Assessment of the DIXTAL DX-2710 Automated Oscillometric Device for Blood Pressure Measurement with the Validation Protocols of the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI)

OBJECTIVE: To assess the Dixtal DX2710 automated oscillometric device used for blood pressure measurement according to the protocols of the BHS and the AAMI. METHODS: Three blood pressure measurements were taken in 94 patients (53 females 15 to 80 years). The measurements were taken randomly by 2 observers trained to measure blood pressure with a mercury column device connected with an automated device. The device was classified according to the protocols of the BHS and AAMI. RESULT: The mean of blood pressure levels obtained by the observers was 148±38/93±25 mmHg and that obtained with the device was 148±37/89±26 mmHg. Considering the differences between the measurements obtained by the observer and those obtained with the automated device according to the criteria of the BHS, the following classification was adopted: "A" for systolic pressure (69% of the differences < 5; 90% < 10; and 97% < 15 mmHg); and "B" for diastolic pressure (63% of the differences < 5; 83% < 10; and 93% < 15 mmHg). The mean and standard deviation of the differences were 0±6.27 mmHg for systolic pressure and 3.82±6.21 mmHg for diastolic pressure. CONCLUSION: The Dixtal DX2710 device was approved according to the international recommendations.

Assessment of the techniques of blood pressure measurement by health professionals

OBJECTIVE: To assess blood pressure measurement by health professionals of a public hospital in São Paulo State. METHODS: Semi-structured interviews and direct observation were performed with a verification list according to the criteria reported by Perloff et al. One hundred and five health professionals took part in the study. After measuring blood pressure, the level of concordance between the way the procedure was performed and the recommended one was assessed. RESULTS: Nurses and nurse's aides abided by 40% of the recommended procedures for adequate blood pressure measurement. The other categories of health professionals (nursing and medicine teachers, physicians, residents, and nursing students) abided by approximately 70%. CONCLUSION: Permanent educational activities aiming at standardizing blood pressure measurement should be implemented among the different categories of health professionals.

Ultrasound Blocks for the Anterior Abdominal Wall - Adult and Pediatric Surgery

Somatic post-surgical pain is invalidating and distressing to patients and carries the risk of important complications. The anterior abdominal wall is involved in most surgical procedures in general, gynecologic, obstetric, urological, vascular and pediatric surgery. Combined multimodal strategies involving nerve blocks, opiates, and non-steroidal anti-inflammatory drugs for systemic analgesia are necessary for optimal pain modulation. Anterior abdominal wall blocks, transverse abdominal plexus block, iliohypogastric and ilioinguinal nerveblock, genitofemoral nerve block and rectus sheath block have an important role as components of multimodal analgesia for somatic intraoperative and postoperative pain control. Ultrasound visualization has improved the efficacy and safety of abdominal blocks and implemented the application in the clinical setting. For this reason, they are a very important tool for all anesthesiologists who aim to treat effectively patients’ pain. This guide provides an evidence based comprehensive and necessary overview of anatomical, anesthesiological and technical information needed to safely perform these blocks.

Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room

Background:Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions.Objective:To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care.Methods:One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated.Results:The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection.Conclusion:The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy.

SMPI model : a stepwise process model to facilitate software measurement process improvement along the measurement paradigms

Software engineering, software measurement, software process engineering, capability, maturity

Theory and measurement of social intelligence as a cognitive performance construct

Social intelligence

Framework for a service-oriented measurement infrastructure

Magdeburg, Univ., Fak. für Informatik, Diss., 2009

Framework of quality measurement in CASE tool based software development

Magdeburg, Univ., Fak. für Informatik, Diss., 2010

Disposable, micro-fluidic biosensor array for online analysis of adherent cells activity combining quartz crystal resonators and impedance measurement techniques

Magdeburg, Univ., Fak. für Elektrotechnik und Informationstechnik, Diss., 2011

Model-based measurement and control of fluidised bed spray granulation processes

Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2012

Computer-assisted motion compensation and analysis of perfusion ultrasound data

Magdeburg, Univ., Fak. für Informatik, Diss., 2014

Absolute and relative deprivation and the measurement of poverty

This paper develops the link between poverty and inequality by focussing on a class of poverty indices (some of them well-known) which aggregate normative concerns for absolute and relative deprivation. The indices are distinguished by a parameter that captures the ethical sensitivity of poverty measurement to ``exclusion'' or ``relative-deprivation'' aversion. We also show how the indices can be readily used to predict the impact of growth on poverty. An illustration using LIS data finds that he United States show more relative deprivation than Denmark and Belgium whatever the percentiles considered, but that overall deprivation comparisons of the four countries considered will generally necessarily depend on the intensity of the ethical concern for relative deprivation. The impact of growth on poverty is also seen to depend on the presence of and on the attention granted to concerns over relative deprivation. }

Regional income inequalities in Europe: an updated measurement and some decomposition results

In this paper well-known summary inequality indexes are used to explore interregional income inequalities in Europe. In particular, we mainly employ Theils’population-weighted index because of its appealing properties. Two decomposition analysis are applied. First, regional inequalities are decomposed by regional subgroups (countries). Second, intertemporal inequality changes are separated into income and population changes. The main results can be summarized as follows. First, data confirm a reduction in crossregional inequality during 1982-97. Second, this reduction is basically due to real convergence among countries. Third, currently the greater part of European interregional disparities is within-country by nature, which introduce an important challenge for the European policy. Fourth, inequality changes are due mainly to income variations, population changes playing a minor role.

The Measurement of social polarization in a multi-group context

Polarization indices presented up to now have only focused their attention on the distribution of income/wealth. However, in many circumstances income is not the only relevant dimension that might be the cause of social conflict, so it is very important to have a social polarization index able to cope with alternative dimensions. In this paper we present an axiomatic characterization of one of such indices: it has been obtained as an extension of the (income) polarization measure introduced in Duclos, Esteban and Ray (2004) to a wider domain. It turns out that the axiomatic structure introduced in that paper alone is not appropriate to obtain a fully satisfactory characterization of our measure, so additional axioms are proposed. As a byproduct, we present an alternative axiomatization of the aforementioned income polarization measure.

Ambulatory blood pressure measurement and antihypertensive therapy.

The traditional basis for assessing the effect of antihypertensive therapy is the blood pressure reading taken by a physician. However, several recent trials have been designed to evaluate the blood pressure lowering effect of various therapeutic agents during the patients' normal daytime activities, using a portable, semi-automatic blood pressure recorder. The results have shown that in a given patient, blood pressure measured at the physician's office often differs greatly from that prevailing during the rest of the day. This is true both in treated and untreated hypertensive patients. The difference between office and ambulatory recorded pressures cannot be predicted from blood pressure levels measured by the physician. Therefore, a prospective study was carried out in patients with diastolic blood pressures that were uncontrolled at the physician's office despite antihypertensive therapy. The purpose was to evaluate the response of recorded ambulatory blood pressure to treatment adjustments aimed at reducing office blood pressure below a pre-set target level. Only patients with high ambulatory blood pressures at the outset appeared to benefit from further changes in therapy. Thus, ambulatory blood pressure monitoring can be used to identify those patients who remain hypertensive only when facing the physician, despite antihypertensive therapy. Ambulatory monitoring could thus help to evaluate the efficacy of antihypertensive therapy and allow individual treatment.