Accuracy of pulse interval timing in ambulatory blood pressure measurement

Blood pressure (BP) monitors rely on pulse detection. Some blood pressure monitors use pulse timings to analyse pulse interval variability for arrhythmia screening, but this assumes that the pulse interval timings detected from BP cuffs are accurate compared with RR intervals derived from ECG. In this study we compared the accuracy of pulse intervals detected using an ambulatory blood pressure monitor (ABPM) with single lead ECG. Twenty participants wore an ABPM for three hours and a data logger which synchronously measured cuff pressure and ECG. RR intervals were compared with corresponding intervals derived from the cuff pressure tracings using three different pulse landmarks. Linear mixed effects models were used to assess differences between ECG and cuff pressure timings and to investigate the effect of potential covariates. In addition, the maximum number of successive oscillometric beats detectable in a measurement was assessed. From 243 BP measurements, the foot landmark of the oscillometric pulse was found to be associated with fewest covariates and had a random error of 9.5 ms. 99% of the cuff pressure recordings had more than 10 successive detectable oscillometric beats. RR intervals can be accurately estimated using an ABPM

A qualitative research study to explore young people's disengagement from learning

"The ‘One Wales’ agreement includes a commitment to establish an “enquiry into disengagement from learning amongst children and young people to look at evidence of what works”. In response, a research project was commissioned to investigate young people’s experience and perspectives on their disengagement from learning. The research fills an evidence gap on personal accounts of disengagement from young people in Wales. As such it therefore represents a useful source of information to support the review of young people who are not in education employment or training (NEET)." - Welsh Assembly Government website

Opportunistic detection of atrial fibrillation using blood pressure monitors: a systematic review

Background: Atrial Fibrillation (AF) affects around 2% of the population and early detection is beneficial, allowing patients to begin potentially life-saving anticoagulant therapies. Blood pressure (BP) monitors may offer an opportunity to screen for AF. Aim: To identify and appraise studies which report the diagnostic accuracy of automated BP monitors used for opportunistic AF detection. Methods: A systematic search was performed of the Medline, Medline-in-process and Embase literature databases. Papers were eligible if they described primary studies of the evaluation of a BP device for AF detection, were published in a peer reviewed journal and reported values for the sensitivity and specificity. Included studies were appraised using the QUADAS-2 tool to assess their risk of bias and applicability to opportunistic AF detection. Values for the sensitivity and specificity of AF detection were extracted from each paper and compared. Results and Conclusion: We identified seven papers evaluating six devices from two manufacturers. Only one study scored low risk in all of the QUADAS-2 domains. All studies reported specificity greater than 85% and six reported sensitivity greater than 90%. The studies showed that blood pressure devices with embedded algorithms for detecting arrhythmias show promise as screening tools for AF, comparing favourably with manual pulse palpation. But the studies used different methodologies and many were subject to potential bias. More studies are needed to more precisely define the sensitivity and specificity of opportunistic screening for AF during blood pressure measurement before its clinical utility in the population of interest can be assessed fully

2016 ASC Bidding Competition – Commercial Building

Our group traveled to Reno Nevada to participate in the Associated Schools of Construction (ASC) annual bidding competition which took place from February 10th- 14th. The competition included teams from all over the western United States with many different categories for groups to participate in. The category that our group decided to participate in for our senior design project was commercial bidding. The commercial bidding category had a total of 12 teams competing on a bid estimate for Mortenson construction. The project, which we did not know anything about until arrival, was a multi-million dollar sporting complex addition that we only had 16 hours to prepare the bid for. Once the bid estimate and any documentation that was required was completed and turned in our group had to prepare a presentation for the judges who were all Mortenson employees that knew the project extremely well. In order to prepare for the completion we met weekly and worked on a practice bid estimate that we though would be similar to what we would be exposed to in Reno. The competition was a valuable experience to all group member as it gave us all practice for problems and scenarios that we may come across when we are out working in industry