A simple prognostic index in acute heart failure

Background Rapid effective triage is integral to emergency care in patients hospitalized for heart failure, to guide the type and intensity of therapy. Several indexes and scores have been proposed to predict outcome; most of the them are complex and unfit to use at the bedside. Methods We propose a new prognostic index for in hospital mortality in acute heart failure. The index was built according to the formula; 220 – age – heart rate + systolic blood pressure – ( creatinine X 10). The index was tested in 1628 patients admitted for acute heart failure and enrolled, from November 2007 to December 2009, in the Italian Registry on Heart Failure Outcome ( IN-HF); a prospective, multicentre, observational study. Results The prognostic index was an independent predictor for in hospital mortality risk ( c statistic= 0.74) (p<0.0001), together with left ventricular ejection fraction (p= 0.001), Glycemia ( p= 0.019) and hemoglobin concentration (p = 0.002). Conclusion A simple prognostic index based on variables easily assessed can be useful to predict mortality in acute heart failure at the first arrival in hospital

Examining adherence to activity monitoring devices to improve physical activity in adults with cardiovascular disease: A systematic review

Background Activity monitoring devices are currently being used to facilitate and monitor physical activity. No prior review has examined adherence to the use of activity monitoring devices amongst adults with cardiovascular disease. Methods Literature from June 2012 to October 2017 was evaluated to examine the extent of adherence to any activity monitoring device used to collect objective physical activity data. Randomized control trials comparing usual care against the use of an activity monitoring device, in a community intervention for adults from any cardiovascular diagnostic group, were included. A systematic search of databases and clinical trials registers was conducted using Joanna Briggs Institute methodology. Results Of 10 eligible studies, two studies reported pedometer use and eight accelerometer use. Six studies addressed the primary outcome. Mean adherence was 59.1% (range 39.6% to 85.7%) at last follow-up. Studies lacked equal representation by gender (28.6% female) and age (range 42 to 82 years). Conclusion This review indicates that current research on activity monitoring devices may be overstated due to the variability in adherence. Results showed that physical activity tracking in women and in young adults have been understudied

Design Thinking

{Excerpt} In a world of continuous flux, where markets mature faster and everyone is affected by information overload, organizations regard innovation, including management innovation, as the prime driver of sustainable competitive advantage. To unlock opportunities, some of them use mindsets and protocols from the field of design to make out unarticulated wants and deliberately imagine, envision, and spawn futures. Design is more important when function is taken for granted and no longer helps stakeholders differentiate. In the last five years, design thinking has emerged as the quickest organizational path to innovation and high-performance, changing the way creativity and commerce interact. In the past, design was a downstream step in the product development process, aiming to enhance the appeal of an existing product. Today, however, organizations ask designers to imagine solutions that meet explicit or latent needs and to build upstream entire systems that optimize customer experience and satisfaction. Therefore, although the term design is commonly understood to describe an object (or end result), it is in its latest and most effective form a process, an action, and a verb, not a noun: essentially, it is a protocol to see, shape, and build. Lately, design approaches are also being applied to infuse insight into the heart of campaigns and address social and other concerns

Prediction of liver disease in patients whose liver function tests have been checked in primary care : model development and validation using population-based observational cohorts

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.Peer reviewedPublisher PD

Design and initial validation of the Raster method for telecom service availability risk assessment

Crisis organisations depend on telecommunication services; unavailability of these services reduces the effectiveness of crisis response. Crisis organisations should therefore be aware of availability risks, and need a suitable risk assessment method. Such a method needs to be aware of the exceptional circumstances in which crisis organisations operate, and of the commercial structure of modern telecom services. We found that existing risk assessment methods are unsuitable for this problem domain. Hence, crisis organisations do not perform any risk assessment, trust their supplier, or rely on service level agreements, which are not meaningful during crisis situations. We have therefore developed a new risk assessment method, which we call RASTER. We have tested RASTER using a case study at the crisis organisation of a government agency, and improved the method based on the analysis of case results. Our initial validation suggests that the method can yield practical results