Cumulative Radiation Dose from Medical Imaging in Children with Congenital Heart Disease: A Systematic Review.

Children with congenital heart disease are exposed to repeated medical imaging throughout their lifetime. Although the imaging contributes to their care and treatment, exposure to ionising radiation is known to increase one's lifetime attributable risk of malignancy. A systematic search of multiple databases was performed.

Performance of externally validated enhanced computer-aided versions of the National Early Warning Score in predicting mortality following an emergency admission to hospital in England: a cross-sectional study.

Objectives: In the English National Health Service, the patient's vital signs are monitored and summarised into a National Early Warning Score (NEWS) to support clinical decision making, but it does not provide an estimate of the patient's risk of death. We examine the extent to which the accuracy of NEWS for predicting mortality could be improved by enhanced computer versions of NEWS (cNEWS).

Design: Logistic regression model development and external validation study.

A prospective study of consecutive emergency medical admissions to compare a novel automated computer-aided mortality risk score and clinical judgement of patient mortality risk.

Objectives: To compare the performance of a validated automatic computer-aided risk of mortality (CARM) score versus medical judgement in predicting the risk of in-hospital mortality for patients following emergency medical admission.

Design: A prospective study.

Setting: Consecutive emergency medical admissions in York hospital.

The inclusion of delirium in version 2 of the National Early Warning Score will substantially increase the alerts for escalating levels of care: findings from a retrospective database study of emergency medical admissions in two hospitals .

Background: The National Early Warning Score (NEWS) is being replaced with NEWS2 which adds 3 points for new confusion or delirium. We estimated the impact of adding delirium on the number of medium/high level alerts that are triggers to escalate care.

Methods: Analysis of emergency medical admissions in two acute hospitals (York Hospital (YH) and Northern Lincolnshire and Goole NHS Foundation Trust hospitals (NH)) in England.

Medication-related risk factors and its association with repeated hospital admissions in frail elderly: A case control study.

Background: Repeated hospital admissions are prevalent in older people. The role of medication in repeated hospital admissions has not been widely studied. The hypothesis that medication-related risk factors for initial hospital admissions were also associated with repeated hospital admissions was generated.

A comparison of logistic regression models with alternative machine learning methods to predict the risk of in-hospital mortality in emergency medical admissions via external validation.

We compare the performance of logistic regression with several alternative machine learning methods to estimate the risk of death for patients following an emergency admission to hospital based on the patients' first blood test results and physiological measurements using an external validation approach. We trained and tested each model using data from one hospital ( = 24,696) and compared the performance of these models in data from another hospital ( = 13,477). We used two performance measures - the calibration slope and area under the receiver operating characteristic curve.

Gait termination on a declined surface in trans-femoral amputees: Impact of using microprocessor-controlled limb system.

Background: Walking down ramps is a demanding task for transfemoral-amputees and terminating gait on ramps is even more challenging because of the requirement to maintain a stable limb so that it can do the necessary negative mechanical work on the centre-of-mass in order to arrest (dissipate) forward/downward velocity. We determined how the use of a microprocessor-controlled limb system (simultaneous control over hydraulic resistances at ankle and knee) affected the negative mechanical work done by each limb when transfemoral-amputees terminated gait during ramp descent.

Methods: Eight transfemoral-amputees completed planned gait terminations (stopping on prosthesis) on a 5-degree ramp from slow and customary walking speeds, with the limb's microprocessor active or inactive.

The National Early Warning Score and its subcomponents recorded within ±24 h of emergency medical admission are poor predictors of hospital-acquired acute kidney injury.

Hospital-acquired acute kidney injury (H-AKI) is a common cause of avoidable morbidity and mortality. Therefore in the current study, we investigated whether vital signs data from patients, as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. We analysed all emergency admissions (n=33,608) to York Hospital with NEWS data over a 24-month period.

Development and External Validation of an Automated Computer-Aided Risk Score for Predicting Sepsis in Emergency Medical Admissions Using the Patient's First Electronically Recorded Vital Signs and Blood Test Results.

Objectives: To develop a logistic regression model to predict the risk of sepsis following emergency medical admission using the patient's first, routinely collected, electronically recorded vital signs and blood test results and to validate this novel computer-aided risk of sepsis model, using data from another hospital.

Design: Cross-sectional model development and external validation study reporting the C-statistic based on a validated optimized algorithm to identify sepsis and severe sepsis (including septic shock) from administrative hospital databases using International Classification of Diseases, 10th Edition, codes.

Setting: Two acute hospitals (York Hospital - development data; Northern Lincolnshire and Goole Hospital - external validation data).

Is objective and accurate cognitive assessment across the menstrual cycle possible? A feasibility study.

Objectives: Variation in plasma hormone levels influences the neurobiology of brain regions involved in cognition and emotion processing. Fluctuations in hormone levels across the menstrual cycle could therefore alter cognitive performance and wellbeing; reports have provided conflicting results, however. The aim of this study was to assess whether objective assessment of cognitive performance and self-reported wellbeing during the follicular and luteal phases of the menstrual cycle is feasible and investigate the possible reasons for variation in effects previously reported.

Custom and practice: a multi-center study of medicines reconciliation following admission in four acute hospitals in the UK.

Background: Many studies have highlighted the problems associated with different aspects of medicines reconciliation (MR). These have been followed by numerous recommendations of good practice shown in published studies to decrease error; however, there is little to suggest that practice has significantly changed. The study reported here was conducted to review local medicines reconciliation practice and compare it to data within previously published evidence.

Assessment of cognitive function across pregnancy using CANTAB: a longitudinal study.

Significant changes in endogenous plasma hormone levels are required to sustain pregnancy which provides a unique opportunity to study their effect on cognitive function. Four carefully selected tests from the Cambridge Neuropsychological Automated Test Battery (CANTAB) were administered to assess the cognitive function of a group of 23 women during each trimester of pregnancy and at three months following birth. Test scores were compared with a control group of 24 non-pregnant women.

First episode psychosis patients show impaired cognitive function--a study of a South Asian population in the UK.

Background: Cognitive deficits are a core symptom of schizophrenia, severely debilitating and untreated by current medication. However, to date there is limited research focusing on the precise nature of the cognitive disturbances at first episode in ethnic populations. Improved understanding of this will allow improved approaches to therapy.

Bilateral changes in foveal structure in individuals with amblyopia.

Purpose: To examine foveal structure in amblyopia using spectral-domain optical coherence tomography (SD-OCT).

Design: Prospective, cross-sectional study.

Participants And Controls: Two subject groups were recruited to the study: 85 amblyopes (34 adults, 51 children) and 110 visually normal controls (44 adults, 66 children).

Importance of binocular vision in foot placement accuracy when stepping onto a floor-based target during gait initiation.

This study investigated the importance of binocular vision to foot placement accuracy when stepping onto a floor-based target during gait initiation. Starting from stationary, participants placed alternate feet onto targets sequentially positioned along a straight travel path with the added constraint that the initial target (target 1) could move in the medio-lateral (M-L) direction. Repeated trials when target 1 remained stationary or moved laterally at the instant of lead-limb toe-off (TO) or 200 ms after TO (early swing) were undertaken under binocular and monocular viewing.

Medicines reconciliation using a shared electronic health care record.

Objective: : This study aimed to evaluate the use of a shared electronic primary health care record (EHR) to assist with medicines reconciliation in the hospital from admission to discharge.

Methods: : This is a prospective cross-sectional, comparison evaluation for 2 phases, in a short-term elderly admissions ward in the United Kingdom. In phase 1, full reconciliation of the medication history was attempted, using conventional methods, before accessing the EHR, and then the EHR was used to verify the reconciliation.

When is visual information used to control locomotion when descending a kerb?

Background: Descending kerbs during locomotion involves the regulation of appropriate foot placement before the kerb-edge and foot clearance over it. It also involves the modulation of gait output to ensure the body-mass is safely and smoothly lowered to the new level. Previous research has shown that vision is used in such adaptive gait tasks for feedforward planning, with vision from the lower visual field (lvf) used for online updating.

Adaptive gait changes in older people due to lens magnification.

Purpose: Intervention trials that reduce visual impairment in older adults have not produced the expected improvements in reducing falls rate. We hypothesised that this may be caused by adaptation problems in older adults due to changes in magnification provided by new spectacles and cataract surgery. This study assessed the effects of ocular magnification on adaptive gait in young and older adults.

What drives adaptive gait changes to acutely presented monocular blur?

Purpose: To determine whether gait alterations due to monocular spherical lens blur were a safety strategy or driven by lens magnification.

Methods: Adaptive gait and visual function were measured in 10 older adults (mean age, 74.9 ± 4.

Adaptive gait changes in long-term wearers of contact lens monovision correction.

Introduction: The aim of the present study was to determine adaptive gait changes in long-term wearers of monovision correction contact lenses by comparing gait parameters when wearing monovision correction to those observed when wearing binocular distance correction contact lenses.

Methods: Gait and toe clearance parameters were measured in eleven participants (53.5 +/- 4.

Repeatability and reproducibility of macular thickness measurements using fourier domain optical coherence tomography.

Aim: To evaluate repeatability and reproducibility of macular thickness measurements in visually normal eyes using the Topcon 3D OCT-1000.

Methods: Phase 1 investigated scan repeatability, the effect of age and pupil dilation. Two groups (6 younger and 6 older participants) had one eye scanned 5 times pre and post- dilation by 1 operator.

The effects of monocular refractive blur on gait parameters when negotiating a raised surface.

Falls in the elderly are a major cause of mortality and morbidity. Elderly people with visual impairment have been found to be at increased risk of falling, with poor visual acuity in one eye causing greater risk than poor binocular visual acuity. The present study investigated whether monocular refractive blur, at a level typically used for monovision correction, would significantly reduce stereoacuity and consequently affect gait parameters when negotiating a raised surface.

Visual guidance of landing behaviour when stepping down to a new level.

When stepping down from one level to another, the leading limb has to arrest downward momentum of the body and subsequently receive and safely support bodyweight before level walking can begin. Such step downs are performed over a wide range of heights and predicting when and where contact between the landing limb and the lower level will be made is likely a critical factor. To determine if visual feedback obtained after movement initiation is habitually used in guiding landing behaviour, the present study determined whether pre-landing kinematics and the mechanics of landing would be modulated according to the type of visual feedback available during the stepping down phase.

Multifocal spectacles increase variability in toe clearance and risk of tripping in the elderly.

Purpose: Epidemiologic studies have indicated that elderly people who wear multifocal spectacles have an increased risk of tripping, particularly on stairs. Yet no studies have experimentally examined how wearing multifocal spectacles affects stair and step negotiation. The purpose of this study was to determine the effects of wearing multifocal compared with single-distance vision spectacles on minimum toe clearance and risk of tripping during step negotiation in the elderly.

Falls in older people: effects of age and blurring vision on the dynamics of stepping.

Purpose: The risk of falling increases dramatically with age, and visual impairment is known to be an important risk factor. Therefore, it is highly pertinent to assess the effects of age and vision on the performance of everyday tasks linked to falling, such as stepping from one level to another.

Methods: Nine young (age, 26 +/- 4 years) and ten elderly (age, 72 +/- 5 years) subjects performed a stepping-up task of three different heights.