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Screening for atrial fibrillation in care homes using pulse palpation and the AliveCor Kardia Mobile® device: a comparative cross-sectional pilot study.
Get PDFBACKGROUND
Atrial fibrillation (AF) is a major cause of stroke in older people. Exacerbated by age and co-morbidities, residents of care homes are more likely to develop AF and less likely to receive oral anticoagulants.
AIM
To determine the prevalence of AF using the design and methodology of the Pharmacists Detecting Atrial Fibrillation (PDAF) study in a care home setting.
METHOD
A cross-sectional AF screening pilot study within four UK care homes, three residential and one residential/nursing. Screening followed the original PDAF protocol: a manual pulse check, followed by a single-Lead ECG (ECG, AliveCor Kardia Mobile (KMD)) delivered by a pharmacist. All recorded ECG were reviewed by a cardiologist and any residents requiring follow-up investigations were referred to their general practitioner.
RESULTS
Fifty-three of 112 care home residents participated. From 52 ECGs recorded, the cardiologist interpreted 13.5% (7/52) as having possible AF of which 9.6% (5/52) were previously unknown. One resident with previously unknown AF received anticoagulation.
CONCLUSION
This study has shown a need for AF screening in care homes and that elements of the PDAF screening protocol are transferable in this setting. Early diagnosis and treatment of AF are essential to reduce the risk of stroke in this population
The importance of measuring heart rate recovery alongside aerobic capacity; a role for HRV?
Get PDFThe article outlines the interplay between both branches of the ANS and explains why HRR should be utilised alongside conventional aerobic tests which are underpinned by sympathetic dominance. The article proposes HRVB as a practical solution to improve PNS efficiency and discusses why this should form an essential part of any cardiac health programme, and how research in this area can improve to facilitate better guidelines and field-based outcomes
Error‐correction mechanisms in language learning: modeling individuals
Get PDFAbstractSince its first adoption as a computational model for language learning, evidence has accumulated that Rescorla–Wagner error‐correction learning (Rescorla & Wagner, 1972) captures several aspects of language processing. Whereas previous studies have provided general support for the Rescorla–Wagner rule by using it to explain the behavior of participants across a range of tasks, we focus on testing predictions generated by the model in a controlled natural language learning task and model the data at the level of the individual learner. By adjusting the parameters of the model to fit the trial‐by‐trial behavioral choices of participants, rather than fitting a one‐for‐all model using a single set of default parameters, we show that the model accurately captures participants’ choices, time latencies, and levels of response agreement. We also show that gender and working memory capacity affect the extent to which the Rescorla–Wagner model captures language learning
Report on the second meeting of high-level working group for privacy and safety
Get PDFThe online harms world is a challenging one, where most parties, we are sure, would agree that it is important that citizens can engage with online platforms and discourses in a manner that mitigates harm and does not expose them to abuse. However, how we achieve this is complex and many stakeholders have conflicting viewpoints. These range from the prohibitive (“Harms occur on platforms, therefore platforms need to stop it”) to the progressive (“Harms are caused by people, how do we reduce them by being mindful of people’s right to participate free from excessive surveillance?”). There are many views that fit between these two positions. However, it is unquestionable that these perspectives all wish to achieve the same goal – that people, particularly young people, can experience the online world while not being harmed.
The ‘High-Level Working Group for Privacy & Safety’ aims to advocate for a holistic, person-centred approach to online safeguarding that respects people’s rights to online participation and to their privacy.
Convened by Prof Andy Phippen and Prof Emma Bond, the Working Group intends to drive discussions where central concepts such as harm, risk, vulnerability, well-being, and the best interest of the child are addressed in a nuanced and contextual manner to move conversations on from the traditional prohibitive narratives that beset the online harms work. In convening this group, Andy Phippen and Emma Bond, who collectively have 40 years’ experience working in this area, are hoping to develop a more inclusive and progressive narrative that moves from “someone needs to stop this” to “what can we all do to make online experiences more inclusive while understanding and reducing harm”. Current political narratives generally centre around how platforms can reduce or eliminate harms, with little consideration of other stakeholders that might be better placed to mitigate these risks
A meta-analysis of Osteoarthritis Synovial Biomarkers
No full textEstablishing disease biomarkers has been a long-sought after goal to improve Osteoarthritis (OA) diagnosis, prognosis, clinical and pharmaceutical interventions. Given the role of the synovium in contributing to OA, a meta-analysis was performed to determine significant synovial biomarkers in human OA tissue, compared to non-OA patients. Outcomes will direct future research on marker panels for OA disease modelling in vitro/in vivo , aiding clinical research into OA disease targets.
A PRISMA compliant search of databases was performed to identify potential biomarker studies analysing human, OA, synovial samples compared to non-OA/healthy participants. The Risk of Bias In Non-Randomised Studies of Interventions (ROBINS-I) tool assessed methodological quality, with outcome analysed by Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were conducted for individual biomarkers using fixed or random effect models, as appropriate. Where three or more studies included a specific biomarker, Forest Plot comparisons were generated.
3230 studies were screened, resulting in 34 studies encompassing 25 potential biomarkers (1581 OA patients and 695 controls). Significant outcomes were identified for thirteen comparisons. Eleven favoured OA (IL-6, IL-10, IL-13, IP-10, IL-8, CCL4, CCL5, PIICP, TIMP1, Leptin and VEGF), two favoured non-OA controls (BMP-2 and HA). Notably, PIICP showed the largest effect (SMD 6.11 [3.50, 8.72], p <0.00001, I 2 99%), and TIMP1 resulted critically important (0.95 [0.65, 1.25], p <0.00001, I 2 82%). Leptin and CCL4 showed lower effects (SMD 0.81 [0.33, 1.28], p =0.0009; 0.59 [0.32, 0.86], p <0.0001, respectively).
Thirteen significant synovial biomarkers showed links with OA bioprocesses including collagen turnover, inflammatory mediators and ECM components. Limitations arose due to bias risk from incomplete or missing data, publication bias of inconclusive results, and confounding factors from patient criteria. These findings suggest markers of potential clinical viability for OA diagnosis and prognosis that could be correlated with specific disease stages
Prevalence and demographic distribution of hypermobility in a random group of school-aged children in Nigeria
Get PDFBackground: The purpose of this study was to determine the prevalence of hypermobility in randomly selected healthy children, without previous trauma or disease process affecting the joints and whether other demographic variables (age, sex, BMI) had an impact on Beighton scores and range of motion (RoM) in children between 6 and 10 years of age
Results: 286 children were included; 27.3% of them had a Beighton score ≥7/9 and 72% would be classified hypermobile if we had used a Beighton cut-off score ≥4/9. Prevalence declined with increasing age. Girls were more often hypermobile (34%) than boys (20%) and this was mainly caused by increased RoM in the knees. Positive scores of finger items of the Beighton were more common than on the other items, leading to a high prevalence of peripheral hypermobility. Localized hypermobility was only found in the fifth MCP joint. A total of 15% of the children with normal mobility reached 20 excess degrees RoM of the left and right fifth MCP. Pain was present in 12 of the 239 children but was not linked to the level of mobility.
Conclusion: Hypermobility is the rule in this pain-free population of children with GJH
Guide to inclusion of particulate monitoring in planning conditions
No full textThis two-page note and ten-step guide has been produced by University of Suffolk for West Suffolk Council, as part of a project funded by the Local Government Association in their Net Zero Innovation Programme (NZIP). Further details are included in the full report, Particulates Monitoring: Guide for Planning and Case Study, By Steventon, H., and Leggett, L., from University of Suffolk
Capturing narratives: adopting a reflexive approach to research with disabled young people
No full text‘A lot of the time it’s dealing with victims who don’t want to know, it’s all made up, or they’ve got mental health’: rape myths in a large English police force
Get PDFDespite an increase in the reporting of rape, convictions in England and Wales have fallen significantly in recent years. Previous research has found high rape myth acceptance among police officers. Given that the police act as gatekeepers to the criminal justice system, subscribing to rape myths may have significant effects upon victim attrition and conviction rates. This study explores police officers’ use of rape myths and how these may impact investigations and prosecutions. A total of 17 semi-structured interviews were conducted with police officers from a large English police force. The interview data were analysed using the qualitative method of thematic analysis. Although there were instances where officers demonstrated some awareness of the need to dispel or counter rape myths, rape myths were employed by most officers, with the most common relating to (1) victim fabrication (‘women lie’) and (2) victim precipitation (‘women ask for it’). Recommendations are made around screening and training for police officers
Evaluation of pain in the paediatric patient admitted to sub-intensive care: a scoping review protocol.
Get PDFpain is considered as the 5th vital sign thus it's paramount that healthcare professionals are equipped with validated tools for his correct assessment. There are different paediatric pain assessment scales that take into account patients' age. Actually, the "Face, Legs, Activity, Cry, Consolability" (FLACC), Wong-Baker and NRS scales are regarded as the gold standard in low intensity clinical areas, while the COMFORT-Behavior (COMFORT-B) and Behavioral Pain Scale (BPS) ones are used for high intensity clinical areas where paediatric patients are sedated/intubated. It's unclear which pain assessment scale should be used in sub-intensive areas such as Sub-Paediatric Intensive Care Unit (Sub-PICU) e Sub-Neonatal Intensive Care Unit (Sub-NICU). The aim of this protocol is to map the literature in order to identify what evidences are available regarding the assessment of pain in the paediatric sub-intensive clinical areas. "What is the literature available on pain assessment in paediatric patients in sub-intensive clinical areas such as Sub-PICU and sub-NICU?". literature search will be performed through the following databases: PubMed, Scopus, CINAHL, Cochrane Library, Open Dissertations (EBSCO) and DOAJ. Furthermore, Cochrane CENTRAL and ClinicalTrials.gov will also be included. this scoping review will be conducted in accordance to the Joanna Briggs Institute guidelines and the results presented through a PRISMA flowchart. Open Science Framework https://doi.org/10.17605/OSF.IO/8KBRQ