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1.
Heliyon ; 9(12): e22493, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38046161

RESUMO

Employee ambidexterity (EA) is becoming increasingly recognised as a significant factor in enhancing individual and organisational performance across diverse industries. Ambidexterity refers to the capacity to exploit and explore organisational resources simultaneously. Scholars from diverse industry sectors have been motivated to delve deeper into the topic of EA due to its growing popularity. The objective of conducting a scoping review was to scrutinise the existing literature and identify the key drivers and constraints that impact EA to thrive in the changing work landscape. The insights gained from this review can assist decision-makers in formulating effective strategies to cultivate the ambidexterity skills of their workforce and achieve desirable outcomes. This review adheres to the PRISMA-ScR protocol. Articles were obtained from databases including Scopus, Web of Science, and EBSCOhost (Academic Search Complete, Business Source Complete). The body of literature concerning EA is in its nascent stage. 23 articles assessing EA's performance outcomes were identified using targeted search terms and thorough screening. After conducting a thorough thematic analysis using the iterative categorisation (IC) technique, tailored for scoping a review, we successfully identified twenty-nine factors contributing to the enhancement of EA, meticulously organised into five distinct categories: organisational factors, social connectedness, employee behaviour, employee personality, and work environment related factors. Similarly, we discovered four factors that impede EA: functional tenure, team identification, bounded discretion, and conscientiousness. Our findings underscore the profound impact of employee ambidexterity on distinct types of performance. Among the sixteen types of performance reported to be enhanced by EA, ten are linked to individual performance, while six are tied to organisational performance. Notably, our analysis revealed that nearly all studies have relied on cross-sectional research methods except for one. However, we advocate for the exploration of longitudinal studies as they hold the promise of offering a more comprehensive understanding of EA. The paper presents valuable insights into how to cultivate ambidextrous capabilities in the workforce for unparalleled success in today's rapidly evolving work environment. Additionally, it identifies several intriguing avenues for future research that could further elucidate and bridge existing knowledge gaps.

2.
J Strength Cond Res ; 35(12): 3300-3307, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34593725

RESUMO

ABSTRACT: Hatfield, DL, Stranieri, AM, Vincent, LM, and Earp, JE. Effect of a neoprene knee sleeve on performance and muscle activity in men and women during high-intensity, high-volume resistance training. J Strength Cond Res 35(12): 3300-3307, 2021-The purpose of this study was to assess the effects of a commercially available neoprene knee sleeve (KS) on exercise performance and muscle activity during an exhaustive leg press exercise. Twenty resistance-trained individuals, 11 men {21.0 ± 2.2 years; 77.7 ± 8.7 kg; 1 repetition maximum (1RM/body mass [BM]): 0.30 ± 0.04} and 9 women (22.0 ± 3.5 years; 66.1 ± 9.1 kg; 1RM/BM: 0.30 ± 0.04), all subjects (21.5 ± 2.8 years; 72.5 ± 10.5 kg; 1RM/BM: 0.30 ± 0.04), participated in 3 testing sessions. The second and third sessions were performed using a counterbalanced and randomized design in which subjects exercised with (WS) or without (NS) KSs and performed 6 sets of leg press exercise at 80% of 1RM until failure with a 3-minute rest between sets. Number of repetitions, blood lactate (BL), heart rate (HR), rating of perceived exertion (RPE), and peak and average power were recorded after each set. Surface electromyography (EMG) of the right and left vastus lateralis muscles was also recorded to compare muscle activity between conditions. Significance was set at p ≤ 0.05, and values are presented as mean ± SD. No significant differences were observed in the total number of repetitions for all sets (p = 0.3; WS 75.3 ± 33.7, NS 79.8 ± 34.3) and the number of repetitions per set between conditions (p ≤ 0.05) or between men and women. Similarly, no significance differences (p ≤ 0.05) were observed for BL, HR, RPE, or EMG per set between conditions or between men and women. These results suggest that wearing compressive neoprene KSs has no effect on improving performance and associated variables during high-load, high-volume lower-body resistance training.


Assuntos
Neopreno , Treinamento de Força , Feminino , Humanos , Joelho , Masculino , Força Muscular , Músculo Esquelético , Músculo Quadríceps , Levantamento de Peso
3.
Health Informatics J ; 26(4): 3009-3036, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32969296

RESUMO

Health-related data is stored in a number of repositories that are managed and controlled by different entities. For instance, Electronic Health Records are usually administered by governments. Electronic Medical Records are typically controlled by health care providers, whereas Personal Health Records are managed directly by patients. Recently, Blockchain-based health record systems largely regulated by technology have emerged as another type of repository. Repositories for storing health data differ from one another based on cost, level of security and quality of performance. Not only has the type of repositories increased in recent years, but the quantum of health data to be stored has increased. For instance, the advent of wearable sensors that capture physiological signs has resulted in an exponential growth in digital health data. The increase in the types of repository and amount of data has driven a need for intelligent processes to select appropriate repositories as data is collected. However, the storage allocation decision is complex and nuanced. The challenges are exacerbated when health data are continuously streamed, as is the case with wearable sensors. Although patients are not always solely responsible for determining which repository should be used, they typically have some input into this decision. Patients can be expected to have idiosyncratic preferences regarding storage decisions depending on their unique contexts. In this paper, we propose a predictive model for the storage of health data that can meet patient needs and make storage decisions rapidly, in real-time, even with data streaming from wearable sensors. The model is built with a machine learning classifier that learns the mapping between characteristics of health data and features of storage repositories from a training set generated synthetically from correlations evident from small samples of experts. Results from the evaluation demonstrate the viability of the machine learning technique used.


Assuntos
Blockchain , Registros de Saúde Pessoal , Registros Eletrônicos de Saúde , Humanos , Aprendizado de Máquina , Tecnologia
4.
J Med Internet Res ; 21(12): e14684, 2019 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-31841114

RESUMO

BACKGROUND: With the growing use of social media in health care settings, there is a need to measure outcomes resulting from its use to ensure continuous performance improvement. Despite the need for measurement, a unified approach for measuring the value of social media used in health care remains elusive. OBJECTIVE: This study aimed to elucidate how the value of social media in health care settings can be ascertained and to taxonomically identify steps and techniques in social media measurement from a review of relevant literature. METHODS: A total of 65 relevant articles drawn from 341 articles on the subject of measuring social media in health care settings were qualitatively analyzed and synthesized. The articles were selected from the literature from diverse disciplines including business, information systems, medical informatics, and medicine. RESULTS: The review of the literature showed different levels and focus of analysis when measuring the value of social media in health care settings. It equally showed that there are various metrics for measurement, levels of measurement, approaches to measurement, and scales of measurement. Each may be relevant, depending on the use case of social media in health care. CONCLUSIONS: A comprehensive yardstick is required to simplify the measurement of outcomes resulting from the use of social media in health care. At the moment, there is neither a consensus on what indicators to measure nor on how to measure them. We hope that this review is used as a starting point to create a comprehensive measurement criterion for social media used in health care.


Assuntos
Atenção à Saúde/métodos , Mídias Sociais/normas , Humanos
5.
Stud Health Technol Inform ; 264: 1765-1766, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438333

RESUMO

Electronic Health Records (EHRs) constitute evidence of online health information management. Critical healthcare information technology (HIT) infrastructure facilitates health information exchange of 'modern' health systems. The growth and implementation of EHRs are progressing in many countries while the adoption rate is lagging and lacking momentum amidst privacy and security concerns. This paper uses an interrupted time series (ITS) analysis of OECD data related to EHRs from many countries to make predictions about EHR adoption. The ITS model can be used to explore the impact of various HIT on adoption. Assumptions about the impact of Information Accountability are entered into the model to generate projections if information accountability technologies are developed. In this way, the OECD data and ITS analysis can be used to perform simulations for improving EHR adoption.


Assuntos
Registros Eletrônicos de Saúde , Privacidade , Humanos
6.
Muscle Nerve ; 60(5): 598-603, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31350753

RESUMO

BACKGROUND: Recent investigations have questioned the role of hydration and electrolytes in cramp susceptibility and thus the efficacy of consuming electrolyte-rich carbohydrate beverages (EB) to control/prevent cramping. METHODS: Nine euhydrated, cramp-prone participants had their cramp susceptibility assessed by measuring the nerve stimulation threshold frequency at which cramping occurs (TF) before and after consumption of an EB (kCal: 120, Na: 840 mg, K: 320 mg, Mg: 5 mg) and placebo beverage (PB: kCal: 5, Na: 35 mg). Cramp intensity was assessed using a verbal pain scale and poststimulation electromyography (EMG). RESULTS: TF was greater in EB (14.86 ± 7.47 Hz) than PB (14.00 ± 5.03 Hz; P = .038) and reported pain was lower in EB (2.0 ± 0.6) than PB (2.7 ± 0.8; P = .025) while EMG was similar (P = .646). DISCUSSION: EB consumption decreased cramp susceptibility and pain but did not prevent cramping in any participants. These results suggest that electrolyte consumption independent of hydration can influence cramp susceptibility in young people.


Assuntos
Bebidas , Eletrólitos/uso terapêutico , Cãibra Muscular/prevenção & controle , Nervo Tibial , Adulto , Alanina/uso terapêutico , Sacarose na Dieta/uso terapêutico , Estimulação Elétrica/métodos , Eletromiografia , Feminino , Humanos , Magnésio/uso terapêutico , Masculino , Músculo Esquelético , Medição da Dor , Potássio/uso terapêutico , Sódio/uso terapêutico , Adulto Jovem
7.
Digit Health ; 5: 2055207619844362, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31019723

RESUMO

OBJECTIVES: The aim of the current study is to generate waist circumference to height ratio cut-off values for obesity categories from a model of the relationship between body mass index and waist circumference to height ratio. We compare the waist circumference to height ratio discovered in this way with cut-off values currently prevalent in practice that were originally derived using pragmatic criteria. METHOD: Personalized data including age, gender, height, weight, waist circumference and presence of diabetes, hypertension and cardiovascular disease for 847 participants over eight years were assembled from participants attending a rural Australian health review clinic (DiabHealth). Obesity was classified based on the conventional body mass index measure (weight/height2) and compared to the waist circumference to height ratio. Correlations between the measures were evaluated on the screening data, and independently on data from the National Health and Nutrition Examination Survey that included age categories. RESULTS: This article recommends waist circumference to height ratio cut-off values based on an Australian rural sample and verified using the National Health and Nutrition Examination Survey database that facilitates the classification of obesity in clinical practice. Gender independent cut-off values are provided for waist circumference to height ratio that identify healthy (waist circumference to height ratio ≥0.45), overweight (0.53) and the three obese (0.60, 0.68, 0.75) categories verified on the National Health and Nutrition Examination Survey dataset. A strong linearity between the waist circumference to height ratio and the body mass index measure is demonstrated. CONCLUSION: The recommended waist circumference to height ratio cut-off values provided a useful index for assessing stages of obesity and risk of chronic disease for improved healthcare in clinical practice.

8.
Stud Health Technol Inform ; 254: 105-115, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30306963

RESUMO

Continuous monitoring of patient's physiological signs has the potential to augment traditional medical practice, particularly in developing countries that have a shortage of healthcare professionals. However, continuously streamed data presents additional security, storage and retrieval challenges and further inhibits initiatives to integrate data to form electronic health record systems. Blockchain technologies enable data to be stored securely and inexpensively without recourse to a trusted authority. Blockchain technologies also promise to provide architectures for electronic health records that do not require huge government expenditure that challenge developing nations. However, Blockchain deployment, particularly with streamed data challenges existing Blockchain algorithms that take too long to place data in a block, and have no mechanism to determine whether every data point in every stream should be stored in such a secure way. This article presents an architecture that involves a Patient Agent, coordinating the insertion of continuous data streams into Blockchains to form an electronic health record.


Assuntos
Segurança Computacional , Registros Eletrônicos de Saúde , Monitorização Fisiológica , Telemedicina , Algoritmos , Humanos , Tecnologia
9.
BMC Health Serv Res ; 18(1): 643, 2018 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-30119624

RESUMO

BACKGROUND: Ward rounds are an important and ubiquitous element of hospital care with a history extending well over a century. Although originally intended as a means of educating medical trainees and junior doctors, over time they have become focused on supporting clinical practice. Surprisingly, given their ubiquity and importance, they are under-researched and inadequately understood. This study aims to contribute knowledge in human reasoning within medical teams, meeting a pressing need for research concerning the reasoning occurring in rounds. METHODS: The research reported here aimed to improve the understanding of ward round reasoning by conducting a critical realist case study exploring the collaborative group reasoning mechanisms in the ward rounds of two hospitals in Victoria, Australia. The data collection involved observing rounds, interviewing medical practitioners and holding focus group meetings. RESULTS: Nine group reasoning mechanisms concerning sharing, agreeing and recording information in the categories of information accumulation, sense-making and decision-making were identified, together forming a program theory of ward round reasoning. In addition, themes spanning across mechanisms were identified, further explaining ward round reasoning and suggesting avenues for future exploration. Themes included the use of various criteria, tensions involving mechanisms, time factors, medical roles and hierarchies. CONCLUSIONS: This paper contributes to the literature by representing rounds in a manner that strengthens understanding of the form of the group reasoning occurring within, thus supporting theory-based evaluation strategies, redesigned practices and training enhancements.


Assuntos
Tomada de Decisões , Educação Médica , Quartos de Pacientes , Visitas com Preceptor , Pensamento , Comportamento Cooperativo , Feminino , Pessoal de Saúde/educação , Humanos , Masculino , Vitória
10.
Stud Health Technol Inform ; 247: 596-600, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29678030

RESUMO

Many complementary and alternative medical practices (CAM) are readily assessable in Australia alongside Allopathic practitioners. Although CAM practices are prevalent, little is known about how patients seek and use information when deciding which system to consult. We report some preliminary findings of a longitudinal study, designed to solicit factors that influence the Australian public when selecting from diverse medical systems. Fifty-four general public participants, willing to provide their confidential and anonymous opinion were included. The magnitudes of importance, critical in influencing factors, were screened. Results indicated a medical system was selected for its effectiveness, safety, credentials and care (p<0.001). Consultation time, convenience, cost, empowerment and rapport were less important factors (p<0.001) influencing selection of a medical system. The level of choices by participants [χ2 (1, N=54) = 53.445, p<0.001] follow similar trends found for those in conventional medical systems. This contrasts with findings in other locations, where cost and time were major contributing factors when selecting medical systems.


Assuntos
Comportamento de Escolha , Terapias Complementares , Pessoal de Saúde , Austrália , Humanos , Estudos Longitudinais
11.
J Strength Cond Res ; 32(5): 1197-1206, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29683913

RESUMO

Faigenbaum, AD, Kang, J, Ratamess, NA, Farrell, A, Golda, S, Stranieri, A, Coe, J, and Bush, JA. Acute cardiometabolic responses to a novel training rope protocol in children. J Strength Cond Res 32(5): 1197-1206, 2018-The purpose of this study was to quantify the acute cardiometabolic responses to a novel training rope (TR) protocol in children. Fifteen boys (10.6 ± 1.4 years) were tested for peak oxygen uptake (V[Combining Dot Above]O2) on a treadmill and subsequently (2-7 days later) performed a progressive 10-minute protocol of 5 TR exercises (EX): EX1: standing side-to-side waves, EX2: seated alternating waves, EX3: standing alternating waves, EX4: jumping jacks, and EX5: double-arm slams. Participants performed 2 sets of each TR exercise for 30 seconds per set with a 30-second rest interval between sets and exercises. A 12.8-m TR (4.1 kg) was used for all trials, and a metronome was used to standardize cadence. Peak values for V[Combining Dot Above]O2 and HR during the treadmill test were 47.4 ± 8.8 ml·kg·min and 195.1 ± 6.6 b·min, respectively. During the TR protocol, mean V[Combining Dot Above]O2 and HR significantly increased (p ≤ 0.05) from set 1 of EX1 (10.3 ± 2.6 ml·kg·min and 103.2 ± 11.6 b·min, respectively) to set 2 of EX5 (30.0 ± 3.9 ml·kg·min and 168.6 ± 11.8 b·min, respectively). Percentage of peak V[Combining Dot Above]O2 and peak HR values attained during the TR protocol ranged from 21.5 to 64.8% and from 52.9 to 86.4%, respectively. These descriptive data indicate that TR exercise can pose a moderate to vigorous cardiometabolic stimulus in children and with proper supervision and instruction may serve as a worthwhile complement to youth fitness programs.


Assuntos
Teste de Esforço/métodos , Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Consumo de Oxigênio/fisiologia , Criança , Humanos , Masculino , Descanso/fisiologia
12.
Stud Health Technol Inform ; 246: 24-28, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29507257

RESUMO

BACKGROUND: This regional pilot site 'end-user attitudes' study explored nurses' experiences and impressions of using the Nurses' Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. METHODS: Focus groups were conducted, followed by a four-week pilot site 'end-user attitudes' trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. RESULTS: Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. CONCLUSIONS: Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff.


Assuntos
Demência/terapia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Telemedicina , Idoso , Atitude do Pessoal de Saúde , Feminino , Humanos , Recursos Humanos de Enfermagem
14.
Comput Biol Med ; 75: 90-7, 2016 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-27268735

RESUMO

Glycated haemoglobin (HbA1c) is being more commonly used as an alternative test for the identification of type 2 diabetes mellitus (T2DM) or to add to fasting blood glucose level and oral glucose tolerance test results, because it is easily obtained using point-of-care technology and represents long-term blood sugar levels. HbA1c cut-off values of 6.5% or above have been recommended for clinical use based on the presence of diabetic comorbidities from population studies. However, outcomes of large trials with a HbA1c of 6.5% as a cut-off have been inconsistent for a diagnosis of T2DM. This suggests that a HbA1c cut-off of 6.5% as a single marker may not be sensitive enough or be too simple and miss individuals at risk or with already overt, undiagnosed diabetes. In this study, data mining algorithms have been applied on a large clinical dataset to identify an optimal cut-off value for HbA1c and to identify whether additional biomarkers can be used together with HbA1c to enhance diagnostic accuracy of T2DM. T2DM classification accuracy increased if 8-hydroxy-2-deoxyguanosine (8-OhdG), an oxidative stress marker, was included in the algorithm from 78.71% for HbA1c at 6.5% to 86.64%. A similar result was obtained when interleukin-6 (IL-6) was included (accuracy=85.63%) but with a lower optimal HbA1c range between 5.73 and 6.22%. The application of data analytics to medical records from the Diabetes Screening programme demonstrates that data analytics, combined with large clinical datasets can be used to identify clinically appropriate cut-off values and identify novel biomarkers that when included improve the accuracy of T2DM diagnosis even when HbA1c levels are below or equal to the current cut-off of 6.5%.


Assuntos
Algoritmos , Mineração de Dados , Bases de Dados Factuais , Diabetes Mellitus Tipo 2/sangue , Hemoglobinas Glicadas/metabolismo , Biomarcadores/sangue , Feminino , Humanos , Masculino
15.
J Telemed Telecare ; 22(6): 326-32, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26429795

RESUMO

INTRODUCTION: The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination. METHODS: The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional. RESULTS: It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident. DISCUSSION: Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination.


Assuntos
Assistência Odontológica para Idosos/economia , Assistência Odontológica para Idosos/métodos , Economia em Odontologia , Telemedicina/economia , Telemedicina/métodos , Custos e Análise de Custo , Odontologia , Instituição de Longa Permanência para Idosos , Humanos , Enfermeiras e Enfermeiros , Fotografação , População Rural , Vitória
16.
Int. j. high dilution res ; 14(4): 38-53, 2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-783316

RESUMO

The use of homoeopathic remedies to prevent infectious diseases, homoeoprophylaxis (HP), was first described over 100 years ago. To date, no systematic studies have been performed to identify the attitudes that current practitioners hold about HP or current trends in the use of HP. Aims: This study aimed to discover attitudes to HP amongst accredited homeopathic practitioners particularly with respect to overall acceptance, context of use, and preferred remedies. Methodology: Two international surveys were conducted in 2014. Responses were received from 1,124 homeopaths in 35 countries; 104 of whom responded to both surveys. Results: A large proportion of respondents have positive attitudes to HP and currently use HP in their practice. However, responses also indicate that knowledge about HP is chequered. Confidence in the evidence base of HP also is variable. Conclusion: Results indicate that HP is widely practised, however, further research is needed to improve confidence in the evidence base of HP, and better programs are needed to ensure that education about HP is enhanced...


Assuntos
Humanos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Homeopatia , Inquéritos e Questionários , Médicos Homeopatas/estatística & dados numéricos
17.
Int. j. high dilution res ; 14(4): 38-53, 2015. tab, graf
Artigo em Inglês | HomeoIndex - Homeopatia | ID: hom-11149

RESUMO

Background: The use of homoeopathic remedies to prevent infectious diseases, homoeoprophylaxis (HP), was first described over 100 years ago. To date, no systematic studies have been performed to identify the attitudes that current practitioners hold about HP or current trends in the use of HP. Aims: This study aimed to discover attitudes to HP amongst accredited homeopathic practitioners particularly with respect to overall acceptance, context of use, and preferred remedies. Methodology: Two international surveys were conducted in 2014. Responses were received from 1,124 homeopaths in 35 countries; 104 of whom responded to both surveys. Results: A large proportion of respondents have positive attitudes to HP and currently use HP in their practice. However, responses also indicate that knowledge about HP is chequered. Confidence in the evidence base of HP also is variable. Conclusion: Results indicate that HP is widely practised, however, further research is needed to improve confidence in the evidence base of HP, and better programs are needed to ensure that education about HP is enhanced. (AU)


Assuntos
Humanos , Homeopatia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Médicos Homeopatas/estatística & dados numéricos , Inquéritos e Questionários
18.
Comput Biol Med ; 43(10): 1328-33, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24034723

RESUMO

Cardiovascular autonomic neuropathy (CAN) is a serious and well known complication of diabetes. Previous articles circumvented the problem of missing values in CAN data by deleting all records and fields with missing values and applying classifiers trained on different sets of features that were complete. Most of them also added alternative features to compensate for the deleted ones. Here we introduce and investigate a new method for classifying CAN data with missing values. In contrast to all previous papers, our new method does not delete attributes with missing values, does not use classifiers, and does not add features. Instead it is based on regression and meta-regression combined with the Ewing formula for identifying the classes of CAN. This is the first article using the Ewing formula and regression to classify CAN. We carried out extensive experiments to determine the best combination of regression and meta-regression techniques for classifying CAN data with missing values. The best outcomes have been obtained by the additive regression meta-learner based on M5Rules and combined with the Ewing formula. It has achieved the best accuracy of 99.78% for two classes of CAN, and 98.98% for three classes of CAN. These outcomes are substantially better than previous results obtained in the literature by deleting all missing attributes and applying traditional classifiers to different sets of features without regression. Another advantage of our method is that it does not require practitioners to perform more tests collecting additional alternative features.


Assuntos
Doenças Cardiovasculares/diagnóstico , Biologia Computacional/métodos , Mineração de Dados/métodos , Cardiomiopatias Diabéticas/diagnóstico , Neuropatias Diabéticas/diagnóstico , Técnicas de Diagnóstico Cardiovascular , Algoritmos , Inteligência Artificial , Bases de Dados Factuais , Humanos , Informática Médica , Análise de Regressão , Reprodutibilidade dos Testes
19.
Artif Intell Med ; 58(3): 185-93, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23768975

RESUMO

OBJECTIVE: This article addresses the problem of determining optimal sequences of tests for the clinical assessment of cardiac autonomic neuropathy (CAN). We investigate the accuracy of using only one of the recommended Ewing tests to classify CAN and the additional accuracy obtained by adding the remaining tests of the Ewing battery. This is important as not all five Ewing tests can always be applied in each situation in practice. METHODS AND MATERIAL: We used new and unique database of the diabetes screening research initiative project, which is more than ten times larger than the data set used by Ewing in his original investigation of CAN. We utilized decision trees and the optimal decision path finder (ODPF) procedure for identifying optimal sequences of tests. RESULTS: We present experimental results on the accuracy of using each one of the recommended Ewing tests to classify CAN and the additional accuracy that can be achieved by adding the remaining tests of the Ewing battery. We found the best sequences of tests for cost-function equal to the number of tests. The accuracies achieved by the initial segments of the optimal sequences for 2, 3 and 4 categories of CAN are 80.80, 91.33, 93.97 and 94.14, and respectively, 79.86, 89.29, 91.16 and 91.76, and 78.90, 86.21, 88.15 and 88.93. They show significant improvement compared to the sequence considered previously in the literature and the mathematical expectations of the accuracies of a random sequence of tests. The complete outcomes obtained for all subsets of the Ewing features are required for determining optimal sequences of tests for any cost-function with the use of the ODPF procedure. We have also found two most significant additional features that can increase the accuracy when some of the Ewing attributes cannot be obtained. CONCLUSIONS: The outcomes obtained can be used to determine the optimal sequences of tests for each individual cost-function by following the ODPF procedure. The results show that the best single Ewing test for diagnosing CAN is the deep breathing heart rate variation test. Optimal sequences found for the cost-function equal to the number of tests guarantee that the best accuracy is achieved after any number of tests and provide an improvement in comparison with the previous ordering of tests or a random sequence.


Assuntos
Doenças Cardiovasculares/diagnóstico , Técnicas de Apoio para a Decisão , Neuropatias Diabéticas/diagnóstico , Diagnóstico por Computador , Técnicas de Diagnóstico Cardiovascular , Seleção de Pacientes , Algoritmos , Pressão Sanguínea , Determinação da Pressão Arterial , Doenças Cardiovasculares/classificação , Doenças Cardiovasculares/fisiopatologia , Mineração de Dados , Bases de Dados Factuais , Árvores de Decisões , Neuropatias Diabéticas/classificação , Neuropatias Diabéticas/fisiopatologia , Eletrocardiografia , Força da Mão , Frequência Cardíaca , Humanos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Respiração
20.
Stud Health Technol Inform ; 182: 133-41, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23138088

RESUMO

Evidence from the literature indicates that the degree of immersion often referred to as the "sense of being there" experienced by clinicians and patients is a factor in the success of tele-health installations. High definition and 3D telemedicine offers a compelling mechanism to achieve a sense of immersion and contribute to an enhanced quality of use. This article surveys HD3D trials in tele-health and concludes that the way HD3D is integrated into telemedicine depends on the clinical, organisational and technological context. In some settings real time HD3D is not so desirable whereas asynchronous transmission of HD3D images and videos is highly desirable.


Assuntos
Telemedicina/instrumentação , Interface Usuário-Computador , Comunicação , Simulação por Computador , Educação de Pós-Graduação em Medicina/métodos , Humanos , Neoplasias/diagnóstico , Neoplasias/terapia , Psiquiatria , Consulta Remota/instrumentação , Procedimentos Cirúrgicos Operatórios/educação , Procedimentos Cirúrgicos Operatórios/métodos , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/terapia
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