Fifteen Dimensions of Health among Community-Dwelling Older Singaporeans

This paper aims to present a broad perspective of health of older Singaporeans spanning 15 health dimensions and study the association between self-rated health (SRH) and other health dimensions. Using data from a survey of 5000 Singaporeans (≥60 years), SRH and health in 14 other dimensions were assessed. Generalized logit model was used to assess contribution of these 14 dimensions to positive and negative SRH, compared to average SRH. About 86% reported their health to be average or higher. Prevalence of positive SRH and “health” in most other dimensions was lower in older age groups. Positive and negative SRH were associated with mobility, hearing, vision, major physical illness, pain, personal mastery, depressive symptoms, and perceived financial adequacy. The findings show that a majority of older Singaporeans report themselves as healthy overall and in a wide range of health dimensions

Realization of OFCC based transimpedance mode instrumentation amplifier

The paper presents an instrumentation amplifier suitable for amplifying the current source transducer signals. It provides a voltage output. It has a high gain, common mode rejection ratio and gain independent bandwidth. It uses three Operational Floating Current Conveyors (OFCCs) and four resistors. The effect of nonidealities of OFCC on performance of proposed transimpedance instrumentation amplifier (TIA) is also analyzed. The proposal has been verified through SPICE simulations using CMOS based schematicThe paper presents an instrumentation amplifier suitable for amplifying the current source transducer signals. It provides a voltage output. It has a high gain, common mode rejection ratio and gain independent bandwidth. It uses three operational floating current conveyors (OFCCs) and four resistors. The effect of nonidealities of OFCC on performance of proposed transimpedance instrumentation amplifier (TIA) is also analyzed. The proposal has been verified through SPICE simulations using CMOS based schematic

Study of chopper stabilization in single ended amplifiers

Chopper stabilization is one of the prominent techniques used to overcome low-frequency noise and DC offset errors in CMOS amplifiers. This thesis presents a detailed analysis of this approach. The fundamentals of chopping, followed by the design and underlying tradeoffs of a chopper stabilized amplifier, are included. A chopper stabilized, single ended amplifier in closed loop unity gain configuration is designed using the folded cascode topology in 180 nm CMOS process. This design is verified for functionality by a thorough comparison with its non-stabilized counterpart. Simulation results, including the benefits obtained in terms of reduced flicker noise and an amplified output voltage independent of input DC offsets, are discussed

Study of chopper stabilization in single ended amplifiers

Chopper stabilization is one of the prominent techniques used to overcome low-frequency noise and DC offset errors in CMOS amplifiers. This thesis presents a detailed analysis of this approach. The fundamentals of chopping, followed by the design and underlying tradeoffs of a chopper stabilized amplifier, are included. A chopper stabilized, single ended amplifier in closed loop unity gain configuration is designed using the folded cascode topology in 180 nm CMOS process. This design is verified for functionality by a thorough comparison with its non-stabilized counterpart. Simulation results, including the benefits obtained in terms of reduced flicker noise and an amplified output voltage independent of input DC offsets, are discussed

Weak grip strength predicts higher unplanned healthcare utilization among patients with heart failure

Abstract Aims Frailty increases healthcare utilization and costs for patients with heart failure but is challenging to assess in clinical settings. Hand grip strength (GS) is a single‐item measure of frailty yet lacks evidence as a potential screening tool to identify patients at risk of higher unplanned events and related healthcare costs. We examined the association of baseline and longitudinal GS measurements with healthcare utilization and costs among patients with advanced heart failure. Methods and results Between July 2017 and April 2019, we enrolled 251 patients with symptoms of advanced heart failure (New York Heart Association class III or IV) in a prospective cohort study in Singapore. We measured GS at baseline and every 4 months for 2 years and linked patients' survey data with their medical and billing records. We categorized patients as having weak GS if their GS measurement was below the 5th percentile of the age‐ and gender‐specific normative GS values in Singapore. We assessed the association between baseline GS and healthcare utilization (unplanned and planned events and healthcare costs, total costs, and length of inpatient stay) over the next 2 years using regression models. We investigated the association between longitudinal 4‐monthly GS assessments and the ensuing 4 months of healthcare utilization and costs using mixed‐effects logistic and two‐part regression models. At baseline, 22.5% of patients had weak GS. Baseline and longitudinal GS measurements were significantly associated with longer length of inpatient stay, greater likelihood of unplanned events, and higher related costs. Patients with weak GS had higher odds of an unplanned event occurring by 8 percentage points [95% confidence interval (CI) (0.01, 0.14), P = 0.026], incurred longer inpatient stays by 4 days [95% CI (1.97, 6.79), P = 0.003], and additional SG$4792 [US$ ~ 3594, 95% CI (1894, 7689), P = 0.014] in unplanned healthcare costs over the next 4 months. Conclusions GS is a simple tool to identify and monitor heart failure patients at risk of unplanned events, longer inpatient stays, and higher related healthcare costs. Findings support its routine use in clinical settings