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Biomedical subjects

R Blue

Publications and source records attributed to R Blue.

13 recordsLinked to original sources
PubMed1996

The Medication Reduction Project: combating polypharmacy in South Dakota elders through community-based interventions.

The Medication Reduction Project (MED RED) is a community-based program addressing polypharmacy issues in elders. Using educational presentations and one-on-one medication reviews conducted by a pharmacist specializing in geriatrics, MED RED reached over 1,100 older adults in rural and urban southeastern South Dakota communities during 1993. Analysis of the longitudinal data indicate that older adults participating in one-on-one reviews were on fewer medications, had dosage reductions, were more likely to take their medications as directed, and increased their use of non-pharmacological alternatives. These elders also reported feeling better, spent less money per month on medications, and offered indications of improved functioning and increased levels of independence. These findings suggest that education about medication use is a dynamic tool in empowering community-based older adults to be assertive participants in their own health care.

Aged↗
PubMed1995

MealMate: improving the nutritional status of elders using a milk-based nutritional supplement.

MealMate was a longitudinal research project conducted by the staff at the Geriatric Health Institute, a joint venture between Sioux Valley Hospital and the University of South Dakota School of Medicine. During Fall 1994, 64 older adults enrolled in this nutrition study at a Sioux Falls congregate dining site and drank a half-pint of whole milk combined with Carnation Instant Breakfast daily for one month. Pre-test and post-test data collected included anthropometric measures, specific blood tests from a venipuncture blood draw and use of standardized instruments to assess nutritional risk, depression, mental status and general demographic information. Results suggest that a longitudinal study with elders can be done effectively (attrition rate of less than 11%). While elders were very healthy at the onset, they nevertheless showed improved nutritional status over time. Laboratory tests showed significant increases in Vitamin D levels in adults over age 79. Using a more malnourished, home-bound sample of elders over age 79 and adding only whole milk to their diets are discussed as possible considerations for future research.

Aged↗
PubMed1994

CNS-directed case management. Cost and quality in harmony.

Preserving the integrity of high quality care in a financially restricted environment is the primary challenge facing healthcare providers. The critical question is which delivery system will use limited resources most efficiently without jeopardizing quality of care? Case management has been identified as a solution that offers the most promise. The case management model at Sioux Valley Hospital was developed to deal proactively with resource-intensive patients with chronic illnesses who have frequent admissions and who create financial risk for the hospital. The authors describe the fiscal and clinical outcomes of these select patients.

Adolescent↗
PubMed1993

Simultaneously collected monopolar and discrete bipolar electrograms: comparison of activation time detection algorithms.

Designation of the time of local activation is fundamental to electrophysiological mapping. In normal myocardium, the minimum slope in extracellular monopolar (MP) electrograms has been linked through simultaneous intracellular and extracellular recordings to phase 0 of the action potential. However, no similar correlation has been demonstrated for a parameter from bipolar (BP) electrograms, now commonly used during electrophysiological studies and intraoperative mapping. The purpose of this work is to compare the activation time, determined according to several common algorithms applied to BP electrograms, with the time of the minimum slope in MP electrograms. Simultaneous normal epicardial MP and BP electrograms were acquired from subjects undergoing surgery for Wolf-Parkinson-White Syndrome and from dogs. The activation time in BP electrograms was defined by four algorithms: (1) peak (P); (2) greatest absolute slope (S); (3) zero crossing of the segment containing the greatest slope (FZC); and (4) morphological (M). Each was compared to the time of the minimum slope in the simultaneously recorded MP response. The incidence of outliers was tabulated. The distribution of activation times computed using each BP algorithm was statistically different from the distribution of activation times derived from MP electrograms. M performed best (absolute difference: 2.6 +/- 2.9 msec; cor coef: 0.9925 in man). The M, P, FZC, and S algorithms produced 3.2%, 3.5%, 4.7% and 4.7% outliers, respectively. The overall performance of a morphologically based algorithm is superior to simplistic BP algorithms based only on slope or peak.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed1991

Influence of time of sampling onset on parameters used for activation time determination in computerized intraoperative mapping.

The purpose of this work is to determine the sensitivity of the estimated time of peaks and maximum slopes, commonly used in activation time computations, to the instant at which sampling is initiated. Based on complex and quickly changing waveforms, 471 monopolar (MP) and bipolar (BP) epicardial responses in man were selected. These were decimated from 10 kHz to simulate sampling at frequencies ranging from 200 Hz to 2,000 Hz. The peak and maximum absolute slope for BP and the minimum slope for MP were computed repeatedly starting at successive 100 microseconds intervals extending throughout the sampling period and compared with these parameters computed from the waveform sampled at 10 kHz. Slopes were estimated using each of four different algorithms. The average greatest shift (AGS) due to variations in sampling onset ranged from 11.2 +/- 3.5 (200 Hz) to 0.3 +/- 0.2 msec (2,000 Hz). For bipolar algorithms, the peak performed better than the slope algorithms (AGS: 5.9 +/- 3.3 to 0.3 +/- 1.0 msec). For MP algorithms, 2 point linear, and 3 and 5 point Lagrange slope estimates performed similarly (AGS: 5.6 +/- 3.3 to 0.3 +/- 0.2 msec); a 5 point least square fit algorithm performed poorly. Sampling MP and BP electrograms below 500 and 400, respectively, often caused maximum shifts greater than 4 msec. Thus, the resolution of the peak and estimated slope is not limited to the sampling period, variations in initiation of sampling can cause significant outliers especially at low sampling rates, and MP electrograms should be sampled faster than BP electrograms for comparable accuracy.

Electrocardiography↗