HeartDrive: A Broader Concept of Interoperability to Implement Care Processes for Heart Failure.

This paper originates from the HeartDrive project, a platform of services for a more effective, efficient and integrated management of heart failure and comorbidities. HeartDrive establishes a cooperative approach based on the concepts of continuity of care and extreme, patient oriented, customization of diagnostic, therapeutic and follow-up procedures. Definition and development of evidence based processes, migration from parceled and episode based healthcare provisioning to a workflow oriented model and increased awareness and responsibility of citizens towards their own health and wellness are key objectives of HeartDrive. In two scenarios for rehabilitation and home monitoring we show how the results are achieved by providing a solution that highlights a broader concept of cooperation that goes beyond technical interoperability towards semantic interoperability explicitly sharing process definitions, decision support strategies and information semantics.

Five-year retention of the classically conditioned eyeblink response in young adult, middle-aged, and older humans.

Human participants who 5 years earlier participated in studies of acquisition of the classically conditioned eyeblink response to a tone conditioned stimulus (CS) and an air puff unconditioned stimulus (UCS) returned to the laboratory to test for retention of the conditioned response (CR). Retention consisted of 20 tone CS-alone presentations. Young adult participants (23-31 years of age at the time of retention testing) showed good retention of the CR (45%), middle-aged participants (45-52 years) showed reduced retention (28%), and older participants (69-78 years) showed little evidence of retention (< 5%). Retention testing was followed by reacquisition of the CR in which the CS and the UCS were again paired. The ability to reacquire the CR also showed a decline with age. The data suggest that the CR can be retained over long intervals and that the degree of retention is age dependent.

Correlational analysis of five commonly used measures of mental status/functional abilities in patients with Alzheimer disease.

There are multiple assessment techniques to help clinicians diagnose, stage, and measure the rate of progression in Alzheimer disease (AD). We analyzed retrospectively the relationship between scores on commonly used scales and tests (Mini-Mental State, the Blessed Information-Memory-Concentration Test, the Alzheimer's Disease Assessment Scale--cognitive portion, the Activities of Daily Living Scale, and the Global Deterioration Scale) of 100 successive admissions to a memory clinic. Patients were included in the study if they were diagnosed subsequently with probable AD and if all five measures were administered in the same day. Regression analysis yielded 20 linear equations that allowed for conversion between test scores on any two instruments. With the exception of the Activities of Daily Living Scale (intercorrelation range with the other four instruments, r = 0.56-0.66), intercorrelations were generally high (r = 0.81-0.87). The results of this study should provide a clinically useful tool for converting test scores on five commonly used dementia screening/rating instruments.