Health (Health (Irvine Calif) )


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    ABSTRACT: Abnormalities in the concentrations of metallic ions such as calcium and potassium can, in principle, lead to cardiac arrhythmias. Unbalance of these ions can alter the electrocardiogram (ECG) signal. Changes in the morphology of the ECG signal can occur due to changes in potassium concentration, and shortening or extension of this signal can occur due to calcium excess or deficiency, respectively. The diagnosis of these disorders can be complicated, making the modeling of such a system complex. In the present work an artificial neural network (ANN) is proposed as a model for pattern recognition of the ECG signal. The procedure can be, in principle, used to identify changes in the morphology of the ECG signal due to alterations in calcium and potassium concentrations. An arrhythmia database of a widely used experimental data was considered to simulate different ECG signals and also for training and validation of the methodology. The proposed approach can recognize premature ventricular contractions (PVC) arrhythmias, and tests were performed in a group of 47 individuals, showing significant quantitative results, on average, with 94% of confidence. The model was also able to detect ions changes and showed qualitative indications of what ion is affecting the ECG. These results indicate that the method can be efficiently applied to detect arrhythmias as well as to identify ions that may contribute to the development of cardiac arrhythmias. Accordingly, the actual approach might be used as an alternative tool for complex studies involving modifications in the morphology of the ECG signal associated with ionic changes.
    Health 05/2014; 6(66):1323-1332.
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    ABSTRACT: The prevalence of dementia is predicted to increase significantly as the population ages and with no foreseeable cure options the burden of dementia will continue to grow. Early diagnosis provides many benefits, including timely access to appropriate support services and provision of tailored therapeutic interventions for people with dementia and their carers. Memory clinics are a key response to the need for specialist assessment and diagnosis of dementia. Multidisciplinary team memory clinics are considered the “gold standard”; however, such resource intensive clinics are likely unsustainable. The nurse-led memory clinic format may provide a primary care focused, diagnostic service for dementia that does not have the cost implications of multidisciplinary memory clinics but there is limited research using nurse practitioners. This study is exploring the potential of a nurse-led memory clinic as a primary health care approach to health promotion (brain health awareness), disease prevention (risk factor reduction) and early intervention (diagnosis and management of dementia). A realistic evaluation of a nurse practitioner-led memory clinic is described. Realistic evaluation is concerned not only with the outcomes of an intervention but also with the context and mechanisms of the intervention. We are using a mixed methods case study design to describe and evaluate the impact of the nurse practitioner-led memory clinic. The nurse practitioner in this study is an advanced practice aged care nurse who focuses on mental health, and dementia diagnosis, management and risk factor reduction. This study seeks to inform the development of an expanded scope role for nurse practitioners in assessment and referrals for dementia diagnosis. The heterogeneity of clients attending the nurse-led memory clinic will allow us to evaluate what works in the memory clinic, for whom, and under what circumstances, in what respects, and to what extent.
    Health 03/2014; 6(8):748-756.
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    ABSTRACT: Purpose: This study reports the reliability and validity analyses of the Audit on diabetes-dependent quality of life (ADDQoL) and EQ-5D in elderly Slovenian diabetic patients. Methods: A crosssectional study of elderly (age ≥ 65 years) non-insulin dependent diabetes mellitus type 2 (DMT2) patients was carried out. The ADDQoL and EQ-5D surveys were conducted between January and May, 2012. Statistical analysis was performed using IBM SPSS Statistics software, version 20.0. Results: After exclusion of non-eligible respondents, the final sample for the analysis was 261 cases (51% male), resulting in 52.2%of response rate. The mean age of the patients was 70.3 years (SD ± 4.1). The Cronbach’s alpha was 0.93 for ADDQoL and 0.73 for EQ-5D.There was no improvement in the alpha value if any item was deleted in all instruments. Missing value items ranged from 0.8% to 1.5% for EQ-5D, and from 0.8% to 59.1% (working life) in ADDQoL. Spearman’s correlation between the EQ-5D VAS score and ADDQoL weighted overall score resulted in weak correlations coefficient (r = 0.294; p < 0.001). Conclusions: The ADDQoL proved reliable and valid for assessing Health Related Quality of Life (HRQoL) among elderly Slovenian DMT2 patients. EQ-5D seemed to be too generic to describe limitations of DMT2 patients in detail. Using disease specific QoL instruments to learn about patient limitations was recommended. Comparison of ADDQoL results between various studies provided significant differences in the impact of diabetes.
    Health 03/2014; 6(8).
  • Health 12/2013;
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    ABSTRACT: What it is like when a lifelong twin relationship ends through death in later life is the focus of this study. It draws on interview data from seven twins who are part of a longitudinal Swedish twin study (SATSA) and who lost their co-twins in old age. Data were analyzed using qualitative latent content analysis. The results showed that the experience of loss of the co-twin was pro-found, including an emotional as well as a be-havioral dimension. Loss and loneliness were expressed as the dominant feelings related to the quality of the missing relationship as well as the loss of twin identity. However, the grief ex-periences in this study were primarily related to the closeness and quality of the twin relation-ship, rather than identity. Behavioral adjust-ments included the use of outside as well as internal cognitive resources to cope with life after the loss. Despite the devastating experi-ence of losing a co-twin after a lifelong rela-tionship, the participants engaged actively in their own grief processes. It was concluded that twin loss is unique, in the sense of losing the relational twin identity, as well as it is charac-terized by similar features as the loss of a close relationship among non-twins.
    Health 12/2013; 5(12A):64-73.
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    ABSTRACT: The aim of this study was to investigate the efficacy of specially designed zori, a Japanese-style sandal, for enhancing walking performance. A total of 89 women aged 59-75 were randomly assigned to either the intervention or control group. The intervention group wore the zori for 6 months while the control group did not. We conducted physical assessments, including The Good Walker’s Index, which consisted of a 10-m walking time measurement, maximal step length, the 40/20-cm step test and tandem gait, and measurement of the toe-gap force (TGF). Additionally, bare foot plantar pressure distribution was measured using a foot-mapping sensor, while gait characteristics were measured using three dimensional sensors. In the intervention group, means for TGF improved significantly between baseline and three months and between baseline and six months, but this improvement was not evident in the control group. In the intervention group, the means for pressure and surface areas of both left and right feet significantly decreased over time compared with the control group. Three-dimensional analysis found that left and right ankle height was enhanced in the intervention group, and their walking speed was improved by the extension of their stride length and an increase in the height of the tiptoe in one cycle. The findings in our study indicate that zori can be useful in improving lower leg function through TGF enhancement and adjustment of the pressure pattern.
    Health 12/2013; 5:1-7.
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    ABSTRACT: Type I Diabetes Mellitus (DM I) is the third most common chronic childhood disease and can cause both short-term and long-term complications, as well as acute life-threatening events. The announcement of the DM I diagnosis in childhood or adolescence constitutes a major psychosocial stressor for the child and his family. Diabetes in general complicates the parent-child relationship and increases adolescents’ negative thoughts about themselves and depressive mood. The majority of patients experience depressive and/or anxiety symptoms at the time of diagnosis, which generally resolve within six to nine months. Poor adjustment in this initial phase places adolescents at risk for later psychosocial difficulties. On a long-term basis, individuals with DM I may exhibit significant psychiatric and behavioral problems including depression, anxiety and anger. We here reported the case of a 13-year-old boy, suffering from DM I for 3 years, who developed poor metabolic control, depressive symptoms and life-threatening behavior in the past 6 months and was hospitalized at an inpatient psychiatric unit. The complex biopsychosocial needs of adolescents with Type I Diabetes Mellitus should be recognized and addressed through tailored interventions by medical and mental health professionals.
    Health 08/2013; 5(8):1268-1271.
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    ABSTRACT: ABSTRACT Background: Poor birth outcomes are common health problems everywhere in the world. Hence institutional delivery in Ethiopia is very low, improving birth outcomes through recent evidence remained critical. The objective of the study was to determine the prevalence of poor birth outcomes and associated factors among women who delivered in selected health facilities of North Wollo Zone. Methods: A facility based cross-sectional survey was conducted on 295 laboring mothers from May to June 2009. Interviewer administered questionnaire was used to collect the data. Patient’s chart was reviewed to retrieve medical information. Anthropometry of the neonate was taken by standard measurement tools. Data were analyzed using statistical package for social sciences (SPSS), version 15. Binary logistic regression analyses were used to identify predictors of poor birth outcomes. P-value ≤ 0.05 was considered statistically significant. Results: All the data resulted from 295 laboring mothers were made part of the analyses. A total of 266 (90.2%) laboring mothers gave live birth. A quarter, 68 (23.1%) of the laboring mothers had a poor birth outcome. The common adverse outcomes were intrauterine fetal death (IUFD, preterm, and birth defects with the proportion of 29 (42.6%), 22 (32.4%), and 3 (4.4%), respectively). Mother whose husband’s occupation was merchant (AOR = 4.4, 95% CI: 1.0 - 19.0), driver (AOR = 4.2, 95% CI: 1.12 - 15.76), & women who were illiterate (AOR = 4.0, 95% CI: 1.2 - 13.5), primary school completed (AOR = 4.3, 95% CI: 1.3 - 13.8), non-antenatal care visited (AOR = 3.4, 95% CI: 1.12 - 10.2), rural residence, (AOR = 2.6, 95% CI: 1.11 - 5.80), & mother’s HIV status, (AOR = 34.2, 95% CL 5.6, 207.0) were independent predictors of poor birth outcomes. Conclusions: Poor birth outcomes were very common in the study area where low birth weight accounted for much of all adverse pregnancy outcomes. Occupation, residence, antenatal care visit, income, maternal education and HIV status were determinants of poor birth outcomes. Accessing antenatal care in early trimester, mild physical work, maternal education to secondary level and above should be encouraged.
    Health 06/2013; 5(7):1141-50.

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