Abstract: A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.
Abstract: The study was focused on the development and assessment of the illustrated language activities of the 1996 Edition of the Portage Guide to Early Education. It determined the extent of appropriateness, applicability, time efficiency and aesthetics of the illustrated language activities to be used as instructional material not only by teachers, but parents and caregivers as well. The eclectic research design was applied in this study using qualitative and quantitative methods. To determine the applicability and time efficiency of the study, a try out was done. Since the eclectic research design was used, it made use of a researcher-made survey questionnaire and focus group discussion. Analysis of the data was done through weighted mean and ANOVA. The respondents of the study were representatives of Special Education (SPED) teachers, caregivers and parents of a special-needs child, particularly with difficulties in learning basic language skills. The results of the study show that a large number of respondents are SPED teachers and caregivers and are mostly college graduates. Many of them have earned units towards Master’s studies. Moreover, a majority of the respondents have not attended seminars or in-service training in early intervention for them to be more competent in the area of specialization. It is concluded that the illustrated language activities under review in this study are appropriate, applicable, time efficient and aesthetic for use as a tool in teaching. The recommendations are focused on the advocacy for SPED teachers, caregivers and parents of special-needs children to be more consistent in the implementation of the new instructional materials as an aid in an intervention program.
Abstract: Osteoporosis is a complex health disease characterized by low bone mineral density, which is determined by an interaction of genetics with metabolic and environmental factors. Current research in genetics of osteoporosis is focused on identification of responsible genes and polymorphisms. TNFRSF11B gene plays a key role in bone remodeling. The aim of this study was to investigate the genotype and allele distribution of A163G (rs3102735) osteoprotegerin gene promoter and G1181C (rs2073618) osteoprotegerin first exon polymorphisms in the group of 180 unrelated postmenopausal women with diagnosed osteoporosis and 180 normal controls. Genomic DNA was isolated from peripheral blood leukocytes using standard methodology. Genotyping for presence of different polymorphisms was performed using the Custom Taqman®SNP Genotyping assays. Hardy-Weinberg equilibrium was tested for each SNP in the groups of participants using the chi-square (χ2) test. The distribution of investigated genotypes in the group of patients with osteoporosis were as follows: AA (66.7%), AG (32.2%), GG (1.1%) for A163G polymorphism; GG (19.4%), CG (44.4%), CC (36.1%) for G1181C polymorphism. The distribution of genotypes in normal controls were follows: AA (71.1%), AG (26.1%), GG (2.8%) for A163G polymorphism; GG (22.2%), CG (48.9%), CC (28.9%) for G1181C polymorphism. In A163G polymorphism the variant G allele was more common among patients with osteoporosis: 17.2% versus 15.8% in normal controls. Also, in G1181C polymorphism the phenomenon of more frequent occurrence of C allele in the group of patients with osteoporosis was observed (58.3% versus 53.3%). Genotype and allele distributions showed no significant differences (A163G: χ2=0.270, p=0.605; χ2=0.250, p=0.616; G1181C: χ2= 1.730, p=0.188; χ2=1.820, p=0.177). Our results represents an initial study, further studies of more numerous file and associations studies will be carried out. Knowing the distribution of genotypes is important for assessing the impact of these polymorphisms on various parameters associated with osteoporosis. Screening for identification of “at-risk” women likely to develop osteoporosis and initiating subsequent early intervention appears to be most effective strategy to substantially reduce the risks of osteoporosis.
Abstract: Early Intervention Program (EIP) is required to
improve the overall development of children with Trisomy 21 (Down
syndrome). In order to help trainer and parent in the implementation
of EIP, a support system has been developed. The support system is
able to screen data automatically, store and analyze data, generate
individual EIP (curriculum) with optimal training duration and to
generate training automatically. The system consists of hardware and
software where the software has been implemented using Java
language and Linux Fedora. The software has been tested to ensure the
functionality and reliability. The prototype has been also tested in
Down syndrome centers. Test result shows that the system is reliable
to be used for generation of an individual curriculum which includes
the training program to improve the motor, cognitive, and combination
abilities of Down syndrome children under 6 years.
Abstract: According to the statistics, the prevalence of congenital hearing loss in Taiwan is approximately six thousandths; furthermore, one thousandths of infants have severe hearing impairment. Hearing ability during infancy has significant impact in the development of children-s oral expressions, language maturity, cognitive performance, education ability and social behaviors in the future. Although most children born with hearing impairment have sensorineural hearing loss, almost every child more or less still retains some residual hearing. If provided with a hearing aid or cochlear implant (a bionic ear) timely in addition to hearing speech training, even severely hearing-impaired children can still learn to talk. On the other hand, those who failed to be diagnosed and thus unable to begin hearing and speech rehabilitations on a timely manner might lose an important opportunity to live a complete and healthy life. Eventually, the lack of hearing and speaking ability will affect the development of both mental and physical functions, intelligence, and social adaptability. Not only will this problem result in an irreparable regret to the hearing-impaired child for the life time, but also create a heavy burden for the family and society. Therefore, it is necessary to establish a set of computer-assisted predictive model that can accurately detect and help diagnose newborn hearing loss so that early interventions can be provided timely to eliminate waste of medical resources. This study uses information from the neonatal database of the case hospital as the subjects, adopting two different analysis methods of using support vector machine (SVM) for model predictions and using logistic regression to conduct factor screening prior to model predictions in SVM to examine the results. The results indicate that prediction accuracy is as high as 96.43% when the factors are screened and selected through logistic regression. Hence, the model constructed in this study will have real help in clinical diagnosis for the physicians and actually beneficial to the early interventions of newborn hearing impairment.
Abstract: Young people have a high prevalence of mental health
problems, yet tend not to seek help. Trusted adults in young people-s
lives, such as teachers and sports coaches, can make a major positive
contribution to the mental health of young people. Teachers and
sports coaches may be in a position to be effective in supporting
young people-s mental health through promotion, prevention and
early intervention. This study reports findings from interviews with
21 teachers and 13 sports coaches of young people aged 12 to 18 in
Canberra, Australia, regarding their perceptions of the relevance and
effectiveness of their role in supporting young people-s mental
health. Both teachers and coaches perceived having influential but
slightly different roles to play in supporting mental health. There may
be potential to elevate the influence of teachers and coaches as
sources of support for young people and their mental health care.