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Effectiveness of Family-Based Behavioral Treatment Based on Medication Behavior Barkley Compared with Drug Therapy in Reducing the Symptoms of Children with Attention Deficit Disorder-Hyperactivity
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作者 Narges Dolatyari Seyyed Hossein Seid 《Health》 2015年第4期481-486,共6页
Children with attention deficit and hyper activity disorder have various problems such as low academic performance, social and communication problems, anxiety, depression, aggression, conduct disorder and delinquency,... Children with attention deficit and hyper activity disorder have various problems such as low academic performance, social and communication problems, anxiety, depression, aggression, conduct disorder and delinquency, and also when they become adults, they have problems in social relationships that these problems can increase or decrease in dealing with family. Hence, this study was performed in order to examine the impact of family-based behavioral treatment compared with Barkley behavior therapy in reducing symptoms of children with attention deficit disorder—ADHD. To meet the aim, 20 of children with age range of 7 to 12 years old with attention deficit disorder—hyperactivity were selected in both experimental and control groups, and exposed to the treatment of behavioral family therapy groups and changes in behavior Barkley. Before and after the treatment, they were evaluated according to the scale of the Conner’s Parent Rating Scale-Revised Short Form (CPRS-R: S). Results of multivariate analysis of covariance indicated that there were significant differences between the experimental group who had received family-based behavioral treatments based on changes in behavior Barkley and a control group who had received drug treatment in variables, including conduct problems, learning problems, psychosomatic symptoms, and signs of impulsive hyperactivity, anxiety and hyperactivity (p < 0.01). These results could be guidance for counsel or sand therapists for children with attention deficit disorder—ADHD. 展开更多
关键词 Family behavioral Treatment Based on Barkley behavior MEDICATION clinical SYMPtoMS IMPAIRED attention Deficit—Hyperactivity
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Innovation of Neuropsychopharmacological Experimental Methods to Investigate Attention in Human Participants and Its Validation by Randomized Double Blind Placebo Controlled Clinical Trial
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作者 Md. Sahab Uddin Abdullah Al Mamun Md. Asaduzzaman 《Journal of Behavioral and Brain Science》 2016年第7期280-293,共14页
In terms of advancement of life to meet the challenges new method for neuropsychopharmacological research are continually developing to ensure superior safety, accuracy, efficacy, precision etc. In this experiment, we... In terms of advancement of life to meet the challenges new method for neuropsychopharmacological research are continually developing to ensure superior safety, accuracy, efficacy, precision etc. In this experiment, we suggested and validated two neuropsychopharmacological testing methods, these are Numeral Finding (NF) and Typo Revealing (TR) tests for the determination of attention in healthy aged human participants. The objective of this experiment was to generate more effective testing methods for the assessment of attention in human. The rationality of the aforementioned methods was checked by a randomized double blind placebo controlled clinical trial for the period of 21 days among healthy aged human participants. The experiment was conducted at Gazipur Sadar, Gazipur-1703, Dhaka, Bangladesh between the period of December 2015 and March 2016. The experiment center was the Department of Pharmacy, Southeast University, Dhaka-1213, Bangladesh. In this experiment, 60 healthy male participants between the age ranges of 40 to 50 years old were selected and randomly divided by simple randomization process into 3 groups with 20 participants in each. Ginkgo biloba standardized extract’s capsule (Giloba<sup>?</sup><sup></sup> and Kobi<sup>?</sup>) was used as a standard and as a placebo control psyllium seed husk (i.e., seed of the Plantago ovata) was used after filling in the hard gelatin capsule shell (size 0). Group 1 was treated with Giloba<sup>? </sup>in which each capsule contained 120 mg Ginkgo biloba standardized extract (GBG) and group 2 was treated with Kobi<sup>?</sup> in which each capsule contained 60 mg Ginkgo biloba standardized extract (GBK). The treatment procedure for group 3 was psyllium seed husk’s capsule that served as placebo control (PC). Throughout the experiment each capsule was administered 3 times daily. Treatment with Ginkgo biloba standardized extracts for successive days markedly increased the attention of the participants with respect to PC group. In the NF test, administration of GBG and GBK extracts significantly (P P P < 0.01) increased the attention of the participants on 14<sup>th</sup> and 21<sup>st</sup> day as compared to that of PC group. For TR test treatment with GBG and GBK extracts markedly (P P P < 0.01) increased the attention of the participants on 14<sup>th</sup> and 21<sup>st</sup> day with respect to PC group. The existing experiment proved that NF and TR tests undoubtedly revealed the attention enhancing activity of the Ginkgo biloba standardized extracts in healthy aged human participants. Consequently, the recommended newly emerging methods can be used for the assessment of attention in human and will create a miracle in the domain of neuroscience. 展开更多
关键词 NEUROPSYCHOPHARMACOLOGY Numeral Finding Test Typo Revealing Test attention clinical Trial
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How does a real-world child psychiatric clinic diagnose and treat attention deficit hyperactivity disorder? 被引量:3
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作者 Kumi Yuki Jyoti Bhagia +1 位作者 David Mrazek Peter S Jensen 《World Journal of Psychiatry》 SCIE 2016年第1期118-127,共10页
AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS... AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized. 展开更多
关键词 attention DEFICit HYPERACTIVitY DISORDER Oppositional defiant DISORDER Vanderbilt attention DEFICit HYPERACTIVitY DISORDER Diagnostic Rating Scale Quality assessment clinical practice
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Attentional Bias in Anxious Youth: Clinical Applications
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作者 Adam S.Weissman 《Psychology Research》 2020年第12期465-479,共15页
Over the past decade,the clinical applications of cognitive psychology and neuropsychology methods have increased in popularity,permeating the clinical,education,and public health sectors.At the federal level,NIMH and... Over the past decade,the clinical applications of cognitive psychology and neuropsychology methods have increased in popularity,permeating the clinical,education,and public health sectors.At the federal level,NIMH and the Institute of Education Sciences are regarding clinical-translation research as a top priority area for empirical investigation,and several national organizations including APA,the National Academy of Neuropsychology,the Society for Neuroscience,and the Neurocognitive Therapies/Translational Research Special Interest Group are recognizing the important influence of neuroscience and neuropsychology in understanding clinical pathology and guiding intervention plans.This line of inquiry has opened significant avenues for research and innovation in clinical practice,and the study of attentional bias in the etiology,assessment,and treatment of anxiety disorders is one of these important avenues.In recent years,researchers have extended early findings about the neurocognitive processes underpinning threat bias to enhance our understanding of risk factors and mechanisms of anxiety disorders,and inform the development of novel applications for clinical assessment and intervention.However,studies exploring these practical applications of attentional bias and dot probe methodology with anxious children and adolescents lag far behind.The following chapter will briefly review the literature on the clinical implications and direct clinical utility of cognitive psychology methods for measuring attentional threat bias in anxious youth.Applications for enhancing clinical assessment and intervention will be reviewed and discussed.Ultimately,advancing our knowledge of brain-behavior relationships,cognitive mechanisms of therapeutic change,and the efficacy of novel neurocognitive interventions may contribute to a better understanding of emotional and behavior disorders in children and the development of targeted interventions that result in greater treatment efficacy. 展开更多
关键词 youth anxiety attentional bias neurocognitive therapies NEUROPSYCHOLOGY clinical psychology clinical neuroscience
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Innovation and Validation of Neuropsychopharmacological Testing Methods for the Assessment of Memory, Attention and Cognition in Human Participants
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作者 Md. Sahab Uddin Md. Asaduzzaman 《Neuroscience & Medicine》 2016年第3期83-98,共16页
To meet the challenges of time searching for the new method for neuropsychopharmacology is still an ongoing process. In this experiment, we proposed and validated three neuropsychopharmacological testing methods, whic... To meet the challenges of time searching for the new method for neuropsychopharmacology is still an ongoing process. In this experiment, we proposed and validated three neuropsychopharmacological testing methods, which are Matching Capacity (MC), Dissimilarity Identification (DI) and Sense Making (SM) tests for the estimation of memory, attention and cognition respectively in healthy aged human participants. The purpose of this experiment was to generate more effective testing methods for the determination of memory, attention and cognition in human. To endorse proposed methods a randomized double blind placebo controlled clinical trial was conducted among healthy aged human participants between the period of December 2015 and February 2016. The experiment was conducted at Gazipur Sadar, Gazipur-1703, Dhaka, Bangladesh and the experiment center was the Department of Pharmacy, Southeast University, Dhaka-1213, Bangladesh. In this experiment, 60 healthy male participants between the age of 42 to 50 years were selected and divided into 4 groups with 15 participants in each by simple randomization process. Ginkgo biloba standardized extract’s capsule (Giloba?) and Bacopa monnieri standardized extract’s syrup (Monera?) were used as standard. Psyllium seed husk (i.e., seed of the Plantago ovata) was incorporated in the hard gelatin capsule shell (size 0) to prepare capsule and used as a placebo control of the capsule (PCC). Excipients of oral liquid preparation of vitamin were used to prepare syrup and used as a placebo control of the syrup (PCS). The treatment procedure for group 1 was Ginkgo biloba standardized extract’s capsule (120 mg/capsule), 3 times daily for 21 days;group 2 was treated with Bacopa monnieri standardized extract’s syrup (1.21 g/5 ml), 2 teaspoonfuls, 3 times daily for 21 days. Psyllium seed husk’s capsule and excipients of oral liquid vitamin’s syrup were used as placebo control (PC) for group 3 and group 4 and administered in the similar manner of group 1 and group 2, respectively. Administration of Ginkgo biloba (GB) and Bacopa monnieri (BM) standardized extracts for successive days significantly increased the memory, attention and cognition of the participants with respect to PC groups. In the MC test, treatment with GB extract markedly (P < 0.05) increased the memory of the participants on 21st day with respect to PCC group. On the other hand administration of BM extract remarkably (P < 0.01) increased the memory of the participants on 14th day in comparison with PCS group. For DI test, administration of GB extract noticeably (P < 0.01, P < 0.05) increased the attention of the participants on 14th and 21st day as compared to that of PCC group. Conversely BM extract significantly (P < 0.05, P < 0.01) increased the attention of the participants on 7th, 14th and 21st day with regard to PCS group. In the SM test, administration of GB extract noticeably (P < 0.05) increased the cognition of the participants on 7th and 21st day in comparison with PCC group. BM extract administration considerably (P < 0.01) increased cognition of the participants on 14th and 21st day related to the PCS groups. The experiment demonstrates that MC, DI and SM tests clearly exposed the memory, attention and cognition enhancing activity of the GB and BM standardized extracts in healthful aged human participants respectively. Therefore, the proposed method can be used for the fortitude of memory, attention and cognition in human and will generate a landmark in the sphere of neuroscience. 展开更多
关键词 NEUROPSYCHOPHARMACOLOGY Matching Capacity Test Dissimilarity Identification Test Sense Making Test MEMORY attention COGNitION clinical Trial
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维生素D联合盐酸托莫西汀治疗儿童注意力缺陷多动障碍的临床疗效和安全性评价 被引量:1
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作者 钦云峰 凌寅杰 郎妍 《中国药师》 CAS 2024年第2期287-294,共8页
目的 评价维生素D联合盐酸托莫西汀治疗儿童注意力缺陷多动障碍(ADHD)的临床疗效和安全性。方法 回顾性分析2022年9月至2023年9月湖州市第一人民医院收治ADHD患儿资料,根据患儿诊疗方案,将其分为联合组和对照组。观察比较治疗后AHDH患... 目的 评价维生素D联合盐酸托莫西汀治疗儿童注意力缺陷多动障碍(ADHD)的临床疗效和安全性。方法 回顾性分析2022年9月至2023年9月湖州市第一人民医院收治ADHD患儿资料,根据患儿诊疗方案,将其分为联合组和对照组。观察比较治疗后AHDH患儿治疗疗效及治疗前、治疗3个月后认知功能[简易精神状态检测量表(MMSE)评分和韦氏儿童智力量表第四版(WISC-Ⅳ)评分]、行为功能障碍[康纳儿童行为量表(Conners)评分]、神经损伤标志物[神经特异性烯醇化酶(NSE)和神经丝轻链蛋白(NFL)]。观察并记录治疗期间不良反应发生情况评估安全性。结果共纳入101例ADHD患儿,联合组51例,对照组50例。治疗后,联合组治疗总有效率显著高于对照组(P <0.05)。治疗前,两组ADHD患儿的MMSE评分、WISC-Ⅳ评分、Conners各项评分、血清NSE水平和血清NFL水平差异无统计学意义(P> 0.05)。治疗后,两组ADHD患儿的MMSE评分、WISC-Ⅳ评分、Conners各项评分、血清NSE水平和血清NFL水平均较治疗前显著改善(P <0.05),且联合组改善程度较对照组好(P <0.05)。治疗期间,两组患儿不良反应发生率差异无统计学意义(P> 0.05)。结论 与盐酸托莫西汀单药治疗相比,维生素D联合盐酸托莫西汀对ADHD患儿疗效更佳,可改善认知功能、行为功能障碍和神经功能损伤,且安全性高。 展开更多
关键词 维生素D 盐酸托莫西汀 儿童注意力缺陷多动障碍 临床疗效 安全性
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伴情绪失调的注意缺陷多动障碍患儿执行功能与临床特征
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作者 杨燕平 李思迅 +5 位作者 王美雯 王卓 刘沛 罗婷婷 陶煜杰 黄颐 《四川精神卫生》 2024年第4期307-311,共5页
背景伴情绪失调的注意缺陷多动障碍(ADHD)可能是ADHD的一种特殊亚型,其共病焦虑障碍或抑郁障碍的风险更高,临床预后更差,有必要探索其独特的执行功能特征及临床特征。目前,将ADHD患儿分为伴与不伴情绪失调者并分析其临床特征与执行功能... 背景伴情绪失调的注意缺陷多动障碍(ADHD)可能是ADHD的一种特殊亚型,其共病焦虑障碍或抑郁障碍的风险更高,临床预后更差,有必要探索其独特的执行功能特征及临床特征。目前,将ADHD患儿分为伴与不伴情绪失调者并分析其临床特征与执行功能的研究有限。目的探索伴情绪失调的ADHD患儿执行功能与临床特征。方法纳入2020年6月—2023年12月在四川大学华西医院心理卫生中心门诊就诊的、符合《精神障碍诊断与统计手册(第5版)》(DSM-5)诊断标准的7~12岁ADHD患儿118例。采用Achenbach儿童行为量表(CBCL)进行评定,以CBCL中的焦虑/抑郁、攻击性行为、注意问题三个分量表评分之和的T分数,将ADHD患儿分为伴情绪失调组(n=68)和不伴情绪失调组(n=50)。采用中文版注意缺陷多动障碍SNAP-Ⅳ评定量表-父母版(SNAP-IV)、中国修订韦氏儿童智力量表(C-WISC)及Weiss功能缺陷量表父母版(WFIRS-P)分别评定患儿核心症状、智力水平及功能受损情况。采用剑桥神经心理自动化成套测试(CANTAB)中的4个测试评定执行功能:①剑桥球袋测试(SOC)评定空间计划能力;②目标内外注意转换(IED)评定认知灵活度,以完成阶段错误数量为指标;③空间工作记忆(SWM)评定空间工作记忆;④快速视觉信息处理(RVP)评定持续注意力。结果伴情绪失调组SNAP-IV注意缺陷、多动/冲动、对立违抗分量表评分及总评分均高于不伴情绪失调组(t=3.206、5.088、6.316、6.553,P均<0.01)。伴情绪失调组WFIRS-P家庭、学习/学校、生活技能、自我观念、社交活动、冒险活动分量表评分及总评分均高于不伴情绪失调组(t=6.074、4.406、4.143、3.984、6.575、6.662、8.254,P均<0.01)。伴情绪失调组CANTAB中的IED任务中的完成阶段错误数量高于不伴情绪失调组(t=2.168,P<0.05)。结论伴情绪失调的ADHD患儿核心症状及社会功能受损更严重,执行功能中的认知灵活度更差。 展开更多
关键词 注意缺陷多动障碍 情绪失调 临床特征 执行功能
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医学院校临床医学专业学生社交焦虑与人际关系困扰的关系研究——注意焦点的中介作用
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作者 房晓庆 李莉 +4 位作者 孟雨 刘娜 刘雅鑫 丁雪梅 张晓丽 《卫生职业教育》 2024年第13期125-128,共4页
目的探讨临床医学专业学生注意焦点在社交焦虑和人际关系困扰间所起的中介作用。方法采用分层随机抽样法抽取山东省某医学院校临床医学专业本科生为研究对象,采用社会焦虑量表、注意焦点量表、人际关系心理诊断量表进行调查。结果医学... 目的探讨临床医学专业学生注意焦点在社交焦虑和人际关系困扰间所起的中介作用。方法采用分层随机抽样法抽取山东省某医学院校临床医学专业本科生为研究对象,采用社会焦虑量表、注意焦点量表、人际关系心理诊断量表进行调查。结果医学院校临床医学专业本科生社交焦虑、注意焦点、人际关系困扰两两间呈正相关关系,社交焦虑不仅对人际关系困扰有直接影响,而且可以通过注意焦点间接影响人际关系困扰。结论临床医学专业学生注意焦点在社交焦虑与人际关系困扰间起部分中介作用,因此,可通过降低学生社交焦虑及注意焦点水平来消除人际关系困扰。 展开更多
关键词 临床医学专业 社交焦虑 注意焦点 人际关系困扰
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重复经颅磁刺激治疗对注意力缺陷伴多动障碍患儿临床疗效、认知功能及神经递质的影响
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作者 卞新华 霍艳飞 +1 位作者 赵永红 韩晓霞 《四川生理科学杂志》 2024年第3期548-550,共3页
目的:分析重复经颅磁刺激(Repeat transcranial magnetic stimulation,rTMS)对注意力缺陷伴多动障碍患儿临床疗效、认知功能及神经递质的影响.方法:选择2020年5月-2023年1月于本院就诊治疗的注意力缺陷伴多动障碍患儿202例作为研究对象... 目的:分析重复经颅磁刺激(Repeat transcranial magnetic stimulation,rTMS)对注意力缺陷伴多动障碍患儿临床疗效、认知功能及神经递质的影响.方法:选择2020年5月-2023年1月于本院就诊治疗的注意力缺陷伴多动障碍患儿202例作为研究对象.根据治疗方案不同,将患儿分为对照组(99例)和观察组(103例).对照组采用药物治疗;观察组在对照组基础上采用rTMS治疗.分析比较两组的临床疗效,认知功能[Conners儿童行为量表、韦氏儿童智力量表(Wechsler Intelligence Scale for Children,WISC-Ⅳ)]、神经递质[脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)、神经元特异性烯醇化酶(Neuron-specific enolase,NSE)].结果:观察组的治疗总疗效显著高于对照组(P<0.05).观察组注意力缺陷、多动-冲动及对立违抗评分下降程度大于对照组(P<0.05).观察组Conners儿童行为量表评分低于对照组,WISC-Ⅳ评分均明显高于对照组(P<0.05).观察组BDNF水平高于对照组,NSE水平低于对照组(P<0.05).结论:rTMS治疗对注意力缺陷伴多动障碍患儿临床疗效具有提升效果,可有效改善认知功能,且调节BDNF、NSE水平. 展开更多
关键词 重复经颅磁刺激 注意力缺陷伴多动障碍 临床疗效 认知功能 神经递质
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深部经颅磁刺激在精神障碍的临床应用
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作者 许月航 王学义 《中国神经精神疾病杂志》 CAS CSCD 北大核心 2024年第11期699-704,共6页
深部经颅磁刺激(deep transcranial magnetic stimulation,dTMS)作为常见物理治疗方式的一种,近年来已越来越多地应用于各类精神疾病的治疗研究中。目前大部分研究集中于抑郁障碍、强迫障碍、物质使用障碍等精神疾病,治疗方案初步成熟,... 深部经颅磁刺激(deep transcranial magnetic stimulation,dTMS)作为常见物理治疗方式的一种,近年来已越来越多地应用于各类精神疾病的治疗研究中。目前大部分研究集中于抑郁障碍、强迫障碍、物质使用障碍等精神疾病,治疗方案初步成熟,取得了较好的疗效,加速治疗方案在抑郁障碍、强迫障碍中初见成效。也有研究尝试使用dTMS治疗双相抑郁、创伤后应激障碍、注意缺陷多动障碍、广泛性焦虑障碍、进食障碍等疾病,改善了部分症状,但是否具有切实的疗效仍需进一步研究。目前研究也在尝试使用不同线圈,探索不同治疗部位、不同治疗方案对各类疾病的疗效,以寻求更好的治疗效果。 展开更多
关键词 深部经颅磁刺激 抑郁障碍 强迫障碍 物质使用障碍 创伤后应激障碍 注意缺陷多动障碍 广泛性焦虑障碍 进食障碍 临床疗效
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临床药学专业学生的药学叙事能力现状调查
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作者 杜林哲 刘宇恺 戈陈艳 《医药前沿》 2024年第27期14-17,26,共5页
目的:调查临床药学专业学生药学叙事能力现状,探索相关教学模式。方法:2022年4—5月,通过问卷形式对江苏省某2所医药类大学临床药学专业学生进行调查。调查问卷包括基本信息、叙事能力、能力评估3部分,记录药学生叙事能力得分,并比较不... 目的:调查临床药学专业学生药学叙事能力现状,探索相关教学模式。方法:2022年4—5月,通过问卷形式对江苏省某2所医药类大学临床药学专业学生进行调查。调查问卷包括基本信息、叙事能力、能力评估3部分,记录药学生叙事能力得分,并比较不同性别、年龄、选择药学专业原因及在本次调查前对叙事药学不同熟悉程度药学生的叙事能力得分差异。本研究共回收问卷112份,有效问卷105份,有效回收率为93.8%。结果:105名学生叙事药学能力4个维度平均得分(3.51±0.75)分,其中关注倾听、沟通回应、理解再现及反思评价平均得分为(2.99±0.95)、(3.52±0.69)、(3.67±0.56)及(3.69±0.72)分。相比于女性而言,男性药学生在沟通回应、理解再现与自我评价维度上得分更高;在选择药学专业原因上,个人兴趣或推荐的药学生在关注倾听维度上得分低于专业调剂或其他原因,而在自我评价维度得分高于专业调剂或其他原因;在本次调查前对叙事药学熟悉程度上,从未接触的药学生在沟通回应和理解再现维度上得分低于听说过或熟悉的药学生,差异均有统计学意义(P<0.05)。结论:临床药学专业学生叙事能力处于中等水平,其中关注倾听维度得分显著低于其他维度,未来在临床药学教育中可考虑增加叙事药学相关内容。 展开更多
关键词 学生 叙事药学 临床药学 药学实践 药学教育 教学模式 关注倾听
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临床路径管理模式DRG付费质量管理对提升医疗质量的效果
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作者 陈秋华 《中国医药指南》 2024年第27期97-99,共3页
目的分析临床路径管理模式DRG付费质量管理对提升医疗质量的意义。方法选取2023年1月至2023年12月我院接收的200例手术住院患者,采用随机数字表法分为观察组(100例)和对照组(100例),对照组采用常规DRG付费质量管理,观察组采用临床路径... 目的分析临床路径管理模式DRG付费质量管理对提升医疗质量的意义。方法选取2023年1月至2023年12月我院接收的200例手术住院患者,采用随机数字表法分为观察组(100例)和对照组(100例),对照组采用常规DRG付费质量管理,观察组采用临床路径管理模式DRG付费质量管理,对两组患者治愈好转率、手术部位感染率、入院至手术间隔时间、住院时间、平均住院费用、药品次均费用、耗材次均费用、病案书写缺陷扣分(患者基本信息、诊疗信息、住院过程信息、费用信息)、患者总满意度进行对比。结果观察组患者治愈好转率、患者总满意度高于对照组(P<0.05),手术部位感染率低于对照组(P<0.05),且观察组患者入院至手术间隔时间、住院时间短于对照组(P<0.05),平均住院费用、药品次均费用、耗材次均费用以及患者基本信息、诊疗信息、住院过程信息、费用信息等病案书写缺陷扣分低于对照组(P<0.05)。结论临床路径管理模式DRG付费质量管理能有效规范病案书写,缩短手术间隔时间、住院时间,降低平均住院费用、药品次均费用、耗材次均费用、病案书写缺陷扣分及手术部位感染率,提高患者满意度,对于提升医疗质量具有积极的意义。 展开更多
关键词 临床路径管理模式 DRG付费质量管理 医疗质量
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面向白内障识别的临床特征校准注意力网络
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作者 章晓庆 肖尊杰 +3 位作者 赵宇航 巫晓 东田理沙 刘江 《计算机工程与应用》 CSCD 北大核心 2024年第3期321-330,共10页
近年来,卷积神经网络(convolutional neural network,CNN)模型已经被广泛用于年龄相关性白内障自动分类任务,然而,鲜有研究工作将年龄相关性白内障的临床先验知识注入卷积神经网络架构设计中,以此来提高年龄相关性白内障的分类效果和改... 近年来,卷积神经网络(convolutional neural network,CNN)模型已经被广泛用于年龄相关性白内障自动分类任务,然而,鲜有研究工作将年龄相关性白内障的临床先验知识注入卷积神经网络架构设计中,以此来提高年龄相关性白内障的分类效果和改善模型决策过程的可解释性。提出了一种临床特征校准注意力网络(clinical feature recalibration attention network,CFANet)模型用于自动识别年龄相关性白内障严重级别。在CFANet中,设计了一个简单且有效的临床特征校准注意力模块(clinical feature recalibration attention block,CFA),其不仅能对不同临床特征类型进行自适应地加权融合,还通过门控操作符来突出重要通道和抑制不重要通道。在一个核性白内障的眼前节光学相干断层成像影像(anterior segment optical coherence tomography,AS-OCT)数据集和一个公开眼科影像数据集上进行了充分实验,实验结果表明,相较于squeeze-and-excitation network(SENet)、efficient channel network(ECANet)、style-based recalibration module(SRM),CFANet在AS-OCT数据集上的分类准确率至少提升了3.54个百分点,同时在公开的眼科影像数据集上的分类结果比先进的神经网络模型和已发表的研究工作提升了1个百分点以上。此外,还通过可视化方法分析临床特征的权重分布和通道的注意力权重分布来提高该文模型决策过程的可解释性。 展开更多
关键词 年龄相关性白内障分类 眼前节光学相干断层成像 临床特征校准注意力模块 可解释性 卷积神经网络 可视化
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USEVis:Visual analytics of attention-based neural embedding in information retrieval
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作者 Xiaonan Ji Yamei Tu +3 位作者 Wenbin He Junpeng Wang Han-Wei Shen Po-Yin Yen 《Visual Informatics》 EI 2021年第2期1-12,共12页
Neural attention-based encoders,which effectively attend sentence tokens to their associated context without being restricted by long-term distance or dependency,have demonstrated outstanding performance in embedding ... Neural attention-based encoders,which effectively attend sentence tokens to their associated context without being restricted by long-term distance or dependency,have demonstrated outstanding performance in embedding sentences into meaningful representations(embeddings).The Universal Sentence Encoder(USE)is one of the most well-recognized deep neural network(DNN)based solutions,which is facilitated with an attention-driven transformer architecture and has been pre-trained on a large number of sentences from the Internet.Besides the fact that USE has been widely used in many downstream applications,including information retrieval(IR),interpreting its complicated internal working mechanism remains challenging.In this work,we present a visual analytics solution towards addressing this challenge.Specifically,focused on semantics and syntactics(concepts and relations)that are critical to domain clinical IR,we designed and developed a visual analytics system,i.e.,USEVis.The system investigates the power of USE in effectively extracting sentences’semantics and syntactics through exploring and interpreting how linguistic properties are captured by attentions.Furthermore,by thoroughly examining and comparing the inherent patterns of these attentions,we are able to exploit attentions to retrieve sentences/documents that have similar semantics or are closely related to a given clinical problem in IR.By collaborating with domain experts,we demonstrate use cases with inspiring findings to validate the contribution of our work and the effectiveness of our system. 展开更多
关键词 interactive visual system Neural embedding attention mechanism Document understanding information retrieval clinical decision-making
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儿童多动症中医学研究现状分析 被引量:28
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作者 韩新民 袁海霞 +1 位作者 杨江 雷爽 《中华中医药学刊》 CAS 北大核心 2020年第2期4-7,共4页
对近40年来中医药治疗儿童多动症临床研究、实验研究进行分析评述,并提出不足和展望。临床学术观点主要分从虚论治和从实论治;临床用药以补益、安神、平肝为主,且缺少治疗实证的中成药;临床路径制订及指南修订促进了行业规范化;中医药... 对近40年来中医药治疗儿童多动症临床研究、实验研究进行分析评述,并提出不足和展望。临床学术观点主要分从虚论治和从实论治;临床用药以补益、安神、平肝为主,且缺少治疗实证的中成药;临床路径制订及指南修订促进了行业规范化;中医药治疗具有不可替代的优势。实验研究获得国家自然科学基金大力资助,取得一定成果。规范临床试验研究,研发确有疗效的中药新药,研究"病证结合"的动物模型,揭示中医药治疗儿童多动症的科学内涵是今后努力的方向。 展开更多
关键词 儿童多动症 注意缺陷多动障碍 中医学 研究现状 综述
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临床药师在DRG实施中的作用思考 被引量:25
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作者 孙雪林 张亚同 胡欣 《中国合理用药探索》 CAS 2020年第8期8-10,共3页
《国家医疗保障DRG分组与付费技术规范》与《国家医疗保障DRG分组方案(核心组ADRG)》的正式发布,标志着我国医保CHS-DRG付费试点正式进入落地实施阶段。目前规定药师为处方审核第一责任人。随着国家疾病诊断相关分组(DRGs)付费试点工作... 《国家医疗保障DRG分组与付费技术规范》与《国家医疗保障DRG分组方案(核心组ADRG)》的正式发布,标志着我国医保CHS-DRG付费试点正式进入落地实施阶段。目前规定药师为处方审核第一责任人。随着国家疾病诊断相关分组(DRGs)付费试点工作的展开,临床药师应助力知识库的完善,规范临床路径中的药品选择,从而提高临床医生在DRGs考核中的效率得分,并最终提高临床科室及整个医院的服务效率得分,提升医疗价值。本文探讨临床药师在实施DRGs付费诊疗后可能发挥的作用,仅供参考。 展开更多
关键词 临床药师 疾病诊断相关分组(DRG) 合理用药 付费诊疗 医疗保障
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优秀女子短跑运动员有氧-无氧能力特征及训练效应 被引量:16
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作者 姜文凯 秦学林 汤强 《中国临床康复》 CSCD 2003年第30期4096-4097,共2页
目的:通过女子短跑运动员1年训练中有氧-无氧能力的跟踪观察,为训练监控中的综合分析评定提供参考。方法:21名优秀女子短跑(100~400m)运动员和10名中跑(800~1500m)运动员参加预期性研究;分别在Max-1气体代谢分析仪上完成最大有氧能力... 目的:通过女子短跑运动员1年训练中有氧-无氧能力的跟踪观察,为训练监控中的综合分析评定提供参考。方法:21名优秀女子短跑(100~400m)运动员和10名中跑(800~1500m)运动员参加预期性研究;分别在Max-1气体代谢分析仪上完成最大有氧能力试验;在Monark834E功率车上完成改进的Wingate无氧试验。根据年训练周期,共进行3次该组合试验并分析其间的关系。结果:在基本能力评定中,短跑组VO2max显著低于中跑组(平均为2.41和2.74L/min,P<0.05);最大无氧功(PeakPower,P-peak)和平均无氧功(AveragePower,P-ave)显著高于中跑组(分别为744.2和584.2W,P<0.01;517.7和427.8W,P<0.01)。在跟踪测试中,短跑组显示前半周期最大输出功率(MaximalOutputPower,Wmax)、最大通气量(MaximalVoluntaryVentilation,VEmax)和P-ave显著提高,后半周期VO2max,VEmax和最小无氧功(LowPower,P-low)明显下降,而起始无氧功(StartofLoading,P-sta)和P-peak显著提高。中跑组仅在后半周期VO2max显著提高;VO2max,Wmax和VEmax分别与P-low,P-ave呈正相关(r=0.47~0.70,P<0.05)。结论:速度耐力是短跑的关键素质,不仅与无氧代谢能力有直接关系,也离不开有氧供能基础.短跑成绩的提高,需重视最大速度和专项耐力的协调发展。对有氧-无氧能力的组合监测,有? 展开更多
关键词 优秀女子运动员 有氧能力 无氧能力 训练效应 短跑 速度耐力
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成人注意缺陷多动障碍不同亚型患者的工作记忆 被引量:5
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作者 赵希希 孙黎 +3 位作者 王恩聪 吴占良 曹庆久 王玉凤 《中国心理卫生杂志》 CSSCI CSCD 北大核心 2014年第6期411-416,共6页
目的:探讨成人注意缺陷多动障碍(ADHD)不同亚型患者的工作记忆特点,比较两种亚型患者的工作记忆受损程度.方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准的50例注意缺陷型(ADHD-I)、20例混合型(ADHD-C)成人... 目的:探讨成人注意缺陷多动障碍(ADHD)不同亚型患者的工作记忆特点,比较两种亚型患者的工作记忆受损程度.方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准的50例注意缺陷型(ADHD-I)、20例混合型(ADHD-C)成人患者及51例年龄、智商相匹配的正常对照(18 ~ 39岁)完成n-back(0、1、2)任务,比较三组被试的反应时(RT)、正确率和个体内反应时标准差(ISD).结果:所有被试在完成n-back任务时,其RT和ISD均随工作记忆负荷增加而增大(P〈0.001),而正确率随工作记忆负荷增加而减小(P〈0.001),呈现等级变化规律.组间比较发现,ADHD-C患者完成n-back任务时反应时间长于正常对照[(535.9±115.9) ms vs.(470.1±66.5) ms,P〈0.01]和ADHD-I患者[(535.9±115.9) msvs.(487.8±76.6)ms,P〈0.05],ADHD-C患者执行n-back任务时正确率低于正常对照[(88.3±10.1)%vs.(94.2±4.3)%,P〈0.01]和ADHD-I患者[(88.3±10.1)%vs.(93.2±6.6)%,P〈0.01],ADHD-C患者完成n-back任务时ISD大于正常对照[(166.7±41.9) vs.(147.3±33.1),P〈0.05];ADHD-I患者完成n-back任务时RT、正确率和ISD[(158.1±37.9) vs.(147.3±33.1)]与正常对照差异均无统计学意义(P〉0.05).结论:成人ADHD不同亚型患者工作记忆受损程度可能不同,混合型患者的工作记忆受损程度可能较注意缺陷型更重. 展开更多
关键词 注意缺陷多动障碍 亚型 工作记忆 n-back任务 临床研究
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山东滨州市6~16岁少儿注意缺陷多动障碍现况调查 被引量:9
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作者 孙殿凤 衣明纪 李彦丽 《中国心理卫生杂志》 CSSCI CSCD 北大核心 2009年第11期806-809,共4页
目的:比较少年(12~16岁)与学龄儿童(6~11岁)注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患病情况及临床特点,为儿童ADHD的全面干预提供依据。方法:用分层整群抽样的方式,以学校为单位从鲁北4县市抽取4263名6~1... 目的:比较少年(12~16岁)与学龄儿童(6~11岁)注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患病情况及临床特点,为儿童ADHD的全面干预提供依据。方法:用分层整群抽样的方式,以学校为单位从鲁北4县市抽取4263名6~16岁儿童,采用问卷调查和专科访谈相结合的方法,按DSM-Ⅳ的ADHD诊断标准进行诊断,根据症状维度分布进一步区分为3种亚型:注意缺陷型(ADHD-I)、多动冲动型(ADHD-HI)和混合型(ADHD-C)。结果:(1)6~16岁少儿ADHD的总患病率为6.4%,ADHD-I型是主要类型,占63.7%;男童患病率高于女童(8.9%vs4.1%,P<0.001);少年患病率低于学龄儿童(5.3%vs.7.7%,P=0.002)。(2)不同年龄少儿ADHD亚型分布有差别,与学龄儿童组相比,少年组ADHD-HI和ADHD-C明显减少(9.5%vs.18.4%,9.5%vs.32.7%),ADHD-I明显增多(81.0%vs.49.0%)(P<0.001);少年ADHD患者的3项注意缺陷症状因子和6项多动-冲动症状因子患病率降低(P<0.001或0.01或0.05)。结论:注意力缺陷是少儿注意缺陷多动障碍的核心症状;注意缺陷多动障碍在较高年龄组的少年中患病率有降低趋势,多动-冲动症状改善更明显。 展开更多
关键词 注意缺陷多动障碍 患病率 临床特点 学龄儿童 少年 横断面研究
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五味子种质资源雌花心皮数及相关性状研究 被引量:1
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作者 艾军 王英平 +3 位作者 王志清 郭靖 李昌禹 郭修武 《中草药》 CAS CSCD 北大核心 2007年第3期436-439,共4页
目的研究五味子种质雌花心皮数的精确估算方法及其变异规律,为五味子种质资源的收集、评价和品种选育提供理论依据。方法采用资源调查和统计分析相结合的方法。结果采用公式y=5z+n(y=心皮数;z=各行一致心皮数;n=顶端心皮数)对五... 目的研究五味子种质雌花心皮数的精确估算方法及其变异规律,为五味子种质资源的收集、评价和品种选育提供理论依据。方法采用资源调查和统计分析相结合的方法。结果采用公式y=5z+n(y=心皮数;z=各行一致心皮数;n=顶端心皮数)对五味子雌花心皮数的估算值与实测值差异不显著。五味子种内雌花心皮数的变异系数为14.33%,种质平均心皮数19.5~44.0枚。五味子种质雌花心皮数与心皮坐果率呈极显著负相关;雌花心皮数同心皮坐果率的乘积与果穗质量、果穗果粒数呈极显著正相关;雌花心皮数与同节位雌花数呈极显著正相关;不同粗度枝条雌花心皮数差异显著。结论公式y=5z+n可较精确估算五味子雌花心皮数。五味子种内雌花心皮数存在较大变异,可作为五味子种质资源收集、评价及品种选育的重要性状。进行雌花心皮数评价时需注意取样的代表性和典型性。 展开更多
关键词 五味子 心皮数 估算 变异
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