A dialogue game for multi-party goal-setting in health coaching

Goal-setting is a frequently adopted strategy in behaviour change coaching. When setting a goal, it is important that it is understood and agreed upon by all parties, and not simply accepted as-is. We present here a dialogue game for multi-party goal-setting, in which multiple health coaches can contribute in order to find a goal that is acceptable to both the patient, and the coaches themselves. Our proposed game incorporates three important aspects of goal-setting and health coaching, (1) coaches can query each other's proposed goals, (2) the patient takes ownership of the goal, and (3) the patient themselves can propose goals

A demonstration of multi-party dialogue using virtual coaches:The first council of coaches demonstrator

We demonstrate here the first Technical Demonstrator for Council of Coaches a project that is aiming to deploy a platform for virtual health coaching, and will incorporate computational models of argument and dialogu

Troponin release following endurance exercise: is inflammation the cause? a cardiovascular magnetic resonance study

Background: The aetiology and clinical significance of troponin release following endurance exercise is unclear but may be due to transient myocardial inflammation. Cardiovascular magnetic resonance (CMR) affords us the opportunity to evaluate the presence of myocardial inflammation and focal fibrosis and is the ideal imaging modality to study this hypothesis. We sought to correlate the relationship between acute bouts of ultra endurance exercise leading to cardiac biomarkers elevation and the presence of myocardial inflammation and fibrosis using CMR.Methods: 17 recreation athletes (33.5 +/- 6.5 years) were studied before and after a marathon run with troponin, NTproBNP, and CMR. Specific imaging parameters to look for inflammation included T2 weighted images, and T1 weighted spin-echo images before and after an intravenous gadolinium-DTPA to detect myocardial hyperemia secondary to inflammation. Late gadolinium imaging was performed (LGE) to detect any focal regions of replacement fibrosis.Results: Eleven of the 17 participant had elevations of TnI above levels of cut off for myocardial infarction 6 hrs after the marathon (0.075 +/- 0.02, p = 0.007). Left ventricular volumes were reduced post marathon and a small increase in ejection fraction was noted (64 +/- 1% pre, 67 +/- 1.2% post, P = 0.014). Right ventricular volumes, stroke volume, and ejection fraction were unchanged post marathon. No athlete fulfilled criteria for myocardial inflammation based on current criteria. No regions of focal fibrosis were seen in any of the participants.Conclusion: Exercise induced cardiac biomarker release is not associated with any functional changes by CMR or any detectable myocardial inflammation or fibrosis

A case report and brief review of the literature on bilateral retinal infarction following cardiopulmonary bypass for coronary artery bypass grafting

Postoperative visual loss is a devastating perioperative complication. The commonest aetiologies are anterior ischaemic optic neuropathy (AION), posterior ischaemic optic neuropathy (PION), and central retinal artery occlusion (CRAO). These appear to be related to certain types of operation, most commonly spinal and cardiac bypass procedures; with the rest divided between: major trauma causing excessive blood loss; head/neck and nasal or sinus surgery; major vascular procedures (aortic aneurysm repair, aorto-bifemoral bypass); general surgery; urology; gynaecology; liposuction; liver transplantation and duration of surgery. The non-surgical risk factors are multifactorial: advanced age, prolonged postoperative anaemia, positioning (supine v prone), alteration of venous drainage of the retina, hypertension, smoking, atherosclerosis, hyperlipidaemia, diabetes, hypercoagulability, hypotension, blood loss and large volume resuscitation. Other important cardiac causes are septic emboli from bacterial endocarditis and emboli caused by atrial myxomata. The majority of AION cases occur during CPB followed by head/neck surgery and prone spine surgery. CPB is used to allow coronary artery bypass grafting on a motionless heart. It has many side-effects and complications associated with its use and we report here a case of bilateral retinal infarction during routine coronary artery bypass grafting in a young male patient with multiple risk factors for developing this complication despite steps to minimise its occurrence

Perioperative management of left ventricular assist devices

The use of mechanical circulatory support for patients with severe heart failure is on the rist. The poeoperative, intraoperative and postoperative challenges the anaesthesiologists skills. These are discussed in this review

Role of Kanchanara Twaka Kwatha with Shunthi Churna in Hypothyroidism (Dhatuwagni Vikriti)

The thyroid is an important part of human endocrine system which are responsible for regulation of oxygen use, BMR, cellular metabolism and growth and development. Hypofunctioning of Jatharagni which in turn effect Dhatwagni eventually brings out Pathological sequence and ultimately the disease condition develop. In hypothyroidsim etiological factors mainly vitiate Tridosha (Kapha predominance along with Pitta vitiation and Margavarana leading to provoking of Vata). The line of treatment with specific target to Rasavaha, Mamsavaha, Medovaha, Manovaha Srotas as well as Vata-Kapha Nashaka, Agnideepan, Sroto Shodhana, Vatanuloman, Amapachan treatment should be administered in hypothyroidism. Keeping the same in mind, present study was carried out to assess the role of Kanchanara Twaka Kwatha with Shunthi Churna in hypothyroidism (Dhatuwagni Vikriti). For this study 40 patients were selected and are divided into two groups with 20 patients in each group on the basis of inclusion and exclusion criteria and were assessed on the basis of subjective and objective parameters by applying appropriate statistical test. Most of the patients in group 1 (Kanchanaradi Kwatha) shows marked improvement in their symptoms as well as in objective parameters (thyroid profile) as compared to group 2 (Tab. Levothyroxine 50 mcg) which was taken as control group. From this study it can be concluded that hypothyroidism can be managed effectively with Kanchanara Twaka Kwatha with Shunthi Churna mention in Sharangdhar Samhita Madhyam Khanda Adhyaya 2 Shloka no.126

Experimental superensemble forecasts of tropical cyclones over the Bay of Bengal

This study entails the implementation of an experimental real time forecast capability for tropical cyclones over the Bay of Bengal basin of North Indian Ocean. This work is being built on the experience gained from a number of recent studies using the concept of superensemble developed at the Florida State University (FSU). Real time hurricane forecasts are one of the major components of superensemble modeling at FSU. The superensemble approach of training followed by real time forecasts produces the best forecasts for tracks and intensity (up to 5 days) of Atlantic hurricanes and Pacific typhoons. Improvements in track forecasts of about 25-35 compared to current operational forecast models has been noted over the Atlantic Ocean basin. The intensity forecasts for hurricanes are only marginally better than the best models. In this paper, we address tropical cyclone forecasts over the Bay of Bengal for the years 1996-2000. The main result from this study is that the position and intensity errors for tropical cyclone forecasts over the Bay of Bengal from the multimodel superensemble are generally less than those of all of the participating models during 1- to 3-day forecasts. Some of the major tropical cyclones, such as the November 1996 Andhra Pradesh cyclone and October 1999 Orissa super cyclone were well handled by this superensemble approach. A conclusion from this study is that the proposed approach may be a viable way to construct improved forecasts of Bay of Bengal tropical cyclone positions and intensity