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PubMed2001

An electronic simulator for testing infant apnoea monitors that uses actual physiologic data.

An electronic simulator of physiologic signals used in infant monitoring has been designed, constructed and applied in the Collaborative Home Infant Monitor Evaluation (CHIME). A unique feature of the simulator is that it contains actual physiologic waveforms recorded from infants rather than artificial, idealized signals. The simulator stores breathing waveforms that can be used to test transthoracic-impedance- and inductance-plethysmography-based monitors, and heart rate channels are tested by playing a neonatal QRS complex at preset fixed rates or a variable rate as determined from infant recordings. The transfer characteristics of the simulator are constant over frequencies ranging from 0.5 to 8 Hz for the respiration channels. Data stored in memory are divided into 60 second epochs that can be presented to the monitor being tested in a programmable sequence. A group of 66 CHIME monitors was tested using a simulator programmed with 17 apnoea and bradycardia waveforms. The agreement between monitors as to the duration of detected apnoea decreases as the amount of artefact in the signal increases. Discrepancies between monitors in detecting apnoea duration were found to be similar to inconsistencies between CHIME investigators manually scoring similar waveforms.

Analog-Digital Conversion↗
PubMed1999

Step activity monitor: increased accuracy in quantifying ambulatory activity.

This study compares the accuracy of a two-dimensional accelerometer worn on the ankle (a step activity monitor) with that of an electronic, digital pedometer worn on the belt line. Twenty-nine human subjects were evaluated while they briskly walked 400 M, slowly walked 10 M, and ascended and descended a flight of stairs. The step activity monitor had less error in all activities; its mean absolute error was 0.54%, whereas that of the pedometer was 2.82%. The difference was more pronounced in obese subjects (body mass index greater than 30), with an overall mean absolute error of 0.48% for the step activity monitor and 6.12% for the pedometer (nearly 13 times that of the step activity monitor). For subjects with a body mass index less than 30, the step activity monitor had an overall error of 0.56% and the pedometer had an overall error of 1.56% (less than 3 times that of the step activity monitor). The absolute error of the pedometer was positively correlated with body mass index (r = 0.792, p < 0.0001) and weight (r = 0.753, p < 0.0001), whereas the error of the step activity monitor was not significantly correlated with either. Neither device was significantly biased by age, gender, or the presence of a lower-extremity joint prosthesis. The accuracy and additional capabilities, including a real-time memory record of activity, of the step activity monitor make it well suited for objectively quantifying ambulatory activity, especially for obese subjects.

Acceleration↗
PubMed1997

Detection of interstitial lung abnormalities on picture archive and communication system video monitors.

The purpose of this study was to compare the detection of interstitial lung abnormalities on video display workstation monitors between radiologists experienced with video image interpretation and radiologists who lack this experience. Twenty-four patients with interstitial lung abnormalities documented by high-resolution computed tomography (HRCT) and lung biopsy, and 26 control patients with no history of pulmonary disease or a normal HRCT and normal chest radiographs were studied. Images were acquired using storage phosphor digital radiography and displayed on 1,640 x 2,048 pixel resolution video monitors. Five board-certified radiologists evaluated the images in a blinded and randomized manner by using a six-point presence of abnormality grading scale. Three radiologists were from 1 to 4 years out of residency and considered to be experienced workstation monitor readers with between 1 to 3 years of video monitor image interpretation. For the inexperienced readers, one radiologist had no prior experience with reading images from a video monitor and was direct out of residency, and the other radiologist had less than 4 months of intermittent exposure and was 1 year out of residency. Sensitivity and specificity were determined for individual readers. Positive predictive values, negative predictive values, accuracy, and receiver-operating curves were also generated. A comparison was made between experienced and inexperienced readers. For readers experienced with video monitor image interpretation, the sensitivity ranged from 87.5% to 92%, specificity from 69% to 92%, positive predictive value (PPV) from 73% to 87.5%, negative predictive value (NPV) from 87% to 90%, and accuracy from 80% to 88%. For inexperienced readers, these values were sensitivity 58%, specificity 50% to 65%, PPV 52% to 61%, NPV 56.5% to 63%, and accuracy 54% to 62%. Comparing image interpretation between experienced and inexperienced readers, there were statistically significant differences for sensitivity (P < .01), specificity (P < .01), PPV (P < .05), NPV (P < .05), accuracy (P < .05), and area under the receiver operator curve (Az) (P < .01). Within the respective experienced and inexperienced groups, no statistical significant differences were present. Our results show that digitally acquired chest radiographs displayed on high-resolution workstation monitors are adequate for the detection of interstitial lung abnormalities when the images are interpreted by radiologists experienced with video image interpretation. Radiologists inexperienced with video monitor image interpretation, however, cannot reliably interpret images for the detection of interstitial lung abnormalities.

Adult↗
PubMed1999

PROFILE: Integrating Stressor and Response Monitoring into a Resource-Based Water-Quality Assessment Framework.

/ South African water law as well as the country's water resource management policies are currently under review. The Water Law Principles, which were established as part of this review process, indicate a commitment to sustainable development of water resources and the protection of an ecological "reserve." Such policy goals highlight the limitations of traditional and current water-quality management strategies, which rely on stressor monitoring and associated regulation of pollution. The concept of an assimilative capacity is central to the implementation of the current water-quality management approach. Weaknesses inherent in basing water management on the concept of assimilative capacity are discussed. Response monitoring is proposed as a way of addressing some of the weaknesses. Following a global trend, the new policy goals emphasize the need to protect rather than to use the ability of ecosystems to recover from disturbances. This necessitates the adoption of response measurements to quantify ecological condition and monitor ecological change. Response monitoring focuses on properties that are essential to the sustainability of the ecosystem. These monitoring tools can be used to establish natural ranges of ecological change within ecosystems, as well as to quantify conceptually acceptable and unacceptable ranges of change. Through a framework of biological criteria and biological impairment standards, the results of response monitoring can become an integral part of future water resource management strategies in South Africa. KEY WORDS: Stressor monitoring; Response monitoring; Assimilative capacity; Ecosystem stability; Resilience; Biocriteria

Journal Article↗
PubMed2006

ROC analysis for diagnostic accuracy of fracture by using different monitors.

BACKGROUND: The purpose of this study was to compare diagnostic accuracy by using two types of monitors. METHODS: Four radiologists with 10 years experience twice interpreted the films of 77 fracture cases by using the ViewSonic P75f+ and BARCO MGD221 monitors, with a time interval of 3 weeks. Each time the radiologists used one type of monitor to interpret the images. The image browser used was the Unisight software provided by Atlastiger Company (Shanghai, China), and interpretation result was analyzed via the LABMRMC software. RESULTS: In studies of receiver operating characteristics to score the presence or absence of fracture, the results of images interpreted through monochromic monitors showed significant statistical difference compared to those interpreted using the color monitors. CONCLUSION: A significant difference was observed in the results obtained by using two kinds of monitors. Color monitors cannot serve as substitutes for monochromatic monitors in the process of interpreting computed radiography (CR) images with fractures.

Artificial Intelligence↗
PubMed2007

Personal digital assistants are comparable to traditional diaries for dietary self-monitoring during a weight loss program.

Dietary self-monitoring is considered the core of behavioral weight control programs. As software for personal digital assistants (PDA) has become more available, this study investigated whether the use of a PDA would improve dietary self-monitoring frequency and subsequent weight loss over the use of traditional paper diaries. One-hundred-seventy-six adults (BMI 25-39.9) participated in a 6-month behavioral weight control program. Treatment subjects (n = 61) were provided with a PalmZire 21 with Calorie King's Diet Diary software installed. Their self-monitoring habits and weight loss were compared with the results from a previous program (n = 115) which followed the same protocol using paper diaries for self-monitoring. No significant differences in weight loss or dietary self-monitoring were found. More frequent self-monitoring correlated with weight loss in both groups (p<.001). People seeking to lose weight should be encouraged to self-monitor and be matched with a mode of self-monitoring that is fitting to their lifestyle and skills.

Adult↗
PubMed1995

Data quality assurance, monitoring, and reporting.

In conclusion, the quality assurance and monitoring program is an integral and continuing part of study operations. A system must be devised and implemented by the coordinating center investigators, with the endorsement of the study leadership and support of the field site and resource center personnel. Proactive mechanisms for promoting high-quality data acquisition and reporting must be implemented. Data quality monitoring must address the entire process by which the data are gathered, transmitted, stored, and analyzed. Data quality should be monitored continually, with summary reports prepared and distributed to the study leadership. Appropriate training and certification enhance data quality, and site visits allow data collection and storage processes to be observed directly. The quality assurance and monitoring system must be documented. It should be flexible enough so that new means of quality assurance or monitoring can be added when necessary during the course of the study. At the completion of the study, quality monitoring results should be summarized in a final report regarding the level of quality achieved by the study investigators and personnel. Finally, for a quality assurance and monitoring program to be successful, the coordinating center investigators and personnel must provide prompt feedback and suggestions for corrective action whenever a data quality problem is discovered. This need can be met only when the coordinating center staff understand data quality goals and are up to date with all phases of data management and reporting. Delays in initiating any stage of data management and quality monitoring may result in uncorrectable data problems. Thus, knowledgeable and efficient coordinating center personnel are essential to achieving good data quality studywide.

Clinical Trials as Topic↗
PubMed1985

Influence of self-monitoring on heterosexual conversational behaviors of head trauma youth.

This study evaluates the impact of self-monitoring on three heterosexual conversational behaviors of head trauma youths. Two 5-minute audiotaped conversations occurred daily between the youths and unfamiliar female confederates. Two conversations occurring on alternate days in clinical and natural conversational settings were scored for the frequency of compliments, questions, and self-disclosures. A multiple baseline analysis with alternating treatments for "instructions to self-monitor" and "no instructions to self-monitor" revealed (a) self-monitoring had an accelerative effect on compliments and questions and a decelerative effect on self-disclosure; (b) self-monitoring effects were maintained despite transferring from a mechanical counter to an unspecified covert monitoring procedure; (c) self-monitoring had a comparable effect whether employed in a clinical or functional communication setting; (d) performance of the target behavior was most strongly influenced under the "instructions to self-monitor condition;" (e) once intervention was directed to another response, the rate under the instructions and no instruction conditions became equivalent; and (f) the results maintained over a 1-month follow-up for one youth available for observation. Finally, social comparison and subjective evaluation data supported the importance of intervention.

Adult↗
PubMed1993

Growth monitoring and the promotion of breastfeeding.

Recent studies evaluating the efficacy of growth monitoring programs have scrutinized their educational and preventive capabilities. Advocates claim that growth monitoring can be effective if communities and mothers are more actively involved in the process of weighing and measuring, and if the technology is understood by all as an aid for disease prevention and health promotion rather than as a 'curative' procedure. Others have argued that this theory is rarely possible to implement. The ways in which preventive growth monitoring can be made possible are still under exploration, given that the reasons for such deeply imbedded 'curative' expectations of growth monitoring are not fully understood. Any such understanding requires an analysis of growth monitoring within the context of the GOBI (growth monitoring, oral rehydration therapy, breastfeeding and immunization) child survival framework. To attain this type of understanding, a series of qualitative methodological techniques were used in a population of 50 mothers and several health care facilities in Pelotas, RS, Brazil, as a complement to pre-existing epidemiological data from the Center for Epidemiology at the Federal University of Pelotas. With a subsample of 15 mothers, intensive interviews and observations were specifically focused on: (1) mothers' understanding of growth monitoring, (2) breastfeeding practices and beliefs, (3) doctor-patient communication. Findings from this study suggest that, even in a program with widespread attendance and a relatively 'interactive' growth monitoring approach, the use of growth charts do little to promote duration or frequency of breastfeeding, and may even pay a role in the factors which deter women from choosing to breastfeed for longer durations or with greater frequency. We found that mothers' personal interpretations of the charts were representative of the larger socio-cultural and economic issues that affected their lives on a daily basis. Growth charts thus served as one of the many tangible domains onto which mothers could project their worries and measure their personal 'successes' and 'failures'.

Adolescent↗
PubMed2005

The effectiveness of out-of-hospital use of continuous end-tidal carbon dioxide monitoring on the rate of unrecognized misplaced intubation within a regional emergency medical services system.

STUDY OBJECTIVE: We evaluate the association between out-of-hospital use of continuous end-tidal carbon dioxide (ETCO2) monitoring and unrecognized misplaced intubations within a regional emergency medical services (EMS) system. METHODS: This was a prospective, observational study, conducted during a 10-month period, on all patients arriving at a regional Level I trauma center emergency department who underwent out-of-hospital endotracheal intubation. The regional EMS system that serves the trauma service area is composed of multiple countywide systems containing numerous EMS agencies. Some of the EMS agencies had independently implemented continuous ETCO2 monitoring before the start of the study. The main outcome measure was the unrecognized misplaced intubation rate with and without use of continuous ETCO2 monitoring. RESULTS: Two hundred forty-eight patients received out-of-hospital airway management, of whom 153 received intubation. Of the 153 patients, 93 (61%) had continuous ETCO2 monitoring, and 60 (39%) did not. Forty-nine (32%) were medical patients, 104 (68%) were trauma patients, and 51 (33%) were in cardiac arrest. The overall incidence of unrecognized misplaced intubations was 9%. The rate of unrecognized misplaced intubations in the group for whom continuous ETCO2 monitoring was used was zero, and the rate in the group for whom continuous ETCO2 monitoring was not used was 23.3% (95% confidence interval 13.4% to 36.0%). CONCLUSION: No unrecognized misplaced intubations were found in patients for whom paramedics used continuous ETCO2 monitoring. Failure to use continuous ETCO2 monitoring was associated with a 23% unrecognized misplaced intubation rate.

Adolescent↗
PubMed2004

A comparison of the fertile phase as determined by the Clearplan Easy Fertility Monitor and self-assessment of cervical mucus.

The purpose of this study was to compare the fertile phase of the menstrual cycle as determined by the Clearplan Easy Fertility Monitor (CPEFM) with self-monitoring of cervical mucus. One-hundred women (mean age = 29.4 years) observed their cervical mucus and monitored their urine for estrogen and luteinizing hormone metabolites with the CPEFM on a daily basis for 2-6 cycles and generated 378 cycles of data; of these, 347 (92%) had a CPEFM peak. The beginning of the fertile window was, on average, day 11.8 (SD = 3.4) by the monitor and day 9.9 (SD = 3.0) by cervical mucus (r = 0.43, p < 0.001). The average first day of peak fertility by the monitor was 16.5 (SD = 3.6) and by cervical mucus 16.3 (SD = 3.7) (r = 0.85, p < 0.001). The mean length of the fertile phase by the monitor was 7.7 days (SD = 3.1) and by cervical mucus 10.9 days (SD = 3.7) (t = 12.7, p < 0.001). The peak in fertility as determined by the monitor and by self-assessment of cervical mucus is similar but the monitor tends to underestimate and self-assessment of cervical mucus tends to overestimate the actual fertile phase.

Adolescent↗
PubMed2005

Confusing thoughts and speech: source monitoring and psychosis.

To explore the idea that deficits in source monitoring may underlie positive symptoms of schizophrenia, the current study compared schizophrenic patients' performance (n=15) on an internal source-monitoring task with that of normal controls (n=15). On the basis of a source-monitoring task in which participants had to recall whether they had verbalized answers or merely thought about these answers, overall source monitoring performance, discrimination index, and response bias were calculated. In addition, participants completed cognitive tests and symptomatology questionnaires. Relative to controls, patients had significantly more difficulties with monitoring their own actions and showed a tendency towards misclassifying imagined thoughts as verbalized thoughts. Source-monitoring performance was related to selective attention, but not to other cognitive domains. No relationship was found between source-monitoring and symptomatology. Failures in internal source monitoring are a prominent feature of schizophrenia, and our results suggest that they form a more enduring characteristic of this disorder than has previously been assumed.

Adult↗
PubMed1981

Long-term transtelephonic electrocardiographic monitoring in the detection and evaluation of variant angina.

To facilitate the outpatient diagnosis of variant angina by documenting transient ST segment evaluation during chest pain, we studied the feasibility of transtelephonic ECG monitoring during angina episodes. Eight patients with known coronary artery spasm underwent simultaneous continuous ambulatory and transtelephonic ECG monitoring during a 24-hour period. Five patients (62%) had transient diagnostic ST segment shifts on both continuous ambulatory and transtelephonic monitoring. Another eight patients with coronary spasm underwent 24-hour continuous ambulatory monitoring and separate 14-day period of transtelephonic monitoring. The addition of this longer monitoring period provided diagnostic ST segment shifts in three patients. We conclude that transtelephonic monitoring in patients with suspected coronary artery spasm can provide important additional diagnostic information to continuous ambulatory monitoring, particularly in the patient with infrequent or predictable chest pain.

Adult↗
PubMed2003

Reality monitoring and metacognitive beliefs related to cognitive confidence in obsessive-compulsive disorder.

The present study investigated general reality monitoring ability, and selective reality monitoring ability for anxiety relevant actions in a group of individuals with obsessive-compulsive disorder (OCD) and a group of non-anxious controls. In addition, reality monitoring confidence was assessed, as well as specific meta-cognitive beliefs related to cognitive confidence (by means of the Meta-Cognitions Questionnaire (MCQ)). No differences were found between both groups in actual reality monitoring ability. Unlike previous studies, the reality monitoring task included actions that were related to the individual concerns of the OCD patients and were ideographically selected. Nevertheless, no differential reality monitoring effect was observed for the anxiety relevant stimuli. Data from the MCQ, however, revealed that OCD patients had less overall confidence in their memory for actions and their reality monitoring ability. Analysis of the confidence ratings of the reality monitoring task showed that this reduced confidence was restricted to the neutral actions. No differences were observed for patients that reported low or high frequencies of checking behaviour. The whole of these data do not support memory deficit models of OCD, but are in line with recent emphasis on the importance of memory confidence and other meta-cognitive beliefs in OCD.

Adult↗
PubMed2000

Biological Monitoring of Pesticide Exposure: a review. Introduction.

Pesticides are used worldwide in agriculture, industry, public health and for domestic applications: as a consequence, a great part of the population may be exposed to these compounds. In spite of this extensive use, knowledge on the health risks associated with prolonged exposure is rather poor, and major uncertainties still exist. Epidemiological observations in man have so far produced little conclusive information, mainly because of weaknesses in exposure assessment. Therefore, information on the type and levels of exposure is fundamental in order to better understand and characterize risk to human health. Exposure assessment can be carried out via measurement of environmental concentrations, as well as via determination of the chemical or its metabolites in body tissues (biological monitoring). Besides indices of internal dose, biological monitoring also includes measurements of early effects attributable to interaction between the chemical agent and the human body. Biological monitoring has the advantage, over environmental monitoring, of determining the dose actually absorbed via any possible route: differences in absorption can be taken into account. whether they are due to biological variability or to use of protective equipment. When, in some cases, a combination of occupational and non-occupational exposure occurs, this also can be taken into consideration by biological monitoring. Few reference documents have been published on biological monitoring of pesticides. For this reason, the Office of Occupational Health of the World Health Organization gave ICPS a mandate to prepare a monograph specifically addressed to reviewing methods for biological monitoring of pesticide exposure. This review is based on more than 300 studies published over the period 1980-1999. For the most representative chemical classes, the available biological exposure indices are reported. Both indices of internal dose and. when available, of early effects are discussed. The reported tests were used to monitor exposure of pesticide applicators in agriculture and public health, manufacturing and formulating workers. subjects poisoned after accidental exposure or attempted suicide, volunteers involved in pharmacokinetic studies, as well as sub-groups of the general population exposed to environmentally persistent pesticides. Single chapters deal with organophosphorus insecticides, carbamate pesticides, dithiocarbamates, phenoxyacids, quaternary ammonium compounds. coumarin rodenticides, synthetic pyrethroids, organochlorine pesticides, chlorotriazines, and pentachlorophenol.

Animals↗
PubMedDate not supplied

Do apnea monitors decrease emotional distress in parents of infants at high risk for cardiopulmonary arrest?

INTRODUCTION: The immediate post-partum period is stressful for most parents. The need to use a home apnea monitor may tax parental coping skills even further. Therefore, we conducted a study to assess the psychosocial consequences of apnea monitoring on parental emotional distress and family functioning. METHOD: We studied 104 parents of infants at high risk for cardiopulmonary arrest. Fifty-two parents had infants who used home apnea monitors, and 52 parents were age-matched and gender-matched control subjects. Data were collected during the infant's hospitalization, and then at 2 weeks, 3 months, and 6 months after discharge. At 1 year, parents were interviewed about their attitudes toward using the apnea monitor. RESULTS: Both groups experienced elevated levels of emotional distress, but the group with infants who used the monitors had significant increases in depression and hostility immediately following discharge from the hospital compared with baseline, whereas the non-monitored group had a significant increase in hostility at 6 months. At 1-year follow-up, the majority of the parents reported that they used the monitor every night, felt more secure in using it, and judged it helpful. DISCUSSION: The immediate period following hospital discharge of infants who need to use a home apnea monitor is characterized by significant emotional distress for the parents, which resolves over time. Anticipatory education and counseling of parents is recommended.

Adaptation, Psychological↗
PubMed2000

Home blood pressure: accuracy is independent of monitoring schedules.

Long-term morbidity and mortality from hypertension are more closely related to home than to casual office blood pressure levels. There is no generally accepted recommendation on how to best schedule home blood pressure (HBP) recordings, perhaps because the effect of varying the home monitoring schedule on the HBP average is not well studied. The goals of this analysis are to describe the effects of HBP monitoring schedules on the accuracy of resultant HBP averages and to determine which monitoring schedule parameters correlate with HBP accuracy. Twelve published studies, each including home, office, and awake ambulatory blood pressure means were identified. Accuracy of office and HBP averages were determined by their agreement with corresponding awake ambulatory averages. Variations in HBP monitoring schedule parameters did not significantly affect the accuracy of the resultant HBP averages among the studies. In univariate analyses, no individual parameter correlated significantly with the final HBP average accuracy. As the total number of HBP readings obtained increased, or as other monitoring schedule parameters intensified, the superior accuracy of HBP levels as compared to that of casual office values also failed to significantly improve. No HBP accuracy differences were found among groups characterized by different HBP schedule parameter ranges. In conclusion, the accuracy of HBP measurements, as determined by their agreement with an awake ambulatory mean, is maintained regardless of substantial variations in HBP monitoring schedules. Therefore, the majority of the benefits derived from HBP monitoring will likely be achieved by obtaining only a few HBP measurements using a minimally complex monitoring schedule.

Blood Pressure↗
PubMed2000

Perceived parental monitoring and health risk behaviors among urban low-income African-American children and adolescents.

PURPOSE: To examine gender and age differences among urban, low-income, African-American children and adolescents in perceived monitoring by their parents, and the association of perceived parental monitoring with family characteristics, health risk behaviors, and risk perceptions. METHODS: Three cross-sectional surveys were conducted in 1992 (n = 455), 1994 (n = 355), and 1996 (n = 349). Respondents aged 9-17 years were recruited from low-income urban areas including public housing communities and associated recreation centers. Both multivariate analysis of variance and correlation analysis were performed. RESULTS: Low levels of perceived parental monitoring were associated with participation in several health risk behaviors, including sexual behavior, substance/drug use, drug trafficking, school truancy, and violent behaviors. Females perceived themselves to be more monitored than did males. In general, the perceived parental monitoring tended to decrease with advancing age of the youth. CONCLUSIONS: The strong inverse correlation between perceived parental monitoring and adolescent risk behavior suggests that parental monitoring initiatives may be an effective intervention tool. Longitudinal studies are needed to determine the long-term relationship between perceived parental monitoring and adolescent risk involvements.

Adolescent↗