30 research outputs found
Examining the Base Rates of Atrial Fibrillation in Eastern North Carolina: Community Screening, Associated Risk Factors, and Psychological Correlates of Disease
No full textBackground: Eastern North Carolina has historically high prevalence rates of cardiovascular disease. Novel solutions such as mobile screening technology may aid in reaching this region’s vulnerable health population to prevent further disease progression. Additionally, symptoms of psychological distress are commonly comorbid with cardiovascular disease but often overlooked as formal predictors or modifiers of increased disease burden. Behavioral medicine providers recognize the importance of screening for psychological stress as it relates to cardiovascular disease as a way to reduce disease burden and advancement. Therefore, mobile-ECG screening for atrial fibrillation and exploration of adding psychological variables to a well-established cardiovascular stroke risk calculator (CHA₂DS₂-VASc) are discussed.
Methods: Participants (N = 250) were approached at pharmacies in Eastern North Carolina. Participants completed demographic and medical history questionnaires, the DASS-21, and were administered a single-lead mobile-ECG (mECG). All mECG readings were interpreted by the mECG device in addition to adjudication by three electrophysiologists. Medical referrals were provided when indicated. Chi-squared statistics were utilized to investigate regional rates of atrial fibrillation and associated risk factors. Binary logistic regression modeling measured the capability of the CHA₂DS₂-VASc stroke risk calculator to predict abnormal mECG readings both with and without the addition of DASS-21 symptom scores.
Results: Rates of previously undiagnosed atrial fibrillation were much higher than rates found in studies of similar scope and design. Participants’ average CHA₂DS₂-VASc scores (2.68 ± 1.35) signify an alarming rate of untreated ischemic stroke risk in a community sample. Additionally, the prevalence rates of six, known independent stroke risk factors were also significantly higher in the study sample than reported national US averages. Significant correlations were not found between psychological endpoints and abnormal mECG readings or elevated CHA₂DS₂-VASc scores, but binary logistic regression modeling revealed that a longstanding stroke risk calculator could be potentially strengthened with the addition of one (anxiety) or three (depression, anxiety, and stress) psychological endpoints.
Discussion: The results of the current study further the knowledge of the utility of using mobile-health techniques to capture previously undiagnosed atrial fibrillation and associated risk factors. Prevalence of chronic disease and other health metrics in the Eastern North Carolina region are substantially worse than the general US population. Additionally, the results presented begin a compelling argument for the addition of psychological symptom scores to a long-standing stroke risk calculator
Cardiac Monitoring with Smartphones: MobileECG Usage in ICD Patients
No full textBackground: Addressing behavioral risk factors and having access to high quality medical care with increased information, biometrics, and treatment planning could reduce global cardiovascular mortality. There has been a surge of medical technologies that can help prevent, manage, and even forecast medically distressing cardiovascular events. As a new wave of medical technologies are developed, patients will increasingly be considered “key personnel” in the process of using novel techniques to improve self-care, engagement and overall quality of life. The purpose of this study was to examine the perceived added value of smartphone-ECG technology to an ICD patient user experience.
Methods: Fifty-one participants were recruited from an existing ICD patient population at the East Carolina Heart Institute in Greenville, North Carolina. Participants were given smartphone-ECG devices and asked to take a thirty-second reading at least once per day. In addition to overall technology satisfaction, three major constructs were examined in this population including cardiac and device-specific anxiety, quality of life, and self-management. Time points of data collection were at baseline, thirty-day, and ninety-day.
Results: The current study findings indicate that smartphone-ECG technology is widely accepted and positively appraised by this user base. Positive technology appraisal did not correlate to significant within-group changes in domains of quality of life and self-management after using the technology for thirty days. ICD shock anxiety was significantly increased during the period of technology usage, which may have been maintained by the task of using a device that required them to focus on their disease state at least once per day. Conversely, overall ICD device acceptance increased significantly indicating that the external technology use of the mECG device may have led to positive appraisals of their implantable devices.
Discussion: The results of the current study further the knowledge of the mobile-health field by asking a series of simple, yet important, questions related to device acceptance and technology satisfaction. Medical technology development will most likely continue to outpace the speed at which clinicians and researchers are able to critically evaluate and integrate novel technology into their patient care centers. QoL, shock-related anxiety, and more general cardiac anxiety remain important treatment targets among ICD patient populations
Pilot evaluation of a web-based intervention targeting sexual health service access
No full textSexual health service access is fundamental to good sexual health, yet interventions designed toaddress this have rarely been implemented or evaluated. In this paper, pilot evaluation findingsfor a targeted public health behavior change intervention, delivered via a website and web-app,aiming to increase uptake of sexual health services amongst 13 to 19 year-olds are reported. Apre-post questionnaire-based design was used. Matched baseline and follow-up data wasidentified from 148 respondents aged 13-18 years. Outcome measures were self-reported serviceaccess, self-reported intention to access services, and beliefs about services and service accessidentified through needs analysis. Objective service access data provided by local sexual healthservices was also analyzed. Analysis suggests the intervention had a significant positive effect onpsychological barriers to and antecedents of service access amongst females. Males, whoreported greater confidence in service access compared with females, significantly increasedservice access by time 2 follow-up. Available objective service access data supports the assertionthat the intervention may have led to increases in service access. There is real promise for thisnovel digital intervention. Further evaluation is planned as the model is licensed to and rolled outby other local authorities in the UK. Publisher Statement: This is a pre-copyedited, author-produced version of an article accepted for publication in Health Education Research following peer review. The version of record Brown, KE, Newby, K, Caley, M, Danahay, A & Kehal, I 2016, 'Pilot evaluation of a web-based intervention targeting sexual health service access' Health Education Research, vol 31, no. 2, pp. 273-282 is available online at: https://dx.doi.org/10.1093/her/cyw00
Cardiac Monitoring with Smartphones: MobileECG Usage in ICD Patients
No full text"Background: Addressing behavioral risk factors and having access to high quality medical care with increased information , biometrics , and treatment planning could reduce global cardiovascular mortality. There has been a surge of medical technologies that can help prevent , manage , and even forecast medically distressing cardiovascular events. As a new wave of medical technologies are developed , patients will increasingly be considered ""key personnel€ in the process of using novel techniques to improve self-care , engagement and overall quality of life. The purpose of this study was to examine the perceived added value of smartphone-ECG technology to an ICD patient user experience. Methods: Fifty-one participants were recruited from an existing ICD patient population at the East Carolina Heart Institute in Greenville , North Carolina. Participants were given smartphone-ECG devices and asked to take a thirty-second reading at least once per day. In addition to overall technology satisfaction , three major constructs were examined in this population including cardiac and device-specific anxiety , quality of life , and self-management. Time points of data collection were at baseline , thirty-day , and ninety-day. Results: The current study findings indicate that smartphone-ECG technology is widely accepted and positively appraised by this user base. Positive technology appraisal did not correlate to significant within-group changes in domains of quality of life and self-management after using the technology for thirty days. ICD shock anxiety was significantly increased during the period of technology usage , which may have been maintained by the task of using a device that required them to focus on their disease state at least once per day. Conversely , overall ICD device acceptance increased significantly indicating that the external technology use of the mECG device may have led to positive appraisals of their implantable devices. Discussion: The results of the current study further the knowledge of the mobile-health field by asking a series of simple , yet important , questions related to device acceptance and technology satisfaction. Medical technology development will most likely continue to outpace the speed at which clinicians and researchers are able to critically evaluate and integrate novel technology into their patient care centers. QoL , shock-related anxiety , and more general cardiac anxiety remain important treatment targets among ICD patient populations.
Examining the Base Rates of Atrial Fibrillation in Eastern North Carolina: Community Screening, Associated Risk Factors, and Psychological Correlates of Disease
No full textBackground: Eastern North Carolina has historically high prevalence rates of cardiovascular disease. Novel solutions such as mobile screening technology may aid in reaching this region’s vulnerable health population to prevent further disease progression. Additionally, symptoms of psychological distress are commonly comorbid with cardiovascular disease but often overlooked as formal predictors or modifiers of increased disease burden. Behavioral medicine providers recognize the importance of screening for psychological stress as it relates to cardiovascular disease as a way to reduce disease burden and advancement. Therefore, mobile-ECG screening for atrial fibrillation and exploration of adding psychological variables to a well-established cardiovascular stroke risk calculator (CHA2DS2-VASc) are discussed.\r\n\r\nMethods: Participants (N = 250) were approached at pharmacies in Eastern North Carolina. Participants completed demographic and medical history questionnaires, the DASS-21, and were administered a single-lead mobile-ECG (mECG). All mECG readings were interpreted by the mECG device in addition to adjudication by three electrophysiologists. Medical referrals were provided when indicated. Chi-squared statistics were utilized to investigate regional rates of atrial fibrillation and associated risk factors. Binary logistic regression modeling measured the capability of the CHA2DS2-VASc stroke risk calculator to predict abnormal mECG readings both with and without the addition of DASS-21 symptom scores.\r\n\r\nResults: Rates of previously undiagnosed atrial fibrillation were much higher than rates found in studies of similar scope and design. Participants’ average CHA2DS2-VASc scores (2.68 ± 1.35) signify an alarming rate of untreated ischemic stroke risk in a community sample. Additionally, the prevalence rates of six, known independent stroke risk factors were also significantly higher in the study sample than reported national US averages. Significant correlations were not found between psychological endpoints and abnormal mECG readings or elevated CHA2DS2-VASc scores, but binary logistic regression modeling revealed that a longstanding stroke risk calculator could be potentially strengthened with the addition of one (anxiety) or three (depression, anxiety, and stress) psychological endpoints.\r\n\r\nDiscussion: The results of the current study further the knowledge of the utility of using mobile-health techniques to capture previously undiagnosed atrial fibrillation and associated risk factors. Prevalence of chronic disease and other health metrics in the Eastern North Carolina region are substantially worse than the general US population. Additionally, the results presented begin a compelling argument for the addition of psychological symptom scores to a long-standing stroke risk calculator
Examining the Base Rates of Atrial Fibrillation in Eastern North Carolina: Community Screening , Associated Risk Factors , and Psychological Correlates of Disease
No full textBackground: Eastern North Carolina has historically high prevalence rates of cardiovascular disease. Novel solutions such as mobile screening technology may aid in reaching this region's vulnerable health population to prevent further disease progression. Additionally , symptoms of psychological distress are commonly comorbid with cardiovascular disease but often overlooked as formal predictors or modifiers of increased disease burden. Behavioral medicine providers recognize the importance of screening for psychological stress as it relates to cardiovascular disease as a way to reduce disease burden and advancement. Therefore , mobile-ECG screening for atrial fibrillation and exploration of adding psychological variables to a well-established cardiovascular stroke risk calculator (CHA‚‚DS‚‚-VASc) are discussed. Methods: Participants (N = 250) were approached at pharmacies in Eastern North Carolina. Participants completed demographic and medical history questionnaires , the DASS-21 , and were administered a single-lead mobile-ECG (mECG). All mECG readings were interpreted by the mECG device in addition to adjudication by three electrophysiologists. Medical referrals were provided when indicated. Chi-squared statistics were utilized to investigate regional rates of atrial fibrillation and associated risk factors. Binary logistic regression modeling measured the capability of the CHA‚‚DS‚‚-VASc stroke risk calculator to predict abnormal mECG readings both with and without the addition of DASS-21 symptom scores. Results: Rates of previously undiagnosed atrial fibrillation were much higher than rates found in studies of similar scope and design. Participants' average CHA‚‚DS‚‚-VASc scores (2.68 ± 1.35) signify an alarming rate of untreated ischemic stroke risk in a community sample. Additionally , the prevalence rates of six , known independent stroke risk factors were also significantly higher in the study sample than reported national US averages. Significant correlations were not found between psychological endpoints and abnormal mECG readings or elevated CHA‚‚DS‚‚-VASc scores , but binary logistic regression modeling revealed that a longstanding stroke risk calculator could be potentially strengthened with the addition of one (anxiety) or three (depression , anxiety , and stress) psychological endpoints. Discussion: The results of the current study further the knowledge of the utility of using mobile-health techniques to capture previously undiagnosed atrial fibrillation and associated risk factors. Prevalence of chronic disease and other health metrics in the Eastern North Carolina region are substantially worse than the general US population. Additionally , the results presented begin a compelling argument for the addition of psychological symptom scores to a long-standing stroke risk calculator
A New Type of Complexometric Titration
No full textAuthor Institution: Department of Chemistry, The Ohio State University, Columbus 1
Resilience to large-scale disturbance in coral and fish assemblages on the Great Barrier Reef
No full textRecognition of the complex spatial and temporal variability of abundance and diversity found in many populations has led to a greater focus on the roles of heterogeneity, stochasticity, and disturbance in the structure and persistence of communities. This focus is directly relevant to coral reef communities that are characterized by very high species diversity in a spatially heterogeneous environment, display stochastic variability in community structure at small spatial and temporal scales, and are subject to major disturbances. We monitored coral and fish assemblages over 14 years on fixed sites spread over 80 km of the southern Great Barrier Reef (GBR), Australia, and found evidence of large-scale resilience and predictable recovery of these assemblages. Sometime between November 1987 and October 1989, live coral cover on the shallow northeast flanks of some reefs in the southern GBR decreased from >80% to <10%, probably as a result of storm damage. We compared the fish and benthic communities present in these areas prior to the disturbance (1983-1984) with those present in 1992 and the subsequent changes through to 1998. Hard coral cover increased slowly from 1992 to 1994, then accelerated to be indistinguishable from pre-impact levels by 1998. The response of the coral assemblages was largely due to the predominance of tabulate Acropora species and their characteristics of rapid growth and competitive dominance. Patterns of species richness of the fish families Acanthuridae, Chaetodontidae, Scaridae, and Pomacentridae mirrored that of hard coral, except the Pomacentridae had not recovered to pre-impact levels by 1998. Of the 26 fish species analyzed for changes in abundance, 88% decreased after the disturbance, then subsequently increased, with all but two recovering to pre-impact levels by 1998. Although processes such as settlement and immigration are ultimately responsible for replenishment of local populations, our data suggested that habitat plays a strong role in modifying fish assemblages. Thus, both coral and fish assemblages demonstrated resilience to large-scale natural disturbance and predictability in the structure of the assemblages, with most taxa approaching the asymptote of abundance and species richness that existed prior to the disturbance.PT: J; CR: ALLEN GR, 1998, GUIDE ANGELFISHES BU AULT TR, 1998, ECOL MONOGR, V68, P25 BAIRD AH, 2000, J EXP MAR BIOL ECOL, V251, P117 BELL JD, 1984, MAR ECOL-PROG SER, V15, P265 BOHNSACK JA, 1983, ENVIRON BIOL FISH, V9, P41 BORMANN FH, 1979, AM SCI, V67, P660 BROTHERS EB, 1983, MAR BIOL, V76, P319 BROWN BE, 1997, CORAL REEFS, V16, P129 BUDDEMEIER RW, 2002, CORAL REEFS, V21, P1 BYTHELL JC, 2000, MAR ECOL-PROG SER, V204, P93 CALEY MJ, 1996, J ANIM ECOL, V65, P414 CHABANET P, 1997, CORAL REEFS, V16, P93 CHEAL AJ, 2002, CORAL REEFS, V21, P131 CHESSON PL, 1986, COMMUNITY ECOLOGY, P229 CHOAT JH, 1996, MAR ECOL-PROG SER, V134, P15 CLEY MJ, 1997, P 8 INT COR REEF S, V1, P993 COLGAN MW, 1987, ECOLOGY, V68, P1592 CONNELL JH, 1978, SCIENCE, V199, P1302 CONNELL JH, 1983, AM NAT, V121, P789 CONNELL JH, 1997, CORAL REEFS S, V16, P101 CONNELL JH, 1997, ECOL MONOGR, V67, P461 CORNELL HV, 1996, J ANIM ECOL, V65, P233 DAVIES PJ, 1979, SEARCH, V10, P776 DAVIES PJ, 1980, NATURE, V287, P37 DOHERTY PJ, 1987, B MAR SCI, V41, P411 DOHERTY PJ, 1991, ECOLOGY FISHES CORAL, P261 DOHERTY PJ, 1997, P 8 INT COR REEF S P, V1, P1005 DONE TJ, 1992, CONT SHELF RES, V12, P859 FOWLER AJ, 1990, MAR ECOL-PROG SER, V64, P39 FOWLER AJ, 1992, MAR ECOL-PROG SER, V82, P131 FRIEDLANDER AM, 1998, J EXP MAR BIOL ECOL, V224, P1 GREEN AL, 1996, MAR ECOL-PROG SER, V133, P1 HANSKI I, 1998, NATURE, V396, P41 HART AM, 1996, MAR ECOL-PROG SER, V132, P11 HART AM, 1996, MAR ECOL-PROG SER, V132, P21 HEINSELMAN ML, 1981, P C FIR REG EC PROP, P7 HIXON MA, 1991, ECOLOGY FISHES CORAL, P475 HIXON MA, 1993, ECOL MONOGR, V63, P77 HOBBS RJ, 1994, PACIFIC CONSERVATION, V1, P170 HOLLING CS, 1973, ANNUAL REV ECOLOGY S, V4, P1 HUGHES TP, 1994, SCIENCE, V265, P1547 HUGHES TP, 1999, LIMNOL OCEANOGR 2, V44, P932 JONES GP, 1991, ECOLOGY FISHES CORAL, P294 JONES GP, 1998, AUST J ECOL, V23, P287 KARLSON RH, 1993, CORAL REEFS, V12, P117 LASSIG BR, 1983, ENVIRON BIOL FISH, V9, P55 LEWIS AR, 1997, MAR ECOL-PROG SER, V161, P37 LITTELL RC, 1996, SAS SYSTEM MIXED MOD LUCKHURST BE, 1978, MAR BIOL, V49, P317 MASSEL SR, 1993, CORAL REEFS, V12, P153 MCCULLAGH P, 1989, GENERALIZED LINEAR MEEKAN MG, 1999, B MAR SCI, V64, P383 NINIO R, 2000, MAR ECOL-PROG SER, V194, P65 NINIO R, 2002, CORAL REEFS, V21, P95 NOTT J, 2001, NATURE, V413, P508 ODUM EP, 1969, SCIENCE, V164, P262 OLIVER JK, 1995, LONG TERM MINITORING PAINE RT, 1981, ECOL MONOGR, V51, P145 PICKETT STA, 1986, ECOLOGY NATURAL DIST PIUMM SL, 1991, BALANCE NATURE ECOL RANDALL JE, 1990, FISHES GRET BARRIER ROBERTS CM, 1987, MAR ECOL-PROG SER, V41, P1 SALE PF, 1978, ENVIRON BIOL FISH, V3, P85 SALE PF, 1982, AM NAT, V120, P121 SANO M, 2000, MAR ECOL-PROG SER, V198, P121 STIMSON J, 1985, ECOLOGY, V66, P40 SWEATMAN H, 2000, 4 I MAR SCI SWEATMAN H, 2001, 5 AUSTR I MAR SCI SYMS C, 1998, J EXP MAR BIOL ECOL, V230, P151 SYMS C, 2000, ECOLOGY, V81, P2714 THOMPSON AA, 2002, MAR ECOL-PROG SER, V232, P247 VANWOESIK R, 1991, J COASTAL RES, V7, P551 WALSH WJ, 1983, CORAL REEFS, V2, P49 WELLINGTON GM, 1985, OECOLOGIA, V68, P15 WILKINSON CR, 1999, MAR FRESHWATER RES, V50, P867 WILLIAMS DM, 1982, CORAL REEFS, V1, P35 WILLIAMS DM, 1983, MAR ECOL-PROG SER, V10, P239 WILLIAMS DM, 1986, MAR ECOL-PROG SER, V28, P157 WILLIAMS DM, 1991, ECOLOGY FISHES CORAL, P437 WOODLEY JD, 1981, SCIENCE, V214, P749 WU JG, 1995, Q REV BIOL, V70, P439; NR: 81; TC: 9; J9: ECOLOGY; PG: 14; GA: 843VASource type: Electronic(1
Unexpected Fine-Scale Population Structure in a Broadcast-Spawning Antarctic Marine Mollusc
No full textSeveral recent empirical studies have challenged the prevailing dogma that broadcast-spawning species exhibit little or no population genetic structure by documenting genetic discontinuities associated with large-scale oceanographic features. However, relatively few studies have explored patterns of genetic differentiation over fine spatial scales. Consequently, we used a hierarchical sampling design to investigate the basis of a weak but significant genetic difference previously reported between Antarctic limpets (Nacella concinna) sampled from Adelaide and Galindez Islands near the base of the Antarctic Peninsula. Three sites within Ryder Bay, Adelaide Island (Rothera Point, Leonie and Anchorage Islands) were each sub-sampled three times, yielding a total of 405 samples that were genotyped at 155 informative Amplified Fragment Length Polymorphisms (AFLPs). Contrary to our initial expectations, limpets from Anchorage Island were found to be subtly, but significantly distinct from those sampled from the other sites. This suggests that local processes may play an important role in generating fine-scale population structure even in species with excellent dispersal capabilities, and highlights the importance of sampling at multiple spatial scales in population genetic surveys
Evaluation and acceptance of mobile‐electrocardiogram use in implantable cardioverter defibrillator patients – Can I see my ECG?
No full text
