...1. Introduction This assignment is a critique on the study published in The New England Journal of Medicine (NEJM) entitled ‘Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction’ by Bonaa et. al (2006) (also known as The NORVIT study). NEJM’s most recent impact factor was 51.296 (in 2006). NEJM boasts the largest paid circulation among medical journals, with close to 200,000 paying subscribers. It is printed weekly in the United States, Canada, the Netherlands, and Japan, and a range of translated articles reaches approximately 140,000 (New England Journal of Medicine.org, 2006). The NORVIT study was designed as a randomized, controlled, double-blind, intervention study. It included 3,749 men and women who had suffered and acute myocardial infarction within the last 7 days. The rationale behind the study was that high homocysteine levels are considered a risk factor for cardiovascular disease (Bonaa et al, 2006). The aim was to measure how effective lowering blood serum homocysteine levels with B vitamins was in preventing a secondary event. A collaborative meta-analysis published in The Journal of the American Medical Association, states that homocysteine levels are an independent predictor of ischemic heart disease and that studies on disease risk of genetic variants affecting homocysteine may help establish whether homocysteine is causally linked to vascular disease (2002: cited by Bonaa et al, 2006). The meta-analysis suggests that a large...
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...Charleston, South Carolina Atrial fibrillation is the arrhythmia most commonly encountered in family practice. Serious complications can include congestive heart failure, myocardial infarction, and thromboembolism. Initial treatment is directed at controlling the ventricular rate, most often with a calcium channel blocker, a beta blocker, or digoxin. Medical or electrical cardioversion to restore sinus rhythm is the next step in patients who remain in atrial fibrillation. Heparin should be administered to hospitalized patients undergoing medical or electrical cardioversion. Anticoagulation with warfarin should be used for three weeks before elective cardioversion and continued for four weeks after cardioversion. The recommendations provided in this two-part article are consistent with guidelines published by the American Heart Association and the Agency for Healthcare Research and Quality. (Am Fam Physician 2002;66:249-56. Copyright© 2002 American Academy of Family Physicians.) I Members of various family practice departments develop articles for “Practical Therapeutics.” This article is one in a series coordinated by the Department of Family Medicine at the Medical University of South Carolina. Guest editor of the series is William J. Hueston, M.D. This is part I of a twopart article on atrial fibrillation. Part II, “Prevention of Thromboembolic Complications,” appears in this issue on pages 261-4. n recent years, management strategies for atrial...
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...Privacy Snooper: IOT Arnab Kumar1 , Harishma Dayanidhi1 and Vijay Kumar KS1 {arnabk, hdayanid, vkanlanji}@andrew.cmu.edu 1 Carnegie Mellon School of Computer Science, Pittsburgh, USA Abstract. In various ML-as-a-service cloud systems, the process of performing machine learning over the data is almost treated as a black box, where the user just feeds in their data, knows the model used and the system outputs required insights. In this work, we explore the idea of being able to predict sensitive attributes associated with the database given that the adversary would have access to a few quasi-identifiers associated with the database. We use inversion attack as the theoretical foundation for our attack, and implement the same for our database. We experiment this attack for di↵erent variants of classification algorithms, like classification tree and regression tree. We follow it up with analysing the accuracy of our attack for each of our classification based machine learning algorithms for di↵erent size of training datasets. We end our work by trying to figure out what we say is the ”most impactful attribute”, by selectively removing the data pertaining to an attribute and check what is the corresponding e↵ect on inversion attack. We hope our work in this domain pushes future batches of this class to explore this question even further, and too look into understanding if Di↵erential Privacy solves this problem. Keywords: Inversion Attack, Black Box, Classification Tree...
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...Renub Research www.renub.com Personalized Medicine Diagnostics (Flow Cytometry, Sepsis Immunos, Routine Coagulation, Psychiatric Disorders, Tumor Markers, Molecular Blood Typing and Other Testing) Market & Forecast Published: June, 2013 Copyright © 2013 Renub Research – All Rights Reserved Personalized Medicine - Market Overview Personalized Medicine is often defined as “the right treatment for the right person at the right time.” Personalized medicine is becoming the place to be in clinical diagnostics as well and slowly becoming the reality of future in the diagnostics industry By Technology Segment - Personalized Medicine diagnostics market is expected to grow with a double digit CAGR for the period of 2013 to 2018. It is expected that personalized medicine diagnostics market by technology is going to double by 2018 from its current market size in 2012. In this segment, Point of Care Testing and Molecular Diagnostics segments control the #1 and #2 positions in 2012. By Diseases Segment - Personalized Medicine diagnostics market is expected to be more than US$ 30 Billion by 2018. Diabetes management test and Cancer management test are the leading market in this segment. Renub Research report entitled “Personalized Medicine Diagnostics (Flow Cytometry, Sepsis Immunos, Routine Coagulation, Psychiatric Disorders, Tumor Markers, Molecular Blood Typing and Other Testing)” report provides a comprehensive analysis of the emerging personalized medicine diagnostic market segments...
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...Ways to Rock The Prepping you for the FCAT. Prepping you for the FCAT. L/A!!!!! Table of Contents Chapter 1-Reference and Research/Reliability/Validity/Synthesizing Page 1-2. Reference * What is Reference ? * Why is Reference important? * Think about it. Page 3-4. Research * What is Research? * Why is Research important? * Think about it. Page 5-6. Reliability * What is Reliability? * Why is Reliability important? * Think about it. Page 7-8. Validity * What is Validity? * Why is Validity important? * Think about it. Page 9-10. Synthesizing * What is Synthesizing? * Why is Synthesizing important? * Think about it. Table of Contents Chapter 3-Context Clue/Inference Page 1-2. Context clue * What is Reference? * Why is Reference important? * Think about...
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..................................................................................7 Vendors and Cost of EMR ......................................................................................................7 EMR Stimulus.........................................................................................................................8 Different Uses of EMR ....................................................................................................................9 Uses of EMR in Health Management .....................................................................................9 Uses of EMR in Disease Management .................................................................................10 Uses of EMR in Genomics Research ....................................................................................11 Management Workflow Training, Implementation...
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...Wesley D. Pointjour Final Research Paper: Telehealth In Nursing Homes Health Quality Management April 02, 2015 Introduction In many nursing home facilities, patient safety is little to non-existent and if they are, there displayed on a need be and not obliged basis. They are displayed case by case rather than nursing home protocol. Even with changes in regulations, reporting systems, and documentation over the past couple of years, the nursing home industry still has its share of problems. Patient safety is meant to provide patients freedom from healthcare associated preventable harm, meaning when things go right, nothing bad happens. Nursing home organizations have been constantly trying to improve their reputation and the way people view them, but how? Don’t patients make up a nursing home? What about their safety? Shouldn’t we start there? How do we make improvements? Telehealth, a new approach to improving patient safety in nursing homes, will use telecommunication technologies to deliver health related services and information that support patient care, administrative activities, and health education (Dixon, Hook, McGowan, 2008). In this paper I will explore the major benefits of Telehealth and how its implications can improve patient safety in nursing home care. What is Telehealth and why is it important? Telehealth is the means and methods to improving access to care and reducing healthcare associated costs. It is also a system that can be used for education...
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...Atrial Fibrillation And Nursing Considerations As a nurse one must provide holistic care. To better understand aspect of providing holistic nursing care one must have an in-depth understanding of primary body systems and their pathology. This paper will educate the prudent nurses who read it with detailed information about the specific cardiac pathology of atrial fibrillation. Written with a basic understanding of human heart function/structure as a prerequisite, this paper will first discuss key terms one must be familiar with before providing researched information explaining the pathophysiology of atrial fibrillation (AF). Next, it will discuss the etiology, clinical manifestations, common laboratory diagnostics, and interventions. Lastly, this paper continues by providing readers with nursing diagnoses and patient teachings associated with AF. Key Terms As a nurse one must become a scientist of sorts and must be familiar with technical nursing terminology. Atrial fibrillation, or AF, is a cardiac dysrhythmia in which “multiple rapid impulses from many atrial foci depolarize the atria in a totally disorganized manner at a rate of 350 to 600 times per minute” [ (Ignatavicius & Workman, 2010) ]. A dysrhythmia is a disorder of the heartbeat involving a disturbance in cardiac rhythm and an irregular heartbeat; whereas an arrhythmia is basically a fast or irregular heartbeat caused by a disorder in the heart's electrical system. Tachydysrhythmia is an abnormal...
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...CHAPTER I INTRODUCTION Background of the Study The papaya, papaw, or pawpaw is the fruit of the plant Carica papaya, the sole species in the genus Carica of the plant family Caricaceae. It is native to the tropics of the Americas, perhaps from southern Mexico and neighbouring Central America. It was first cultivated in Mexico several centuries before the emergence of the Mesoamerican classical civilizations. Papaya leaves contains coumarin, papain and iron which are the three main essentials that increase blood platelets. Dengue viruses, mosquito-borne members of the Flaviviridae family, are the causative agents of dengue fever. Dengue is the most important emerging viral disease of humans that in recent decades has become a major international public health concern. There is a widespread of dengue cases in every corner of our country. Many people can’t afford to go to hospitals just to get medical assistance especially indigent families. Therefore because of the expensive disbursement in prestigious hospitals such as medicines needed to cure dengue, affected people die without being aided. Most people know about papayas but not many know about the amazing health benefits of Papaya Leaves. Papaya Leaves contain powerful healing compounds that are very important for great health and vitality... and for curing cancer and dengue fever. With the rising number of people catching dengue fever, the demand for papaya leaf juice has soared. The extract of raw papaya leaf...
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...Patel suggesting that one of the valued things provided by music is emotional power. According to the ‘multiple mechanism’ theory, music can influence human emotion in many different ways except *a. visual imagery and association with past, present and future event b. expectancy and fulfilment or violation c. activation of the brainstem by arousing acoustic features d. acoustics cues that resemble the sound of emotional voices medium Source: Section 6.1 page 22, 2nd paragraph, line 6 More questions being arise due to lack explanation on how the music’s universality can affect the emotion. Therefore Patel discuss how the multiple mechanism theory states that music can enhance emotion in five different ways which are 1) expectancy and its fulfilment or violation, 2) activation of the brainstem by arousing acoustic features (e.g., sudden, sharp onsets); 3) association with past events; 4) visual imagery; or 5) acoustic cues that resemble the sounds of emotional voices. The two examples of biological power of music discuss by Patel in the reading are I recovery of brain functions after stroke II recovery of cerebral palsy in premature baby III recovery of verbal fluency in aphasia IV recovery of deaf due to exposure of high volume sound *a) I and III b) I and II c) II and III d) III and IV Easy-medium Source: Patel reading section 4 of the biological power of music: two examples Patel clearly discuss the two examples of music and the recovery of brain functions...
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...Acupuncture research in Cerebrovascular Accident induced hemiplegia. By Introduction to Cerebrovascular Accident and Hemiplegia Cerebrovascular Accident also known as stroke can broadly be described as an interruption of the blood supply to the brain. Without blood the brain cells are staved of oxygen, and can begin to die within minutes if the blood supply is completely cut off. It is this cellular death which has the greatest influence on the sequelae or after math of the stroke. Hemiplegia is the most common sequelae of stroke, this medical condition characterised by paralyses of one side of the body. It is similar to, but should not be confused with hemiparesis which is when one side of the body is weak but still mobile. While the leading cause of hemiplegia is a Cerebrovascular Accident, it is not the only cause, other neural conditions such as a unilateral pyramidal (UMN) lesion may also cause hemiplegia. It is difficult to discuss Hemiplegia without also discussing Stroke, similar to cause and effect, if stroke is the cause then hemiplegia is effect. A sudden stroke can be deadly, and how well someone recovers or if they recover depends largely on how fast they receive treatment. In Australia the most popular method for identifying stroke is the FAST test: * Face – Check their face. Has their mouth dropped? * Arms – Can they lift both arms? * Speech – Is their speech slurred? Do they understand you? * Time – Time is critical. If you see any of these...
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...Why Are There So Many Deaths Caused By Medical Errors and What Solutions Can Decrease Them? Health Service Systems – HSM541 June 20 2015 Background Medical errors kill at least 44,000 people and perhaps as many as 98,000 people per year. Or do they kill over 180,000 per year? Maybe even 440,000 people killed by medical errors? Allen (2013) In 1999 the Institute of Medicine (IOM) published a report titled “To Err Is Human: Building A Safer Health System” that leveled the healthcare community. They reported that according to two studies “perhaps as many as 98,000 people die in hospitals each year as a result of medical errors that could have been prevented”. IOM (1999) Then the Office of Inspector General for Health and Human Services followed up with a report in 2010 that stated “bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year”. Allen (2013) And finally in 2013, the numbers were once again raised. Per a report from the Journal of Patient Safety that approximately “440,000 PAEs (preventable/potential adverse events) that contribute to the death of patients each year from care in hospitals. This is roughly one-sixth of all deaths that occur in the United States each year”. They are now the U.S.’s third leading cause of death, behind only heart disease and cancer. All of the numbers mentioned in the first paragraph are medical errors that were “preventable”. Mistakes by the people you put your trust in killed you...
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...SCHOOL OF PHARMACY REPORT WRITING UCS 1263 Assignment 1 Hospital Attachment Report Name : Thiban Ellumalay ID : 012011051056 Programme : BPH Lecturer Name : Dr. Jiyauddin Khan Submission Date : 30th September 2013 An attachment report based on the lesson learned, activity being carried out, experience gained, problem faced and suggestion at Hospital Tuanku Ampuan Rahimah, Klang in various pharmacy departments for period of 3 weeks Submitted to Dr. Jiyauddin Khan, PhD Report writing lecturer, School of Pharmacy Management & Science University Shah Alam, Selangor Darul Ehsan, Malaysia. Prepared by, Thiban Ellumalay, 012011051056 3rd year Bachelor of Pharmacy, Management & Science University Shah Alam, Selangor Darul Ehsan, Malaysia. 30th September 2013 Acknowledgement First and foremost I would like to thank the almighty lord for giving me wisdom to get my attachment done with successfully as well as with the preparation of the report. Without his blessings I wouldn’t have achieved this stage. Besides that, throughout my attachment accomplishment, many people have inspired me, influenced me and contributed their time, energy, ideas, and suggestions for improving my report. I will always be in debt to these people, too numerous to mention. I would...
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...Pathopharmacological Foundations for Advanced Nursing Practice Competency Assessment WUT Task 1 Pamela L. Taylor RN-C(OB), BSN Western Governors University June 2016 A. Disease Process For the purpose of discussion of pathopharmacological features of a specific disease process, this paper will provide information related to heart disease in the form of coronary artery disease (CAD). A1. Pathophysiology Analysis Cardiovascular disease (CVD) is the number one cause of mortality worldwide and becoming a steadily more investigated problem due to its prevalence. Much research is going into genetic, inflammatory mechanisms and neuro-hormonal factors related to CVD as scientific knowledge evolves regarding complexity of this broad pathophysiology. Atherosclerosis is the leading cause of the subsection of CVD called CAD. This is a form of arteriosclerosis where there is progressive thickening and hardening of the vessel walls of the two major coronary arteries and their branches. The thickening is an accumulation of lipid-laden macrophages inside the wall of the artery leading to the formation of lesions and plaque buildup (McCance, K. & Huether, S., 2014). When the plaque develops on the coronary artery walls the pumping ability of the heart becomes impaired as oxygen and nutrients needed for heart function may be partially or completely impeded. Complete occlusion of a coronary artery or one of its branches leads to a myocardial...
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...0 3 0 Electronic Health Records in the Physician Office CHAPTER OUTLINE Patient Flow in the Physician Practice Step 1. Pre-Visit: Appointment Scheduling and Information Collection Step 2. Patient Check-in and Payment Collection Step 3. Rooming and Measuring Vital Signs Patient Examination and Documentation Step 4. Patient Checkout Step 5. Post-Visit: Coding and Billing Post-Visit: Reviewing Test Results Coding and Reimbursement in Electronic Health Records Computer-Assisted Coding Clinical Tools in the Electronic Health Record Decision-Support Tools Tracking and Monitoring Patient Care Screening for Illness or Disease Identifying at-Risk Patients Managing Patients with Chronic Diseases Improving the Quality and Safety of Patient Care with Evidence-Based Guidelines E-Prescribing and Electronic Health Records Keeping Current with Electronic Drug Databases Increasing Prescription Safety Saving Time and Money LEARNING OUTCOMES After completing this chapter, you will be able to define key terms and: 1. 2. 3. 4. 5. 6. 7. 8. 9. List the five steps of the office visit workflow in a physician office. Discuss the advantages of pre-visit scheduling and information collection for patients and office staff. Describe the process of electronic check-in. Explain how electronic health records make documenting patient exams more efficient. Explain what occurs during patient checkout. Explain what two events take place during the post-visit step of the visit workflow. Describe the advantages of computer-assisted...
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