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PubMed2005

Accuracy of popular automatic QT interval algorithms assessed by a 'gold standard' and comparison with a Novel method: computer simulation study.

BACKGROUND: Accurate measurement of the QT interval is very important from a clinical and pharmaceutical drug safety screening perspective. Expert manual measurement is both imprecise and imperfectly reproducible, yet it is used as the reference standard to assess the accuracy of current automatic computer algorithms, which thus produce reproducible but incorrect measurements of the QT interval. There is a scientific imperative to evaluate the most commonly used algorithms with an accurate and objective 'gold standard' and investigate novel automatic algorithms if the commonly used algorithms are found to be deficient. METHODS: This study uses a validated computer simulation of 8 different noise contaminated ECG waveforms (with known QT intervals of 461 and 495 ms), generated from a cell array using Luo-Rudy membrane kinetics and the Crank-Nicholson method, as a reference standard to assess the accuracy of commonly used QT measurement algorithms. Each ECG contaminated with 39 mixtures of noise at 3 levels of intensity was first filtered then subjected to three threshold methods (T1, T2, T3), two T wave slope methods (S1, S2) and a Novel method. The reproducibility and accuracy of each algorithm was compared for each ECG. RESULTS: The coefficient of variation for methods T1, T2, T3, S1, S2 and Novel were 0.36, 0.23, 1.9, 0.93, 0.92 and 0.62 respectively. For ECGs of real QT interval 461 ms the methods T1, T2, T3, S1, S2 and Novel calculated the mean QT intervals(standard deviations) to be 379.4(1.29), 368.5(0.8), 401.3(8.4), 358.9(4.8), 381.5(4.6) and 464(4.9) ms respectively. For ECGs of real QT interval 495 ms the methods T1, T2, T3, S1, S2 and Novel calculated the mean QT intervals(standard deviations) to be 396.9(1.7), 387.2(0.97), 424.9(8.7), 386.7(2.2), 396.8(2.8) and 493(0.97) ms respectively. These results showed significant differences between means at >95% confidence level. Shifting ECG baselines caused large errors of QT interval with T1 and T2 but no error with Novel. CONCLUSION: The algorithms T2, T1 and Novel gave low coefficients of variation for QT measurement. The Novel technique gave the most accurate measurement of QT interval, T3 (a differential threshold method) was the next most accurate by a large margin. The objective and accurate 'gold standard' presented in this paper may be useful to assess new QT measurement algorithms. The Novel algorithm may prove to be more accurate and reliable method to measure the QT interval.

Algorithms↗
PubMed2005

Rating of personality disorder features in popular movie characters.

BACKGROUND: Tools for training professionals in rating personality disorders are few. We present one such tool: rating of fictional persons. However, before ratings of fictional persons can be useful, we need to know whether raters get the same results, when rating fictional characters. METHOD: Psychology students at the University of Copenhagen (N = 8) rated four different movie characters from four movies based on three systems: Global rating scales representing each of the 10 personality disorders in the DSM-IV, a criterion list of all criteria for all DSM-IV personality disorders in random order, and the Ten Item Personality Inventory for rating the five-factor model. Agreement was estimated based on intraclass-correlation. RESULTS: Agreement for rating scales for personality disorders ranged from 0.04 to 0.54. For personality disorder features based on DSM-IV criteria, agreement ranged from 0.24 to 0.89, and agreement for the five-factor model ranged from 0.05 to 0.88. The largest multivariate effect was observed for criteria count followed by the TIPI, followed by rating scales. Raters experienced personality disorder criteria as the easiest, and global personality disorder scales as the most difficult, but with significant variation between movies. CONCLUSION: Psychology students with limited or no clinical experience can agree well on the personality traits of movie characters based on watching the movie. Rating movie characters may be a way to practice assessment of personality.

Denmark↗
PubMed2006

Medicinal plants popularly used in the Xingó region - a semi-arid location in Northeastern Brazil.

The aim of this study was to identify plant species among the diverse flora of the caatinga ecosystem that are used therapeutically. Research was undertaken in the municipalities of Piranhas and Delmiro Gouveia, in the Xingó region (state of Alagoas, NE Brazil). In order to identify the medicinal plants used in this region, semi-structured questionnaires were applied. The species cited were collected and sent to the Xingó Herbarium for taxonomic analysis. The relative importance (RI) of each species cited was calculated to verify their cultural importance. The therapeutic indications attributed to the species were classified under 16 body systems. A total of 187 medicinal species were cited, from 64 families and 128 genera. The main indications for medicinal plant use were against common colds, bronchitis, cardiovascular problems, kidney problems, inflammations in general, and as tranquilizers. Approximately 16% (30 plant species) were versatile in relation to their use, with an Relative Importance value over 1, having been indicated for up to nine body systems. The body systems that stood out the most were: the respiratory system, the gastrointestinal system, and infectious diseases. Most cited plant parts used for medicinal purposes were flowers, leaves, and inner stem bark.

Adult↗
PubMed2001

Plants as de-worming agents of livestock in the Nordic countries: historical perspective, popular beliefs and prospects for the future.

Preparations derived from plants were the original therapeutic interventions used by man to control diseases (including parasites), both within humans and livestock. Development of herbal products depended upon local botanical flora with the result that different remedies tended to develop in different parts of the world. Nevertheless, in some instances, the same or related plants were used over wide geographic regions, which also was the result of communication and/or the importation of plant material of high repute. Thus, the Nordic countries have an ancient, rich and diverse history of plant derived anthelmintic medications for human and animal use. Although some of the more commonly used herbal de-wormers were derived from imported plants, or their products, many are from endemic plants or those that thrive in the Scandinavian environment. With the advent of the modern chemotherapeutic era, and the discovery, development and marketing of a seemingly unlimited variety of highly efficacious, safe synthetic chemicals with very wide spectra of activities, herbal remedies virtually disappeared from the consciousness--at least in the Western world. This attitude is now rapidly changing. There is a widespread resurgence in natural product medication, driven by major threats posed by multi-resistant pest, or disease, organisms and the diminishing public perceptions that synthetic chemicals are the panacea to health and disease control. This review attempts to provide a comprehensive account of the depth of historical Nordic information available on herbal de-wormers, with emphasis on livestock and to provide some insights on potentially rewarding areas of "re-discovery" and scientific evaluation in this field.

Animals↗
PubMed1980

Prometheus revisited: popular myths, medical realities, and legislative actions concerning death.

Natural Death Acts have been enacted in eight states in an effort to permit terminally ill patients an opportunity to refuse extraordinary therapeutic measures. In part, these laws reflect fear of a painful, lingering terminal illness which actually occurs in a very small minority of patients. These acts fail to take into account that (1) a small but significant fraction of patients judged terminal by their attending physicians survive for a much longer time than predicted an even recover, (2) in many cases, "extraordinary therapy" will restore critically ill or even unconscious patients to functional life, (3) with the rapid advances in medical science, "extraordinary measures" may quickly become commonplace therapy, and (4) "extraordinary therapy" often makes a terminal illness less painful and distressing. The difficulties surrounding revocation of a directive under a Natural Death Act by an unconscious or seriously incapacitated patient require additional safeguards. Adequate due process should be assured before Natural Death Act provisions are applied to incompetent persons or minors. Substitution of brain death for the common law definition would permit withdrawal of useless life-support measures. Natural Death Acts may be largely superfluous in view of the balance between established common law principles of the state's interest in preservation of life and the individual's right to privacy and to refuse therapy. The interests of incompetent or minor persons can be safeguarded by application of the doctrine of "substituted judgment" by the courts. A discussion of major legal decisions relating to the right to withhold treatment and under what circumstances is reviewed in the context of the Natural Death Acts, and recent definitions of brain death.

Attitude to Death↗
PubMed1990

The media construct a menstrual monster: a content analysis of PMS articles in the popular press.

A content analysis was conducted to evaluate the description of premenstrual syndrome in magazine articles which appeared during the years 1980-1987. Seventy-eight articles were identified and evaluated for their discussion of symptoms and treatments, the language and terms used in the articles and their titles, and the types of issues covered by different kinds of magazines. The results indicate a strong bias in favor of reporting negative menstrual cycle changes. Articles are generally negative in tone and present a confusing array of symptoms and contradictory treatment recommendations. The media coverage of PMS supports the stereotype of the maladjusted woman. Implications of this negative coverage are discussed and recommendations to improve media reports of PMS are made.

Female↗
PubMed2000

Singing "the baby blues": a content analysis of popular press articles about postpartum affective disturbances.

A content analysis was conducted to evaluate the description of postpartum mood disturbances in magazine articles that appeared during the years 1980-1998. Nineteen articles about postpartum depression and eight articles about "the baby blues" were identified and analyzed for their discussion of etiologies, symptoms, treatments, resources, and demographic assumptions about their readers. The results indicate a strong bias in favor of the medical model of postpartum affective disorders. The articles contained contradictory information about the definition, prevalence, onset, duration, symptoms, and treatment of postpartum disorders, and the authors generally assumed that their readers were heterosexual, married, and middle class. Although the purpose of the articles was to educate readers about an important topic in women's health, they failed to provide accurate information, and thus are not a sufficient resource for new mothers who are seeking to learn about psychosocial aspects of the postpartum period.

Bibliometrics↗
PubMed2000

Queering Bollywood: alternative sexualities in popular Indian cinema.

In this essay, I demonstrate through numerous examples taken from four identifiable Hindi film subgenres queer themes which, though nontransgressive in their native Indian context, acquire subversive value and serve as queer points of identification when viewed from a non-nationalist bias. Watching particular films with this "queer diasporic viewing practive," sex/gender play which is normative (yet still coded) in the land of the films' production can be reclaimed as queer through the differently subjective lens of transnational spectatorship, a lens removed from patriarchy, sexism, and homophobia. This particularly becomes apparent in the Bollywood dance sequence-the frequent site of Hindi sex/gender play-whose coded queer desires are much easier to de-code (or re-code) when in the diaspora.

Art↗
PubMedDate not supplied

Popular Medicaid programs do battle with state budget pressures: perspectives from twelve states.

Many are concerned that growth of state Medicaid and State Children's Health Insurance Program (SCHIP) spending, along with limited political clout among beneficiaries, make these programs extremely vulnerable in periods of serious state budget constraints. But observations based on Community Tracking Study site visits show that states have thus far largely avoided major cuts that would seriously harm beneficiaries' access, primarily because programs have more support among coalitions of public officials, health care providers, and local advocates than commonly assumed. However, the limits to this surprising level of support are exemplified by decisions in many states to shelve some planned future expansions indefinitely.

Budgets↗
PubMedDate not supplied

The puzzling popularity of the PPO.

Surging growth in preferred provider organization (PPO) participation has been fueled by migration away from the undesirable features of health maintenance organizations (HMOs). While employers, consumers, and providers seem to know what it is they do not want from HMOs, the advantages offered by PPO design are not so clear. This is attributable in part to difficulties in determining what a PPO arrangement actually is. But it may also reflect a lack of strong evidence that PPOs control costs, provide active care management, or promote quality improvement.

Health Benefit Plans, Employee↗