52 resultados para computerized electrocardiogram


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The Victorian Marine Mapping Project will improve knowledge on the location, spatial distribution, condition and extent of marine habitats and associated biodiversity in Victorian State waters. This information will guide informed decision making, enable priority setting, and assist in targeted natural resource management planning. This project entails benthic habitat mapping over 500 square kilometers of Victorian State waters using multibeam sonar, towed video and image classification techniques. Information collected includes seafloor topography, seafloor softness and hardness (reflectivity), and information on geology and benthic flora and fauna assemblages collectively comprising habitat. Computerized semi-automated classification techniques are also being developed to provide a cost effective approach to rapid mapping and assessment of coastal habitats.

Habitat mapping is important for understanding and communicating the distribution of natural values within the marine environment. The coastal fringe of Victoria encompasses a rich and diverse ecosystem representative of coastal waters of South-east Australia. To date, extensive knowledge of these systems is limited due to the lack of available data. Knowledge of the distribution and extent of habitat is required to target management activities most effectively, and provide the basis to monitor and report on their status in the future.

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Computerized clinical guidelines can provide significant benefits to health outcomes and costs, however, their effective implementation presents significant problems. Vagueness and ambiguity inherent in natural (textual) clinical guidelines is not readily amenable to formulating automated alerts or advice. Fuzzy logic allows us to formalize the treatment of vagueness in a decision support architecture. This paper discusses sources of fuzziness in clinical practice guidelines. We consider how fuzzy logic can be applied and give a set of heuristics for the clinical guideline knowledge engineer for addressing uncertainty in practice guidelines. We describe the specific applicability of fuzzy logic to the decision support behavior of Care Plan On-Line, an intranet-based chronic care planning system for General Practitioners.

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A growing research base supports the predictive validity of actuarial methods of risk assessment with sexual offenders. These methods use clearly defined variables with demonstrated empirical association with re-offending. The advantages of actuarial measures for screening large numbers of offenders quickly and economically are further enhanced when the variables used can be extracted from existing electronic databases. This study reports the results of applying a computerized set of historical variables with a sample of 1,133 male sexual offenders released from prison by the New Zealand Department of Corrections. Area under the curve figures of 0.70-0.78 were obtained over periods of 5 to 15 years, reflecting a significant level of association with sexual recidivism. Detected rates of re-offending across risk levels were comparable to those previously reported for the Static-99. Rates of sexual re-offending by child molesters for all sexual offences and offences against child victims are reported separately.

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Objectives To review systematically studies examining the association between sedentary lifestyle and low back pain (LBP) using a comprehensive definition of sedentary behaviour including prolonged sitting both at work and during leisure time.

Methods Journal articles published between 1998 and 2006 were obtained by searching computerized bibliographical databases. Quality assessment of studies employing a cohort or case–control design was performed to assess the strength of the evidence.

Results Using pre-determined keywords, we identified 1,778 titles of which 1,391 were considered irrelevant. Then, 20 of the remaining 387 publications were scrutinized for full review after an examination of all the 387 abstracts. Finally, 15 studies (10 prospective cohorts and 5 case–controls) were included in the methodological quality assessment, of which 8 (6 cohorts and 2 case–controls; 53%) were classified as high-quality studies. One high-quality cohort study reported a positive association, between LBP and sitting at work only; all other studies reported no significant associations. Hence, there was limited evidence to demonstrate that sedentary behaviour is a risk factor for developing LBP.

Conclusions The present review confirms that sedentary lifestyle by itself is not associated with LBP.

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Cardiovascular disease (CVD) is the leading cause of death and hospitalization in both men and women in nearly all countries of Europe. The most frequent forms of CVD are those of an atherosclerotic origin, mainly ischaemic heart disease, stroke and heart failure. The magnitude of the problem contrasts with the usual paucity and poor quality of data available on incidence and prevalence of CVD, except for few rigorous but limited studies.

The objectives of the health interview and health examination surveys (HIS/HES) are to evaluate the frequency and the distribution of the disease, to evaluate trends and treatment effectiveness, to estimate risk factors distribution and prevalence of high risk conditions and to monitor prevention programmes.

According to the EUROCISS project (EUROpean Cardiovascular Surveillance Set) recommendations, surveys are aimed at describing the prevalence of the following CVD conditions: myocardial infarction, heart failure, angina pectoris, peripheral arterial disease, stroke, and ischaemic heart disease.

HIS and HES were developed to supplement information collected from routine databases and population-based registers to implement consistent public health policies. HIS can be repeated periodically in a new sample of the population, or can follow up over time the population recruited at baseline. Procedures and methods to collect information from participants include self-administered questionnaires, direct interviewer-administered questions and telephone interviews. A minimum set of questions to be administered every year, along with a longer, more detailed module to be administered periodically are recommended to evaluate CVD prevalence. The addition of HES provides more detailed and objective information that can be used to improve estimates regarding prevalence of both risk factors and disease status.

The selection of more specialized CVD-specific tests will depend on the objective the survey is designed to achieve, the assumed response rate and the cost and time considerations. For HES on CVD the minimum required is to perform the following measurements: height, weight, blood pressure, waist circumference, total and high density lipoprotein-cholesterol and glucose assay in a nonfasting blood sample. The next appropriate step would be to perform an electrocardiogram. High costs usually make HES difficult to carry out.

Standardization of measurements, training of personnel and quality control are essential to assure reliable data. A high response rate is extremely important, as nonrespondents tend to have different health characteristics from the rest of the sample and their omission therefore results in bias.

This manual of operations is intended for health professionals and policy makers and provides a standardized and simple model for the implementation of a CVD survey.

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Objective : To describe time adolescents spend using electronic media (television, computer, video games, and telephone); and to examine associations between self-reported health/well-being and daily time spent using electronic media overall and each type of electronic media.

Methods :
Design–Cross-sectional data from the third (2005) wave of the Health of Young Victorians Study, an Australian school-based population study. Outcome Measures–Global health, health-related quality of life (HRQoL; KIDSCREEN), health status (Pediatric Quality of Life Inventory 4.0; PedsQL), depression/anxiety (Kessler-10), and behavior problems (Strengths and Difficulties Questionnaire). Exposure Measures–Duration of electronic media use averaged over 1 to 4 days recalled with the Multimedia Activity Recall for Children and Adolescents (MARCA) computerized time-use diary. Analysis–Linear and logistic regression; adjusted for demographic variables and body mass index z score.

Results :
A total of 925 adolescents (mean ± standard deviation age, 16.1 ± 1.2 years) spent, on average, 3 hours 16 minutes per day using electronic media (television, 128 minutes per day; video games, 35; computers, 19; telephone, 13). High overall electronic media use was associated with poorer behavior, health status, and HRQoL. Associations with duration of specific media exposures were mixed; there was a favorable association between computer use (typing/Internet) and psychological distress, whereas high video game use was associated with poorer health status, HRQoL, global health, and depression/anxiety. Television and telephone durations were not associated with any outcome measure.

Conclusions :
Despite television's associations with obesity, time spent in other forms of media use appear more strongly related to adolescent health and well-being. This study supports efforts to reduce high video game use and further exploration of the role of computers in health enhancement.

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Objective: To briefly review the clinical and biological distinctions between unipolar and bipolar depression critiquing in particular currently available depression rating scales and discuss the need for a new observer-rated scale tailored to bipolar depression.

Method: Relevant literature pertaining to the symptomatic differences between bipolar disorder and unipolar disorder as well as their measurement using existing assessment scales was identified by computerized searches and reviews of scientific journals known to the authors.

Results
: Bipolar depression is distinct from unipolar depression in terms of phenomenology and clinical characteristics. These distinguishing features can be used to identify bipolarity in patients that present with recurrent depressive episodes. This is important because current self-report and observer-rated scales are optimized for unipolar depression, and hence limited in their ability to accurately assess bipolar depression.

Conclusion
: The development of a specific bipolar depression rating scale will improve the assessment of bipolar depression in both research and clinical settings and assist the development of better treatments and interventions.

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OBJECTIVE—Gestational diabetes mellitus (GDM) is an increasingly prevalent risk factor for the development of type 2 diabetes in the mother and is  responsible for morbidity in the child. To better identify women at risk of developing GDM we examined sociodemographic correlates and changes in the prevalence of GDM among all births between 1995 and 2005 in Australia's largest state.
RESEARCH DESIGN AND METHODS—A computerized database of all births (n = 956,738) between 1995 and 2005 in New South Wales, Australia, was used in a multivariate logistic regression that examined the association between sociodemographic characteristics and the occurrence of GDM.
RESULTS—Between 1995 and 2005, the prevalence of GDM increased by 45%, from 3.0 to 4.4%. Women born in South Asia had the highest adjusted odds ratio (OR) of any region (4.33 [95% CI 4.12–4.55]) relative to women born in Australia. Women living in the three lowest socioeconomic quartiles had higher adjusted ORs for GDM relative to women in the highest quartile (1.54 [1.50–1.59], 1.74 [1.69–1.8], and 1.65 [1.60–1.70] for decreasing socioeconomic status quartiles). Increasing age was strongly associated with GDM, with women aged >40 years having an adjusted OR of 6.13 (95% CI 5.79–6.49) relative to women in their early 20s. Parity was associated with a small reduced risk. There was no association between smoking and GDM.
CONCLUSIONS—Maternal age, socioeconomic position, and ethnicity are important correlates of GDM. Future culturally specific interventions should target prevention of GDM in these high-risk groups.

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The overarching goal of this dissertation was to evaluate the contextual components of instructional strategies for the acquisition of complex programming concepts. A meta-knowledge processing model is proposed, on the basis of the research findings, thereby facilitating the selection of media treatment for electronic courseware. When implemented, this model extends the work of Smith (1998), as a front-end methodology, for his glass-box interpreter called Bradman, for teaching novice programmers. Technology now provides the means to produce individualized instructional packages with relative ease. Multimedia and Web courseware development accentuate a highly graphical (or visual) approach to instructional formats. Typically, little consideration is given to the effectiveness of screen-based visual stimuli, and curiously, students are expected to be visually literate, despite the complexity of human-computer interaction. Visual literacy is much harder for some people to acquire than for others! (see Chapter Four: Conditions-of-the-Learner) An innovative research programme was devised to investigate the interactive effect of instructional strategies, enhanced with text-plus-textual metaphors or text-plus-graphical metaphors, and cognitive style, on the acquisition of a special category of abstract (process) programming concept. This type of concept was chosen to focus on the role of analogic knowledge involved in computer programming. The results are discussed within the context of the internal/external exchange process, drawing on Ritchey's (1980) concepts of within-item and between-item encoding elaborations. The methodology developed for the doctoral project integrates earlier research knowledge in a novel, interdisciplinary, conceptual framework, including: from instructional science in the USA, for the concept learning models; British cognitive psychology and human memory research, for defining the cognitive style construct; and Australian educational research, to provide the measurement tools for instructional outcomes. The experimental design consisted of a screening test to determine cognitive style, a pretest to determine prior domain knowledge in abstract programming knowledge elements, the instruction period, and a post-test to measure improved performance. This research design provides a three-level discovery process to articulate: 1) the fusion of strategic knowledge required by the novice learner for dealing with contexts within instructional strategies 2) acquisition of knowledge using measurable instructional outcome and learner characteristics 3) knowledge of the innate environmental factors which influence the instructional outcomes This research has successfully identified the interactive effect of instructional strategy, within an individual's cognitive style construct, in their acquisition of complex programming concepts. However, the significance of the three-level discovery process lies in the scope of the methodology to inform the design of a meta-knowledge processing model for instructional science. Firstly, the British cognitive style testing procedure, is a low cost, user friendly, computer application that effectively measures an individual's position on the two cognitive style continua (Riding & Cheema,1991). Secondly, the QUEST Interactive Test Analysis System (Izard,1995), allows for a probabilistic determination of an individual's knowledge level, relative to other participants, and relative to test-item difficulties. Test-items can be related to skill levels, and consequently, can be used by instructional scientists to measure knowledge acquisition. Finally, an Effect Size Analysis (Cohen,1977) allows for a direct comparison between treatment groups, giving a statistical measurement of how large an effect the independent variables have on the dependent outcomes. Combined with QUEST's hierarchical positioning of participants, this tool can assist in identifying preferred learning conditions for the evaluation of treatment groups. By combining these three assessment analysis tools into instructional research, a computerized learning shell, customised for individuals' cognitive constructs can be created (McKay & Garner,1999). While this approach has widespread application, individual researchers/trainers would nonetheless, need to validate with an extensive pilot study programme (McKay,1999a; McKay,1999b), the interactive effects within their specific learning domain. Furthermore, the instructional material does not need to be limited to a textual/graphical comparison, but could be applied to any two or more instructional treatments of any kind. For instance: a structured versus exploratory strategy. The possibilities and combinations are believed to be endless, provided the focus is maintained on linking of the front-end identification of cognitive style with an improved performance outcome. My in-depth analysis provides a better understanding of the interactive effects of the cognitive style construct and instructional format on the acquisition of abstract concepts, involving spatial relations and logical reasoning. In providing the basis for a meta-knowledge processing model, this research is expected to be of interest to educators, cognitive psychologists, communications engineers and computer scientists specialising in computer-human interactions.

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A decision support tool for production planning was developed to perform the difficult and time consuming task of allocating resources within the industrial partner's machining line, consisting of identical Computerized Numerically Controlled machines. The production-planning tool identified significant labour savings in a number of the industrial partner's production plans.

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The development and application of a novel combination of electrochemical techniques and computerized field-based battery-operated instrumentation is investigated. Low-power complementary metal oxide semiconductor technology has been utilized for the development of the field data acquisition systems and the instrumental performance of the complete analytical system is critically evaluated.

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Aim To explore the nurses role in the process of medication management and identify the challenges associated with safe medication management in contemporary clinical practice.
Background Medication errors have been a long-standing factor affecting consumer safety. The nursing profession has been identified as essential to the promotion of patient safety.
Evaluation A review of literature on medication errors and the use of electronic prescribing in medication errors.
Key issues Medication management requires a multidisciplinary approach and interdisciplinary communication is essential to reduce medication errors. Information technologies can help to reduce some medication errors through eradication of transcription and dosing errors. Nurses must play a major role in the design of computerized medication systems to ensure a smooth transition to such as system.
Conclusion The nurses roles in medication management cannot be over-emphasized. This is particularly true when designing a computerized medication system.
Implication for nursing management The adoption of safety measures during decision making that parallel those of the aviation industry safety procedures can provide some strategies to prevent medication error. Innovations in information technology offer potential mechanisms to avert adverse events in medication management for nurses.

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The aim of this study was to determine whether 5-HT2A receptors mediate cardiovascular and thermogenic responses to acute psychological stresses. For this purpose, adult male Wistar hooded rats instrumented for telemetric recordings of either electrocardiogram (ECG) (n=12) or arterial pressure (n=12) were subjected, on different days, to four 15-min episodes of social defeat. Prior to stress, animals received s.c. injection of the selective 5-HT2A receptor antagonist SR-46349B (trans-4-((3Z)3-[(2-dimethylaminoethyl)oxyimino]-3-(2-fluorophenyl)propen-1-yl)-phenol, hemifumarate) (at doses of 0.3, 1.0 and 3.0 mg/kg) or vehicle. The drug had no effect on basal heart rate or heart rate variability indexes, arterial pressure, and core body temperature. Social defeat elicited significant and substantial tachycardic (347±7 to 500±7 bpm), pressor (77±4 to 97±4 mm Hg) and hyperthermic (37.0±0.3 to 38.5±0.1 °C) responses. Blockade of 5-HT2A receptors, at all doses of the antagonist, completely prevented stress-induced hyperthermia. In contrast, stress-induced cardiovascular responses were not affected by the blockade (except small reduction of tachycardia by the highest dose of the drug). We conclude that in rats, 5-HT2A receptors mediate stress-induced hyperthermic responses, but are not involved in the genesis of stress-induced rises in heart rate or arterial pressure, and do not participate in cardiovascular control at rest.

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1. It is currently unknown whether long-term voluntary exercise has enduring cardioprotective effects in animal models.

2. The present study was conducted in three groups of rats: (i) sedentary controls (n = 6); (ii) 24 h runners (n = 8; unlimited access to running wheels); and (iii) 2 h runners (n = 8; access to running wheels limited to 2 h daily). After termination of the 6 week exercise protocol, all rats were implanted with the telemetric electrocardiogram transmitters and were studied 1 week later.

3. Resting heart rate (HR) values in the control rats, 24 h runners and 2 h runners were 372 ± 7, 361 ± 9 and 298 ± 5 b.p.m., respectively (P < 0.05 for 2 h runners vs controls). The high-frequency spectral power in the control rats, 24 h runners and 2 h runners was 3.9 ± 0.2, 4.3 ± 0.3 and 5.3 ± 0.3 s2, respectively (P < 0.05 for 2 h runners vs controls), whereas intrinsic HR was 383 ± 3, 377 ± 2 and 346 ± 3 b.p.m., respectively (P < 0.001 for 2 h runners vs controls). Restraint stress provoked tachycardia of similar magnitude in all groups.

4. After completion of telemetric studies, haemodynamic indices and susceptibility to cardiac arrhythmias were assessed in anaesthetized animals, there were no major between-group differences in HR, arterial pressure, contractility indices or sensitivity to β-adrenoceptor stimulation (dobutamine) or blockade (atenolol). The effective refractory period in the control rats, 24 h runners and 2 h runners was 49 ± 2, 55 ± 2 and 60 ± 4 ms, respectively (P = 0.054 for 2 h runners vs controls). A significantly higher dose of aconitine was required to provoke ventricular arrhythmias in the 24 h and 2 h running groups compared with controls (489 ± 76, 505 ± 88 and 173 ± 33 μg, respectively; P < 0.05).

5. We conclude that, in rats, long-term voluntary exercise has enduring cardioprotective effects mediated at the level of both the central nervous system and the heart.

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In this paper, we exploit the discrete Coxian distribution and propose a novel form of stochastic model, termed as the Coxian hidden semi-Makov model (Cox-HSMM), and apply it to the task of recognising activities of daily living (ADLs) in a smart house environment. The use of the Coxian has several advantages over traditional parameterization (e.g. multinomial or continuous distributions) including the low number of free parameters needed, its computational efficiency, and the existing of closed-form solution. To further enrich the model in real-world applications, we also address the problem of handling missing observation for the proposed Cox-HSMM. In the domain of ADLs, we emphasize the importance of the duration information and model it via the Cox-HSMM. Our experimental results have shown the superiority of the Cox-HSMM in all cases when compared with the standard HMM. Our results have further shown that outstanding recognition accuracy can be achieved with relatively low number of phases required in the Coxian, thus making the Cox-HSMM particularly suitable in recognizing ADLs whose movement trajectories are typically very long in nature.