This study aimed to produce a prototype system for non-contact vital sign monitoring of the elderly using microwave radar with the intention of reducing the burdens on monitored individuals and nursing caregivers. In ...This study aimed to produce a prototype system for non-contact vital sign monitoring of the elderly using microwave radar with the intention of reducing the burdens on monitored individuals and nursing caregivers. In addition, we tested the ability of the proposed prototype system to measure the respiratory and heart rates of the elderly in a nursing home and discussed the systems effectiveness and problems by examining results of real-time monitoring. The prototype system consisted of two 24-GHz microwave radar antennas and an analysis system. The antennas were positioned below a mattress to monitor motion on the body surface for measuring cardiac and respiratory rates from the dorsal side of the subjects (23.3 ± 1.2 years) who would be lying on the mattress. The heart rates determined by the prototype system correlated significantly with those measured by electrocardiography (r = 0.92). Similarly, the respiratory rates determined by the prototype correlated with those obtained from respiration curves (r = 0.94). Next, we investigated the effectiveness of the prototype system with 7 elderly patients (93.3 ± 10.56 years) at a nursing home. The proposed system appears to be a promising tool for monitoring the vital signs of the elderly in a way that alleviates the need to attach electrodes overnight to confirm patient safety.展开更多
AIM To assess the performance and clinical relevance of the Early Warning Scoring(EWS)system at the Intermediate Care Unit(IMCU).METHODS This cohort study used all the Vital PAC EWS(Vi EWS)scores collected during each...AIM To assess the performance and clinical relevance of the Early Warning Scoring(EWS)system at the Intermediate Care Unit(IMCU).METHODS This cohort study used all the Vital PAC EWS(Vi EWS)scores collected during each nursing shift from 2014through 2016 at the mixed surgical IMCU of an academic teaching hospital.Clinical deterioration defined as transfer to the Intensive Care Unit(ICU)or mortality within 24 h was the primary outcome of interest.RESULTS A total of 9113 aggregated Vi EWS scores were obtained from 2113 admissions.The incidence of the combined outcome was 272(3.0%).The area under the curve of the Vi EWS was 0.72(CI:0.69-0.75).Using a threshold value of six,the sensitivity was 68%with a positive predictive value of 5%and a number needed to trigger(e.g.,false alarms)of 19%.CONCLUSION The Vi EWS at the IMCU has a discriminative performance that is considerably lower than at the hospital ward.The number of false alarms is high,which may result in alarm fatigue.Therefore,use of the Vi EWS in its current form at the IMCU should be reconsidered.展开更多
A study was conducted to describe midwives’ adherence to preoperative care during emergency caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive prospective and retrospective...A study was conducted to describe midwives’ adherence to preoperative care during emergency caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive prospective and retrospective design. A structured questionnaire was administered to all 28 midwives who were directly involved in the preparation of clients for emergency caesarean section. Clients charts were also reviewed using a standard checklist to determine adherence to preoperative care. Data were analyzed using SPSS version 16.0 and descriptive statistics in the form of frequencies and percentages were computed for the dataset. A midwife was supposed to score at least 80% on each component of preoperative care guidelines to be compliant to the stipulated pre-operation standards. The midwives scored above 80% on only four of the 14 preoperative care guidelines which were;bladder catheterization (100%, n = 14), obtaining informed consent (92.9%, n = 12), administration of IV (96.4%, n = 13) and administration of preoperative antibiotics (82.1%, n = 11). Midwives however scored less than 80% on preoperative procedures that dealt with vital signs (28.6%, n = 4): BP check (28.6%, n = 4);Pulse rate check (25%, n = 3.5);respiration check (25%, n = 3.5) and temperature check (25%, n = 3.5). The midwives scored further below standard on blood specimen collection (78.6%, n = 11). Psychological support to clients was also below standard at 60.7%, n = 8. Other components of psychological support such as surgery information (57.1%, n = 8), allowing clients ask questions (28.6%, n = 4) and answering clients’ questions (25%, n = 3.5) were also scored below standard. Overall the standard of preoperative care was below standard at the facility. Most of the midwives were new graduates, who had never received any in-service training on preoperative care. Therefore in service training it is recommended for the midwives to provide good quality of care.展开更多
Relatively soon after their accident, patients suffering a spinal cord injury(SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associa...Relatively soon after their accident, patients suffering a spinal cord injury(SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associated with chronic physical inactivity-related immune function problems and increasing susceptibility to infection that repeatedly requires intensive care treatment. Therapies capable of repairing the spinal cord or restoring ambulation would normally prevent many of these problems but, as of now, there is no cure for SCI. Thus, management strategies and antibiotics remain the standard of care although antimicrobial resistance constitutes a significant challenge for patients with chronic SCI facing recurrent infections of the urinary tract and respiratory systems. Identifying alternative therapies capable of safe and potent actions upon these serious health concerns should therefore be considered a priority. This editorial presents some of the novel approaches currently in development for the prevention of specific infections after SCI. Among them, brain-permeable small molecule therapeutics acting centrally on spinal cord circuits that can augment respiratory capabilities or bladder functions. If eventually approved by regulatory authorities, some of these new avenues may potentially become clinically-relevant therapies capable of indirectly preventing the occurrence and/or severity of these lifethreatening complications in people with paraplegic or tetraplegic injuries.展开更多
文摘This study aimed to produce a prototype system for non-contact vital sign monitoring of the elderly using microwave radar with the intention of reducing the burdens on monitored individuals and nursing caregivers. In addition, we tested the ability of the proposed prototype system to measure the respiratory and heart rates of the elderly in a nursing home and discussed the systems effectiveness and problems by examining results of real-time monitoring. The prototype system consisted of two 24-GHz microwave radar antennas and an analysis system. The antennas were positioned below a mattress to monitor motion on the body surface for measuring cardiac and respiratory rates from the dorsal side of the subjects (23.3 ± 1.2 years) who would be lying on the mattress. The heart rates determined by the prototype system correlated significantly with those measured by electrocardiography (r = 0.92). Similarly, the respiratory rates determined by the prototype correlated with those obtained from respiration curves (r = 0.94). Next, we investigated the effectiveness of the prototype system with 7 elderly patients (93.3 ± 10.56 years) at a nursing home. The proposed system appears to be a promising tool for monitoring the vital signs of the elderly in a way that alleviates the need to attach electrodes overnight to confirm patient safety.
文摘AIM To assess the performance and clinical relevance of the Early Warning Scoring(EWS)system at the Intermediate Care Unit(IMCU).METHODS This cohort study used all the Vital PAC EWS(Vi EWS)scores collected during each nursing shift from 2014through 2016 at the mixed surgical IMCU of an academic teaching hospital.Clinical deterioration defined as transfer to the Intensive Care Unit(ICU)or mortality within 24 h was the primary outcome of interest.RESULTS A total of 9113 aggregated Vi EWS scores were obtained from 2113 admissions.The incidence of the combined outcome was 272(3.0%).The area under the curve of the Vi EWS was 0.72(CI:0.69-0.75).Using a threshold value of six,the sensitivity was 68%with a positive predictive value of 5%and a number needed to trigger(e.g.,false alarms)of 19%.CONCLUSION The Vi EWS at the IMCU has a discriminative performance that is considerably lower than at the hospital ward.The number of false alarms is high,which may result in alarm fatigue.Therefore,use of the Vi EWS in its current form at the IMCU should be reconsidered.
文摘A study was conducted to describe midwives’ adherence to preoperative care during emergency caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive prospective and retrospective design. A structured questionnaire was administered to all 28 midwives who were directly involved in the preparation of clients for emergency caesarean section. Clients charts were also reviewed using a standard checklist to determine adherence to preoperative care. Data were analyzed using SPSS version 16.0 and descriptive statistics in the form of frequencies and percentages were computed for the dataset. A midwife was supposed to score at least 80% on each component of preoperative care guidelines to be compliant to the stipulated pre-operation standards. The midwives scored above 80% on only four of the 14 preoperative care guidelines which were;bladder catheterization (100%, n = 14), obtaining informed consent (92.9%, n = 12), administration of IV (96.4%, n = 13) and administration of preoperative antibiotics (82.1%, n = 11). Midwives however scored less than 80% on preoperative procedures that dealt with vital signs (28.6%, n = 4): BP check (28.6%, n = 4);Pulse rate check (25%, n = 3.5);respiration check (25%, n = 3.5) and temperature check (25%, n = 3.5). The midwives scored further below standard on blood specimen collection (78.6%, n = 11). Psychological support to clients was also below standard at 60.7%, n = 8. Other components of psychological support such as surgery information (57.1%, n = 8), allowing clients ask questions (28.6%, n = 4) and answering clients’ questions (25%, n = 3.5) were also scored below standard. Overall the standard of preoperative care was below standard at the facility. Most of the midwives were new graduates, who had never received any in-service training on preoperative care. Therefore in service training it is recommended for the midwives to provide good quality of care.
文摘Relatively soon after their accident, patients suffering a spinal cord injury(SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associated with chronic physical inactivity-related immune function problems and increasing susceptibility to infection that repeatedly requires intensive care treatment. Therapies capable of repairing the spinal cord or restoring ambulation would normally prevent many of these problems but, as of now, there is no cure for SCI. Thus, management strategies and antibiotics remain the standard of care although antimicrobial resistance constitutes a significant challenge for patients with chronic SCI facing recurrent infections of the urinary tract and respiratory systems. Identifying alternative therapies capable of safe and potent actions upon these serious health concerns should therefore be considered a priority. This editorial presents some of the novel approaches currently in development for the prevention of specific infections after SCI. Among them, brain-permeable small molecule therapeutics acting centrally on spinal cord circuits that can augment respiratory capabilities or bladder functions. If eventually approved by regulatory authorities, some of these new avenues may potentially become clinically-relevant therapies capable of indirectly preventing the occurrence and/or severity of these lifethreatening complications in people with paraplegic or tetraplegic injuries.
