青光眼筛查的必要性及方法评价

青光眼的筛查是非常必要的.对于青光眼的筛查应遵循简易、快捷、价廉、有效的原则,但目前国内外尚缺少一套公认、成熟的青光眼筛查方法.通过探讨几种常用的青光眼筛查方法,认为应创建中心医院与社区医院结合的青光眼筛查新模式.     

人文关怀与青光眼的诊治

青光眼是一类不可逆性致盲性眼病,早期诊断、早期治疗具有十分重要的意义.眼科医师在青光眼早期诊断中应遵循最优化原则,避免过度医疗,给予患者更多的人文关怀.     

人工智能辅助的自闭症早期患者的筛查与诊断

自闭症谱系障碍(AutisticSpectrumDisorders,ASD)的症状早在婴幼儿期就会显现,越早发现,越早干预,治疗效果越好。传统自闭症早期筛查与诊断在评估方法、流程上存在局限,无法满足大规模筛查和诊断需求。随着人工智能技术的快速发展,使用智能化方法进行自闭症早期大规模无感筛查与诊断逐渐成为可能。近10年间,国内外对自闭症智能化识别方法的探索在经典任务行为、面部表情和情绪、眼动、脑影像、运动控制和运动模式、多模态6个领域积累了丰富的研究成果。未来研究应围绕构建国内自闭症早期智能医学筛查与诊断体系,开发针对婴幼儿患者的筛查工具,构建融合多模态数据的自闭症婴幼儿智能化识别模型,建立结合脑影像技术的自闭症精细化诊断方法等方面来开展。     

浅谈我国癌症筛查的利弊

筛查作为有效控制癌症的重要手段之一,已引起国际上众多政府机构和众多学者的广泛关注,根据我国及全球癌症筛查的现状与进展,分析癌症早期筛查的积极意义、癌症筛查的弊端,探讨适合我国国情的癌症筛查制度。我国应通过建立政府机构、教育机构和卫生系统共同参与的筛查模式,改进并寻求价廉效实的筛查技术,选择合理的因地制宜的筛查方式,推进全民健康教育,提高群众防癌意识,加强癌症的一级预防,从而实现到2030年我国总体癌症的生存率提高15%的目标。     

心理咨询在闭角型青光眼治疗中的应用

闭角型青光眼的发生不但与浅前房,短眼轴、角膜直径小等解剖、遗传因素有关,而且与个性心理特征以及社会环境因素有密切关系。闭角型青光眼的大小发作均和情绪有明显关系,是眼科典型的心身疾病。随着心理行为科学研究的进展,心理学方法和技术已被越来越广泛地应用于临床疾病的防治和康复过程。本文应用心理咨询与集体心理咨询相结合的方法,探索心理咨询在闭角型青光眼治疗中的应用。对象与方法     

关于肿瘤筛查的争议与思考

肿瘤筛查的目的是希望在"正常的"人群中发现事实上已患癌症的患者,通过确诊和及时治疗,以取得良好的疗效。但事实上适合筛查的肿瘤不多,对肿瘤筛查也有许多争议,争议主要来自对筛查效果的评价、成本—效益比以及社会、伦理诸方面的问题,笔者认为筛查只是一种临床流行病学的研究手段,应将其成果转化为公共卫生项目或通过健康教育,使癌症的高危人群能主动定期进行防癌检查,方能使肿瘤的早期发现"常态化"。     

我国产后抑郁评估与诊断方法应用现状分析

早期评估与诊断是产后抑郁预防干预的第一步,通过分析国内产后抑郁评估与诊断方法的应用现状,为提高评估与诊断结果的科学性提供依据。发现爱丁堡产后抑郁量表为筛查首选量表,分析显示采用同一种量表和不同量表进行评估的检出率均有较大差异。因此,应根据研究特点选择适宜的筛查量表以提高不同研究结果的可比性,同时,需加强量表分界值本土化的研究。     

化繁为简——老年人营养不良的评估并不难

老年营养不良在临床上十分常见,积极干预并改善老年患者的营养不良,可缩短住院时间并能改善患者的预后。干预的前提是必须要进行营养不良的筛查和评估,但筛查和评估方法有10余种之多,临床医生感到筛查和评估既难又繁琐。因而,本文简要介绍了常用的一些筛查和评估方法,重点介绍了两种简单的筛查和评估方法,可在数分钟内完成。本文的目的旨在告诉临床医生,营养不良的筛查和评估可以化繁为简,筛查和评估并不难。     

我国产后抑郁评估与诊断方法应用现状分析

早期评估与诊断是产后抑郁预防干预的第一步,通过分析国内产后抑郁评估与诊断方法的应用现状.为提高评估与诊断结果的科学性提供依据.发现爱丁堡产后抑郁量表为筛查首选量表,分析显示采用同一种量表和不同量表进行评估的检出率均有较大差异.因此,应根据研究特点选择适宜的筛查量表以提高不同研究结果的可比性,同时,需加强量表分界值本土化的研究.     

原发性开角型青光眼局部药物治疗的比较及决策最优化

通过对目前治疗原发性开角型青光眼局部降眼压药物的作用机制、治疗效果、不良反应、药品价格及使用方便程度进行综合的比较分析,运用比较治疗学的理论和方法来指导和规范该类青光眼局部药物治疗的临床决策,以期提高治疗效果、减少并发症、降低费用及提高患者的生存质量。     

Using the theory of planned behaviour to predict screening uptake in two contexts

Given current policy that decisions about screening should be based on informed choice, such decisions should reflect people's values and attitudes. This prospective study compares the attitudes and other cognitive predictors of screening uptake in two contexts: when conducted as part of a routine visit and when it is conducted at a separate, test-specific visit. It was conducted in two hospitals in England, differing in method of screening organisation. 1499 pregnant women offered serum screening for Down Syndrome completed a questionnaire assessing theory of planned behaviour constructs: attitude towards undergoing the test, subjective norms of others, perceived behavioural control and intention to undergo the test.

Intention predicted screening uptake in both screening settings, but more strongly when screening was part of a routine visit. Perceived behavioural control was not predictive of uptake, and only weakly predictive of intention in both settings. Subjective norm predicted intention more strongly when it referred to partner and friends than when it referred to health professionals, in both settings.

Attitude was more strongly predictive of intention to attend screening when screening was organised as a part of routine screening, rather than requiring a separate visit. These results suggest that offering a screening test at a routine visit compared with a separate visit is more likely to facilitated uninformed choices, given the stronger association between attitudes and intention and the absence of an association with the perceived influence of health professionals.     

Validity and utility of computer-based test interpretation

Computers have been important to applied psychology since their introduction, and the application of computerized methods has expanded in recent decades. The application of computerized methods has broadened in both scope and depth. This article explores the most recent uses of computer-based assessment methods and examines their validity. The comparability between computer-administered tests and their pencil-and-paper counterparts is discussed. Basic decision making in psychiatric screening, personality assessment, neuropsychology, and personnel psychology is also investigated. Studies on the accuracy of computerized narrative reports in personality assessment and psychiatric screening are then summarized. Research thus far appears to indicate that computer-generated reports should be viewed as valuable adjuncts to, rather than substitutes for, clinical judgment. Additional studies are needed to support broadened computer-based test usage.     

Attention Deficit Disorder and hospitalization due to injury among older adolescents in New South Wales,Australia

The association between Attention Deficit Disorder (ADD) and injuries among children has long been studied. More recently, research interest has extended to the long-term consequences of childhood ADD in adolescents and young adults, mainly focusing on motor vehicle-related accidents, but not other injuries. Very little work has investigated the associations between individual characteristics, type of injuries, outcomes, and the diagnosis of ADD upon admission of injured patients to a hospital. To investigate these associations, this study used a population-based epidemiological design that analyzed data routinely collected on patients hospitalized due to injuries. Results showed that younger, male, and more socioeconomically disadvantaged patients were more likely to be diagnosed with ADD upon admission. Significant association between different causes of injuries, in particular self-inflicted injuries, and diagnosis of ADD were also found. Patients diagnosed with ADD stayed in the hospital longer than others disregarding the cause of their injury. These results illustrate clearly that ADD is underrecognized among injured patients upon admission to hospitals. Information on the ADD status of injured patients is important for treatment decision making. A screening tool should be developed for assessing all injured patients upon admission to hospitals.     

The utilization of genetic counselors within a newborn screening program

Genetic counselors have participated in the Michigan Newborn Screening Program on a contractual basis since 1988. Their role includes newborn screening education and training, newborn nursery site visits, and monitoring newborn screening in hospitals. Their impact has been to improve the quality of newborn screening services by reducing errors and increasing completion of data fields on newborn screening cards, improving hospital nursery cooperation and problem solving, and enhancing health department response to specific problems.     

医院药学服务与人文关怀

医院药学服务是医院医疗服务中的重要组成部分,药师在医院人文服务中起着重要作用。本文阐述了人文关怀在医院药学服务中的实施,指出药师在日常工作中的每个环节都要为患者提供充满人文关怀的服务,并指出了现在医院药学服务的人文关怀中存在的困难及解决办法。     

Screening language skills at 2;0

Early screening of children at risk for language difficulties is challenging. This study aimed to analyze the specificity and sensitivity of two screening methods at 2;0 years of age. In addition, the matter of what kind of information the use of word combinations and parental concern provide for screening was analyzed. The subjects were 78 children. The screening methods used were the Finnish versions of the short-form version of the MacArthur Communicative Development Inventories (FinCDI-SF) and the Communication and Symbolic Behavior Scales, Developmental Profile, Infant-Toddler Checklist (FinCSBS). The specificity and sensitivity of the screening methods were analyzed based on result of the Reynell Developmental Language Scales III. Both screening methods had high specificity but only moderate sensitivity. The use of word combinations and parental concern provided relevant information on early language development. The results imply that it is important to take into consideration receptive language development in early screening.     

Should we screen for depression? Caveats and potential pitfalls

The availability of brief screening instruments encourages their routine use in identifying individuals who are presumed to be at risk for clinical depression. In primary medical care where this idea has been most tested, however, there is little evidence that screening by itself improves the outcome of depression. Reasons why screening cannot serve as an efficient basis for the prevention of depression are reviewed. Moreover, a positive score on a screening instrument does not indicate a clear need for intervention or the form that any intervention should take. Routine screening should be undertaken only when the resources are available for interpreting the significance of positive screen scores, appropriate and acceptable interventions are available, and potential negative effects of screening can be avoided. Until these conditions can be met, alternatives to screening should be considered.     

急性高原病易感人群筛选研究的一些思考

高原缺氧存在易感人群,目前对高原易感人群的筛查主要从进入高原前后人体功能、组织因子及蛋白的变化等方面进行研究,有学者开始从基因水平筛查高原易感人群,基因研究虽然面临许多困难,但它可能是高原易感人群筛查中最有前景的研究方法,应是今后研究的重要方向。     

德鲁克医院管理思想研究

德鲁克医院管理思想主要有:医院管理与企业管理没有多大差异;医疗保健是21世纪增长最快、最需要管理的部门;医疗服务需要合理组织及团队精神;评价医疗服务质量的标准是"最佳";医院要实施目标管理并不断致力于变革,通过"专业化"提高效率和效益;医院管理者与员工之间是伙伴关系;信息技术对医疗服务有深刻的影响;医院应实行"职业化"管理.     

Psycho-ophthalmology: Contributions of Health psychology to the assessment and treatment of glaucoma

Background: Asymptomatic in its early stages, glaucoma is the second leading cause of blindness worldwide. While psychosocial factors are taken into consideration for a host of diseases such as cancer, heart disease and autoimmune conditions, to date, psychological issues have been ignored in the clinical management of glaucoma.

Objective: This work reviews the most relevant contributions from a health psychology perspective for the assessment and treatment of glaucoma, which is emerging in the field of psycho-ophthalmology.

Method: To provide scientific evidence regarding contributions of psychology to the comprehension of glaucoma, a bibliographic review of three databases (Psicodoc, PsycInfo and Medline) was conducted, spanning the period between 1940 and 2016.

Results: This review yielded a total of 66 studies published in the period analysed and identified three areas where health psychology has made substantive contributions to glaucoma screening, monitoring and treatment: the emotional impact on patients suffering from glaucoma, the adherence to treatment and the effects of stress on intraocular pressure.

Conclusions: A health psychology approach for research and therapy of glaucoma must focus on the management of the negative affect associated with the diagnosis, the optimisation of treatment adherence and the stress management of the intraocular pressure measurements.