Self-help program components and linkage to aftercare following inpatient detoxification.

Many patients fail to initiate aftercare for addictive disease rehabilitation following detoxification. This study of 136 inpatients compared characteristics of those who initiated aftercare (behavior therapy or self-help programs) during the week following discharge with those who did not. Among this group of patients, 77% (91/119) linked to aftercare.

Characterisation of heart rate changes and their correlation with EEG during neonatal seizures.

The effect of seizures on instantaneous HR (iHR) in 12 neonates is investigated here. HR can be readily extracted from the ECG and can be employed as an additional signal in seizure detection algorithms. The change in instantaneous HR and its correlation with the change in RMS EEG amplitude were examined.

Automated single channel seizure detection in the neonate.

Neonatal seizures are the most common neurological emergency in the neonatal period and are associated with poor long-term outcome. EEG is considered the gold standard for identification of all neonatal seizures, reducing the number of EEG electrodes required would reduce patient handling and allow faster acquisition of data. A method for automated neonatal seizure detection based on two carefully chosen cerebral scalp electrodes but trained using multi-channel EEG is presented.

Seizure detection in neonates: Improved classification through supervised adaptation.

The goal of neonatal seizure detection is the development of a patient independent system to alert staff in the neonatal intensive care unit of ongoing seizures. This study demonstrates the potential in adapting a patient independent classifier using patient specific data. Supervised adaptation is investigated using the basic gradient descent algorithm and least mean squares procedures.

Can state or response entropy be used as a measure of sleep depth?

In this prospective observational study we examined the potential of the spectral entropy measures 'state' and 'response' entropy (Entropy monitor), as measures of sleep depth in 12 healthy adult subjects. Both median state and response entropy values varied significantly with sleep stage (p = 0.017 and p = 0.

Neoadjuvant chemotherapy followed by concurrent hyperfractionated radiation therapy and sensitizing chemotherapy for locally advanced (T3-T4) oropharyngeal squamous cell carcinoma.

Background: Radiation therapy (RT) is commonly used in the management of patients with advanced (T3-T4) oropharyngeal squamous cell carcinomas. In recent years, based upon the meta-analyses of randomized trials, chemotherapy administered concurrently with RT (chemoradiotherapy) has become the standard of care. Twice-a-day hyperfractionated or accelerated-fractionated RT regimens have been shown in a number of randomized trials to significantly improve the rate of local control compared with conventional once-a-day fractionation.

Classifier models and architectures for EEG-based neonatal seizure detection.

Neonatal seizures are the most common neurological emergency in the neonatal period and are associated with a poor long-term outcome. Early detection and treatment may improve prognosis. This paper aims to develop an optimal set of parameters and a comprehensive scheme for patient-independent multi-channel EEG-based neonatal seizure detection.

Behaviour of spectral entropy, spectral edge frequency 90%, and alpha and beta power parameters during low-dose propofol infusion.

Background: In this study we analyse the behaviour, potential clinical application and optimal cortical sampling location of the spectral parameters: (i) relative alpha and beta power; (ii) spectral edge frequency 90%; and (iii) spectral entropy as monitors of moderate propofol-induced sedation.

Methods: Multi-channel EEG recorded from 12 ASA 1 (American Society of Anesthesiologists physical status 1) patients during low-dose, target effect-site controlled propofol infusion was used for this analysis. The initial target effect-site concentration was 0.

Science on the streets of the Big Apple.

A five-day festival of science takes place this week at venues across New York City. The festival features not only leading researchers from New York and beyond but also actors, writers, musicians, and choreographers in a series of multimedia programs designed to reveal science to the general public in exciting new ways.

A comparison of quantitative EEG features for neonatal seizure detection.

Objective: This study was undertaken to identify the best performing quantitative EEG features for neonatal seizures detection from a test set of 21.

Methods: Each feature was evaluated on 1-min, artefact-free segments of seizure and non-seizure neonatal EEG recordings. The potential utility of each feature for neonatal seizure detection was determined using receiver operating characteristic analysis and repeated measures t-tests.

Impact of a hypertension management/health promotion program on commercial driver's license employees of a self-insured utility company.

Objective: Federal regulations governing transportation safety disqualify commercial drivers with persistent uncontrolled hypertension. We sought to determine whether a hypertension management and health promotion program designed for commercial drivers improved blood pressure (BP) outcomes among drivers employed by a self-insured utility company.

Methods: This retrospective study examined the employment-related medical examinations of 501 randomly selected commercial drivers for measurements of BP, height, and weight taken before and after the intervention.

DNA protein kinase-dependent G2 checkpoint revealed following knockdown of ataxia-telangiectasia mutated in human mammary epithelial cells.

Members of the phosphatidylinositol 3-kinase-related kinase family, in particular the ataxia-telangiectasia mutated (ATM) kinase and the catalytic subunit of the DNA-dependent protein kinase (DNA-PKcs), regulate cellular responses to DNA double-strand breaks. Increased sensitivity to ionizing radiation (IR) in DNA-PKcs- or ATM-deficient cells emphasizes their important roles in maintaining genome stability. Furthermore, combined knockout of both kinases is synthetically lethal, suggesting functional complementarity.

Automated estimation of sedation depth from the EEG.

A method is presented for the automatic determination of a patient's level of sedation from the EEG. Six bipolar channels of EEG recorded from 12 adult patients sedated with low-dose propofol (2, 6-disopropylphenol) were used to develop a linear discriminant based system for depth of sedation monitoring using a number of quantitative EEG measures. A cross fold validation estimate of the performance of the algorithm as a patient independent system yielded a sensitivity of 74.

The effect of frequency band on quantitative EEG measures in neonates with hypoxic-ischaemic encephalopathy.

The effect of frequency ranges on three quantitative EEG measures as related to neurodevelopmental outcome at 12-24 months is reported here. Thirteen EEG records from term neonates with moderate hypoxic-ischaemic encephalopathy (HIE) were analyzed. The spectral entropy, spectral edge frequency and relative power were calculated for each EEG channel.

Multi-channel EEG based neonatal seizure detection.

A multi-channel method for patient specific and patient independent, EEG based neonatal seizure detection is presented. Two classifier configurations are proposed and tested, along with a number of classifier models. Existing methods for neonatal seizure detection have been empirical threshold based or based on a single EEG channel.

Healthy and safe school environment, Part I: Results from the School Health Policies and Programs Study 2006.

Background: Policies set at the state, district, and school levels can support and enhance a healthy and safe school environment.

Methods: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n=461).

Facilitators and barriers to improving interprofessional referral relationships between primary care physicians and chiropractors.

Objective: Findings from recent studies suggest that there are poor interprofessional referral relationships between primary care physicians (MDs) and chiropractors (DCs) and this can lead to fragmentation of care. The objective of this study is to identify potential facilitators and barriers to developing positive interprofessional referrals relationships between MDs and DCs.

Methods: We conducted 2 rounds of focus group interviews on a convenience sample of MDs and DCs.

How often are physicians and chiropractors provided with patient information when accepting referrals?

The objective of our study is to document how often MD/DOs and doctors of chiropractic (DCs) receive patient information from referring MD/DOs and DCs and highlight to what extent there is a lack of formal intraprofessional and interprofessional referral relationships between MD/DOs and DCs. A total of 517 MD/DOs and 452 DCs participated in this study. The study results suggest that patient information is not regularly provided by either MD/DOs or DCs, even when making formal referrals to a provider of the same type.

Reinventing CME: the role of the care pilot in the medical group practice.

This article recommends that the content of traditional continuing medical education be changed significantly to include the concepts and skills necessary to enable practice teams to feedback information into the practice, which would result in the creation of a learning organization with the ability to plan for and anticipate future activities. The primary role in this new organization would be called a care pilot who would have as a primary responsibility, the successful navigation and improvement of the 6 aims as spelled out in the Institute of Medicine report Crossing the Quality Chasm.

The use of chiropractors by older adults in the United States.

Background: In a nationally representative sample of United States Medicare beneficiaries, we examined the extent of chiropractic use, factors associated with seeing a chiropractor, and predictors of the volume of chiropractic use among those having seen one.

Methods: We performed secondary analyses of baseline interview data on 4,310 self-respondents who were 70 years old or older when they first participated in the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD). The interview data were then linked to their Medicare claims.

Linkage to primary medical care following inpatient detoxification.

It is important to address the medical problems of individuals admitted for detoxification by arranging for follow-up with primary care physicians after discharge. This was a prospective cohort study of 119 patients admitted for detoxification. Follow-up data were collected over the telephone one week following discharge.

Electrocardiogram based neonatal seizure detection.

A method for the detection of seizures in the newborn using the electrocardiogram (ECG) signal is presented. Using a database of eight recordings, a method was developed for automatically annotating each 1-min epoch as "nonseizure" or "seizure". The system uses a linear discriminant classifier to process 41 heartbeat timing interval features.

Combination of EEG and ECG for improved automatic neonatal seizure detection.

Objective: Neonatal seizures are the most common central nervous system disorder in newborn infants. A system that could automatically detect the presence of seizures in neonates would be a significant advance facilitating timely medical intervention.

Methods: A novel method is proposed for the robust detection of neonatal seizures through the combination of simultaneously-recorded electroencephalogram (EEG) and electrocardiogram (ECG).