Postpartum care attendance at a rural district hospital in Zambia

Postpartum care is an important tool in both preventive and promotive maternal health care. We studied the postpartum care attendance rate in 540 women who delivered at a district hospital in Zambia. Forty-two percent of the women attended postpartum care within six weeks of delivery. Women who did not come for postpartum care were older and had to travel more hours to the hospital than women who attended postpartum care. The low postpartum care attendance rate could be increased if health workers provided mother and child health care in an integrated way and were aware that recently delivered women also visit the hospital for reasons other than postpartum care. Health workers need to inform pregnant women about the benefits of postpartum care and make them feel welcome to attend this health service, also when women decide to deliver at home

How to Systematically Assess Serious Games Applied to Health Care

The usefulness and effectiveness of specific serious games in the medical domain is often unclear. This is caused by a lack of supporting evidence on validity of individual games, as well as a lack of publicly available information. Moreover, insufficient understanding of design principles among the individuals and institutions that develop or apply a medical serious game compromises their use. This article provides the first consensus-based framework for the assessment of specific medical serious games. The framework provides 62 items in 5 main themes, aimed at assessing a serious game's rationale, functionality, validity, and data safety. This will allow caregivers and educators to make balanced choices when applying a serious game for healthcare purposes. Furthermore, the framework provides game manufacturers with standards for the development of new, valid serious game

The effects of probe placement on measured flow velocity in transcranial Doppler ultrasound imaging in-vitro and in-vivo experiments

The measurement of the blood flow in the middle cerebral artery (MCA) using transcranial Doppler ultrasound (US) imaging is clinically relevant for the study of cerebral autoregulation. Especially in the aging population, impairement of the autoregulation may coincide or relate to loss of perfusion and consequently loss of brain function. The cerebral autoregulation can be assessed by relating the blood pressure to the blood flow in the brain. Doppler US is a widely used, non-invasive method to measure the blood flow in the MCA. However, Doppler flow imaging is known to produce results that are dependent of the operator. The angle of the probe insonation with respect to the centerline of the blood vessel is a well known factor for output variability. In patients also the skull must be traversed and the MCA must be detected, influencing the US signal intensity. In this contribution we report two studies. We describe first an in-vitro setup to study the Doppler flow in a situation where the ground truth is known. Secondly, we report on a study with healthy volunteers where the effects of small probe displacements on the flow velocity signals are investigated. For the latter purpose, a special probe holder was designed to control the experiment

How to systematically assess serious games applied to health care

The usefulness and effectiveness of specific serious games in the medical domain is often unclear. This is caused by a lack of supporting evidence on validity of individual games, as well as a lack of publicly available information. Moreover, insufficient understanding of design principles among the individuals and institutions that develop or apply a medical serious game compromises their use. This article provides the first consensus-based framework for the assessment of specific medical serious games. The framework provides 62 items in 5 main themes, aimed at assessing a serious game's rationale, functionality, validity, and data safety. This will allow caregivers and educators to make balanced choices when applying a serious game for healthcare purposes. Furthermore, the framework provides game manufacturers with standards for the development of new, valid serious games

Baroreflex function is reduced in Alzheimer's disease: a candidate biomarker?

AbstractThe baroreflex (BR) reflects autonomic blood pressure control. Alzheimer’s disease (AD) affects the autonomic system. Detailed properties of BR in AD are unknown. We hypothesized that BR is reduced in AD, and is influenced by autonomic effects of cholinesterase inhibitors (ChEI). BR was determined in 18 AD patients, 11 patients with mild cognitive impairment (MCI) and 19 healthy control subjects. In AD, BR was measured again after ChEI treatment. Receiver operating characteristic analysis was used to define a BR cutoff value, which was then tested in an independent validation sample of 16 AD, 18 MCI, and 18 control subjects. BR was lower in AD compared with MCI (p < 0.05) and in MCI compared with healthy control subjects (p < 0.01). Receiver operating characteristic analysis between AD and healthy control subjects yielded a sensitivity of 89% and a specificity of 94%. ChEI treatment increased BR with 66% (p < 0.01). BR was reduced in AD and increased after treatment with ChEI. BR might be a good biomarker to further explore the link between cardiovascular disease and AD

Distribution of maximal systolic blood pressure drops due to head rotation in the patient group.

<div><p>Notes.</p> <p>X-axis; the maximal systolic blood pressure drop due to head rotation, Y-axis; the number of patients that met the specified systolic blood pressure drop.</p> <p>The systolic blood pressure drops of 20-29 mmHg are due to left head rotation in 3 patients, right head rotation in 4 patients and hyperextension in 7 patients.</p> <p>The systolic blood pressure drops of 30-39 mmHg are due to left head rotation in 5 patients, right head rotation in 5 patients and hyperextension in 6 patients.</p> <p>The systolic blood pressure drops of 40-49 mmHg are due to left head rotation in 2 patients, right head rotation in 1 patients and hyperextension in 4 patients.</p> <p>The systolic blood pressure drops >50 mmHg are due to left head rotation in 4 patients.</p></div