In 2023, we announced LY Foundation's inaugural Vision, Mission, and Values:

Under the guidance of our VMV, LY Foundation launched three core programs: Generative AI for Rural Healthcare, International Medical Knowledge Exchange, and Accompany with Music.

Based on the decision of the board of directors in December 2023, starting in 2024, LY Foundation will transition from an operating model to a grantmaking model. We look forward to continuing practicing the Foundation's VMV through funding external projects, cooperating with more philanthropic partners and change makers to carry out innovative interventions in the domain of public health.

The new strategy officially takes effect from the date of this announcement. The details are as follows:

Grant Amount

Each grant will range from 100,000 to 500,000 RMB each year, and will be disbursed annually for a total of three years. The specific amount will be determined based on the project's needs.

Each grantee will start with project-based restricted funding in the first year, but may transition to unrestricted funding based on evaluation and demand from the second year onwards.

Profiles of Grantmaking Targets

We look for innovative projects to fund and support. Innovation is not necessarily about the application of cutting-edge technology. More importantly, we value new perspectives and approaches to real issues faced by vulnerable populations, and in particular, we are interested in pre-MVP stage initiatives. Considering the intrinsic interdisciplinarity of public health, we also welcome projects that intersect with other domain areas that are relevant to people's health and wellbeing.

Grantees profiles include but are not limited to the following categories:

• Non-profit organizations led by professional healthcare workers (e.g., doctors, nurses, social workers)
• Social entrepreneurship projects in public health
• Academics conducting research-based interventions in public health
• Media teams promoting public health education and outreach

Guiding Principles

• Guided by our value in health equity, we pay close attention to initiatives that support economically disadvantaged groups, urban-rural exchange, and cooperation between eastern and western regions in China.
• We believe in the power of technology and value teams that can meaningfully incorporate technology into their intervention.
• We emphasize evidence-based evaluation of project outcomes.
• We consider knowledge as public good. We commit to openly sharing our decisions and reflections in the grantmaking process.

How to Participate

Our grant process is by invitation only. We do not directly accept project proposals. If your organization and project align closely with our grantmaking strategy, feel free leave a message via our WeChat platform or send an email to victor.lian@marswalk.com. We are happy to chat!

Guided by our value of Health Equity, LY Foundation pays close attention to the issue of grassroots healthcare in China. There are approximately 1.3 million rural doctors in China, who have long served a rural population of 500 million. In recent years, the accessibility of primary medical and health resources has been significantly improved under the guidance of policies, but the quality of primary medical services still has considerable room for improvement.

In recent years, smartphones have been widely used in primary care settings, and rural doctors generally have experience in retrieving information through mobile phones and the Internet. Regarding the training and empowerment of rural doctors, the medical field and the social sector have carried out a series of internet-based experiments, including online training, remote consultation and artificial intelligence-assisted diagnosis (CDSS) . Since 2022, we are pleased to see that the rapid development of the field of generative artificial intelligence provides innovative opportunities. The advantages of Generative AI are simple user interaction, powerful functions, round-the-clock response, and low learning curve. This may become a game changer for grassroots diagnosis and treatment and for traditional village doctor training.

At the beginning of 2023, LY Foundation and the Center for Experimental Economics in Education of Shaanxi Normal University (hereinafter referred to as "CEEE"), which has long been concerned about rural grassroots diagnosis and treatment issues, jointly launched the "Using Generative AI to Empower Rural Doctors" project, aiming to verify the application of generative AI at the grassroots level. This article summarizes the process and outcome of the project pilot in 2023 and our reflections. We are excited to share with charity peers. Your comments and feedback are welcome.

What did we do?

In the first half of 2023, the project team investigated the current status of diagnosis and treatment problems for rural doctors. We went to Shaanxi province to conduct interviews, learned about rural doctors’ needs for diagnosis and treatment auxiliary tools, and made initial design decisions about the use case of generative AI in the rural scenario. In the second half of 2023, the project team conducted product research and development of auxiliary diagnosis and treatment tools for village doctors and completed a small-scale pilot evaluation in a county in Shaanxi.

March-June 2023: Analyze the current situation of primary medical services through field surveys and desk research.

• The project team visited 2 township health centers and 6 village clinics, and interviewed the directors of the health centers and village doctors to learn about local patient profiles, common diseases, medical conditions, village doctors’ training status, and the scientific and technological literacy of village doctors.

July-September 2023: Plan the intervention model, complete the product development of "Village Doctor Assistant", and design AI prompts.

• Based on the needs of village doctors, the project team designed and developed a "Village Doctor Assistant" tool based on generative AI technology, which was deployed on mobile phones and computers in the form of web links. After multiple rounds of experiments and tests with real doctors, the project team customized prompts for village doctor assistants. By engaging in multiple rounds of dialogue with the Village Doctor Assistant on their phones, doctors were able to obtain suggestions on diagnosis and treatment, which integrated both Chinese and Western medicine knowledge.
• In order to improve the user experience for users of the Shaanxi dialect, the project team cooperated with the iFlytek Sansheng AI charity project team of the University of Science and Technology to add Shaanxi dialect voice dictation capabilities. In this way, users were able to "talk" directly to the Village Doctor Assistant in their own dialect.
• The project team also developed a set of user guides specifically tailored to the needs of village doctors, as shown below.

September 2023: Go to the project site for product deployment and training.

• The project team selected fifteen doctors from two towns. Five village doctors from Village A and Five township doctors from Village A served as the intervention group of the project to receive the Village Doctor Assistant. Five village doctors from Village B served as the control group of the project.
• The project team conducted training sessions on the Village Doctor Assistant in the township health center, where they installed it on doctors’ mobile phones and conducted case demonstrations and exercises. Additionally, the project team conducted on-site visits in five village clinics.

August-September 2023: Post-intervention research and evaluation

• In order to analyze the intervention effect, the project team conducted pre- and post-tests on the diagnosis and treatment of village doctors, using interview questionnaires, clinical scenario knowledge tests and standardized patient methods to gain an in-depth understanding of the condition of village clinics, doctors’ work needs, internet literacy, medical service quality, and other information. The effectiveness of Village Doctor Assistant was tested.

In 2023, LY Foundation's total spending on the project was 172,675 CNY. During the development process, the foundation team used open source large language model technology and free public resources to reduce development costs. The specific details are as follows:

What did we learn?

During the 13-day pilot, rural doctors treated many patients with the support of Village Doctor Assistant. On average, each consultation involved 2-3 rounds of dialogue with the tool. The tool was used a total of 141 times. Click this link to get the Project Report on this experiment. The main points are as follows.

Regarding the user experience of the Village Doctor Assistant, surveys reflected high satisfaction. Users indicated that they believed the Village Doctor Assistant could solve 70% of their daily work needs. They felt that their clinical knowledge and skills improved, as well as their confidence in diagnoses. In terms of internet technology literacy, doctors’ attitude toward the use of AI medical tools, trust in information, and trust in functions all improved. 83% of patients indicated support for the doctors’ use of Village Doctor Assistant.

At the same time, doctors reported that Village Doctor Assistant sometimes gave irrelevant or lengthy answers. Most village doctors were not proficient in using Pinyin or the dialect-to-text functions, which caused difficulties with the user interaction.

In terms of intervention effectiveness, standardized patient testing results found that the 13-day short-term intervention did not significantly improve the service quality of the doctors.

This phenomenon not only reflects the limitations of the Village Doctor Assistant itself, but also points to problems in the application of AI products in rural primary care scenarios overall.

1. The auxiliary diagnosis and treatment capabilities of generative AI rely on the consultation habits of the assisted doctors, which happens to be the shortcomings of grassroots doctors. Oversimplified questions would cause the AI to be unable to provide accurate and comprehensive information, affecting the overall intervention effect.
2. Due to the lack of equipment and medicines in the rural clinics, the examination suggestions put forward by the Village Doctor Assistant were often inapplicable.
3. In addition to daily consultations, village doctors were also responsible for providing public health services. However, Village Doctor Assistant only covered their needs with diagnosis and treatment.
4. Most village doctors had frequent questions about Traditional Chinese Medicine (TCM), but Village Doctor Assistant was unable to provide high-quality TCM diagnosis and treatment suggestions.

Overall, the pilot confirmed the user affinity of AI in grassroots diagnosis and treatment scenarios. However, whether the AI-empowered intervention model is the optimal solution in the current scenario requires further product iterations and long-term, large-sample experiments and evaluations. The cost of the current intervention model is low, but considering that the payment capacity of the rural primary medical system is extremely limited, the feasibility of long-term operation of the project at the grassroots level needs further verification.

Future Directions

At this stage, we believe that the Village Doctor Assistant does not have the prospect of large-scale development, unless there exist practical and effective methods to respond to the four problems listed above. The team needs to accumulate more insights into the real needs of rural doctors. Domestic substitution of Generative AI products also needs to be put on the agenda to improve product capability and user experience while ensuring the compliance.

LY Foundation will continue supporting initiatives that improve primary care diagnosis and treatment in rural China as one of its key focus areas. In the next 10 years, through funding external projects, we will accumulate insights, build new partnerships, and work towards more powerful technology-enabled primary care diagnosis and treatment interventions.

If you have a project in the field of primary care that is in line with LY Foundation's funding strategy, please feel free to contact us. Thank you.

The Accompany with Music Program originated from LY Foundation's concern for the psychological health of rural left-behind children. Due to the lack of parental care and education, left-behind children face severe emotional deprivation and behavioral problems. Based on the collaborative relationship between Shanghai and Yunnan province, we chose to carry out our work in Nanjian County, Dali City. The project site, Songlin Elementary School in Bixi Township, is a boarding school where over half of the students are left-behind children. Due to its remote location, children lack opportunities for growth and face mental health issues due to the lack of family companionship.

In early 2023, LY Foundation and the Yunnan Lianxin Community Public Welfare Foundation (referred to as "Lianxin") jointly launched the Accompany with Music Program. With Xixin Social Work Service Center in Nanjian County (referred to as "Xixin") as the implementing partner, we aim to promote the physical and emotional well-being of the children at Songlin Elementary School through a combination of aesthetic education, group education, and companionship. Using this combined methodm, we hope to exemplify a new intervention pathway to address the psychological health issues of left-behind children.

In this article, we are honored to present an annual review of the program. We look forward to hearing everyone's thoughts and suggestions on its future directions.

What did we do?

In order to enhance the self-confidence and self-identity of left-behind children in the project area, reduce their sense of loneliness and helplessness, promote their interpersonal communication and environmental adaptation, and help them establish better teacher-student and peer relationships, the program carried out the following series of actions:

【Aesthetic Education (Music)】He Weicheng, a certified Inheritor of Intangible Cultural Heritage, was hired as a "music accompanist" to teach the children traditional musical instruments, songs and dances of the Yi people. LY Foundation funded and built a brand new music classroom in the school and purchased 198 musical instruments for use in music classes. Teacher He led the children to conduct a participatory music class with a total of 150 hours over the course of two semesters, using traditional musical instruments to perform a piece "Sounds of the Pine Forest" that included elements of singing and dancing.

【Group Education 60 students from Songlin Primary School formed a small band. The teachers organized weekly rehearsals as well as two public performances. During the summer vacation in 2023, 115 students from the program held a ten-day "Dream-Building Growth Camp", and the small band performed the finale performance during the Yi Torch Festival celebrations.

【Companionship】Local social workers conducted home visits for children in need. During the music classes, social workers surveyed and documented the children's mental health and family economic conditions, and teamed up with school teachers to visit the families of children in difficulty and distribute scholarships and daily necessities. During the project period, a total of 60 rounds of home visits were conducted, covering 10 households.

In addition to the intervention measures above, LY Foundation also cooperated with Yunnan musicians to raise funds for children at the Wubaili Music Festival. The project was launched on the Douyin charity platform and received a total of 39,596.8 yuan in public donations. During the summer camp, team volunteers applied for and used the mental health literacy courses developed by the Guangdong Rici Charity Foundation, and received positive feedback from Songlin Primary School. LY Foundation also linked up with the Shanghai Pudong New Area Enpai Charity Foundation's Love and Tongxin Special Fund, and coordinated with other donors to give funds and goods that worthed a total of 200,000 yuan.

What was the outcome?

The most important outcome from the Accompany with Music program was the impact it had on the children.

At the program output level, all children in Songlin Primary School participated in music classes and received a total of 150 hours of music teaching. A total of 5,047 children have received social worker services, 1 dropout child has returned to school, 20 children in need have received scholarships totaling 17,400 yuan, and 2 children without household registration have been established and settled.

In order to comprehensively understand students' musical literacy and teaching environment, identify the possible implementation effects of the project, and provide evidence-based basis and iterative direction for the future feasibility of the project, LY Foundation invited the Center for Experimental Economics in Education of Shaanxi Normal University as the first The tripartite team evaluated the implementation effect of the music companionship plan. During this period, through questionnaire interviews and comparisons with 218 students from Songlin Primary School (as the intervention group) and 528 students from Huilongshan Primary School (as the control group), 20 students and orchestra members were randomly selected from grades 3 to 6 of Songlin Primary School to conduct a semi-structured Interview. Based on the above data, the evaluation team used the propensity score matching method to identify the impact of the music companionship program. Please refer to the evaluation report (in Chinese) for details.

The evaluation found that the project has achieved the following results:

• The proportion of students who like music increased by 35%, the proportion of students with specific musical interests has increased by 19%, and the proportion of students who expressed willingness to engage in music-related careers in the future has increased by 24%.
• Students' emotional regulation and thinking abilities improved by 0.53 points (total score of 5 points), the number of friends made increased by 0.38 points (total score of 5 points), and loneliness decreased by 0.52 points (total score of 5 points)

At the same time, the evaluation also exposed the following shortcomings:

• Students reported a shortage of music equipment and insufficient opportunities to use instruments outside the classroom.
• Cooperation between the project team and front-line teachers in schools was limited and no synergy was produced.
• The children who received home visits from social workers only accounted for 4.6% of the total number of intervention groups, and the contribution of home visits to children's mental health was not significant.

We also heard from the following voices directly from the volunteers and the children:

"I give the music class 100 points because I feel that I have gained a lot from taking the music class. In other places, you have to spend money to learn Jiudian and cucurbit flute. Teacher He will also tell some stories from daily life to make us happy. Study The musical instrument may go to a big city to perform, and then you can see the outside world." - Songlin Elementary School student

"I am honored to participate in this growth camp activity. As a volunteer, I am deeply immersed in the joyful faces of the children. Watching them go from being a little reserved at the beginning to taking the initiative to communicate and care for the volunteers, I know that the love between us and the children goes in both directions and is meaningful. All I can do is give him as much love and help as possible during this short-term growth camp, and constantly guide him to pay more attention to what he has. There are too many similar situations. Every time I see these children, I can't help but feel sorry for them. Because I have been caught in the rain, I want to hold an umbrella for them. I deeply hope that they can grow up bravely! "——Summer camp volunteer

Our reflections

Since December 2023, we have conducted a month-long internal review of the program. We consulted the evaluation by the Shaanxi Normal University team and listened to feedback on the project from many domestic and overseas philanthropic colleagues. The following is our overall review of the project——

Pluses

• 【Innovative Intervention Method】The combination of music aesthetic education and intangible cultural heritage has produced a good chemical reaction. The children exhibited high enthusiasm for music courses. The evaluation report shows that music teaching can significantly improve the mental health of participants and has long-term practical value.
• 【Cultural Confidence】Music teaching that incorporates intangible cultural heritage elements is more likely to be accepted by children. By learning the cultural background and playing skills of their own indigenous musical instruments, the children were able to deepen their understanding of their ethnic culture and improve their self-confidence and pride.
• 【Positive Feedback on Summer Camp】Through a diversified curriculum and the support volunteers, the summer camp brought a wealth of holiday activities to the children. It cultivated team awareness and enhanced the relationships among the children.

Minuses

• 【Poor Fundraising Results】The public fundraising activities of Wubaili Music Festival did not achieve breakeven. It reflected the program team's lack of experience in fundraising planning. Considering that LY Foundation's work focus is not on content production and dissemination, we will consider leaving the local execution team to handle fundraising in the future.
• 【Limited Outcome from Individual Case Service】For families in extreme poverty, case services such as social workers' home visits and the issuance of small grants are difficult to improve the structural problems of income.
• 【Low Scalability】Evaluation shows that current program outcomes are highly dependent on the quality of the music curriculum and the overall literacy of intangible cultural heritage bearers. If the music class is converted into a regular classroom teaching model, it is difficult to guarantee that the overall intervention effect of the project will hold up to the same level, and it needs to be gradually verified through relevant pilot work.

Next steps

2023 is the debut of the Accompany with Music program. As the first project initiated by LY Foundation, the results of the project are inseparable from local charity partners such as Lianxin and Xixin, and other social organizations such as Enpai.

After discussions by the board of directors at the end of 2023, we decided to continue funding the Accompany with Music Program project team from 2024 onward. We will make the following in the progam design and execution:

• The overall funding will be converted to non-restricted funding to provide local teams with space for independent exploration and innovation and trial and error.
• The team will most actively communicate with the school to provide small orchestras and choirs with more opportunities to rehearse and enrich extracurricular activities with themes related to aesthetic education.
• The team will network more broadly with social organizations that work on rural education and the mental health of left-behind children, and gather more resources for primary and secondary schools in Nanjian County.
• The team will track the long-term effectiveness of the project, complete the project post-test and intervention effectiveness evaluation in 2025, and explore large-scale implementation paths.

Thank you again for your support of LY Foundation, thank you for your time to learn about our Yunnan project.

October 10, 2023, marks the 32nd World Mental Health Day. We call for attention to the mental well-being of children and adolescents, promoting their health and welfare, and fostering social harmony and stability. Every matter concerning children is significant. The main text reads as follows.

致健康｜孩子的事，每一件都是大事

少年儿童是国家的未来、民族的希望。少年儿童的健康成长，事关全民健康、社会稳定和家庭幸福。心理健康是健康的重要组成部分。2023年10月10日世界精神卫生日全国宣传主题为“促进儿童心理健康，共同守护美好未来”，旨在呼吁全社会共同关注少年儿童心理健康，增进少年儿童健康福祉，促进社会和谐稳定。

PART.01

心理健康素养十条

心理健康的人不是没有过多痛苦和烦恼，而是他们能及时从痛苦和烦恼中解脱出来，积极地寻求改变不良现状的方法，他们能明白人生冲突是严峻和难于回避的，在深刻认识之后依旧能热爱生活。

心理健康是一个动态平衡的状态，考试焦虑≠焦虑症、抑郁情绪≠抑郁症等，是心理处于动态失衡的健康状况。出现动态失衡时，会根据严重程度区分为不同等级的心理问题，与“疾病”严格区分，经过调节后能恢复平衡，属于正常情况，心理问题≠心理疾病。

第一条：心理健康是健康的重要组成部分，身心健康密切关联、相互影响。

第二条：适量运动有益于情绪健康，可预防、缓解焦虑抑郁。

第三条：出现心理问题积极求助，是负责任、有智慧的表现。

第四条：睡不好，别忽视，可能是心身健康问题。

第五条：抑郁焦虑可有效防治，需及早评估，积极治疗。

第六条：服用精神类药物需遵医嘱，不滥用，不自行减停。

第七条：儿童心理发展有规律，要多了解，多尊重，科学引导。

第八条：预防老年痴呆，要多运动，多用脑，多接触社会。

第九条：要理解和关怀精神心理疾病患者，不歧视，不排斥。

第十条：用科学的方法缓解压力，不逃避，不消极。

PART.02
青少年常见心理问题

常见心理问题

儿童与青少年常见的心理问题：厌学、考试焦虑、学习疲惫、烦恼、抑郁情绪、逆反心理、网络成瘾等。

1.狭隘：斤斤计较，心胸太狭窄，不能容人也不理解别人，对小事也耿耿于怀，爱钻牛角尖。

2.嫉妒：当别人比自己好时，表现出不自然、不舒服甚至怀有敌意，更有甚者竟用打击、中伤手段来发泄内心的嫉妒。

3.敏感：即神经过敏，多疑，常常把别人无意中的话、不相干的动作当作对自己的轻视或嘲笑，为此而喜怒无常，情绪变化很大。

4.失落：中小学生抱有许多的幻想，希望将其变为现实，他们会付出种种努力甚至刻意追求，当这种需求持续得不到满足或部分满足，就产生了失败感。

5.自卑：对自己缺乏信心，以为在各方面都不如别人，无论是学习上，还是在生活中，总把自己看得比别人低一等，这种自卑严重影响了自己的情绪。

6.叛逆：中小学生正处于成长过渡期，独立意识和自我意识日益增强，迫切希望摆脱大人的监护。同时，为了表现自己的与众不同，对任何事情持批判的态度。

分析原因

PART.03
心理健康教育策略

1、深呼吸有助于情绪平稳

当处于压力状态时，要放慢呼吸，同时尽量往后卷舌，建议情绪波动时，深呼吸并耐住性子等6秒钟，等情绪平稳，能够冷静思考时，再去做决定。

2、积极心理暗示让自己快乐

同样经历焦虑和抑郁，能主动发现积极一面的学生，比只会哭着发泄的人能更快走出来，每天早上出门前，不妨对着镜子笑一笑，告诉自己今天很快乐。

3、光亮环境对抗不良情绪

研究发现，季节性情绪失调主要由于光照不足引起。因此，让自己身处光亮的环境中，能有效对抗不良情绪的干扰。

4、听音乐缓解负面情绪

听音乐可以促进心理健康，让人放松、同时还可以通过释放个体被压抑的情绪，来达到有效维护心理健康的目的。

5、运动促进多巴胺分泌

运动能帮助身体分泌快乐多巴胺，是缓解坏情绪最有效的方法之一。跑步、骑车、游泳等有氧运动是最佳选择。建议坚持每周锻炼5次，每次20分钟。

来源：基本公共卫生服务项目宣传平台【2023年卫生健康宣传日】世界精神卫生日——促进儿童心理健康，共同守护美好未来

编辑：白｜审核：Victor

September 21, 2023 marked the 30th World Alzheimer's Day. We would like to recommend a remarkable speech on the topic of dementia by Ms. Hong Li, co-founder of the Chinese Dementia Friends Charity Initiative. The main text reads as follows.

致健康｜就算得了认知症，也能好好生活

洪立，中国认知症好朋友公益行动联合发起人。

病知口木，有苦难言，这就是他们真实的体验。所以他们更需要得到理解、支持，还有帮助。

就算得了认知症，也能好好生活

2023.08.19 上海

大家好，我叫洪立，是15年来天天琢磨认知症的一名非医疗专业工作者。

哪怕你没有听说过“认知症”这个词，也肯定听说过“痴呆”或者“老年痴呆”。随着人口老龄化，“痴呆”这个词对很多人、很多家庭都已经不再陌生。

在全球，目前至少有5500万人得了痴呆。

在中国，这个人数已经超过了1500万。

几千万个家庭成员正在陪伴着他们的亲人，走在属于他们的特殊旅程之上。

这是我小时候的一张照片。

我是被外公、外婆带大的，他们给了我很多的爱和很好的教育，让我至今充满感激。

上个世纪90年代的时候，我的外婆出现了明显的记忆衰退的迹象。十年之后，她被确诊为痴呆。2007年，外婆因为痴呆过世了，所以我是一名痴呆老人的孩子。

外婆去世以后，我开始专攻认知症照护。我就想把这件事情搞明白。之后15年的时间里，我一直在不间断地给中国的认知症（痴呆）家庭，给照料者们提供疾病的信息和照护的知识。

今天我也想把我知道的告诉给大家。

“痴呆”这个词其实已经叫了很多年，目前它依然是医学的标准术语，全称叫做“痴呆综合征”，坊间的俗称是“老年痴呆症”。

但这个词乍一看，的确容易让人联想起呆滞、愚蠢、笨拙这样一些负面印象。因此很多病人和他们的家人从理智到感情都不愿意接受它。这个词也阻碍了很多人及时地寻求医疗诊断。

所以从2000年开始，全球使用汉字的很多国家和地区纷纷开始了对痴呆的更名。

作为一家患者组织（中国认知症好朋友公益行动），我们是在2015年正式启用了“认知症”这个词。此后我们所有的公共健康传播或者专业的培训项目都使用“认知症”一词。

为什么用这个词？因为它能够客观地反映出痴呆的基本症状，也就是认知功能衰退，又没有负性的意义，很简单也很好记。所以这个词我们一直用到了现在。

在工作中经常有人问我，“洪老师，我觉得我最近记性不太好，我是不是得了认知症？”我们现在一起来看一看到底什么是认知症。

认知症指的是一种或者多种认知功能衰退、进而影响到日常生活和工作的症状。可能是记忆减退、学习能力下降，可能是语言的理解和表达出现了困难，也有可能是判断思考、解决问题的能力下降。

当这些现象影响到了一个人的日常生活，认知症就算光临了。

回到刚才那个问题：记性不好是不是就是得了认知症？不一定——要看这种记忆减退是不是已经影响到了生活。这是一个警示。它告诉我们，我们的脑功能可能出了一些问题。

最好的做法就是及时寻求医疗诊断，看一看到底是什么原因导致了记忆衰退。

在很多人的印象里，得认知症的都是老年人。的确，认知症的发作与年龄的增长是高度相关的。

在65岁以上的人群当中，每隔5年发病率就要翻将近一倍。85岁以上有认知症的比例超过30%。

正是因为它和增龄高度相关，所以有人会认为，认知症就是衰老的自然结果，年纪大了记性不好、思考有问题、变糊涂，可能是正常的。其实真的不是这样。

大家想一想，如果认知症是衰老的自然结果的话，那岂不是我们每个人老了以后都会得认知症？事实当然不是这样。

这是股神巴菲特在搞怪，真的太皮了。

他已经90多岁了，依然在一边工作一边享受生活。其实在我们身边，有很多长者即便到了高龄也依然心智敏锐。

所以认知症并不是衰老的自然结果。要是这么想的话，很多老年人就错过了及时寻求医疗诊断、治疗和干预的最佳时机。

同时我们也要知道，认知症并不仅影响老年人。在座各位有没有读过科幻作家韩松老师的作品？韩松老师是在57岁的时候被确诊为认知症。

今年年初，北京宣武医院诊断出了一名全球最年轻的阿尔茨海默病型的认知症患者（仅19岁）。当然，19岁就得认知症是极为罕见的，所以在座的年轻人不必担忧。

但是像韩松老师这样50多岁得认知症的，真的不在少数。医学研究告诉我们，至少有5%的人在65岁以前就发病了。也就是在进入老年期之前，他们的认知症就发作了。所以认知症真的不是老年人的专属。

认知症的成因非常非常复杂：有遗传风险因素；有生活方式因素，比如抽烟、酗酒、久坐不动、吃垃圾食品，长期处于慢性压力之下，包括贫穷。

你们为什么笑了？是因为贫穷吗？贫穷真的会带来长时间的慢性压力，会对脑造成持久性的损伤。

还有环境因素，比如空气污染、食品安全问题等等。这么多的风险因素累加在一起，让我们的大脑不堪重负，认知症就是脑损伤的一个结果。

医学研究告诉我们，有100多种疾病或者医学原因会导致一个人出现脑损伤，进而发展成认知症。

大家肯定都听说过阿尔茨海默病吧？实际上，60%以上的认知症人士都是阿尔茨海默病。其他常见的认知症类型有：血管性认知症、路易体认知症、额颞叶认知症。

有一些医学原因导致的认知损伤，是有可能通过及时的干预而扭转的，比如营养素缺乏、酗酒导致的酒精型脑损伤，以及药物的副作用。因此，及时诊断真的非常重要。

我想特别提醒的是，老年人服用的很多药物是有可能导致永久性的认知损伤的。而在老年人群当中，多重用药的情况非常常见。

什么叫多重用药呢？老人常规用药，也就是平时吃的药至少有5种，就叫多重用药。如果吃的药超过10种，就叫超多重用药。

所以如果我们身边的长辈、亲人要去看医生，你一定要提醒他们带上目前服用的所有药物的完整清单。

12年前，我在写《聪明的照护者》这本书的时候，曾经这么写道：“痴呆就像是一个狡猾的敌人，悄悄潜伏进我们的大脑。”

早期的迹象并不容易察觉，但是如果我们能够捕捉到那些蛛丝马迹的话，我们就可以抓住及时诊断、治疗还有干预的最佳时机；会帮助我们在认知功能还没变得那么糟糕的情况下，及时地为未来做好准备。

全球很多主要的认知症协会都在推广认知症的“十大早期迹象”，我们一起来看一看。

记忆减退是最常见的迹象，几乎50%以上的认知症人士最早出现的就是记忆减退的问题。

我们在生活中可以发现的一个迹象是什么呢？就是这个人会在很短的时间内不断地重复说一句话，或者重复问一个问题。这就说明他的短时记忆受损了。

第二个早期迹象是做不好熟悉的事情。我的外婆就是一个例子。

我记得小时候，过年期间，她能一个人做出我们全家几天几夜都吃不完的菜。但是得了认知症以后，她连做一道简单的炒青菜都会放好多次盐。以前非常熟悉的生活任务，她后来做不了了。

另一个早期迹象是在说话或者写作的时候出现找词困难。我说的“找词困难”，并不是说找不到特别冷僻的专用名词，而是指找不到生活中常用的那些词。

比如，他实在想不起来“冰箱”这个词怎么说，他就会说“那个放吃的东西的地方”，或者干脆就说“这个这个”、“那个那个”，用这样的方式去代替。

如果我们身边的人，不管是长辈还是朋友，跟我们表达他们在记忆或者思考方面的一些担忧，我们千万不要说“没事的，老了都这样”，或者“你那么聪明的一个人，怎么可能得痴呆呢”。他们的担心需要得到聆听和重视。

大家已经知道了，认知症并不仅仅影响记忆，这是为什么呢？我们现在看两张脑图——

▲ 来源：美国Amen Clinics

左侧是一个健康的大脑，看上去就很漂亮、很饱满、很有力量。右侧的图是阿尔茨海默病的大脑，属于一名59岁的女性。

大家可以看到认知症造成的那种支离破碎的残缺感，它破坏了我们不同的脑区，造成了不同的功能损伤。

大家看到，地面上是一块黑色的地垫。但是在一些认知症人士的眼里，它看上去就像一个黑洞。

其实认知症人士的眼睛是正常的，但是他们的视觉皮层，也就是解读视觉信息的脑区受到了损害，所以他们看到的东西和我们看到的已经不一样了。

有些认知症人士会出现嗅觉受损的情况，有些干脆失去了嗅觉，也有些会闻到实际上并不存在、但是特别强烈的味道，比如轮胎烧焦的气味。

还有一些认知症人士的精细运动能力会受损。比如灵活操控我们的手指、脚趾，就属于精细运动的范畴。大家想一想，如果不能很好地使用手指，那我可能连拿筷子、用勺子都会有困难。

如果不能灵活使用脚趾，大家想象一下，你们只能用脚掌走路会是什么感觉？无论是转弯、前行、停止，都会变得特别不灵便，你的步态就会改变。

还有一些认知症人士到了晚期以后，会出现大范围的肌肉运动失调，表现在吞咽出现困难，或者长期卧床不起。

▲ 来源：纪录片We Are Family

认知症也会导致一个人的情绪和行为发生改变。有的人可能会不断地焦虑，有的人可能会一直处在“不是战斗就是逃跑”的状态，也就是说他们对周围的环境变化太过警觉，因而处于一种恐惧反应当中。

还有一些人的同理心会丢失，更加以自我为中心，有时候说的话会不太好听，甚至会做出一些匪夷所思的事情。

我的一位医生朋友认识一对50多岁的夫妇。有一段时间，那位丈夫出现了他们婚姻生活当中从来没有过的情况，就是频繁地接触婚外女性，有一些言语或者行动上的性暗示。

那些女性就会觉得很不舒服，他的太太也很痛苦，那段时间她都准备要离婚了。但是这对夫妻在这个时候做了一个非常明智的决定，就是寻求医疗帮助。

我的这位医生朋友就为丈夫做了一个全面的检查。最后的诊断结果是他得了额颞叶认知症。这位丈夫的前额叶已经严重萎缩了——

▲ 大脑的前额叶严重萎缩。来源：shutterstock

前额叶是整个大脑的司令部，它控制我们的行为和本能。所以是疾病导致这位丈夫出现了没有办法控制性冲动的症状，这在医学上叫做与性相关的“脱抑制”。

刚才我们谈的都是认知症对认知功能的影响，现在大家看到的是认知症可能引起的各种各样的健康问题——跌倒、骨折、口腔疾病、睡眠障碍、营养不良、体重减轻、牙床感染、尿路感染、便秘，等等等等。

认知症的的确确会给一个人带来更高的健康风险。雪上加霜的是，在经历这些病痛的时候，他们又没有办法很清楚地用语言表述出来。这本身就是一个巨大的痛苦。

很多时候，很多人不知道认知症会给一个人带来这么大的影响，总觉得这些人反正什么都记不住了，可能也什么都不在乎，也就没有痛苦了。事实真的不是这样。

我们看“痴呆”这两个字，就会感叹汉字真的好有智慧。我们把这两个字拆解开，是不是“病、知、口、木”？

病知口木，有苦难言，这就是他们真实的体验。所以他们更需要得到理解、支持，还有帮助。

我们刚才讲了，认知症会带来很多的功能缺损，但是认知症不会夺走一个人所有的功能。

如果我们在生活中仔细观察，还是可以发现，认知症人士的很多功能都是悄悄藏在那里的。比如做事情的技能（程序性记忆），几十年的生活经验给他们带来的直觉和敏感，以及体验情感和爱的能力。

这位是成都的周妈妈。她在10年前（2013年）被确诊为中度的认知症。

确诊以后，他们家人做了什么事情呢？——鼓励她积极地参与家庭生活。无论是帮厨、洗碗，还是剥辣椒，她在参与这些活动的时候就会变得特别开心。

▲ 左右滑动查看周妈妈参与家庭生活。

去年年底，周妈妈成功战胜了新冠病毒。这是她前几天的照片。

在确诊认知症10年后的今天，她依然保持着非常好的生活自理能力和快乐的心境，已经成为了养老社区的一个“老宝贝”。

接下来我想给大家播放一段视频，是2014年母亲节的前一天发生在美国的一个真实故事

当爱已成本能，痴呆也无法夺走。那两位警察的行动就告诉我们，对于认知症人士来说，理解真的是最最宝贵的礼物。

如果我们家里面出现了一位有认知症的亲人，我们作为照护伙伴能够做什么呢？

首先，我们得建立全新的沟通模式。因为过去我们人际交流的时候都是以言语为主，但是认知症人士的言语功能会受到影响。

但是他们还有一个技能保留得特别好，就是他们会对周围人的非语言表达表现得非常敏感，比如面部表情、音调、语气、身体姿势，他们会对这些线索保持高度的敏感。

在这种情况下，我们就必须改变沟通方式——从原来的以词语表达为主，转化成注重非语言的表达。

也就是说，你就是认知症亲人的一面镜子。如果你表现得有点焦虑、担心，他们也会变得焦虑、担心；如果你是从容、自在、喜悦的，他们也会变得从容、自在、喜悦。

平时在日常生活中，我们可以采取“沟通5S法”来跟他们交流。“5S法”是什么呢？

第一就是Smile，微笑，是全世界人民都懂的表情。

第二是Slow，放慢你的速度，包括你的语速、你在他们面前做动作的速度，让他们已经受损的大脑有充足的时间去处理信息。

第三是Simple，简单，你说的话要简单，一句话只说一个意思。

第四是Specific，具体，因为他们的抽象思维能力也会受损。

第五是Show，演示、示范给他们看，有时候还可以使用一些视觉辅助工具，比如图片卡来帮助亲人理解。

我还想分享沟通中不要做的事情。不要做的事情有很多，由于时间关系我先说两件事。第一是，不要挑战他们已经缺损的记忆。

我发现，有些人喜欢去问有认知缺损的人：你还记得我是谁吗？我叫什么名字？

我强烈建议不要这样做！我们在和认知功能正常的人交往的时候，也不会这样问，因为这样很不礼貌。你已经知道人家有记忆缺损了还这么问，多扎心。

第二不要做的是baby talk（婴语），不要像对小孩子一样对认知症人士讲话。

每一位认知症人士都有着几十年丰富的人生经验。所以有时候我觉得这种baby talk，哪怕是无心之举，哪怕是出于善意，对成年人的人格也是一种贬损。

此外，我们要支持认知症人士生活的独立性。

所谓支持独立性，并不是让他一个人独自生活，也不是让他自己去处理生活中遇到的各种各样的琐事，而是我们要创造一些机会，让认知症亲人能够发挥自己的现有功能，去做那些力所能及的事情。

我们以吃饭为例，比如他已经用不好勺子或者筷子了，一般的做法就是直接喂饭。我们可以想一想，还有没有其他的做法呢？比如我们是不是可以尝试做一点手指食物，这样他能直接抓来吃。

如果他必须要使用筷子和勺子，那怎么办呢？因为就算他手指的精细运动能力受损了，他整个手还是可以抓握，手臂也可以移动。

在这种情况下，我就可以握住他的手，然后让他的手抓住我的手。我用我的手指替代他的手指，来拿筷子或者是勺子，实际是由他引导着我，一口一口地吃东西。
支持独立性不是替代他去做事情，而是一起做事情。伟大的儿童教育家玛利亚·蒙台梭利博士曾经说过：“你替我做的每一件事，就是夺去我做这件事的能力。请帮助我，让我自己做。”跟所有的照护伙伴共勉。

另外还要尊重意愿和选择。你乍一看可能会说，尊重有什么难的？不是大家都在做吗？但是在真实世界当中，其他人替认知症人士拿主意的情况比比皆是。

他知道他的诊断结果吗？他知道他吃的都是什么药吗？如果入住养老机构，他有没有机会参与制定自己的照护计划？在养老机构生活，他有没有权利根据自己的作息习惯选择睡觉和起床的时间？

答案往往都是否定的。

所以作为照护伙伴，我们得在生活中有意识地去创造一些机会，给他们提供选择。比如要吃早饭了，我们可以先问一问，今天早晨你想吃馄饨，还是想喝豆浆？

比如洗澡的时候可以问一问，你想先洗前面，还是先洗后面？比如我们要邀请妈妈一起做事情，就可以问，妈妈今天是想帮我浇花，还是帮我一起晾衣服？

提供选择——细小的关心能够让认知症亲人觉得“我的生活我做主”。这样会带来很好的感觉。

还有的时候我们会遇到一些复杂的情况，比如他们不愿意做什么事情，怎么办？例如不肯吃药。会有一些家庭照料者或者机构的护理人员，干脆把药碾碎了、混在饭菜里给老人吃。我强烈建议不要这样做，除非万不得已。

一位家属朋友的真实案例：家人把药碾碎了以后放到妈妈的饭菜里，结果妈妈连饭菜都不吃了，她说，“你们给我下毒了”。某种意义上说，这就是真相——认知症老人可怕的直觉！

所以当认知症人士不肯吃药的时候，我们至少要问一问他为什么不吃药。也许他会告诉你药太多了；也许有些药物带来了很强烈的副作用，他真的不舒服；还可能是他有吞咽方面的问题，让他吃这些药他觉得很辛苦，等等

每当碰到认知症人士拒绝吃药的情况，我们不能硬塞给他吃，而是要赶紧去咨询医生和药师，看一看他目前吃的所有的药物可不可以精简处方。

我们要让认知症亲人过上一种有尊严的生活，就得尊重他们的意愿和选择。

美国有一位认知症照护专家叫朱迪·康尼什（Judy Cornish），她说：“尊严在于自主，在于能够做出决定，按照自己的意愿塑造自己的生活。认知症人士并不会迷失自我。只有当我们剥夺他们的尊严、不承认他们仍然拥有的技能和偏好时，他们才会失去自我。”

我们每一天的生活都是丰富多彩的。我们同样也要为认知症亲人去安排有意义的活动。我们可以基于他们的兴趣爱好和特长，给他们开发一些他们喜欢的活动，让他们觉得每一天都过得有意思。

活动可以是无所不在、包罗万象的，可以是日常生活的活动，可以是感官类的活动，可以是认知方面的活动，也可以是文化和社交方面的活动。

我们刚才看到的周妈妈很喜欢做家务，家务劳动就属于日常生活活动。也有一些认知症长者，他们喜欢听音乐、拼图、香薰这类感官活动。

说到认知活动，一定不要局限在背诗词或者做算术、做数独，因为这种活动仅仅能够激活我们大脑的部分区域。可是音乐就不一样，音乐除了是听觉的感官活动以外，也是一项超棒的认知活动。

因为人们在从事音乐活动的时候，会点亮好多脑区，比如负责记忆的脑区得记歌词、负责旋律和节奏的脑区、负责运动的脑区、计划的脑区，还有情绪表达的脑区。

大家可以想象一下，认知症亲人在参与音乐活动的时候整个脑区都被点亮的壮观景象。

我在走访一些家庭或者养老机构的时候还会发现，照料者会买来小孩子用的填色本和彩铅，让认知症长者去做涂色游戏，就好像完成功课一样。

每每看到这样的景象，我心里都在暗暗地问：我们是不是低估了认知症人士作为成年人的能力？我们有没有因为自身的认知局限，阻碍了他们去发挥创造性？

大家看到的这些画作，是上海社区记忆咖啡馆的长者的作品。

▲ 上海社区记忆咖啡馆长者的作品

他们从来没有用过丙烯或油画的颜料，但他们在志愿者的陪伴下勇敢地拿起笔涂鸦。

他们的手绘作品后来被印在环保袋和杯子上面，并参与了公益的售卖。我想这样有创造力的绘画活动，是真正能够为认知症长者的生命带去光彩的。

很多认知症人士必须居家生活很长一段时间。如果我们家里有这样一位长者的话，我们就要考虑适当地调整居家环境，让它更加认知症友好化。

首先是增加照明。通常来说，认知症人士需要2到3倍于普通光照度的照明。如果我们在家居改造的时候只能做一件事情的话，那就是增加照明，让你的亲人能够看清楚。

其次，要排除掉家里那些容易导致跌倒的风险因素。

认知症人士的视野可能会发生改变，他们的视野宽度可能只是我们的一部分。他们有很多视觉盲区，所以我们得把盲区中那些容易绊倒他们的东西移走，比如小块的地毯、很乱的电线、特别低矮的小茶几、小柜子。

另外家里的地面一定要防滑，而且是防止眩光的。认知症人士如果已经出现了步态的变化，也就是说如果他的平衡能力或走路能力已经有缺损，就不要让他在家里面继续穿拖鞋了，可以换成“一脚蹬”。穿拖鞋会增加跌倒的风险。

最后很重要的一点就是要加强色彩对比。人是需要通过色彩的对比来区分边界的。认知症人士也一样。他们更加需要明确的色彩对比，来辨别物品到底在哪里。

举例来说，通常卫生间和厨房的墙面和地面都是一样的颜色。在他们眼里可能就是一个平面，区分不出边界，他们就有可能撞上去。

白色的开关放在白色的墙面上就看不见了，可以加一个彩色的边框。

马桶放在白色的地砖上面后，都是白色，就看不清了。可以换一个彩色的坐便圈，这样认知症亲人就可以很准确地坐到上面去。

最后但也是最重要的是，作为一名家庭照料者，你要照顾好认知症亲人，请先照顾好你自己。

2012年我出版了那本《聪明的照护者》以后，接下来的十几年，我一直在跟认知症家庭一起工作。他们为了照护亲人，真的放弃了好多自己的生活，身心健康也顾不上了。

每每看到这样的情况，我都觉得特别心痛。你想一想，如果你的身心健康出了问题，你的认知症亲人该怎么办呢？所以我会鼓励他们积极寻找来自家庭、社区乃至社会的支持资源，没有道理一个人去扛这件事情。

每天都要告诉自己，我已经尽力做到了最好，我无愧于我的家庭照护者的责任。这样才能坦坦荡荡地过好每一天。

我自己的认知症之旅到今天走了15年。和15年前几乎无人问津的状态相比，现在无论是政府还是医学界，乃至社区，都在大规模地倡导早诊断、早治疗（后文简称“早诊早治”）。

但是作为患者组织，我们不是说早诊早治不重要，它很重要，它的好处毋庸置疑。但是我们更关注的是诊断后支持。

因为现在社会上存在着很多对痴呆的偏见，而且我们的社会照护资源也不足。雪上加霜的是，认知症的治愈希望是很渺茫的。

所以当一个家庭接到改变生活历程的这样一个诊断的时候，难免会有焦虑、抑郁、痛苦、无助，甚至绝望的情绪。

去年，国际阿尔茨海默病协会（ADI）的执行总裁宝拉·芭芭里诺（Paola Barbarino）说：“如果没有诊断后支持，我们就不应该鼓励人们前去诊断。”

所以从两年前开始，我和我的工作伙伴燕青老师觉得，应该写一本书，专门支持刚刚获得诊断的认知症家庭，让他们知道整个病程会往哪个方向发展、每个阶段可能会遇到什么样的困难。

我们希望每一个认知症家庭都能看到这本书，医生来不及告诉大家的事情就让我们告诉大家，帮助大家更好地走在认知症之旅中。
我工作中经常会被问到的一个问题是：洪老师，你认为认知症照护最重要的是什么？我的回答往往是，你要看到认知症背后的那个人，看到那个独特个体的存在。

我们要共情他们得了认知症以后的体验和感受，鼓励他们积极地参与生活、享受生活的乐趣，继续他们有意义的生命。
因为毕竟，生活远比认知症更重要，有认知症的那个人也远比认知症更重要。
谢谢大家。

策划丨张畅剪辑丨star设计丨49 挠挠

来源：微信「一席」我觉得我最近记性不太好，我是不是得了“老年痴呆”？| 洪立 一席第1013位讲者

编辑：白｜审核：Victor

A week later, reflecting on the "Dream Building Summer Camp" project at Songlin Elementary School, the volunteer team played a crucial role. Over the course of 13 days, volunteers lived and ate together with the children, engaging in activities such as poetry, painting, and using music to dispel worries. The children at the camp greatly benefited from the companionship of the volunteer brothers and sisters, and the successful conclusion of the camp wouldn't have been possible without the kind and lovely volunteers.

In this issue, we delve into the perspective of volunteers during the growth camp, sharing carefully crafted poetry and artwork by the children under the guidance of volunteer teachers. At the same time, we look forward to listening together with readers to the voices of volunteer partners about their aspirations for the "distance."

Collect “Poetry”

Why Did the Camp Include Poetry Classes?

Children are the closest to poetry. For children, writing poetry isn't a mysterious endeavor; it's a playful interaction with language. — Shu Cai, “Writing Poetry is Really Fun”

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收藏一幅「画」

Collect “Artwork”

Why Did the Camp Include Art Classes?

Every time I see a child scribbling and drawing on the streets, on asphalt roads, or on walls, I stop in my tracks... What they put on paper often surprises us... It can teach me something every time... — Pablo Picasso

每次见到小孩子在街上、在沥青路面或在墙上乱涂乱画，我都会停住脚步…… 他们笔下的东西往往令人感到意外…… 总可以让我学到一些东西……—— 毕加索

Collect “Dreams”

Their poetry and art are the dream in the distance.

I yearn for poetry and distant places, so I came to Songlin Elementary School as a volunteer teacher, carrying poetry and dreams. Two weeks of being together made me realize that poetry and distant places can be very concrete. The children's poetry and artwork, their joy and laughter, and the gradually opening doors of their hearts... these are the ideals and distant places I've been seeking. Not saying goodbye, looking forward to the next reunion! — Songlin Elementary School Volunteer Team

Voices of Volunteers

"The greatest part was being fulfilled and having fun. Under the guidance, encouragement, and support of Lianxin, the project took shape and was successfully implemented. With careful support from the school and local connections, issues related to safety, accommodation for child volunteers, and other daily life matters were addressed one by one. Under the support of the music companionship program by LY Foundation, children and volunteers opened up their hearts through music. This facilitated the integration of volunteers and children and provided companionship for disadvantaged children.

"Volunteers optimized course design and teaching methods, offering guidance for the children's growth. They observed and provided feedback on each child's situation during the process of accompanying them. After each day's activities, they reviewed and jointly found solutions to any issues, ensuring the smooth implementation of the project. Throughout the project, sparks were created through the interaction between volunteers, children, local social workers, and volunteer groups. Everyone, to varying degrees, experienced personal growth during this period. For me, this will be an extremely important and bright memory. It strengthened my commitment to public welfare, provided personal growth, and they cherish the encounter. How fortunate it is to meet a group of shining individuals, moving forward together, working hard for a common cause – it's cool!"

Voices of Social Workers

"It was exhausting sometime, but when I saw the children, volunteers, and other partners involved in the camp all having fun and showing smiles, I felt that it was all worthwhile. I look forward to having more opportunities like this to organize everyone to participate in public welfare activities, to jointly focus on the psychological well-being of children in need and the development of underdeveloped areas."

Author: Yufan | Review: Victor

From July 30th to August 11th, the LY Foundation, in collaboration with the Yunnan Heart to Heart Community Foundation and the Nanjian Xixin Social Work Service Center, organized a 13-day “Summer Dream Growth Camp” at Songlin Primary School in Bixi, Nanjian, Yunnan. The camp aimed to focus on the real-life difficulties faced by minority orphans and left-behind children through thematic teaching on “minority culture education and music education”. It brought together the strength of volunteers and provided care and companionship to orphans and left-behind children in order to bridge the gaps in their safety, education, and psychological well-being.

The camp focused on two main areas: home visits and teaching.

During August 9th to August 11th, an inspection team led by the Chairman of the LY Foundation visited five local families of assisted children, distributing relief funds and essential living supplies. Immersing themselves in the living environments of the assisted children, the team strived to understand the difficulties and needs of their families in order to develop long-term assistance plans.

Teaching was conducted in classrooms as part of the “Summer Dream Growth Camp” at Songlin Primary School. From July 30th to August 11th, a team of 14 volunteers served as teachers and provided 115 students with 10 different courses, including physical education, sexual education, mental health, adapting to school life, building peer relationships, self-awareness, safety education, protection and inheritance of minority cultures, appreciation of minority music, and poetry writing. Children engaged in crafts and games with volunteers, reflecting on themselves and their surroundings through joyful learning.

During this activity, the LY Foundation donated a total of 23,114 CNY. Of this amount, 2,400 CNY was used to provide cash red envelopes and living supplies to five families of children in difficulty. The remaining 20,714 CNY was entrusted to the Yunnan Heart to Heart Community Foundation to support the preparation of the “Summer Dream Growth Camp”. Specific expenses included volunteer recruitment, training, food, accommodation, and project coordination.

“Let's go to the front line. The Accompany with Music is all about companionship, and we need to take action to bring real and effective support to the children. Everything is for the sake of putting smiles on their faces!”

Author: Yufan | Review: Victor

Art Education (“美育”) is a crucial pillar of rural cultural revitalization. There is significant room for improvement in resource allocation and teaching staff for rural art education. To advance rural art education further, it is necessary to continue exploring and making efforts in areas such as art education philosophies, immersive experiences, digitization and other aspects. The main text reads as follows.

乡村振兴｜“凡是学校所有课程，都没有与美育无关的”

编者荐语：文化振兴是乡村振兴的重要基石、乡村发展内生动力的重要源泉。美育从娃娃抓起，不仅是推动治理工作有序进行、振兴乡村美育的关键着力点，更是改善乡村儿童心理状况、护航国家未来栋梁树立健康成长观的最佳时期。乐知一心发起音乐陪伴计划，透过民族音乐陪伴乡村留守儿童、困境儿童，通过循序渐进传授美的理念，为文化振兴发力，为乡村振兴尽责。

下文是北京师范大学张璐教授对乡村儿童美育当前面临现实困境的解读，以及对此在思维拓展角度的建议举措分享。

我国实施乡村振兴战略，高度重视乡村文化治理工作。从乡村基础教育阶段启航开展乡村美育工作，不仅是实现乡村文化治理、促进乡村振兴的手段与方式，也是提升我国教育均衡的重要抓手。

乡村美育的当前困境

现实情况中，乡村美育工作推进难，尤其是在乡村基础教育方面，在资源配置、师资力量、课堂内外等方面还存在较大的提升空间。特别是在乡村美育师资方面，主要集中在整体数量不足（乡村学校的美育教师人数占全部专任教师总人数比例低）、教龄断层（集中在50岁以上的教师与30岁以下的教师较多）、师生比不合理等方面，而且老教师难以迈出传统教学模式，致使美育课堂大打折扣。

具体表现为，担任美育课程的教师主要是以音乐、美术、舞蹈等现有师资为主，甚至在很多乡村，语文、数学教师担任了音乐、美术、舞蹈的课程，目前又兼顾了美育课程，许多教师缺乏必备的艺术能力，不能在课堂上进行示范教学，只能让孩子们听音频、看视频。同时，乡村美育教师科研能力较弱，没有时间和精力学习专业理论知识，接受新知识的渠道又比较少。随着时代的发展，教育技术与方法都发生了变化，我国基础教育的理念已经完成几代更迭，2022年新颁布的艺术课程课标对艺术教师提出了新的要求，但乡村教师较难与时俱进地更新自己的教学理念与手段。

根据我们的调查反馈，乡村一线教师对当前美育教学工作的意见和建议主要聚焦在美育的理解问题。在河北阜平县马兰小学的调研中，有教师这样说：“音乐课堂本身就有太多美的旋律与作品，但从美育角度融入原有的音乐教学，我们还在摸索中。”乡村教师已经显示出对于美育工作的认可度与重视度，但具体实施推进比较受阻，主要体现在乡村地区美育意识的不健全、各方进行美育工作的经验不足等问题上，相关统筹管理体系需要完善。

乡村美育思维需要拓展

在中央的教育精神和一线教师务实的实践之间还需要一个强有力的承上启下的力量，这个力量目前主要表现为高等院校或社会专业机构进行的各项美育行动计划。根据调研，乡村美育的深入推进还有赖于政府深入美育引领，加强美育师资补给，制定翔实培育计划。具体建议：

1）深化美育理念，精准定位开展美育计划

要想切实推进基础教育阶段的美育发展，首当其冲的就是全方位、高密度地展开美育倡导，使教师、学生认识、认知、认可美育，沉浸于乡村美育的氛围中。

据不完全统计，2015年《国务院办公厅关于全面加强和改进学校美育工作的意见》颁发以来，全国义务教育阶段美育师资总数增加近25万人，但从资源配置上看，美育师资队伍缺额仍然较大，尤其乡村美育教师匮乏，乡县政府不仅要继续注入美育师资投入，实行专人专任，还要加大对乡村美育教师的专业培训力度。也可以创造性地开展美育师生下乡、艺术家进校园等形式改善师资空缺、教师水平参差不齐的状况。

2020年7月教育部等六部门发布的《关于加强新时代乡村教师队伍建设的意见》要求，“各地要加强面向乡村学校的师范生委托培养院校建设”，提出了“定向”和“精准”培养本土化乡村教师的要求。一方面，高校美育师资、师范学生要主动对接基础教育，深入中小学，共同开展合作与研究，了解学校美育的现状和当今中小学美育教师的素养与需求。另一方面，优秀中小学美育教师应走进高校，定期为师范生开设具有一线课堂指导性的专题讲座、承担教师教育课程教学、共同开展教育实践、分析教学案例、专题研讨。

2）加强美育浸润式体验，促成美育大课堂

目前教师们的美育思维观念滞留于学校课堂本身，广大乡村提供的广大无际的美育资源没有得以有效利用。

不能单单依托艺术课老师，各学科老师都可以参与学生美育的引导；美育不能仅仅拘泥于课堂，更不应该局限于学点知识和音体美技能。而重在引导学生理解美与生活、生长的关联，打造具有地方本土化特色的乡村美育课堂，使美育浸润于生活、学校、田间地头……在油菜花盛开的季节里，鼓励学生置身于“山间”学习、课堂“观景”，打造“春日里的一缕美育色彩”，实现浸润式的体验与分享。这不仅能在一定程度上补全乡村美育教师资源缺口，还在无形中引导孩子们察觉“美”的无处不在，使乡村孩子们在本土资源中置身于美——“发现美”“体验美”，自信地“表现美”，进而逐渐养成“创造美”的意识与能力。

比如中国美术学院“乡村艺课”美育公益项目，集结了一批以中国美术学院师生、优秀毕业生为主体的美育志愿者。“乡村艺课”团队建立起线上线下美育双师制度，帮助乡村学校美育助教在参与教学实践的过程中提升审美素养、提高教学能力，使之由“完全输血”逐渐变成“辅助造血”。

3）跟上数字化进程，助力建设乡村美育资源平台

构建美育与文旅联动发展的机制成为乡村美育良性发展的路径，将美育有意识地融入自然资源，建设顺应新时代的数字美育共享村。“十四五”规划和2035年远景目标纲要对智慧教育提了要求：推动社会化高质量在线课程资源纳入公共教学体系，推动优质教育资源在线辐射农村和边远地区薄弱学校，发展场景式、体验式学习和智能化教育管理评价。

国家中小学智慧教育平台（设有课程教学、美育等模块）为广大农村地区免费送去优质美育资源，更好地服务于农村薄弱学校特别是乡镇寄宿制学校和乡村小规模学校开足开齐开好课程，跨区域优质资源的共享，目的就是弥补数字鸿沟，促进教育公平，提高美育质量。

“推进教育数字化”写进了党的二十大报告，加快推进教育数字化转型，是我国教育实现从基本均衡到优质均衡、从教育大国到教育强国的必然选择。对于广大乡村地区来说，要充分结合本土文化资源、艺术样式与形态（如本地民歌、器乐、舞蹈等民间音乐或具有地方代表性的仪式音乐），通过如抖音等短视频平台对我国乡村文化场景与艺术内容进行输入与传播。在音乐语言、生态场景中去理解我国优秀传统文化，不能仅依靠传统的田野调查方式，需要加快对我国丰富民族民间艺术的智能数字化步伐，聚合乡村多元民族民间艺术数据形态，并应用于美育课程的开发与美育实践资源的拓展，使乡村公共资源与美育均衡双向发力，助推数字美育资源一村一落。

习近平总书记强调：“从中华民族伟大复兴战略全局看，民族要复兴，乡村必振兴。”乡村美育振兴需要各级政府、村民、文化艺术民间组织以及各类企业等多方面力量的参与和助力，而乡村美育的振兴，也必将助力于乡村振兴。

作者：张璐 北京师范大学艺术与传媒学院副院长、副教授

原文：微信「人民政协报教育在线周刊」让乡村振兴与乡村美育互相赋能

编辑：白｜审核：Victor

On July 15, meeting the expectations of numerous elbow joint enthusiasts from both domestic and international locations, the 2023 Shanghai Elbow Joint Summer Forum was successfully held at the Shanghai Jiahui International Hospital. This forum was academically supported by the Shoulder and Elbow Working Group of the Shanghai Medical Doctor Association and the Fudan University-affiliated Huashan Hospital. It was co-organized by the LY Foundation. The Shanghai Jiahui International Hospital was the host.

Forum Overview

This forum focused on the trends and advances in radial head fractures and replacement. It invited experts from outstanding teams both domestically and internationally, creating an academic feast that emphasized both theory and technique, as well as sharing perspectives and discussions.

Since the start of the Shanghai Elbow Joint Forum, it has consistently adhered to its belief and original intention of conveying advanced concepts and techniques to every participant online and offline. It has made many efforts and contributions to promote the development of elbow joint technology in China. A long-term cooperative relationship has been established with Professor Shawn O'Driscoll and his team from the Mayo Clinic in the United States. Starting from November 2022, quarterly themed discussions have been established.

In the spring forum held in March this year, discussions were centered around distal humeral fractures. This forum focused on radial head fractures and replacement. Each year, the forum progresses in a cycle, widely disseminating the basic concepts and cutting-edge developments in elbow joint surgery globally, promoting the development of the discipline, and cultivating and promoting new forces.

Expert Speeches

The Chairman of the conference, President Xu Jianguang, delivered the opening speech. President Xu welcomed all the domestic and foreign guests and attendees at the various venues in both Chinese and English. He expressed a warm welcome to the holding of this forum and sincere congratulations. He also expressed keen expectations for the young scholars who came to participate. President Xu extended heartfelt thanks to the organizers of this forum, Shanghai Jiahui International Hospital, and the LY Foundation.

Academician Gu Yudong, Director of the Department of Hand Surgery at Fudan University-affiliated Huashan Hospital, delivered a sincere congratulatory message online.‌‌

Frontline Exchanges

Professor O'Driscoll generously shared his knowledge and gave a special lecture on radial head prosthesis design and application techniques. He presented various surgical videos and cases, capturing the high attention of all participants. Despite the late hour in the United States, Professor O'Driscoll maintained a high level of focus and patiently discussed and exchanged ideas with Chinese scholars across the ocean.

Similarly, Professor In-Ho Jeon from Korea Asan Medical Center summarized the high-risk factors leading to the failure of radial head prosthesis surgery and the experience of revision surgery around the theme of elbow joint replacement.

In addition to the sharing by foreign experts, the sharing and discussions by domestic experts were equally enthusiastic. This conference had a total of eight venues, namely Fudan University-affiliated Huashan Hospital in Shanghai, Ji Shui tan Hospital in Beijing, Tianjin Hospital in Tianjin, Xi'an Honghui Hospital in Xi'an, Wuxi Ninth People's Hospital in Jiangsu, Hebei Third Hospital of Hebei Medical University in Hebei, Zhengzhou Orthopedic Hospital in Henan, and Sichuan Orthopedic Hospital in Sichuan.

Professor Dong Jingming's team from Tianjin Orthopedic Hospital, Professor Rui Yongjun's team from the Ninth People's Hospital in Wuxi, Professor Lu Jiuzhou's team from Fudan University-affiliated Huashan Hospital, and Professor Gong Maoqi's team from Beijing Sixth People's Hospital shared their insights and techniques regarding radial head fractures and replacement. The academic atmosphere at the venues was strong, and the exchanges were enthusiastic.

In the closing remarks by President Xu Jianguang and Professor Jiang Xieyuan of Beijing Ji Shui Tan Hospital, this forum came to a successful conclusion. Through this grand elbow joint event, new and old friends in the elbow joint field gathered at the forum. They joined in the grand event and discussed development together. Advanced technologies and valuable experiences in the diagnosis and treatment of elbow joint diseases, both domestically and internationally, were once again fully exchanged. It is believed that this will help China's elbow joint field advance to a higher level and broader scope, making a greater contribution to the improvement of elbow joint disease diagnosis and treatment!

Editor: Yufan | Review: Victor

Manuscript: Shanghai Elbow Joint Forum | Images: Yi Hui Bao

When confronting depression, don't be afraid. Seek help both externally and internally through appropriate means, and believe that you will eventually overcome it and emerge from the darkness. The main text reads as follows.

致健康｜当面对抑郁时，请这样做

导读：7月5日，歌手李玟因抑郁症病去世的消息令人悲痛惋惜。面对抑郁，选择积极的面对而非只是将它看作坏心情，我们可以通过求助专业人士、写日记、记住自己感受良好的时刻、对抑郁症保有合理期望的方式向外、向内寻求援助。文末附心理援助7*24小时咨询热线。

抑郁症越来越近

7月5日晚20：54，歌手李玟的姐姐@李思林Nancy在社交媒体发文宣布：CoCo李玟于数年前不幸患上抑郁症，7月2日病情加重在家中轻生，最终于7月5日与世长辞。

歌手李玟去世的消息引发社会广泛关注，哀悼惋惜之余，抑郁症这一疾病再次受到热议。

近年来，"抑郁症"话题越来越密集的出现在各大社交平台，#抑郁症不是情绪问题 #抑郁症不是简单的坏心情 #抑郁离你有多近 #抑郁的孩子为什么会有这么多...抑郁症相关词条频登热搜。抑郁似乎距离我们越来越近，在我们周围，冷不丁会听到有朋友确诊抑郁症，不少人甚至我们自己也时常会陷入低落、难过的消极情绪中。

面对抑郁，请这样做

当感到抑郁时，请尝试这些方法：

1）有时候，药物治疗是必须的。

很多人会担心吃抗抑郁药会导致成瘾，因此抗拒用药。实际上，抗抑郁药并不会让人成瘾。但每个人对于每种精神科药物的反应都可能不一样，你需要花一些时间去尝试和调整，从而找到合适自己的药物。

抑郁症患者因为受到抑郁影响，容易对治疗感到绝望和消极。特别对周期性抑郁症患者来说，反复经历发作会让人沮丧而疲惫（Van Rhoads & Gelenberg， 2005）。但保持对治疗的期待是重要的，研究发现，如果人们越倾向于认为自己能在治疗中获益，那么治疗的效果也会更好（Rutherford，et al.，2010）。

2）除了向专业人士求助外，也有些日常的方法可以帮助我们更好地面对抑郁。

你可以写日记。不止记录发生的事件，而是要记录围绕这个事件的感受和想法。处于抑郁状态的人时常会描述自己的思想像是“被困住了（stuck）”，好像头脑结成了一块，不知道自己在想些什么。写日记正可以帮助我们同自己的心智（psyche）对话。

记住自己感受良好的时刻。即使接受了治疗，我们也会有感觉非常糟糕、甚至生不如死的时候。但是，记住自己曾经感受良好的时刻，这样我们会知道抑郁带来的痛苦不会是永恒的，而自己有能力感到快乐。

对抑郁有合理的期望。和抑郁为伴可能会是个漫长的过程，可能会经历一次甚至多次反复；而即使经过治疗，我们在将来可能依然会因为一些事感到低落或痛苦。虽然治疗无法彻底消除问题，但是我们可以学着更好地和抑郁共存，到那时，可能你会发现抑郁也并非那么可怕。

抑郁确有其事。它是一个是实实在在存在的东西，并不是一种臆想。如果你感觉到你的症状已经到了相当严重的程度，可以寻求专业机构和心理治疗师的帮助，来缓解内心的痛苦；如果你身边有人表现出抑郁，即使你难以理解，至少可以学习尊重。

注：以上两点建议引自公众号【KnowYourself】的《#抑郁症不是简单的坏心情# 有些人，会微笑着抑郁。》

感到抑郁时，可拨打

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致健康

乐知一心为提高公众健康素养而设立健康知识普及栏目——【致健康】。健康的生活指有益于健康的习惯化的行为方式，具体表现为饮食结构健康、睡眠健康以及心理健康等。本栏目旨在帮助大众做出合理的健康决策、从而维持和促进自身的健康生活。

作者：白｜审核：Victor

封面图：家庭医生名医在线

Introduction: In the 181 days of 2023, the LY Accompany with Music has made organized progress in four main areas: classroom construction, music education, child home visits, and fundraising. In this report, we will provide an overview of the progress made in the first half of the year and outline the plans for the second half of the year for our partners who support the Accompany with Music.

“On weekends, I'm afraid to go home, I don't want to go back. It's very dark at night, and I'm the only one at home. I dare not close my eyes, I dare not sleep alone.” ——A second-grade girl from Songlin Primary School.

On January 1, 2023, the LY Foundation and the Yunnan Heart to Heart Community Foundation jointly launched the Accompany with Music, with the Xixin Social Work Service Center in Nanjian County as the executing organization. The Accompany with Music aims to connect with each other through music and provide daily companionship, psychological comfort, and life support to the children of Songlin Primary School in Bixi Township, Nanjian County, Yunnan Province. Six months have passed since the official launch of the program, and various activities planned for the program have gradually been implemented. As of June 30th, the Accompany with Music has been developed along four main lines: Classroom construction, music education, child home visits, and fundraising. The progress of the program is reported as follows.

Music Space Construction and Utilization

On March 1st, the Accompany with Music was launched, and a musical instrument donation ceremony was held at Songlin Primary School. During the ceremony, The LY Foundation donated a batch of musical instruments worth 20,000 CNY for the construction of the school's music space. The music classroom has been completed and equipped with over ten musical instruments, including lusheng, hulusi, ukulele, hand drums, guitar, erhu, and more, all of which are used for daily music education.

Ethnic Musical Instrument Education and Performances

Since the launch ceremony on March 1st, the music classroom has been open for use. The LY Foundation invited Mr. He Weicheng, a traditional ethnic music heritage teacher from Nanjian, to provide lessons for the children every Wednesday and Thursday from 14:00 to 16:30. The music courses have now provided 39 teaching sessions, serving over 2,500 students from the entire school, including all the targeted children (left-behind and children in difficulty). On Children's Day, June 1st, with the guidance of The LY Foundation, the Yunnan Heart to Heart Community Foundation, and the Nanjian Xixin Social Work Service Center, Songlin Primary School successfully held the first Arts and Culture Performance of the Accompany with Music . During the performance, a band mainly composed of left-behind and children in difficulty presented a wonderful ensemble of Yunnan ethnic music titled “Sounds of Songlin”, bringing joy and laughter to the audience.

Accompaniment and Home Visits for Children in Difficulty

Home visits are conducted by a team consisting of Nanjian Xixin Social Work Service Center’s social workers and Songlin Primary School teachers. From February to June, the home visit team has carried out home visits 46 times, covering 39 students, including 12 left-behind and children in difficulty who are the primary focus of the Accompany with Music. The home visit information has been further organized and placed in the individual files of each student to facilitate the formulation of work guidelines for the second half of the year.

Donations and Fundraising from Caring Individuals

On May 27-28, The LY Foundation promoted the Accompany with Music at the Five Hundred Li Music Festival and attracted the active participation of well-known local Yunnan musicians and groups, including Yunnan Yingxiang, Big Tongue, Nanzhengbeizhan, and Duan Weili. As of June 29, a total of 2,396 caring individuals have donated, with a total donation amount of 19,287 CNY. This fund has already been allocated for use in the summer camp, teaching maintenance, the purchase of new musical instruments, and the renovation of the music classroom.

181 days may not be enough to completely transform lives, but what we can do is implement the plan in a tangible way, harnessing the power of music, individual efforts, and the children's own strength to provide companionship where care is lacking. Let music become a bridge of communication and let love re-enter the hearts of these children.

In the second half of the year, The LY Foundation will build on the experience gained in the first half, continue to implement existing activities, and bring even more diverse and enriching cultural and entertainment activities to the children. The work plan will be divided into five aspects:

Launch a Summer Camp

The “Young Generation · Songlin Primary School Accompany with Music Dream Growth Camp” is scheduled to open in late July and conclude in mid-August. The summer camp will focus on “Minority Culture Education and Music Education”, enriching the summer vacation life of left-behind and children in difficulty and providing them with care and companionship.

Transition to Multi-threaded and Personalized Curriculum Arrangements

Regular introductory music classes will be held for all students, and small-group classes of 50 students will be offered to those with a strong interest in music. After training and practice, these students will have the opportunity to participate in provincial music competitions and performances.

Continuation of Home Visit Work

The focus of home visits will remain on left-behind and children in difficulty, with visits being extended to all students. Based on the actual situation of the children's families, material assistance and social assistance will be provided accordingly.

Deepen Program Professionalism

Child psychology experts will be invited to provide professional guidance for the Accompany with Music. This will involve assessing the impact and actual effects of the music program on the children's psychological well-being and trying to establish generalizable practices. Additionally, experts will provide training to local primary school teachers in child psychology and mental health to build a strong team of local youth mental health educators.

Regular Information Disclosure and Updates

On a monthly basis, the Accompany with Music's progress will be publicly disclosed through text, images, videos, and other formats via The LY Foundation's official platforms.

"What should the slogan be?"

“Accompany with Music, children, loneliness, fear, night, future, soul. How about ‘With music, childern shall not be afraid of dark’!”

Together, with the healing power of local music, let's work tirelessly so that countless children, like the second-grade girl at Songlin Primary School, no longer fear the night, can blossom in health, break free from the darkness, and have an equally bright future. As midsummer fades and late summer begins, in those days accompanied by music, it seems... the smiles on the children's faces have grown a bit more.

Author: Yufan | Review: Victor

For non-smokers, avoiding second-hand smoke might be possible, but thirdhand smoke is a different challenge altogether. The harm caused by thirdhand smoke is often insidious, as people can absorb it through breathing and skin contact, making it easy to go unnoticed. Furthermore, thirdhand smoke clings to the surfaces of objects and can persist for days, weeks, or even years. The main text reads as follows.

致健康｜三手烟防不胜防，我们到底该怎么办？

今天，很多烟民已经意识到了“二手烟”给家人带来的危害，于是会在吸烟时特意避开小孩子和孕妇，选择下楼抽烟、车里抽烟、去阳台抽、在抽油烟机下抽……

不论你在哪里抽了一根烟，烟雾中的有害物质都可能会附着在你的衣服上，并跟随你的行动，带到家人面前。当我们在出入一些吸烟的场合，身上穿的衣服，尤其是棉质衣服，会吸附空气中的烟味。回到家里抱起孩子，衣服上的烟味就自然被孩子吸进去了，成为“三手烟”。 那么，三手烟到底是什么？它对人体的危害都有哪些？我们到底该如何尽量避免三手烟给亲人带来的危害呢？

什么是三手烟

“三手烟”( third-hand smoke）是指烟民的“吞云吐雾”后残留在衣物、墙壁、地毯、窗帘、皮革、家具，甚至头发和皮肤等表面的烟草烟雾残留物，是目前危害最为广泛的室内空气污染。这些残留物中的尼古丁与空气中的亚硝酸反应，可形成强大的致癌物亚硝胺。

对于不吸烟的群体而言，二手烟或许能躲，三手烟却难防。看到有人在吸烟，我们可以选择躲开，但是遭受三手烟的毒害往往是不自知的，人们通过呼吸、皮肤进行吸收，很容易被忽略。不仅如此，二手烟可以通过开窗通风的方式方式排走，而三手烟沾染在物体表面，可长达数日数周甚至数年。

三手烟对人体的危害

和二手烟相比，三手烟的危害可能更大。三手烟当中的有害物质如甲烷、丁烷等会相对应的滞留在吸烟空间中的墙壁、家具、衣服以及那个区域可以依附的所有载体上，对人体产生长期的影响。

据美国加州大学河滨分校（UCR）的科学家领导的一个研究团队发现，长期接触三手烟可改变鼻上皮细胞基因表达，对细胞带来不可逆的损害。进入体内的三手烟可改变跟氧化应激有关的生物学通路，使得细胞DNA受到损害，增加患癌风险。

三手烟还会影响孕妇的健康。孕妇体质特殊，且在室内的时间较长，再加上孕妇呼吸频率快，代谢能力和免疫系统发生改变，孕妇对污染物更加敏感，即使暴露在低剂量的三手烟环境中，同样也会影响孕妇和胎儿身体。

不仅如此，婴幼儿最易受到三手烟的侵害。据北京青年报报道，婴幼儿经常在地板上爬行、玩耍，喜欢直接抓起东西就往嘴里送，因此近距离接触环境中残留三手烟的机会更多。经常暴露于三手烟的婴幼儿容易患哮喘、急性支气管炎等呼吸系统疾病。此外，长期接触三手烟， 可能导致肝脏脂肪变性、肺纤维化、糖尿病等疾病风险升高；还可能导致人体的免疫功能受损、伤口愈合缓慢等。

如何防范“三手烟”带来的危害

迄今为止，还没有有效的对“三手烟”彻底净化去除的措施。即便使用臭氧清除烟味，也是一种适得其反的措施。臭氧对物体表面吸附的尼古丁的确有脱附作用，但臭氧会和尼古丁反应，生成有害的氧化产物，具有更大的潜在危害。另一方面，就算我们管住了家人，一些长辈的亲朋好友来到家中和家人聊天，难免不会点燃一支香烟，在一呼一吸中谈笑风生。那么，我们应该怎么将家中“三手烟”残留物的依附降到最低呢？

1. 构建无烟的家庭环境，任何人、任何时间、在家的任何地点不吸烟。
2. 在私家车内保证不吸烟，让乘客远离三手烟。
3. 定期清理烟灰缸等烟具，可以放置一些活性炭、茶叶渣、橘子皮等在烟灰缸内来吸附三手烟；
4. 如果预算充足，可以考虑在家中配置一台空气净化器，尤其是带有720度风道进出风口的空气净化器更佳，可以全方位净化空气及三手烟等空气污染物；
5. 室内可以多摆放一些绿色植物，比如绿萝、仙人掌、常青藤、芦荟等植物，这样也能帮助吸附二手或三手烟。

6. 有吸烟者或工作场所有吸烟者的家庭，要经常清洁室内环境，擦桌子、拖地、擦沙发，勤换床单被罩、洗窗帘、地毯，定期擦拭家具。

最后，三手烟的问题值得所有人去重视，我们期望未来吸烟群体可以给社会营造一个更好的公共卫生环境。

We believe that in the near future, through broader societal awareness and business involvement, we can create a comfortable environment for individuals with Parkinson's and their families, where they no longer have to struggle alone. This will contribute to improving their quality of life and mental well-being. The main text reads as follows.

科技助老｜从爱出发：帕金森前中后期照护建议，让我们一起为病人和家属减负！

导读：我的思绪像蝴蝶一样漂浮在空中自由盘旋，我有那么多想做还未做的事情，而我的身体却禁锢住了我的所有！

帕金森病现状

2023年4月11日是第27个世界帕金森病日，这一天是帕金森病的发现者英国内科医生詹姆斯·帕金森博士的生日。帕金森病是常见的神经系统退行性疾病之一，现阶段尚未有治愈手段，是一种退行性疾病。据统计，目前全球约有共570万帕金森患者，我国约有270万，我国帕金森病患病人数约占全球半数左右。预计到2030年，中国帕金森病患者将达到490万，给家庭和社会都带来了沉重的负担。

相对于认知症、渐冻症等近几年通过社交媒体而被部分群众所知的疾病而言，帕金森对于大众来说仍然是一个相对陌生的疾病。常常看到有人在网上拿帕金森病症状调侃，或对有行动障碍的老年人表示嫌弃，却少有人真正关注和理解这个在中国庞大的老龄化群体中肆虐的“病魔”，它究竟是什么样子？

如果在互联网上搜索帕金森病，出现最多的也是疾病诊断、药物管理等相关信息，对于家中有帕金森患者需要照护的家庭来讲，长达十年甚至更久的照护过程中，有哪些方面是需要注意的，很少有文章提及。

帕金森患者典型症状

1. 静止型颤抖

坐着看电视，手没有摆任何姿势的时候，手部会像数钞票一样颤抖

2. 整个动作会慢下来  

脸部表情僵硬木讷、俗称扑克脸，面具脸

3.关节僵硬

随着疾病的发展，关节、肌肉会慢慢僵硬，日常生活无法独自完成

4. 姿势跟平衡能力受损

小碎步，走路时双脚迈不出去，走起来后无法立即停下来。跌倒风险极高。因为肌肉僵硬，家属在协助步行时会更加困难

帕金森患者家庭适老化产品介绍

对于家中有帕金森患者需要照护的家庭来讲，现阶段我们有哪些辅具产品可以使用呢？下面我们将介绍一些帕金森患者在前中后期可选择的家庭适老化产品。

① 初期适用产品——卫生间扶手

在疾病初期，日常生活大部分动作本人仍可完成，但起身困难，已经存在跌倒风险，安装扶手，可以增加稳定性以及借力让起身动作更加顺畅。此外，家具的选择、摆放也需要符合疾病特征，如家属计划长期在家照护，可尽早咨询相关专业机构或人员，根据患者现状及今后会出现的情况提前调整。

② 初期适用产品——防颤抖勺

为了让帕金森患者能好好吃饭，谷歌旗下的Liftware公司推出了暖心设计防抖勺，让帕金森患者也能像正常人一样吃饭。这款防抖勺通过一根绑带固定在使用者手上，防止由于震颤而勺子脱落。它内部的传感器能够感应到手的移动方向，并使得勺子的移动方向与手的震颤相抵消，勺子能基本保持平衡，帮助患者进餐。通过在各大电商平台搜索后发现，目前国内已经有相关产品在售。

③初期适用产品——Arc震动笔

对于帕金森氏病患者而言，重要的是不仅要满足基本需求，还要满足更高水平的需求。Arc使用振动来刺激手部的关键肌肉，并减少了将笔在纸上移动所需的精力。笔中的高频振动可以保护他人的社交身份和虚荣心。恢复以前的笔迹意味着他们可以恢复以前的身份和信心。

④ 从家门口到楼门口——外出可能性的保留

随着疾病的发展，患者会无法上下楼梯，需坐轮椅出行。然而，国内很多老旧小区没有配备电梯，家属可在早期考虑到这件事情，更换住房，搬到一楼或跟当地打听是否今后有安装电梯的计划。如等到患者已无法下楼再做调整时，时机会有些晚。很多患者从无法下楼到生命的最终期，仍有5-10年的时间。提前做好计划，可避免患者最后的漫长时光只能留在房间里。

⑤ 中后期适用产品——外出福祉用车

福祉车指的是装配有辅助轮椅上下车的车型，在国内市场福祉车又被称为无障碍车，以行动不便的老人或残障人群为目标客户，在车辆设计时增加辅助设备，满足用户的出行需求。随着中国进入老龄化社会以及社会保障制度的完善，福祉车市场有望得到进一步发展。目前，国产品牌上汽通用就推出了GL8福祉车版本，一些日产品牌也有福祉车版本，患者家属可根据自身需求选择购买或租赁一辆福祉车。在一些紧急情况下，患者就医时可以在叫车平台中选择无障碍车型。

⑥ 中后期适用产品——吞咽障碍增稠剂

帕金森患者吞咽困难的原因是食物或药物在口腔内停留和咀嚼困难，因此出现呛咳。此外，由于患者不能自动吞咽唾液，大量的唾液停留在口腔和咽喉处还会影响发声。通过在国内各大电商网站上搜索，我们发现目前已经在售专门针对喝水吞咽困难的人群的增稠剂，来防止患者呛咳。

写在最后

帕金森疾病，目前在国内仍属于罹患人员及家属关注，社会层面普及较少的疾病。帕金森同认知症一样，属于退行性疾病。即使罹患疾病，仍然会面对数年甚至数十年的生命旅程。而帕金森从确诊到生命最终期，需要更多的社会力量的积极介入，无论是对于患者本人而言还是对于照护的家属而言，都非常需要社会力量的介入。

被设定的人生终点可能并不那么令人恐惧，恐惧的是意识尚在时，自己却被束缚在逐渐僵硬的躯体中。明明什么都很清楚，但日常生活中的事情都会慢慢无法做到，连简单用笔画一条直线都不可能。对于日常生活的无力感，家属的愧疚感，未来的恐惧，都会对本人造成精神压力。据统计，40%左右的帕金森患者，会罹患抑郁症。而对于面临漫长照护生涯的家属而言，个人时间的锐减、个人家庭与照护的两难全、还有害怕因为自己的失误而让亲人明明可以享受更多却没能享受的身体和精神双倍压力，是一直被社会忽视掉的问题。‍

4月11日是“世界帕金森日”，2023年的主题是关注心理健康，全面全程管理。这里面的心理健康应该是指本人及家属双方，而全程管理意味着疾病的诊断只是新的旅途的开始。相信不久的将来，通过社会层面的普及和企业层面的介入，我们可以营造给罹患帕金森本人及家属一个不再单独奋斗的舒适环境，为改善他们的生活质量和心理精神状况做出一份贡献。

撰文：晓雪

编辑：刘城宏

Tripping and falling might seem like a minor incident. For young and middle-aged individuals, falling down and getting up is no big deal. However, for the elderly, a fall can potentially become “the last fall” of their life. The main text reads as follows.

科技助老｜智能产品辅助步行，减少长者摔倒风险

1、一半的老年人，最后的死因是摔倒

跌倒摔跤，看起来是件不值一提的小事。对于青壮年而言，摔了一跤爬起来就好，但如果老年人摔一跤，可能就会变成人生“最后一跤”。

2022年，极目新闻报道，因一名保姆玩手机时疏忽，上海一位94岁老奶奶从床上摔倒，后脑着地，送院救治后不幸身亡；腾讯新闻在今年发布的一篇新闻报道提到，山东一位66岁大爷骑车时突然摔倒，被送医院后抢救无效，最后死于突发性脑溢血。

据《中国伤害预防报告》显示，我国65岁以上老年居民中，男性有21%-23%曾经跌倒过，女性跌倒比例为43%-44%。此外，世界卫生组织的一份报告显示，全球每年有30余万人死于摔倒，其中一半是60岁以上的老人。在中国，每年有4000万老人至少跌倒一次，每1万人中就有8人因摔倒而过早死亡，是65岁以上老年人伤害死亡的首位原因。‍

2、长者“最后一跤”的风险

那么，「摔倒」这件看似普通的小事，怎么就可能变成人生中的最后一跤呢？

老年人摔跤后，由于本身可能存在的骨质疏松、肌肉萎缩、关节不稳定等原因，跌倒后很容易导致骨折。而老年人骨折，死亡率可达20%-30%；且致残率更高，42%的患者不能恢复伤前活动力，35%伤后不能独立行走。

摔跤→骨折→卧床静养→①②

① 伤筋动骨一百天，骨折发生后，翻身坐起变得困难，需要长期卧床。而老年人本身肌力较弱，长期卧床后肌力恢复速度比青壮年慢，导致日常生活动作在骨折恢复后，如无有意识锻炼的话-恢复速度仍旧较慢。很多人从骨折后的不得不卧床直到骨折恢复后肌肉严重萎缩，无法独立走路。

②卧床后产生的并发症，如肺部感染而引发的高烧、褥疮、尿路感染、血栓等可能会产生生命危险。据统计，老年髋部骨折一年死亡率可达50%，而即使没致死，致残率比例也较高。‍

由于摔跤而导致的后续一系列的严重影响，很大可能让老年人的生活发生降崖式的变化，导致生活不能自理，生命质量会急速下降。因此，老年人的跌倒有可能成为“人生最后一跤”。

3、跌倒风险评估，使用智能产品助力

当老年人行动能力较弱时，大家都知道要防跌倒。而最容易出现跌倒的，往往是我们认为跌倒风险不大的人群。也就是相对较健康的老年人群。比如退休后身体还算健康的，每天还在承担接送孙女、为家庭买菜的这些活力老人。

这个群体的防摔意识，无论是本人角度还是家属角度，都是比较容易忽略掉的。本人会觉得，随着年纪的增长腿脚不如以前了很正常，不会觉得自己会跌倒。而家属，也从未想过这个状态的老年人需要预防跌倒。即便觉得需要注意一下，可也不会为此专门去医疗机构，检查步行能力及跌倒风险。

因此，本文将介绍以下几款智能化的产品，来帮助家属相对客观的发现风险。

4、跌倒风险评估智能设备

Q'z TAG® walk plus

适用场景：

家属为自家的老人进行简单测评，或是医疗机构或养老机构如用TUG进行步行能力测评时，该设备可以替代人工，进行数据化测评。

评估方式：

被测试者坐在椅子上，在椅子前方3米处放一个标志物。被测试者需要在开始后，从椅子站起，步行3米至标志物，绕标志物后返回直到坐回椅子后，测试结果。

评估结果：

通过步行过程中对 [重心移动]、[前后左右平衡]、[身体动向]、 [节奏]、[速度]这6项指标进行分析，最终得出各项评估结果。

蓝色表示此次各项评估结果，红色为上次评估结果。棕色标识被测试者所在年龄层的平均测试结果。经过对比，家属们可发现此次结果和上次相比，老年人的哪些功能有所退化。而和此平均年龄层相比，哪些能力是优于或差于平均能力。最后该产品可以提供一个综合性步行评估结果（如下图所示）。

托尔托智能App（トルト）

适用场景：

家属简单测评。评估结果及相关视频均比较简单，没有康复或医疗背景知识人员也可以理解。

评估方式：

该软件的使用方法也很简单，测试者打开app，镜头对准被测试者，让被测试者直线步行5米并录像，即可得到可视化评估结果及运动建议。

评估结果：

对于步行能力（步行速度、步行节奏）、平衡能力（头部较大摆动、左右脚负重程度）进行分析并得到结果。

特点①：除了出具简单步行评估外，根据评估结果，系统会推送相关简单步行能力训练视频，使用者可跟着视频一起锻炼。

特点②：可将步行画面及结果发送给指定相关人员，如家属或者医疗机构相关人员。

社交病例智能APP（skシセイカルテ）

适用场景：

相比前面介绍的App，此款产品的评估及建议更加专业，适合医院、康复中心等医疗相关企业使用。

• 特点1：康复治疗效果可视化
• 特点2：3D形式，走路姿势更加直观
• 特点3：分析内容更加专业
• 特点4:  针对性训练内容，精细到各肌肉群的训练

05 写在最后

国内数字化产品在养老领域的使用目前还处于起步阶段，特别是从预防的角度延伸出的产品还相对较少。防跌倒，是直接关系老年人生命质量的一个关键问题。如何运用智能产品避免“人生最后一跤”，除了评估风险的功能角度外、还有肌肉训练以及安全守护角度等多个方面。在“9073”的养老格局下，如何安全的守护在家的老年人，让老年人可以尽可能延迟健康寿命，提高晚年生活质量，是一个非常重要且紧急的课题。而在此过程中，也需要有更多智能化产品的研发及运用。

撰文：晓雪

编辑：城宏

On March 1, 2023, the launch ceremony for the “Accompany with Music” was held successfully at Songlin Primary School in the Bixi Township of Nanjian Yi Autonomous County, Dali. During the ceremony, National Second-class Actor Aben Zhi, Intangible Cultural Heritage inheritor of Nanjian's serving dance He Weicheng, staff from the Yunnan Heart to Heart Community Foundation, personnel from the Nanjian Xixin Social Work Service Center, and officials from Nanjian County attended the program's launch ceremony, joining forces to support the “Accompany with Music”.

At the launch ceremony, the LY Foundation donated a batch of teaching instruments valued at approximately 20,000 CNY to Songlin Primary School. These instruments will be used for the subsequent “Accompany with Music”. The program aims to provide companionship to children through music education and the professional services of social workers, allowing the children to experience the healing power of music and promoting their healthy growth.

It is worth mentioning that the “Accompany with Music” jointly initiated by The LY Foundation and the Yunnan Heart to Heart Community Foundation has received strong support from Principal Zuo of Songlin Primary School. In addition, all the leaders who attended the event expressed their best wishes for this charitable program.

Principal Zuo stated at the launch ceremony, 'We are honored to receive the generous support from the LY Foundation. To record this moment of goodness, we have gathered here today for this donation ceremony! If you want to dispel worries and forget pain, music and dance are the best remedies. If you want to have a sunny and healthy mindset, music and dance are also the fertile soil that nourishes our souls. Your love brings spiritual comfort to our teachers and students, and your kindness will undoubtedly inspire all of us at Songlin Primary School to move forward!'

Furthermore, the staff from the Dali Municipal Education and Sports Bureau mentioned that the LY Foundation's “Music Companionship” philanthropic program has brought warmth like spring to all the teachers and students at Bixi Township's Songlin Primary School. It has truly alleviated the difficulties the school faced due to a lack of music curriculum resources, and at the same time, it has provided a heartfelt lesson in philanthropy for all the teachers and students. To focus on education is immeasurably meritorious, and to excel in education is boundlessly joyful.

The dedicated social workers also expressed at the launch ceremony that they believe, with the leadership and support of superior departments and the assistance and guidance of the LY Foundation and the Yunnan Heart to Heart Community Foundation, they will make use of their professional advantages to provide students with satisfactory results. They aim to convey the power of music and love to the children through professional services.

After the speeches, teachers led the students to the spacious football field, kicking off the first music lesson. National Second-class Actor Aben Zhi, combining the Yi ethnic culture of Nanjian County, and He Weicheng, inheritor of Nanjian's Intangible Cultural Heritage “serving dance”, introduced the history of the Yi ethnic instrument, the lusheng, to the children and performed it live.

The social workers on-site recalled, “As soon as we moved the instruments to the playground, many children crowded around, eager to try the instruments. They were excited and expressed their desire to learn to play the lusheng, ukulele, and hand drum. Active children came forward first, and the children who had been keeping to themselves in the corner are the ones we intend to infect, accompany, and heal through music.”

Zhang Yaxian, Deputy Director of the Yunnan Heart to Heart Community Foundation, pointed out, “The purpose of the ‘Accompany with Music’ is to use the power of love and music to help left-behind and children in difficulty in mountainous areas. We want music to be their friend on the way to school, at school, and at home, so that they are not alone and do not get lost. In music, they can find the power to create and be strong.”

It is believed that the launch ceremony and the collective music activity have planted seeds of kindness and interest in the hearts of the children, as well as seeds of hope in the hearts of those children who lack companionship."