The development of an algorithm to track blood pressure accurately based on the pulse transit time method

Oscillometric blood pressure (BP) monitors are currently used to diagnose hypertension both in home and clinical settings. These monitors take BP measurements once every 15 minutes over a 24 hour period and provide a reliable and accurate system that is minimally invasive. Although intermittent cuff measurements have proven to be a good indicator of BP, a continuous BP monitor is highly desirable for the diagnosis of hypertension and other cardiac diseases. However, no such devices currently exist. A novel algorithm has been developed based on the Pulse Transit Time (PTT) method, which would allow non-invasive and continuous BP measurement. PTT is defined as the time it takes the BP wave to propagate from the heart to a specified point on the body. After an initial BP measurement, PTT algorithms can track BP over short periods of time, known as calibration intervals. After this time has elapsed, a new BP measurement is required to recalibrate the algorithm. Using the PhysioNet database as a basis, the new algorithm was developed and tested using 15 patients, each tested 3 times over a period of 30 minutes. The predicted BP of the algorithm was compared to the arterial BP of each patient. It has been established that this new algorithm is capable of tracking BP over 12 minutes without the need for recalibration, using the BHS standard, a 100% improvement over what has been previously identified. The algorithm was incorporated into a new system based on its requirements and was tested using three volunteers. The results mirrored those previously observed, providing accurate BP measurements when a 12 minute calibration interval was used. This new system provides a significant improvement to the existing method allowing BP to be monitored continuously and non-invasively, on a beat-to-beat basis over 24 hours, adding major clinical and diagnostic value.

CALR mutation profile in Irish patients with myeloproliferative neoplasms

Insertion and/or deletion mutations of the CALR gene have recently been demonstrated to be the second most common driver mutations in the myeloproliferative neoplasms (MPNs) of essential thrombocythemia (ET) and primary myelofibrosis (PMF). Given the diagnostic and emerging prognostic significance of these mutations, in addition to the geographical heterogeneity reported, the incidence of CALR mutations was determined in an Irish cohort of patients with MPNs with a view to incorporate this analysis into a prospective screening program. A series of 202 patients with known or suspected ET and PMF were screened for the presence of CALR mutations. CALR mutations were detected in 58 patients. Type 1 and Type 1-like deletion mutations were the most common (n = 40) followed by Type 2 and Type 2-like insertion mutations (n = 17). The CALR mutation profile in Irish ET and PMF patients appears similar to that in other European populations. Establishment of this mutational profile allows the introduction of a rational, molecular diagnostic algorithm in cases of suspected ET and PMF that will improve clinical management.

Relevance of anatomy to medical education and clinical practice: perspectives of medical students, clinicians, and educators

Introduction: Against a backdrop of ever-changing diagnostic and treatment modalities, stakeholder perceptions (medical students, clinicians, anatomy educators) are crucial for the design of an anatomy curriculum which fulfils the criteria required for safe medical practice. This study compared perceptions of students, practising clinicians, and anatomy educators with respect to the relevance of anatomy education to medicine. Methods: A quantitative survey was administered to undergraduate entry (n = 352) and graduate entry students (n = 219) at two Irish medical schools, recently graduated Irish clinicians (n = 146), and anatomy educators based in Irish and British medical schools (n = 30). Areas addressed included the association of anatomy with medical education and clinical practice, mode of instruction, and curriculum duration. Results: Graduate-entry students were less likely to associate anatomy with the development of professionalism, teamwork skills, or improved awareness of ethics in medicine. Clinicians highlighted the challenge of tailoring anatomy education to increase student readiness to function effectively in a clinical role. Anatomy educators indicated dissatisfaction with the time available for anatomy within medical curricula, and were equivocal about whether curriculum content should be responsive to societal feedback. Conclusions: The group differences identified in the current study highlight areas and requirements which medical education curriculum developers should be sensitive to when designing anatomy courses.

Einsatzstrategien von Zeitarbeit in Unternehmen

Zeitarbeit ist eine Boombranche. Zeitarbeit ist prekäre Beschäftigung. Mit Zeitarbeit wird Missbrauch getrieben. Zeitarbeit ist wichtig. Jeder, der die öffentliche Diskussion verfolgt, hat einen dieser Sätze schon einmal gehört. Wir reden über Zeitarbeit, wie über die Frage, ob Entlohnung gut oder schlecht ist. Vergessen wird dabei oft, dass Zeitarbeit nicht gleich Zeitarbeit ist, sondern sich Motive und Einsatz der Zeitarbeit von Unternehmen zu Unternehmen deutlich unterscheiden können. So kann ein Personaldienstleister Hausfrauen an eine Versicherung vermitteln, um dort für die Reinigung und Sauberkeit der Büros zu sorgen. Ebenso kann ein Ingenieurbüro eigene Mitarbeiter an eine Kraftwerksfirma verleihen, um hochspezielle Projektaufgaben an einem Solarkraftwerk zu verrichten. Und genau darum geht es, wenn wir die Zukunft der Zeitarbeit gestalten wollen: herauszufinden, unter welchen Bedingungen und für welche Zwecke Zeitarbeit in Unternehmen eingesetzt wird und was ihre Nutzung fördert bzw. behindert. Um darauf eine Antwort zu haben, muss man zunächst die Verschiedenartigkeit der Zeitarbeit anerkennen. Im Anschluss daran muss man herausfinden, welchen Typ Zeitarbeit man in einem bestimmten Unternehmen vor sich hat, wovon dieser beeinflusst wird und was man anders oder besser machen kann. Es geht in diesem Beitrag also zuallererst darum, Motive der Zeitarbeitsnutzung herauszuarbeiten und zu untersuchen, wie sie zu verschiedenen Formen des Zeitarbeitseinsatzes in Unternehmen führen.

CHARLESTON AFTER THE EARTHQUAKE August 31st 1886

[18] p. : ill. ; 9 x 13 cm. This is a lithographic souvenir book with 18 pages of various Charleston scenes of destruction after the 1886 earthquake.

Factores de éxito en el programa de responsabilidad social empresarial (RSE) para el sector salud, aplicación de la norma ISO 26000 en la IPS Fundación Cardio Infantil

El presente estudio tiene como objetivo mostrar los factores de éxito del programa de Responsabilidad Social de la Fundación Cardioinfantil, teniendo en cuenta que esta institución se ha convertido en un referente de compromiso social y sostenibilidad en el sector salud y en las instituciones de cuarto nivel de complejidad. Para alcanzar este objetivo se realizaron visitas y se aplicó un instrumento en la Fundación Cardioinfantil y en cuatro instituciones más del mismo nivel de atención en las ciudades de Bogotá, Cali y Medellín, donde generosamente aportaron información acerca del desarrollo de sus programas de Responsabilidad Social y de la aplicación de los tópicos contenidos en la ISO 26000 dentro de sus instituciones. Así mismo dentro de la Fundación Cardioinfantil se realizó una entrevista con la persona encargada de desarrollar el programa, quien manifestó los detalles del funcionamiento de este y los esfuerzos realizados para lograr la diferenciación en el sector salud. A través de este recorrido por las diferentes instituciones de salud consultadas y de la investigación realizada en la fundación Cardioinfantil se realizó una matriz DOFA que nos reveló la falta de comunicación en las mejoras realizadas en las diferentes organizaciones de salud, una vez han detectado las fallas en inherentes a su actuación con los grupos de interés. La adopción de estándares internacionales para la gobernanza y aplicación de los programas de RSE aún es incipiente en el sector salud en general. También es posible resaltar el hecho de que programas de RSE desarrollados a nivel de la fundación Cardioinfantil evolucionan hacia la innovación en la calidad de la atención y la trasformación de sus organizaciones hacia la mejora continua.

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