/用电脑的时间与椎间盘退变发病风险呈正向因果关联(OR=1.775,95%CI:1.418-2.221,P<0.001)/(OR=1.384,95%CI:1.041-1.839,P<0.001),轻度体力活动与椎间盘退变发病风险呈反向因果关联(OR=1.000,95%CI:0.999-1.000,P=0.020);MR-Egger截距分析轻度体力活动与椎间盘退变存在潜在的水平多效性(P=0.005),看电视的时间、用电脑的时间与椎间盘退变不存在水平多效性(P=0.521,P=0.851)。Cochran’s Q异质性分析看电视的时间、用电脑的时间与椎间盘退变存在异质性(P=3.33×10^(-11),P=0.001),轻度体力活动与椎间盘退变没有观察到显著的异质性(P=0.186)。以上结果表明:Oswestry功能障碍指数评分中久坐和体力活动水平与椎间盘退变存在双向因果关系,即不仅椎间盘退变会影响Oswestry功能障碍指数评分中久坐和体力活动水平,Oswestry功能障碍指数评分中久坐和体力活动水平也会影响椎间盘退变。补充了轻度体力活动对椎间盘退变积极影响的遗传证据,表明中度/剧烈体力活动与椎间盘退变没有显著的因果关系,并扩大了长时间看电视/用电脑的久坐行为是椎间盘退变危险因素的证据基础。

The Need and Its Influence Factors for Community-based Rehabilitation Services for Disabled Persons in One District in Beijing

Purpose To explore the needs for basic community-based rehabilitation services for disabled persons in Xuanwu District, Beijing, China, and to identify factors which influence disabled persons to accept rehabilitation services. Method One hundred and eight disabled persons were selected by systematic sampling and simple random sampling to assess their needs for community-based rehabilitation services. Results Of the interviewees, 57A% needed the community-based rehabilitation services, but only 13.9% took advantage of it. The main factors influencing the interviewees to accept these services were cost （P〈0.05）, knowledge about rehabilitation medicine （P〈0.05）; and the belief in the therapeutic benefit of the community-based rehabilitation service （P〈0.05）. Conclusion A considerable gap exists between the supply of community-based rehabilitation services in Beijing and the needs for these services by disabled residents underscoring the need for improved availability, and for additional research.

Investigation and Countermeasures on the Health-Promoting Lifestyle of the Disabled Elderly in a Rural Area

Objective： To investigate the level of health-promoting lifestyle in the disabled elderly in a rural area and to provide useful countermeasures for health care workers and the government to improve the elderly＇ s lifestyle behaviors. Methods： A total of 446 disabled elderly people were recruited and examined using the General Questionnaire and Health-Promoting Lifestyle Profile II. Results： The mean score of the health-promoting lifestyle was 109.73（ SD = 16.80）, in which 90.6 percent of the disabled elderly demonstrated unhealthy lifestyle behaviors. The average score for each of the subscales includedthe following： interpersonal relations, stress management, nutrition, self-actualization, health responsibility, and sports activity. Conclusions： The health-promoting lifestyle of the disabled elderly needs to be improved; health care workers and the government should pay more attention to the countermeasures that can improve the lifestyle behaviors and promote the health of the disabled elderly.

Medical care and clinical practice for disabled elderly

At preasent,with the continuous development of the trend of population aging worldwide,more elderiy people are increasingly facing s-erious life disorders caused by physical and mental disability.In this study,the common symptoms and the nursing practice related to diseases of the disabled elderly are reviewed with reference to the basic concepts of disability care and the current situation of domestic and foreign research,which is expected to provide the basis for the construction of a new model of disability nursing.

Factors associated with activities of daily living among the disabled elders with stroke

Objective:To determine the factors associated with activities of daily living(ADL)among the disabled elders post-stroke.Methods:A total of 158 patients were chosen from community health service stations in eighteen regions of Tianjin city by convenience sampling from March to November in 2013.The Barthel Index(BI)and the short-formmini-nutritional assessment(MNA-SF)were used to evaluate the ADL,the nutritional status respectively.Statistical analysis was performed using independent sample t-test,one-way ANOVA,Pearson correlation and multiple linear regression analysis.Barthel ADL index was the main outcome.Results:The mean score of ADL was 50.50±27.125.The multiple linear regression showed that the factors which had significant impact on ADL were stroke frequency,types of stroke,nutritional status,financial status,and age.Conclusions:Disabled elders with recurrent strokes,hemorrhagic stroke,dependent financial resources,older age,worse nutritional status and living with family had poorer strokerelated outcome.Healthcare providers can discover the high-risk groups of disability and implement individualized preventive interventions in accordance with the related factors.

Deep Transfer Learning-Enabled Activity Identification and Fall Detection for Disabled People

The human motion data collected using wearables like smartwatches can be used for activity recognition and emergency event detection.This is especially applicable in the case of elderly or disabled people who live self-reliantly in their homes.These sensors produce a huge volume of physical activity data that necessitates real-time recognition,especially during emergencies.Falling is one of the most important problems confronted by older people and people with movement disabilities.Numerous previous techniques were introduced and a few used webcam to monitor the activity of elderly or disabled people.But,the costs incurred upon installation and operation are high,whereas the technology is relevant only for indoor environments.Currently,commercial wearables use a wireless emergency transmitter that produces a number of false alarms and restricts a user’s movements.Against this background,the current study develops an Improved WhaleOptimizationwithDeep Learning-Enabled Fall Detection for Disabled People(IWODL-FDDP)model.The presented IWODL-FDDP model aims to identify the fall events to assist disabled people.The presented IWODLFDDP model applies an image filtering approach to pre-process the image.Besides,the EfficientNet-B0 model is utilized to generate valuable feature vector sets.Next,the Bidirectional Long Short Term Memory(BiLSTM)model is used for the recognition and classification of fall events.Finally,the IWO method is leveraged to fine-tune the hyperparameters related to the BiLSTM method,which shows the novelty of the work.The experimental analysis outcomes established the superior performance of the proposed IWODL-FDDP method with a maximum accuracy of 97.02%.

Physical Accessibility for Disabled People: Analysis of Toilet Facilities in Primary Health Care Units

Background: Accessibility enables the effective participation of disabled persons in public and private areas and the use of urban equipment and street furniture. Objective: This study aimed to analyze the physical accessibility of toilet facilities in urban and rural primary health care units. Methods: It was a quantitative descriptive study conducted in 157 Primary Health Care Units of 16 municipalities in the Baturité Massif region, Ceará, Brazil. The study took place from August 2014 to May 2015, with a checklist type form, designed from the Technical Standard 9050 of the Brazilian National Standards Organization, specifying the ideal access conditions established by law to allow mobility of persons with physical disabilities. Data were processed through the Statistical Package for the Social Sciences software and organized into tables. Results: Toilets designed for physically disabled people were accessible as the location and signs (59.9%), identified with symbols for males and females (57.3%);however, the doorway width was smaller than needed to accommodate a wheelchair (77.7%). Inside the bathroom, only the forward approach was possible (59.9%). Grab bars positioned on the side and rear walls were inadequate or nonexistent (67.6%);toilet seats (91.1%) and toilet paper dispensers (96.2%) were mostly in inaccessible heights;flush controls in appropriate height (59.2%) and activated by light pressure (58%). Sinks without pedestal (51%), but higher than recommended (80.3%) and without single handle faucets (95.6%). It was verified that the toilets of basic health units located in urban areas had better accessibility conditions compared to those in rural areas. Conclusion: Results showed that the analyzed units presented physical inaccessibility in some toilet facilities, making it difficult or even impossible the accessibility for the disabled. The inclusion of accessibility features in health services for this clientele provides equal opportunities and social inclusion.

THE CHARACTERISTIC， DISTRIBUTION AND CAUSING FACTORC OF THE DISABLED IN HENAN PROVINCE

Henan Province is not only one of the provinces with the most POpulation, but also one of the provinces with the most disabled people in China. The characteristics of the disabled People, the distribution law of six typeS of the disabled, and the reason c