认知重构干预对急性心肌梗死介入手术患者不良情绪及疾病感知的影响

目的探讨认知重构干预对急性心肌梗死(AMI)介入手术患者不良情绪及疾病感知的影响。方法72例AMI介入手术患者随机分为两组各36例,对照组给予常规护理干预,研究组在对照组基础上给予认知重构干预,比较两组的不良情绪、疾病感知以及治疗依从性。结果干预后,研究组的HAMA、HAMD评分均低于对照组,疾病感知各项评分均高于对照组(P<0.05)。研究组的治疗依从性为94.44%,高于对照组的75.00%(P<0.05)。结论认知重构干预对急性心肌梗死介入手术患者的不良情绪及疾病感知均有积极的影响,可提升患者的治疗依从性。     

Correlation and agreement of olfactory perception assessed by the Connecticut Chemosensory Clinical Research Center olfactory test and the Brief-Smell Identification Test

IntroductionAssessing olfactory perception in olfactory disorders is of utmost importance in therapy management. However, the University of Pennsylvania Smell Identification Test and the Sniffin’ Sticks are the only tests validated in Brazil.ObjectivesTo evaluate the correlation and agreement between the Chemosensory Clinical Research Center olfactory test and the Brief-Smell Identification Test – University of Pennsylvania Smell Identification Test – in healthy participants and in participants with olfactory disorders based on the results and technical aspects of both tests.MethodsFifty participants without olfactory complaints and 50 participants with olfactory disorders who underwent the Chemosensory Clinical Research Center olfactory test and the Brief-Smell Identification Test were included. The following tests were used for statistical analysis: Mann-Whitney U test, Spearman’s correlation, intraclass correlation coefficient and Bland-Altman plot. An alpha error (significance level) of 0.05 was considered in the statistical analysis.ResultsBoth tests were effective in distinguishing the groups without the presence of overlapping values ??for the measured markers. Additionally, there was a strong correlation between Spearman’s correlation and intraclass correlation coefficient between the tests and for both nostrils. However, the correlations were lower when the groups were individually evaluated. The Bland-Altman plot showed no bias when all participants were simultaneously evaluated.ConclusionsThe tests to assess olfactory perception presented a high level of agreement. In our sample, we could infer that the Connecticut Chemosensory Clinical Research Center olfactory test is similar to the Brief-Smell Identification Test and can be used in the routine diagnosis of patients with complaints of olfactory disorders, considering the advantage of its low cost.     

北京市精神卫生医务人员对严重精神障碍发病报告制度的认知研究

背景 严重精神障碍发病报告制度作为精神卫生监测的重要一环已运行实施多年，实施效果需要进一步探知。 目的 分析北京市三类精神卫生医务人员对严重精神障碍发病报告制度重要性、主要作用、实施效果、存在问题及完善措施的认知，为促进该制度的完善提供建议。 方法 2019年3—6月，采用方便抽样方法选择234例市级精神专科医院医务人员，采用分层抽样方法选择183例区级精神专科医院医务人员，采用分层抽样方法选择214例社区精神卫生防治医务人员作为研究对象，采用"北京市精神卫生法治状况调查问卷"进行问卷调查，问卷主要内容包括医务人员基本信息及对严重精神障碍发病报告制度的认知。 结果 对于制度重要性，56.3%（103/183）的区级精神专科医院和54.7%（117/214）的社区精神卫生防治医务人员认为其"非常重要"，66.7%（156/234）的市级精神专科医院医务人员认为其"比较重要"。对于主要作用，76.9%（180/234）的市级精神专科医院医务人员和82.7%（177/214）的社区精神卫生防治医务人员认为该制度主要作用为"风险预警"，80.9%（148/183）的区级精神专科医院医务人员认为该制度主要作用为"社区管理"。对于实施效果，44.4%（104/234）的市级精神专科医院医务人员、50.3%（92/183）的区级精神专科医院医务人员和50.9%（109/214）的社区精神卫生防治医务人员认为严重精神障碍发病报告制度实施效果比较好。对于存在问题，77.8%（182/234）的市级精神专科医院医务人员、78.1%（143/183）的区级精神专科医院医务人员和83.2%（178/214）的社区精神卫生防治医务人员认为该制度主要存在的问题为"报告涉及患者隐私信息的收集"。对于完善措施，73.5%（172/234）的市级精神专科医院医务人员和76.6%（164/214）的社区精神卫生防治医务人员认为严重精神障碍发病报告制度完善措施为"规范信息录入、登记、更正、汇总制度"，68.9%（126/183）的区级精神专科医院医务人员认为制度完善措施为"规范信息共享及对患者隐私保护的制度"。 结论 三类医务人员对严重精神障碍发病报告制度的作用及实施效果表示肯定，为实现风险防控与隐私保护并重，兼顾患者管理与服务，应当对该制度予以完善，包括：在法律层面细化相关规定；对患者坚持服务保障与管理并重，完善精神卫生服务体系，落实基本与重大公共卫生服务项目；增加政策宣传力度，提高患者及家属对该制度的认可度。     

Delays in the reading and spelling of children with cerebral palsy: Associations with phonological and visual processes

BackgroundThis investigation addresses the question of whether there exists a significant discrepancy in the cognitive abilities of children with cerebral palsy (CP) who, despite the presence of age appropriate communication and language, have reading and spelling delays.AimsWe wanted to discover whether there was a relationship between the phonological and visual perceptual abilities of children with CP and their progress in reading and spelling.Methods and proceduresFifteen children with CP (aged between 6:9 years and 11:6 years) were assessed on reading and spelling; communication and language; non-verbal reasoning; phonological processing; and visual perception.Outcomes and resultsTen of the children had very weak reading and spelling skills. Five children had (mostly) age appropriate scores of reading and spelling. No differences were found between these two groups in non-verbal reasoning or communication and language. However, phonological abilities, visual sequential memory and perception of visuospatial relationships were found to be related to reading and spelling.Conclusions and implicationsThe findings suggest that children with CP are at risk for reading and spelling delays when they have poor phonological processing, visual sequential memory and perception of visuospatial relationships. The implications of the findings for classroom practice are discussed.     

Lasting improvements in left spatial neglect following a protocol combining neck-muscle vibration and voluntary arm movements: a case-study

Purpose: Beyond promising experimental results of sensory passive stimulations in spatial cognition disorders, some questions still remain regarding interests of these stimulations during the daily activities in neglect. The aim of this case-study was to evaluate the effects of a protocol combining left neck-muscle vibration with daily simple movements, like arm pointing movements, on perceptivo-locomotor deficits in a left spatial neglect patient.

Materials and methods: Two neuropsychological tests, one subjective straight-ahead pointing (SSA) test and one wheelchair navigation test were carried out before the combination protocol, immediately after, 1?h later, and 24?h later.

Results: The results showed a reduction of neglect spatial bias following the protocol lasted at least 24?h in all the tests (except for the SSA test due to the unavailability of the pointing device).

Conclusions: The range of improvements in the symptoms of spatial neglect suggests that this therapeutic intervention based on the combining neck-muscle vibration to voluntary arm movements could be a useful treatment for this condition. One of future investigation axes should be the development of a vibratory tool in order to facilitate the combining this proprioceptive stimulation to daily activities.

• Implications for rehabilitation

• Spatial neglect is a perplexing neuropsychological syndrome, affecting different domains of spatial cognition and impacting also the functional domain.

• The treatments based on neck-muscle vibration are simple to use, non-invasive and requires none active participation of patient.

• A therapeutic intervention based on the combining left neck-muscle vibration and voluntary arm movements in a left-spatial-neglect show a lasting reduction of symptoms especially in daily activities.

• The combination of treatments based on the Bottom–Up approach opens innovative perspectives in rehabilitation.

     

Temporal Expectation Hastens Decision Onset But Does Not Affect Evidence Quality

The ability to predict the timing of forthcoming events, known as temporal expectation, has a strong impact on human information processing. Although there is growing consensus that temporal expectations enhance the speed and accuracy of perceptual decisions, it remains unclear whether they affect the decision process itself, or non-decisional (sensory/motor) processes. Here, healthy human participants (N = 21; 18 female) used predictive auditory cues to anticipate the timing of low-contrast visual stimuli they were required to detect. Modeling of the behavioral data using a prominent sequential sampling model indicated that temporal expectations speeded up non-decisional processes but had no effect on decision formation. Electrophysiological recordings confirmed and extended this result: temporal expectations hastened the onset of a neural signature of decision formation but had no effect on its build-up rate. Anticipatory α band power was modulated by temporal expectation and co-varied with intrinsic trial-by-trial variability in behavioral and neural signatures of the onset latency of the decision process. These findings highlight how temporal predictions optimize our interaction with unfolding sensory events.SIGNIFICANCE STATEMENT Temporal expectation enhances performance, but the locus of this effect remains debated. Here, we contrasted the two dominant accounts: enhancement through (1) expedited decision onset, or (2) an increase in the quality of sensory evidence. We manipulated expectations about the onset of a dim visual target using a temporal cueing paradigm, and probed the locus of the expectation effect with two complementary approaches: drift diffusion modeling (DDM) of behavior, and estimation of the onset and progression of the decision process from a supramodal accumulation-to-bound signal in simultaneously measured EEG signals. Behavioral modeling and neural data provided strong, converging evidence for an account in which temporal expectations enhance perception by speeding up decision onset, without affecting evidence quality.     

Surgeons see anatomical structures faster and more accurately compared to novices: Development of a pattern recognition skill assessment platform

Background

This study aimed to identify differences in pattern recognition skill among individuals with varying surgical experience.