Validity of telemetric-derived measures of heart rate variability: a systematic review

Heart rate variability (HRV) is a widely accepted indirect measure of autonomic function with widespread application across many settings. Although traditionally measured from the 'gold standard' criterion electrocardiography (ECG), the development of wireless telemetric heart rate monitors (HRMs) extends the scope of the HRV measurement. However, the validity of telemetric-derived data against the criterion ECG data is unclear. Thus, the purpose of this study was twofold: (a) to systematically review the validity of telemetric HRM devices to detect inter-beat intervals and aberrant beats; and (b) to determine the accuracy of HRV parameters computed from HRM-derived inter-beat interval time series data against criterion ECG-derived data in healthy adults aged 19 to 62 yrs. A systematic review of research evidence was conducted. Four electronic databases were accessed to obtain relevant articles (PubMed, EMBASE, MEDLINE and SPORTDiscus. Articles published in English between 1996 and 2016 were eligible for inclusion. Outcome measures included temporal and power spectral indices (Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). The review confirmed that modern HRMs (Polar® V800™ and Polar® RS800CX™) accurately detected inter-beat interval time-series data. The HRV parameters computed from the HRM-derived time series data were interchangeable with the ECG-derived data. The accuracy of the automatic in-built manufacturer error detection and the HRV algorithms were not established. Notwithstanding acknowledged limitations (a single reviewer, language bias, and the restricted selection of HRV parameters), we conclude that the modern Polar® HRMs offer a valid useful alternative to the ECG for the acquisition of inter-beat interval time series data, and the HRV parameters computed from Polar® HRM-derived inter-beat interval time series data accurately reflect ECG-derived HRV metrics, when inter-beat interval data are processed and analyzed using identical protocols, validated algorithms and software, particularly under controlled and stable conditions

Disability in the Workplace in China: Situation Assessment

A compelling argument can be made that employment of people with disabilities should be gaining recognition as an underutilized weapon in the talent wars of Asia. One has only to look at the proportion of people with disabilities that make up our communities, the continuing employment disparities that people with disabilities continue to face and the resulting high levels of poverty for this population – up against the talent shortages in fast-growth markets across the region. As China’s skewed demographic dynamics become increasingly apparent, resulting in a rapidly aging population and a diminishing supply of workforce entrants, an increasing share of the workforce will include older employees with disabilities, necessitating a fundamental change in workplace practices involving people with disabilities, as well as a greater need to look at persons with disabilities as a potential source of talent. Although China has created a broad legislative framework to protect the right to work for persons with disabilities, it lacks specificity and clear measures of enforcement, as evidenced in continued employment marginalization, poor educational outcomes, and thus higher poverty levels of persons with disabilities. To further understanding of workforce inclusion of persons with disabilities in China, and to identify practical ways forward for employers, The Conference Board China Center and the K. Lisa Yang and Hock E. Tan Institute on Employment and Disability (YTI) at Cornell University’s ILR School partnered to explore how companies can tap the talent pool of people with disabilities and improve their employment outcomes. The scope of the research encompassed a series of interviews with disability rights-focused NGOs in China, a detailed literature review, a comprehensive review of China’s regulatory framework supporting employment for persons with disabilities, and a detailed assessment of the demographics of disability and the status of people with disabilities in China such as prevalence rates, access to education, employment disparities and resulting poverty and household income rates. This report draws from the broader research findings and provides business practitioners with an overview of the current situation, challenges, and root causes of employment barriers for persons with disabilities in China. To complement this work, The China Center and YTI convened a practitioner roundtable in Beijing in September 2018. Participants explored in detail how the official, publicly available data on living and working conditions of persons with disabilities compare to actual experiences of employers in China, whether companies are actively recruiting disabled workers, what the internal and external obstacles are to recruitment, and what the impact of the government quota system is, for good or for bad. A separate report on this roundtable is also availabl

The standard error of measurement is a more appropriate measure of quality for postgraduate medical assessments than is reliability: an analysis of MRCP(UK) examinations

Background: Cronbach's alpha is widely used as the preferred index of reliability for medical postgraduate examinations. A value of 0.8-0.9 is seen by providers and regulators alike as an adequate demonstration of acceptable reliability for any assessment. Of the other statistical parameters, Standard Error of Measurement (SEM) is mainly seen as useful only in determining the accuracy of a pass mark. However the alpha coefficient depends both on SEM and on the ability range (standard deviation, SD) of candidates taking an exam. This study investigated the extent to which the necessarily narrower ability range in candidates taking the second of the three part MRCP(UK) diploma examinations, biases assessment of reliability and SEM.Methods: a) The interrelationships of standard deviation (SD), SEM and reliability were investigated in a Monte Carlo simulation of 10,000 candidates taking a postgraduate examination. b) Reliability and SEM were studied in the MRCP(UK) Part 1 and Part 2 Written Examinations from 2002 to 2008. c) Reliability and SEM were studied in eight Specialty Certificate Examinations introduced in 2008-9.Results: The Monte Carlo simulation showed, as expected, that restricting the range of an assessment only to those who had already passed it, dramatically reduced the reliability but did not affect the SEM of a simulated assessment. The analysis of the MRCP(UK) Part 1 and Part 2 written examinations showed that the MRCP(UK) Part 2 written examination had a lower reliability than the Part 1 examination, but, despite that lower reliability, the Part 2 examination also had a smaller SEM (indicating a more accurate assessment). The Specialty Certificate Examinations had small Ns, and as a result, wide variability in their reliabilities, but SEMs were comparable with MRCP(UK) Part 2.Conclusions: An emphasis upon assessing the quality of assessments primarily in terms of reliability alone can produce a paradoxical and distorted picture, particularly in the situation where a narrower range of candidate ability is an inevitable consequence of being able to take a second part examination only after passing the first part examination. Reliability also shows problems when numbers of candidates in examinations are low and sampling error affects the range of candidate ability. SEM is not subject to such problems; it is therefore a better measure of the quality of an assessment and is recommended for routine use

Supporting the 'Sharing Institution' - Practical Steps Towards a More Open Teaching and Learning Culture

4th International Conference on Open RepositoriesThis presentation was part of the session : Conference PresentationsDate: 2009-05-19 03:00 PM – 04:30 PMInstitutional repositories for research output have developed progressively over the last few years. Although a primary motivation is Open Access both institutional and academic needs must also be met in order to foster this spirit effectively. There is now a greater emphasis on creating a more open culture for teaching and learning and institutions are again beginning to play their part more readily. On a larger scale, there are pioneering global examples of courses being preserved and complex learning materials being deposited in national and international databases. But what does fostering a more open culture in the practice of teaching mean for the institution itself and its academics? The virtual learning environment has given greater opportunities for effective administration of courses but in other ways it has had the opposite effect on sharing and re-use. There is potential for institutional solutions which are complementary to the global landscape. In this paper we report on the practical experiences and issues met, in setting up a institutional resource, EdShare, as a vehicle for sharing educational materials more easily in a multi-disciplinary institution. With constructive feedback from faculty, within the EdSpace project, EdShare has migrated into a more visual, web 2.0 style, resource with a flexible deposit process promoting 'micro-sharing'. It now offers a range of sharing options to support the teaching workflow in an encouraging atmosphere. Other features will support the growing emphasis on multidisciplinary teaching and collaboration - both internally and externally.JIS

Perspectives on activities in nursing homes

Abstract Introduction: Access to meaningful activities is an indicator of quality of nursing homes, and contributes to wellbeing and dignity. Lack of activities can lead to boredom, apathy, disruptive behaviour or lack of confidence or meaning. Recent inspections undertaken by the authorities in nursing homes in Norway show lack of activity provision, which is in line with research. This indicates that the government’s policy and new regulations to increase the level of activities in nursing homes has not succeeded, probably related to challenges in developing care practices. However, nursing homes should strive to incorporate meaningful activities for residents to occupy their time and provide a sense of purpose. Few studies have discussed the meaning of activities as well as the challenges in developing a practice focused on activities. Therefore, we want to point out some important perspectives which policy makers, researchers and practitioners can reflect on. Aims: A scoping study was undertaken to discuss what constitutes meaningful activities as well as the opportunities to develop a person-centred practice focused on activities. Conclusions and implications for practice development: The understanding of activities in a residential nursing home setting needs to be reconsidered, broadened and further developed. For example, what most people might recognize to be passive activity, may be interpreted by nursing home residents as an activity. Activities must be person-centred recognising and accepting individuals wishes. The goal is to transform practice cultures to enable person-centred ways of working

Glutathione s-transferase omega in the lung and sputum supernatants of COPD patients

BACKGROUND: The major contribution to oxidant related lung damage in COPD is from the oxidant/antioxidant imbalance and possibly impaired antioxidant defence. Glutathione (GSH) is one of the most important antioxidants in human lung and lung secretions, but the mechanisms participating in its homeostasis are partly unclear. Glutathione-S-transferase omega (GSTO) is a recently characterized cysteine containing enzyme with the capability to bind and release GSH in vitro. GSTO has not been investigated in human lung or lung diseases. METHODS: GSTO1-1 was investigated by immunohistochemistry and Western blot analysis in 72 lung tissue specimens and 40 sputum specimens from non-smokers, smokers and COPD, in bronchoalveolar lavage fluid and in plasma from healthy non-smokers and smokers. It was also examined in human monocytes and bronchial epithelial cells and their culture mediums in vitro. RESULTS: GSTO1-1 was mainly expressed in alveolar macrophages, but it was also found in airway and alveolar epithelium and in extracellular fluids including sputum supernatants, bronchoalveolar lavage fluid, plasma and cell culture mediums. The levels of GSTO1-1 were significantly lower in the sputum supernatants (p = 0.023) and lung homogenates (p = 0.003) of COPD patients than in nonsmokers. CONCLUSION: GSTO1-1 is abundant in the alveolar macrophages, but it is also present in extracellular fluids and in airway secretions, the levels being decreased in COPD. The clinical significance of GSTO1-1 and its role in regulating GSH homeostasis in airway secretions, however, needs further investigations

The information content of institutional trades on the London Stock Exchange

We construct a unique data set that includes all reported institutional block trades on the London Stock Exchange and analyze the market reaction to buy and sell trades. We find that the type of investors behind the trade and the combination of the trade's size and the trader's resulting level of ownership are the major determinants of the information effects and the asymmetry between price impacts of buy and sell trades. In particular, large trades undertaken by fund managers, the most active investors in our sample, have strong information content, while, for the remaining trades, we report limited support for the information and the price impact asymmetry hypotheses. These results hold even after accounting for trade complexity and volatility effects in the regressions