Sleep disturbances and psychomotor retardation in the prediction of cognitive impairments in patients with major depressive disorder

BACKGROUND Symptoms of depression and comorbid anxiety are known risk factors for cognitive impairment in major depressive disorder(MDD).Understanding their relationships is crucial for developing targeted interventions to mitigate cognitive impairments in MDD patients.We expect that the severity of sleep disturbances and other depressive symptoms will be positively correlated with the degree of cognitive impairments.We also hypothesize that anxiety symptoms,especially psychic anxiety,is a key factor in predicting cognitive performance in MDD patients and may indirectly contribute to cognitive impairment by affecting sleep disturbances and other potential factors.AIM To determine which dimension of the depressive and anxiety symptoms predicts cognitive impairment during a depressive episode.METHODS A comprehensive neurocognitive test battery assessed executive function,attention,processing speed,and memory in 162 medication-free MDD patients and 142 matched healthy controls.The 24-item Hamilton Depression Rating Scale was used to assess depressive symptoms,and the 14-item Hamilton Anxiety Scale was used to assess anxiety symptoms.Linear regression analyses and mediation analyses were conducted to evaluate the impact of depressive and anxiety symptoms,as well as their interactions,on cognitive impairments.RESULTS Among the depressive symptoms,sleep disturbances were associated with poorer executive function(P=0.004),lower processing speed(P=0.047),and memory impairments(P<0.001),and psychomotor retardation(PR)was associated with lower processing speed in patients with MDD(P=0.019).Notably,PR was found to mediate the impact of sleep disturbances on the processing speed.Regarding anxiety symptoms,psychic anxiety,rather than somatic anxiety,was associated with cognitive impairments in all aspects.Sleep disturbances mediated the effect of psychic anxiety on executive function[β=-0.013,BC CI(-0.027,-0.001)]and memory[β=-0.149,BC CI(-0.237,-0.063)],while PR mediated its effect on processing speed(β=-0.023,BC CI(-0.045,-0.004)].CONCLUSION Sleep disturbances may be a key predictor of poorer executive function,lower processing speed,and memory loss,while PR is crucial for lower processing speed during a depressive episode.Psychic anxiety contributes to all aspects of cognitive impairments,mediated by sleep disturbances and PR.

Psychomotor Development of Low Birth Weight Infants at the “Mère-Enfant” University Hospital Centre (UHC) of Libreville

Introduction: Low birth weight is a key indicator of newborn health. The objective of this study was to contribute to the reduction of low birth weight-related morbidity and mortality. Patients and Methods: cohort study conducted from January 2019 to July 2020 at the “Mère-Enfant” University Hospital Centre (UHC) of Libreville. All newborns with a birth weight 2500 g were included. The clinical data of patients were studied. They were followed over a period of 12 months and assessed psychomotorly by the Brunet-Lézine scale. Results: 1260/9035 births of low birth weight (14.0%) were observed, and 300 among them were included. The mortality rate was 27.0% (81) and 219 were followed for 12 months. The sex ratio was 0.8, the average birth weight was 2008.6 ± 215.2 g. The average gestational age was 34 ± 12 weeks with 75.3% prematurity. An infant disease was observed in 61.6% of cases and respiratory pathologies were more observed except at 3 months of age where the proportion of digestive pathologies was 20.5%. At the time of the last consultation at 12 months of life, 76.2% of infants had no pathology. The quotients of postural development, language and coordination were normal (between 110 - 70) respectively in 75.4%, 99.1% and 68% of cases at the age of 12 months. The psychomotor development quotient was correlated with the birth weight in the language area r = 0.15 (p = 0.024), posture r = 0.15 (p = 0.015) and coordination r = 0.15 (p = 0.026) respectively. Conclusion: Low birth weight is a public health problem at UHCME-JEF. Despite the fact that psychomotor development can be said to be satisfactory, many efforts remain to be made to reduce low birth weight levels and improve survival.

Ontogeny of Psychomotor and Sensory Functions in the Rat: Effects of Sexual Dimorphism

Background: We studied the development of eight (8) different psychomotor and sensory functions in male and female rats, from postnatal day 10 to 45, with the aim of determining whether the ontogenesis of these functions was subject to sexual dimorphism. Methods: Wistar rats bred according to standard conditions in our laboratories were put into reproduction. Ten days after whelping, male and female pups were identified and subjected to a battery of behavioral tests on postnatal days 10, 15, 20, 25, 30 and 45, to assess the development of the following psychomotor and sensory functions: Exploratory activity, locomotor activity, emotional defecation, hind paws lifting reflex latency, wire-grasping time, Latencies of execution of crawling along the wire and of leap onto the ground, nociception (tail flick) and body weight. Results: Only complex brain functions generated by cerebral cortex activities, i.e. exploratory activity and leap execution latency, do not undergo differential development sex-dependent. However, voluntary motor functions initiated in the motor cortex, and requiring high peripheral muscle performance such as crawling execution latency and wire-grasping time developed more rapidly in males than in females. Correlatively, body weight i.e. muscle mass index increased more speedily in males than in females. On the other hand, studies of automatic motor functions such as locomotor activity, and reflex motor functions i.e. hind paws lifting reflex latency and tail flick latency showed earlier development in females than in males. In addition, the study of emotional response, an emanation of limbic structures, showed prodigious development in females compared to males. Conclusion: Our studies have shown that there is a developmental sexual dimorphism of the central nervous system in the rat. Indeed, studies of automatic and reflex motor functions, whose activities are essentially linked to the spinal cord and brainstem, indicated that hindbrain areas develop more speedily in females than in males. Likewise, study of the emotional response emanating from diencephalic limbic structures, in particular the hypothalamus, showed a prodigious and early development in females compared to males. Taken together, our studies indicate that the vast majority of brain structures and functions reached maturation earlier in females than in males. Estrogen is the trigger hormone for early maturation of the female brain.

Investigation of the usefulness of zaleplon at two doses to induce afternoon-sleep under noise interference and its effects on psychomotor performance and vestibular function

Background:Military operation personnel often suffer from sleep difficulty because of their work requirements.In this study,we investigated the efficacy of zaleplon at two doses to induce afternoon-sleep under noise interference and its effects on psychomotor performance and vestibular function; we subsequently established the optimal dosage regimen for military operation personnel.Methods:Twenty-two healthy young male volunteers were recruited for the study.Eight subjects took 10 mg or 15 mg of zaleplon and placebo alternately and then were exposed to noise.Changes in polysomnography(PSG) indices,including sleep latency(SL),sleep efficiency(SE) and sleep structure,were recorded after drug administration.After awakening,the volunteers' subjective judgments of sleep quality and sleepiness were measured.Eight volunteers underwent 3 psychomotor performance tests at a one-week interval,and the psychomotor performance tests were conducted before and after taking zaleplon and placebo.Six volunteers participated in the vestibular function test session,and parameters,including optokinetic nystagmus(OKN),vestibular ocular reflex(VOR),visualvestibular ocular reflex(VVOR) and vestibular ocular reflex fixation suppression(VOR-Fix),were detected by the same experimental design as described above.The data of sleep observations were subjected to one-way variance analysis.Results:Compared with the placebo group,SL was shortened significantly,and the scores of subjective sleep quality and sleep depth were clearly increased in the zaleplon 10 mg group(P<0.05).Moreover,the SE and the percent of REM(rapid eye movement) sleep were increased remarkably in the zaleplon 15 mg group(P<0.01).Furthermore,the SE,percent of REM sleep and scores of subjective sleep depth in the zaleplon 15 mg group were significantly higher than in the zaleplon 10 mg group(P<0.05).The psychomotor performance did not change significantly after ingestion of 10 mg or 15 mg of zaleplon,whereas the OKN and VOR gains were lower in the two dose groups of zaleplon(P<0.05) and restored to normal 3h after drug ingestion.Conclusion:Zaleplon is an ideal hypnotic for military personnel,and its hypnotic efficiency is dose-related under noise interference; a 15 mg dose of zaleplon could provide significantly better sleep than a 10 mg dose of zaleplon.

Psychomotor Development of Children Born Premature at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (Cameroon)

Premature infants are at risk for developmental delay. We assessed the psychomotor development of children born before 37 weeks of gestation.?Methods:?This was a descriptive cross-sectional study conducted in the Pediatric Department of the Yaounde Gynaeco-Obstetric and Pediatric Hospital from January to May 2018. We used the Denver II scale to assess the psychomotor development of children born premature aged 9 months to 6 years. Children born between January 2012 and April 2017 at a gestational age strictly below 37 weeks of gestation were included. Using logistic regression, we searched for perinatal factors associated with abnormalities of psychomotor developmental.?Results:?We included 50 children in our study, 60% of whom were boys, giving a sex ratio of 1.5. The mean age was 25 ± 19.5 months. The mean gestational age was 33 ± 2.2 weeks and the mean birth weight was 2178.68 ± 748.01 g. The average Developmental Quotient of the population was 108. Six children (12%) had a global developmental delay (DQ ?70), 22% of the children had a language delay. Convulsion was associated with motor delay (OR = 16;P = 0.03), and pregnancy monitoring a protective factor for language delay (P = 0.02).?Conclusion:?Improving perinatal care remains a preoccupying issue. The assessment of psychomotor development should be done until early childhood to enable early diagnosis of learning disabilities.

CT Aspects of Psychomotor Delays in Children Aged 0 to 5 Years at Bogodogo University Hospital (Ouagadougou)

Background: Psychomotor delays in children are mainly investigated by CT imaging, due to the low availability and accessibility of magnetic resonance imaging in our context. Our aim was to study the CT aspects of psychomotor retardation (PMR) in children under 5 years of age at the University Hospital of Ouagadougou. Materials and Methods: Descriptive study with retrospective collection carried out over a period of twelve months (from September 2020 to August 2021). Our study focused on the reports of cranioencephalic CT scans performed on children aged 0 to 5 years, in whom a clinical diagnosis of psychomotor retardation had been made. Variables studied included socio-demographic data, clinical data, technique of CT examination, description of lesions and normality or not of the conclusion. Results: Cranioencephalic CT in children aged 0 - 5 years represented 9.78% of all CT scans performed in this age group. The sex ratio was 1.39. The mean age of the subjects in these reports was 18.31 ± 13.97 months and the modal class was [13 - 24] months. The CT scan was considered pathological in 85.10% of cases (n = 57). The most frequently noted encephalic anomalies were cerebral atrophy isolated in 54.4% of the cases (n = 31) or associated with other lesions in 30.1% of the cases (n = 17). Hydrocephalus was noted in 19.5% of the cases (n = 11). Conclusion: The lesions were mostly sequelae of cerebral ischaemia or cerebromeningeal infections. There were few cerebral malformations. There was no tumour etiology noted.

Physical,mental and psychomotor development of children born after multifetal pregnancy reduction:a retrospective case-control study

Objective:To assess the perinatal and developmental outcomes of assisted reproductive technologies(ART) children born after multifetal pregnancy reduction(MPR). Methods:Twenty-four ART children born after MPR were compared to 9 triplets without MPR,and 24 matched IVF children without MPR and 24 naturally conceived.Mental and psychological development was assessed by Bayley Scales.of Infant.The outcomes compared included perinatal characteristics,body mass index(BMI), mental development index(MDI) and psychomotor development index(PDI). Results:MPR singletons/twins had better neonatal outcomes than non-MPR triplets.Moreover,PDI of the MPR singletons/twins was significantly higher than that of the non-MPR triplets.There were no significantly difference in perinatal characteristics,BMI,MDI and PDI among 24 MPR children,24 matched IVF children without MPR and 24 matched naturally conceived children. Conclusion:Multifetal pregnancy reduction could improve perinatal outcomes and would not affect physical, mental and psychomotor development for children born after it.

Effects of hyperbaric oxygen therapy on human psychomotor performance:A review

Psychomotor performance is the coordination of a sensory or ideational(cognitive)process and a motor activity.All sensorimotor processes involved in planning and execution of voluntary movements need oxygen supply and seem to be significantly disrupted in states of hypoxia.Hyperbaric oxygen therapy has become a widely used treatment in routine medicine and sport medicine due to its beneficial effects on different aspects of human physiology and performance.This paper presents state-of-the-art data on the effects of hyperbaric oxygen therapy on different aspects of human psychomotor function.The therapy’s influence on musculoskeletal properties and motor abilities as well as the effects of hyperbaric oxygenation on cognitive,myocardial and pulmonary functions are presented.In this review the molecular and physiological processes related to human psychomotor performance in response to hyperbaric oxygen are discussed to contribute to this fast-growing field of research in integrative medicine.

瑞马唑仑与丙泊酚用于无痛胃肠镜检查后对精神运动功能恢复的影响

目的:比较瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉无痛胃肠镜检查患者术后精神运动功能恢复的情况。方法:选择无痛胃肠镜检查患者78例,随机分为瑞马唑仑组(RA组)和丙泊酚组(PA组),两组分别给予瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉,记录术前(T1)、开始检查时(T2)、苏醒时(T3)和离室时(T4)的血压、心率、呼吸和指脉氧饱和度;应用Trieger点测试(trieger dot test,TDT)和数字符号替换测试(digit symbol substitution test,DSST)评估术前(T1)、离室时(T4)和术后1 h(T5)、术后2 h(T6)时精神运动功能情况。结果:与T1相比,两组T4、T5时TDT试验中遗漏点数(number of dots missed,NDM)、遗漏点最远距离(maximum distance of dots missed,MDDM)和遗漏点平均距离(average distance of dots missed,ADDM)均增加,比较差异有统计学意义(P<0.05);与T1相比,两组T4、T5时DSST的完成率和正确率均降低,比较差异有统计学意义(P<0.05)。两组患者T6时TDT和DSST结果与T1比较差异无统计学意义(P>0.05)。与PA组相比,RA组T4、T5时NDM、MDDM和ADDM均降低,比较差异有统计学意义(P<0.05);RA组T4、T5时DSST完成率和正确率均增加,比较差异有统计学意义(P<0.05)。与PA组相比,RA组T2时低血压发生率降低,比较差异有统计学意义(P<0.05)。两组呼吸抑制发生率比较差异无统计学意义(P>0.05)。结论:瑞马唑仑复合阿芬太尼用于无痛胃肠镜检查,术后2 h精神运动功能完全恢复;瑞马唑仑组患者精神运动功能恢复快于较丙泊酚组,且不良反应少。

儿童脑瘫精细化管理在康复治疗中的作用

目的探讨精细化管理在脑瘫患儿康复治疗中的应用价值。方法2021-10—2022-12共71例脑瘫患儿(A组)入住郑州大学第二附属医院进行康复治疗及常规责任制整体护理,2023-02—2023-08入院的84例脑瘫患儿(B组)在精细化管理模式下行责任制整体护理的康复治疗。2组患儿均在入院时和半年后进行运动发育指数(PDI)和智力发育指数(MDI)评分,以及家长满意度调查。比较2组患儿PDI和MDI评分及家长满意度。结果入院时2组患儿PDI和MDI评分无统计学差异(分别为t=0.1495、1.498,P>0.05),治疗半年后,2组患儿PDI和MDI评分均较入院时明显提高,B组优于A组,差异均有统计学意义(分别为t=3.161、3.181,P<0.05)。B组患儿家长满意度显著高于A组,差异有统计学意义(χ2=4.492,P=0.034)。结论精细化管理能够提高脑瘫患儿的康复治疗效果,提高患儿家长的满意度,改善患儿远期预后。

家长参与式早期康复训练在精神运动发育迟缓患儿中的应用效果

目的:观察家长参与式早期康复训练在精神运动发育迟缓患儿中的应用效果。方法:选取2022年7月至2023年6月该院收治的96例精神运动发育迟缓患儿进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各48例。对照组实施常规康复训练,研究组在对照组基础上实施家长参与式早期康复训练。比较两组临床疗效,精神运动发育迟缓程度评分和运动功能评分。结果:研究组治疗总有效率为95.83%(40/48),高于对照组的83.33%(46/48),差异有统计学意义(P<0.05);干预后,两组发育商(DQ)评分高于干预前,且研究组高于对照组,差异有统计学意义(P<0.05);两组粗大运动发育商(GMQ)、精细运动发育商(FMQ)、总体运动发育商(TMQ)评分均高于干预前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论:家长参与式早期康复训练应用于精神运动发育迟缓患儿可提高治疗总有效率、精神运动发育迟缓程度评分和运动功能评分,效果优于单纯常规康复训练。

精神运动康复对住院青壮年精神分裂症患者康复的效果

背景精神分裂症患者的康复主要依靠药物治疗,然而,单纯药物治疗对患者社会功能和生活质量的改善难以达到预期效果。近年来,非药物康复措施越来越多地应用于精神障碍的治疗中,但关于精神运动康复对住院青壮年精神分裂症患者康复效果影响的研究有限。目的探讨精神运动康复对住院青壮年精神分裂症患者康复效果的影响,以期为住院青壮年精神分裂症患者的康复治疗提供参考。方法选取2021年6月—2022年6月在芜湖市第四人民医院住院治疗的、符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的104例青壮年患者为研究对象,采用随机数字表法分为研究组和对照组各52例。研究组和对照组均接受利培酮(2~4 mg/d)治疗及常规护理,研究组此基础上接受为期12周、每周2~3次、每次45~55 min的精神运动康复,对照组在研究结束后接受相同干预。于干预前、干预第4、8、12周接受阳性和阴性症状量表(PANSS)、住院精神病人社会功能评定量表(SSPI)和自知力与治疗态度问卷(ITAQ)评定。结果PANSS阳性症状分量表评分、阴性症状分量表评分、一般精神病理分量表评分、总评分、SSPI评分以及ITAQ评分的时间效应均有统计学意义(F=33.989、204.245、82.817、279.596、26.144、7.463,P均<0.01);PANSS阴性症状分量表评分、一般精神病理分量表评分、总评分和SSPI评分以及ITAQ评分的组间效应均有统计学意义(F=30.053、5.306、33.417、33.013、18.608,P<0.05或0.01);PANSS阳性症状分量表评分、阴性症状分量表评分、一般精神病理分量表评分、总评分和SSPI评分的时间与组间交互效应均有统计学意义(F=3.472、9.798、3.843、14.390、20.661,P<0.05或0.01)。干预第12周,研究组PANSS总评分及各分量表评分均低于干预前,SSPI评分高于干预前,差异均有统计学意义(P均<0.01),且研究组PANSS总评分及各分量表评分均低于对照组,SSPI评分高于对照组,差异均有统计学意义(P均<0.01)。结论精神运动康复可能有助于改善住院青壮年精神分裂症患者的精神病性症状和社会功能,提高康复效果。

运动康复和适应性身体活动对痉挛性脑性瘫痪儿童青少年心理运动功能、运动功能和动作发展的效益:基于ICF的循证研究

目的 系统评价运动康复和适应性身体活动对痉挛性脑瘫儿童心理运动功能、运动功能和动作发展影响的相关证据。方法 在PubMed、Embase、Web of Science和中国知网检索相关文献,时间范围为2010年1月至2023年6月。基于《国际疾病分类第十一次修订本》和《国际功能、残疾和健康分类》对文献内容进行解析和编码,并进行循证证据研究。结果 共纳入9篇文献,来自丹麦、韩国、澳大利亚、沙特阿拉伯、加纳、印度、日本,发表时间2015年至2022年。干预类型主要涉及运动康复(包括物理治疗)和适应性身体活动。运动康复包括上肢力量训练、下肢力量训练、平衡和协调训练、步态训练、功能性有氧运动、伸展和柔韧性练习、灵活性训练、肌肉放松技术;每次10~50 min,每周2~6次,身体活动强度为低~高,持续6~20周。适应性身体活动主要涉及适应性跑步训练、虚拟游戏;每次60 min,每周2~4次,身体活动强度为中至高强度,持续6~12周。干预场所主要为医疗和康复机构、学校、家庭社区。干预人员主要包括职业物理治疗师、大学研究人员、社区卫生人员和教师。干预结局主要体现在4个方面:心理运动功能、运动功能、动作发展、生活质量与福祉。在心理运动功能方面,脑瘫儿童青少年掌握跑步功能和知识,增强平衡反应能力。在运动功能方面,脑瘫儿童青少年肌力增加,肌肉耐力增强,肌张力扩大;步态功能、步行功能、步态对称性改善;行走耐力提高;站立功能改善;动态平衡改善;平衡控制能力改善。在动作发展方面,日常生活活动能力提高,学校以及闲暇时间休闲活动参与水平提高,运动范围扩大。在生活质量与福祉方面,脑瘫儿童青少年自信心和自尊心增强,疼痛缓解,社会幸福感和接受度提升。结论 本研究系统评价运动康复和适应性身体活动对痉挛性脑瘫儿童和青少年心理运动功能、运动功能和动作发展益处的相关证据。在心理运动功能领域,运动康复和适应性身体活动有助于改善痉挛性脑瘫儿童青少年的认知和运动功能;在运动功能方面,运动康复和适应性身体活动能改善肌肉相关功能、步态和步行功能,以及平衡与协调能力;在动作发展方面,运动康复和适应性身体活动显著提高日常生活活动能力和休闲身体活动参与水平;在生活质量与福祉方面,运动康复和适应性身体活动能够增强能量和驱力,缓解疼痛,提高社会幸福感和接受度。

精神运动康复对稳定期精神分裂症患者抑郁情绪的疗效观察

目的评估精神运动康复对稳定期精神分裂症患者抑郁情绪的影响。方法采用随机对照试验设计,共选择68例住院的稳定期精神分裂症患者,随机分配至观察组(34例)和对照组(34例)。对照组接受常规治疗,观察组在对照组的治疗基础上增加精神运动康复治疗,治疗周期为16周。使用抑郁自评量表(SDS)和卡尔加里精神分裂症抑郁量表(CDSS)于治疗前(0周)和治疗后(16周)对患者的抑郁症状进行评估。结果治疗16周后,与对照组相比,观察组的SDS和CDSS评分显著降低(P<0.05)。结论精神运动康复治疗能显著改善住院稳定期精神分裂症患者的抑郁情绪,SDS和CDSS的综合应用在评估治疗效果方面具有重要价值。这一发现为临床将精神运动康复纳入精神分裂症患者的康复治疗提供了实证支持。

重复经颅磁刺激联合感觉统合训练促进精神运动发育迟缓患儿康复的效果

目的:分析重复经颅磁刺激(rTMS)联合感觉统合训练对精神运动发育迟缓患儿康复的促进效果。方法:采取前瞻性随机对照研究方法,选取2020年6月—2022年6月于新余市妇幼保健院儿童神经康复科就诊的110例精神运动发育迟缓患儿作为研究对象,采用随机数字表法分为两组,各55例。对照组采用感觉统合训练,观察组采用rTMS联合感觉统合训练,两组均干预6个月。比较干预前后两组粗大运动功能及发育商。结果:干预6个月后,两组卧位与翻身、坐位、爬与跪、站立位及行走与跑跳评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预6个月后,两组发育商均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。结论:r TMS联合感觉统合训练可有效促进精神运动发育迟缓患儿粗大运动功能、提高患儿发育商。

思维导图在新生儿颅内出血护理中的效果评价

目的探讨与评价思维导图在新生儿颅内出血护理中的效果。方法回顾性选取2017年9月—2022年12月东莞市第八人民医院诊治的78例新生儿颅内出血患儿的临床资料,根据护理方法的不同分为两组,每组39例。对照组给予常规支持护理,导图组在对照组基础上给予思维导图护理,两组护理观察时间为1个月,评价两组新生儿行为能力评分、并发症发生情况与护理满意度。结果护理前,两组新生儿的精神行为能力评分比较,差异无统计学意义(P>0.05);护理后,两组新生儿行为能力评分均升高,且导图组(35.25±2.15)分高于对照组的(33.14±2.17)分,差异有统计学意义(t=13.484,P<0.05)。护理后,导图组并发症(呼吸暂停、惊厥、颅内高压)总发生率为12.82%(5/39),明显低于对照组的33.33%(13/39),差异有统计学意义(P<0.05)。导图组新生儿家属护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论思维导图在新生儿颅内出血护理中的应用能促进患儿的精神行为能力趋于正常,可降低患儿的并发症发生率,提高家属的护理满意度。

精神运动康复管理在老年患者跌倒风险干预中的应用效果

目的:探讨精神运动康复管理在老年患者跌倒风险干预中的应用效果。方法:选取2021年5—6月贵州航天医院收治的179例老年患者作为研究对象,将入院顺序编号为偶数的患者纳入观察组,入院顺序编号为奇数的患者纳入对照组。对照组实施常规护理干预,观察组在对照组基础上开展精神运动康复管理。比较两组生活能力、预防跌倒知信行评分。结果:干预后,观察组日常生活活动能力评估量表评分高于干预前及对照组,差异有统计学意义(P<0.05)。干预后,观察组知识、态度、行为评分高于干预前及对照组,差异有统计学意义(P<0.05)。结论:精神运动康复管理在老年患者跌倒风险干预中的应用效果显著,可改善患者生活能力及预防跌倒知信行情况。

飞行签派员警觉性预测三过程模型

为解决民航飞行签派员警觉性预测问题,在国际通用的警觉性理论基础上,通过电子手环监测与精神运动能力测试(PVT)数据分析,构建面向民航飞行签派员的警觉性预测三过程模型(TPMA)。首先,从国内大型运输航空公司的一线值班飞行签派员中选取120名被试,在40 h睡眠剥夺条件下定时采集体温数据,并对被试进行PVT测试;其次,使用余弦分析法确定相位,根据测试数据,确定模型的上下渐近线,睡眠转换阈值等关键参数;然后,通过提前唤醒,测试修正睡眠惯性过程;最后,测试120名被试用以验证模型,并额外选取3组不同排班方式的被试开展独立验证。结果表明:二谐量的余弦函数可以很好地拟合体温数据,拟合相位为16.88,警觉性昼夜节律参数为-55 ms/℃,上下渐近线分别为750、200 ms,睡眠转换阈值为437 ms;TPMA预测结果与规律作息测试数据拟合优度大于0.90,与实际工作条件下测试数据的拟合优度大于0.81。提出的飞行签派员TPMA具有较好的稳定性和适用性。

Outcome of Very Premature Newborns in a Referral Hospital in a Resource-Limited Setting

Background: In Cameroon, prematurity is considered among the first cause of neonatal mortality and the main cause of sequelae in children under 5 years old. Although some local teams have studied the causes of neonatal deaths, the survival of the very preterm babies in our context remains poorly known. Patients and Methods: We conducted a hospital-based cross-sectional study with both a retrospective and prospective data collection, covering a period of 5 years and 8 months, including 120 participants who presented with very preterm birth. Socio-demographic, anamnestic, and outcome features were studied. The assessment of the child’s psychomotor development was evaluated trough gross motor skills, fine motor skills, language and social contact. We calculated the development quotient (DQ) by dividing the developmental age (DA) by the actual age (RA) of the patient. Qualitative variables were expressed as numbers and percentages and quantitative variables as means ± standard deviations. Results: At the clinic, 23.8% of the children developed cerebral palsy, 3.1% had cerebral palsy with mental delay, and 6.6% had praxis disorders. Hearing impairment was observed in 6.3% of the survivors, visual impairment in 9%, and swallowing disorders in 7.6%. The mean developmental quotient was (89.98 ± 19.7) with a median of 93. A delay in developmental milestones was observed in 10.8%, speech disorder in 57%, severe malnutrition in 7.7%. The mortality rate was 48.5%. Conclusion: Very preterm birth is associated with a higher risk of neonatal death. Cognitive and motor disorders should not be underestimated. The harmonised management of very premature babies is highly recommended in our context for early diagnosis of sequelae.