Modelling STEMI service delivery: a proof of concept study

2021 ◽  
pp. emermed-2020-210334
Author(s):  
Justin Cole ◽  
Richard Beare ◽  
Thanh Phan ◽  
Velandai Srikanth ◽  
Dion Stub ◽  
...  
Keyword(s):  
Traffic Congestion ◽  
Census Data ◽  
Intraclass Correlation ◽  
Application Programming Interface ◽  
Coronary Intervention ◽  
Age Group ◽  
Travel Times ◽  
Group Data ◽  
Efficient Access ◽  
Catchment Size

BackgroundAccess to individual percutaneous coronary intervention (PCI) centres has traditionally been determined by historical referral patterns along arbitrarily defined geographic boundaries. We set out to produce predictive models of ST-elevation myocardial infarction (STEMI) demand and time-efficient access to PCI centres.MethodsTravel times from random addresses to PCI centres in Melbourne, Australia, were estimated using Google map application programming interface (API). Departures at 08:15 and 17:15 were compared with 23:00 to determine the effect of peak hour traffic congestion. Real-world ambulance travel times were compared with estimated travel times using Google map developer software. STEMI incidence per postcode was estimated by merging STEMI incidence per age group data with age group per postcode census data. PCI centre network configuration changes were assessed for their effect on hospital STEMI loading, catchment size, travel times and the number of STEMI cases within 30 min of a PCI centre.ResultsNearly 10% of STEMI cases travelled more than 30 min to a PCI centre, increasing to 20% by modelling the removal of large outer metropolitan PCI centres (p<0.05). A model of 7 PCI centres compared favourably to the current existing network of 11 PCI centres (p=0.18 (afternoon), p=0.5 (morning and night)). The intraclass correlation between estimated travel times and ambulance travel times was 0.82, p<0.001.ConclusionThis paper provides a framework to integrate prehospital environmental variables, existing or altered healthcare resources and health statistics to objectively model STEMI demand and consequent access to PCI. Our methodology can be modified to incorporate other inputs to compute optimum healthcare efficiencies.

scholarly journals Estimating, monitoring, and forecasting COVID-19 epidemics: a spatiotemporal approach applied to NYC data

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vinicius V. L. Albani ◽  
Roberto M. Velho ◽  
Jorge P. Zubelli
Keyword(s):  
New York ◽  
New York City ◽  
Census Data ◽  
Age Group ◽  
Age Classes ◽  
Basic Model ◽  
Monitoring And Forecasting ◽  
Group Sex ◽  
Age Range ◽  
Spatial Locations

AbstractWe propose a susceptible-exposed-infective-recovered-type (SEIR-type) meta-population model to simulate and monitor the (COVID-19) epidemic evolution. The basic model consists of seven categories, namely, susceptible (S), exposed (E), three infective classes, recovered (R), and deceased (D). We define these categories for n age and sex groups in m different spatial locations. Therefore, the resulting model contains all epidemiological classes for each age group, sex, and location. The mixing between them is accomplished by means of time-dependent infection rate matrices. The model is calibrated with the curve of daily new infections in New York City and its boroughs, including census data, and the proportions of infections, hospitalizations, and deaths for each age range. We finally obtain a model that matches the reported curves and predicts accurate infection information for different locations and age classes.

An Evaluation of the Effects of Elevated Body Mass Index on Skeletal Age

2021 ◽  
Author(s):  
Michael H. French ◽  
Michael S. Kung ◽  
W. Nathan Holmes ◽  
Hossein Aziz ◽  
Evelyn S. Thomas ◽  
...  
Keyword(s):  
Chart Review ◽  
Pediatric Patients ◽  
Intraclass Correlation ◽  
Retrospective Chart Review ◽  
Skeletal Age ◽  
Chronological Age ◽  
Age Group ◽  
Obese Children ◽  
Significant Difference ◽  
Hand Radiographs

Abstract BackgroundMany treatment decisions in children’s Orthopaedics are based on age. This study determined whether a discrepancy between chronological age (CA) and skeletal age (SA) is dependent on BMI and if overweight or obese children would have an advanced SA.Materials and Methods120 children between ages 8-17 with an adequate hand radiograph and a correlating BMI were enrolled by retrospective chart review. Stratification based on age, sex, ethnicity, and BMI percentile was performed. For each age group, 6 males and 6 females were selected with 50% of each group having an elevated BMI. Two blinded physicians independently evaluated hand radiographs and recorded the SA. Statistical analyses evaluated inter-rater reliability and any discrepancy between groups.ResultsThe final statistical analysis included 96 children. The Intraclass Correlation Coefficient for SA determined by the two reviewers was excellent at 0.95. A difference of 13 months was found between CA and SA in the elevated BMI cohort versus the non-elevated BMI cohort, (p<0.001). No significant difference was seen between CA and SA for the non-elevated cohort (p=0.72), while matching for age and sex. ConclusionChronological age and skeletal age are not always equivalent especially in pediatric patients who are overweight or obese.

scholarly journals Age-Group Differences in Reactive Strength and Measures of Intra-day Reliability in Female International Footballers

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Brian Doyle ◽  
Declan Browne ◽  
Dan Horan
Keyword(s):  
Soccer Player ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Soccer Players ◽  
Group Differences ◽  
Age Group ◽  
Strength Index ◽  
Warm Up ◽  
Jump Test ◽  
Female Soccer Player

The aim of this present study was to compare the reactive strength index (RSI) characteristics and trial to trial reliability of U17, U19 and Senior female international soccer players. Fifty – seven elite female soccer player participated in the study, (age:  18.1 + 3.1 years; height: 167.5 + 6.3 cm; weight: 61.84 + 7.7 kg). Participants performed 3 maximal repetitions of the 10/5 repeated jump test (10/5RJT) following a specific warm-up and familiarisation protocol. Senior players possessed higher levels of RSI with large effect size present when compared with the U17 (P= 0.043, ES = .97) and U19 (ES = 0.85) age groups. Trivial differences (ES = 0.17) in RSI existed between the U17 and U19 age categories. Trial-to-trial analyses demonstrated 10/5 RJT RSI to possess adequate levels of reliability with a range of mean coefficients of variance (CV) of 3.1 – 7.3 %   and intraclass correlation (ICC) between 0.95 – 0.98 present across all three age groups. However, large variations in the between – athlete CV for RSI were revealed ranging from 1 – 27 %, 0.4 – 10.3%, and 1 – 7 % for U17, U19 and senior age groups respectively. These results suggest that age group can distinguish reactive strength capabilities. In addition, female international footballers with higher levels of RSI appear to produce more reliable measures of RSI via the 10/5 RJT.

scholarly journals Young Children's Exposure to and Ability to Eat Different Food Textures, as Reported by Parents (P11-119-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sarah Smith-Simpson ◽  
Lisa Fries ◽  
Carolyn Ross
Keyword(s):  
Online Survey ◽  
Age Groups ◽  
Age Group ◽  
Older Children ◽  
Research Issues ◽  
Funding Sources ◽  
Food Texture ◽  
Age Related ◽  
Group Data ◽  
Age Appropriate

Abstract Objectives The objective was to identify the age at which parents expose their children to different food textures and how challenging the textures were for their child to eat. It was hypothesized that older children would be exposed to a wider variety of food textures and that parents would consider a larger proportion of these textures to be easy to eat. Methods Parents (n = 365) in Grand Rapids, MI, USA with a child aged 6–36 months completed an online survey. The survey had 37 questions, including 15 unique food texture categories with food examples (Table 1). Parents were asked how difficult each texture category was for their child to eat using a 5-point scale ranging from “Very Easy” to “Very Difficult”, plus an option for “My child hasn't tried this yet”. Children were divided into 5 age groups (6-8 months, 9–12 months, 13–18 months, 19–24 months, 25–36 months) for analysis. Across texture category and age group, data were analyzed using analysis of variance, with mean separation accomplished using Fisher's LSD (P < 0.05). Results A majority of children in the youngest age group (6-8 months) had only eaten foods described as creamy, dissolvable, or pureed. All of the texture categories had been served to a majority of 9–12 month-old children, except for “hard” and “tough meat”. By 18 months of age, a majority of children had tried all food texture categories except “hard”. Across all age groups, creamy, dissolvable, and puree were rated as easy and “tough meat” was rated as difficult. The other textures showed age-related differences, with parents of older children reporting the textures as easier to eat than those of younger children. Food textures were compared within the 9–12 and 13–18 month age groups, when most new food textures are introduced, and similar trends were observed. The easiest textures were creamy, dissolvable, puree and soft, followed by lumpy and juicy, then slippery, chewy, rubbery, and sticky. The most difficult textures were leafy, with skin, hard, tough meat and combination of textures. Conclusions When considering textures of the foods that comprise a well-balanced, healthy diet, many foods are difficult for children to eat. Preparing foods such as green vegetables specifically to have age-appropriate textures could improve consumption. Funding Sources Washington State Univ College of Agricultural, Human and Natural Resource Emerging Research Issues Grant.

VII.—The Fertility of Scottish Married Women, with Special Reference to the Period 1926–1935

1940 ◽  
Vol 59 ◽  
pp. 62-80 ◽  
Author(s):  
R. S. Barclay ◽  
W. O. Kermack
Keyword(s):  
Reasonable Agreement ◽  
Birth Rate ◽  
Census Data ◽  
Married Women ◽  
General Effect ◽  
Age Group ◽  
Fertility Rates ◽  
Standard Rate ◽  
Straight Lines ◽  
Constant Percentage

In a previous communication (Barclay and Kermack, 1938) it has been shown that the specific legitimate fertility rates of Sweden and Denmark, viewed broadly over several decades, exhibit well-marked regularities, briefly described as conformity to a “diagonal law.” The procedure is to express the specific fertility rate, observed for any particular age-group at a certain period, as a percentage of the rate for the same age-group at a time preceding the decline of the birth-rate (“standard rate”). If now these percentages are plotted as contours on a graph, in which the abscissæ represent calendar years and the ordinates women's age, it is found that, when the age-group 15–20 is excluded, the constant percentage curves are approximately straight lines, running parallel to the diagonals in such a sense that, along any line, increase in calendar years corresponds to decrease in women's age. In Finland, the same general effect is apparent, though it is somewhat obscured by minor disturbances. It is found that, in the case of England and Wales, predictions made on the basis of the law give a reasonable agreement with estimated fertility rates calculated by the Registrar-General on the basis of census data.

scholarly journals Reference Group Data for the Functional Gait Assessment

2007 ◽  
Vol 87 (11) ◽  
pp. 1468-1477 ◽  
Author(s):  
Martha L Walker ◽  
Alvis G Austin ◽  
Gina M Banke ◽  
Suzanne R Foxx ◽  
Lynn Gaetano ◽  
...  
Keyword(s):  
Older Adults ◽  
Reference Group ◽  
Intraclass Correlation ◽  
Clinical Tool ◽  
Gait Assessment ◽  
Group Data ◽  
Expected Performance ◽  
Clinical Changes ◽  
Functional Gait ◽  
Patient Performance

Background and Purpose The Functional Gait Assessment (FGA) is a clinical tool for evaluating performance in walking. The purpose of this study was to determine age-referenced norms for performance on the FGA in community-living older adults. Subjects Subjects were 200 adults, ages 40 to 89 years, living independently. Methods Each subject completed the FGA one time and was scored simultaneously by 2 testers. Results The intraclass correlation coefficient for interrater reliability was .93. Mean scores for the FGA ranged from 29/30 for adults in their 40s to 21/30 for adults in their 80s. Discussion and Conclusion Patient performance on the FGA can be compared with age-referenced norms for expected performance. Further research is needed to determine the FGA’s usefulness in tracking clinical changes or predicting falls. The FGA is a reliable test for people without disease, and it is able to detect decreases in gait performance among typical older adults.

scholarly journals Cycling efficiency and energy cost of walking in young and older adults

2018 ◽  
Vol 124 (2) ◽  
pp. 414-420 ◽  
Author(s):  
Glenn A. Gaesser ◽  
Wesley J. Tucker ◽  
Brandon J. Sawyer ◽  
Dharini M. Bhammar ◽  
Siddhartha S. Angadi
Keyword(s):  
Older Adults ◽  
Individual Variation ◽  
Energy Cost ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Net Energy ◽  
Age Group ◽  
Cycling Efficiency ◽  
Considerable Individual Variation ◽  
Energy Cost Of Walking

To determine whether age affects cycling efficiency and the energy cost of walking (Cw), 190 healthy adults, ages 18–81 yr, cycled on an ergometer at 50 W and walked on a treadmill at 1.34 m/s. Ventilation and gas exchange at rest and during exercise were used to calculate net Cw and net efficiency of cycling. Compared with the 18–40 yr age group (2.17 ± 0.33 J·kg−1·m−1), net Cw was not different in the 60–64 yr (2.20 ± 0.40 J·kg−1·m−1) and 65–69 yr (2.20 ± 0.28 J·kg−1·m−1) age groups, but was significantly ( P < 0.03) higher in the ≥70 yr (2.37 ± 0.33 J·kg−1·m−1) age group. For subjects >60 yr, net Cw was significantly correlated with age ( R2 = 0.123; P = 0.002). Cycling net efficiency was not different between 18–40 yr (23.5 ± 2.9%), 60–64 yr (24.5 ± 3.6%), 65–69 yr (23.3 ± 3.6%) and ≥70 yr (24.7 ± 2.7%) age groups. Repeat tests on a subset of subjects (walking, n = 43; cycling, n = 37) demonstrated high test-retest reliability [intraclass correlation coefficients (ICC), 0.74–0.86] for all energy outcome measures except cycling net energy expenditure (ICC = 0.54) and net efficiency (ICC = 0.50). Coefficients of variation for all variables ranged from 3.1 to 7.7%. Considerable individual variation in Cw and efficiency was evident, with a ~2-fold difference between the least and most economical/efficient subjects. We conclude that, between 18 and 81 yr, net Cw was only higher for ages ≥70 yr, and that cycling net efficiency was not different across age groups. NEW & NOTEWORTHY This study illustrates that the higher energy cost of walking in older adults is only evident for ages ≥70 yr. For older adults ages 60–69 yr, the energy cost of walking is similar to that of young adults. Cycling efficiency, by contrast, is not different across age groups. Considerable individual variation (∼2-fold) in cycling efficiency and energy cost of walking is observed in young and older adults.

scholarly journals Effectiveness and safety of primary percutaneous coronary interventions in elderly patients with acute coronary syndrome

2020 ◽  
pp. 14-25
Author(s):  
N.V. Litvinyuk ◽  
◽  
G.V. Matyushin ◽  
A.V. Protopopov ◽  
E.V. Samohvalov ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Elderly Patients ◽  
Coronary Intervention ◽  
Term Treatment ◽  
Age Group ◽  
Average Life Expectancy ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Long Term Treatment ◽  
Choice Of Treatment

Primary percutaneous coronary intervention (PPCI) is the gold standard of treating patients with acute coronary syndrome (ACS). The results of major clinical trials on ACS patients’ treatment are reflected in modern guidelines, where PPCI is of high evidence level and is superior to conservative therapy in long-term treatment results. Treatment of elderly patients over 75 years old is carried due to modern clinical guidelines, even though few patients of this age group are included in the studies. The increase in population average life expectancy causes the increase in number of elderly ACS patients with comorbid pathology. In its turn, it affects both the choice of treatment tactics and PPCI volume. Therefore, a study of this age group is required. The present review reflects the main clinical studies and analysis of elderly patients’ treatment

scholarly journals Dementia care in India: a progress report

2006 ◽  
Vol 3 (4) ◽  
pp. 9-10 ◽  
Author(s):  
K. S. Shaji ◽  
Amit Dias
Keyword(s):  
Older People ◽  
Census Data ◽  
People With Disabilities ◽  
Health Indicators ◽  
Progress Report ◽  
Dementia Care ◽  
Age Group ◽  
Substantial Variation ◽  
Demographic Ageing ◽  
Specialist Services

According to the 2001 census, India is home to more than 76 million people aged 60 years and over. This age-group, currently only 7.4% of the population, is expected to grow dramatically in the coming few decades. Analysis of the census data shows substantial variation in the rate of demographic ageing across India: at present, 10.5% of Kerala's population is older than 60 years, while in Dadra and Nagarhaveli this proportion is only 4%. Regions with more favourable health indicators seem to be ageing faster and the demand for specialist services will soon be evident in such places. There is a growing realisation that the care of older people with disabilities makes enormous demands on their carers. Terms such as ‘dementia’ and ‘Alzheimer's disease’ are now better understood. This was not the case when the Alzheimer's and Related Disorders Society of India (ARDSI) initiated awareness programmes. However, dementia remains a largely hidden problem in those disadvantaged parts of India where poverty and illiteracy remain prevalent.

scholarly journals Estimation and Projection of Fertility, 2001-2031: Province 2, Nepal

2021 ◽  
Vol 29 (43) ◽  
pp. 1-12
Author(s):  
Bijaya Mani Devkota
Keyword(s):  
Census Data ◽  
Population Change ◽  
Linear Interpolation ◽  
Reproductive Age ◽  
Ratio Method ◽  
Age Group ◽  
Number Of Children ◽  
Frequency Table ◽  
Data Files ◽  
Children Ever Born

Fertility is an essential tool of population growth which levels and patterns can assist to formulate and evaluate policies related to population change. Fertility decline in Nepal has been tested and tried with different studies gives different figures like demographic health survey and national census data but varies data in provincial level. This study describes number of children ever born and number of birth before 12 months who were given birth by reproductive (15-49) age group of women. The study has utilized census data from CBS that were conducted in 2001 and 2011. These national household censuses were carried out in 12.5 percent of total household. From census data files 1,063,903 and 1,304,079 number of reproductive age group of women were identified through analysis. The study was carried out adhering to the Arriaga method and changing P/F ratio method. Age sex pyramids and frequency table represent demographic scenario of provincial 2. The TFR values of province 2 exact years 2016, 2021, 2026 and 2031 were obtained by linear interpolation and extrapolation by 2031, it will to reach TFR replacement level. 

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