Performance Of Self-monitoring Research Articles

Research on performance of smart concrete materials and self-monitoring of cracks in beam members

Due to adverse factors such as load and environment exposure, concrete structures often work with cracks during their service period. The occurrence and growth of cracks significantly reduces safety and durability of the structures. It is thus significant to track and monitor cracks in concrete structures in real-time. This paper studies strength, toughness, and crack self-monitoring performance of a large number of smart concrete mixes through addition of two conductive materials, i.e., steel fiber and nano carbon black, into the concrete. Firstly, effect of adding the individual and hybrid conductive materials to concrete mixes on compressive strength, bending toughness and electrical conductivity was investigated. This was followed by studying crack self-monitoring performance and mechanism of the smart concrete beam members under load. The research provides insight and new results of material properties and crack self-monitoring performance in research and development of low-cost smart concrete.

A scoping review of self-monitoring in graduate medical education.

Physicians and physicians-in-training have repeatedly demonstrated poor accuracy of global self-assessments, which are assessments removed from the context of a specific task, regardless of any intervention. Self-monitoring, an in-the-moment self-awareness of one's performance, offers a promising alternative to global self-assessment. The purpose of this scoping review is to better understand the state of self-monitoring in graduate medical education. We performed a scoping review following Arksey and O'Malley's six steps: identifying a research question, identifying relevant studies, selecting included studies, charting the data, collating and summarising the results and consulting experts. Our search queried Ovid Medline, Web of Science, PsychINFO, Eric and EMBASE databases from 1 January 1999 to 12 October 2022. The literature search yielded 5363 unique articles. The authors identified 77 articles for inclusion. The search process helped create a framework to identify self-monitoring based on time and context dependence. More than 20 different terms were used to describe self-monitoring, and only 13 studies (17%) provided a definition for the equivalent term. Most research focused on post-performance self-judgements of a procedural skill (n= 31, 42%). Regardless of task, studies focused on self-judgement (n= 66, 86%) and measured the accuracy or impact on performance of self-monitoring (n= 41, 71%). Most self-monitoring was conducted post-task (n= 65, 84%). Self-monitoring is a time- and context-dependent phenomenon that seems promising as a research focus to improve clinical performance of trainees in graduate medical education and beyond. The landscape of current literature on self-monitoring is sparse and heterogeneous, suffering from a lack of theoretical underpinning, inconsistent terminology and insufficiently clear definitions.

Evaluation of the Performance of Self-monitoring Optimized by Therapeutic Education in the Recurrence of Wet Age-related Macular Degeneration (AMD)

Evaluation of the Performance of Self-monitoring Optimized by Therapeutic Education in the Recurrence of Wet Age-related Macular Degeneration (AMD)

Neuropsychiatric characterization of individuals with inhalant use disorder and polysubstance use according to latent profiles of executive functioning

BackgroundInhalant use disorder (IUD) is associated with deficits in executive functions (EFs). We described latent profiles of EFs and distribution of neuropsychiatric disorders and patterns of severity of use across these profiles. MethodsIndividuals with IUD were recruited at community-based residential facilities for substance use treatment in Mexico City. Latent profile analysis was conducted with the following tasks: self-ordered pointing, Stroop, Iowa gambling, Wisconsin Card Sorting and Tower of Hanoi. ResultsThree latent profiles were extracted from n = 165: lowest performances of inhibition of response and processing speed; lowest performance of self-monitoring, intermediate performance of inhibition of response and relatively spared processing speed; and intermediate performance of processing speed and self-monitoring, and relatively spared inhibition of response. ConclusionBetween-group differences were observed mainly for antisocial personality disorder and lifetime suicidal. Findings remark the need for identifying distinct profiles of EFs within these populations to better understand the transdiagnostic heterogeneity of EFs.

Blood pressure self-monitoring in pregnancy: examining feasibility in a prospective cohort study

BackgroundRaised blood pressure (BP) affects approximately 10% of pregnancies worldwide, and a high proportion of affected women develop pre-eclampsia. This study aimed to evaluate the feasibility of self-monitoring of BP in pregnancy in women at higher risk of pre-eclampsia.MethodsThis prospective cohort study of self-monitoring BP in pregnancy was carried out in two hospital trusts in Birmingham and Oxford and thirteen primary care practices in Oxfordshire. Eligible women were those defined by the UK National Institute for Health and Care Excellence (NICE) guidelines as at higher risk of pre-eclampsia. A total of 201 participants were recruited between 12 and 16 weeks of pregnancy and were asked to take two BP readings twice daily three times a week through their pregnancy. Primary outcomes were recruitment, retention and persistence of self-monitoring. Study recruitment and retention were analysed with descriptive statistics. Survival analysis was used to evaluate the persistence of self-monitoring and the performance of self-monitoring in the early detection of gestational hypertension, compared to clinic BP monitoring. Secondary outcomes were the mean clinic and self-monitored BP readings and the performance of self-monitoring in the detection of gestational hypertension and pre-eclampsia compared to clinic BP.ResultsOf 201 women recruited, 161 (80%) remained in the study at 36 weeks or to the end of their pregnancy, 162 (81%) provided any home readings suitable for analysis, 148 (74%) continued to self-monitor at 20 weeks and 107 (66%) at 36 weeks. Self-monitored readings were similar in value to contemporaneous matched clinic readings for both systolic and diastolic BP. Of the 23 who developed gestational hypertension or pre-eclampsia and self-monitored, 9 (39%) had a raised home BP prior to a raised clinic BP.ConclusionsSelf-monitoring of BP in pregnancy is feasible and has potential to be useful in the early detection of gestational hypertensive disorders but maintaining self-monitoring throughout pregnancy requires support and probably enhanced training.

The Quantitative Relationship Between ISO 15197 Accuracy Criteria and Mean Absolute Relative Difference (MARD) in the Evaluation of Analytical Performance of Self-Monitoring of Blood Glucose (SMBG) Systems.

The relationship between International Organization for Standardization (ISO) accuracy criteria and mean absolute relative difference (MARD), 2 methods for assessing the accuracy of blood glucose meters, is complex. While lower MARD values are generally better than higher MARD values, it is not possible to define a particular MARD value that ensures a blood glucose meter will satisfy the ISO accuracy criteria. The MARD value that ensures passing the ISO accuracy test can be described only as a probabilistic range. In this work, a Bayesian model is presented to represent the relationship between ISO accuracy criteria and MARD. Under the assumptions made in this work, there is nearly a 100% chance of satisfying ISO 15197:2013 accuracy requirements if the MARD value is between 3.25% and 5.25%.

Self-monitoring of lower leg skin temperature: accuracy of self-reported data and adherence to a cooling protocol for the prevention of venous leg ulcers.

BackgroundFor intervention studies that require the use of participant self-reports, the quality and accuracy of recorded data and variability in participant adherence rates to the treatment can cause significant outcome bias.PurposeTo assess the quality and accuracy of participant documentation of daily self-monitoring of leg skin temperature, adherence to a graduated cooling treatment protocol to prevent venous leg ulcers, and the potential for bias in treatment effect in a randomized controlled trial that included a population with chronic venous disease.MethodsIndividuals were randomized to a leg cooling intervention or placebo treatment group to daily self-monitor and record lower leg skin temperature over a 9-month period on monthly paper study logs. Returned study logs for the first 100 completed participants (n=54 cooling intervention, n=46 control) were reviewed for quality and accuracy. Adherence was determined from evaluating the accuracy of participant documentation. To examine potential outcome bias in treatment effect, mean between group and within group comparisons of the before and after treatment differences were conducted using an intention-to-treat (ITT) versus a modified intention-to-treat (mITT) analysis approach with an 85% accuracy cut-off rate. Data were collected in 2011–2014.ResultsOf the expected 900 study logs, 91.8% (826/900) were returned and 8.2% (74/900) were not. Non-mutually exclusive main error types in returned documentation included: 59.2% (489/826) white-outs, cross-off and/or overwrites, 34.9% (288/826) entries omitted, 29.4% (243/826) no performance of daily self-monitoring, 28.7% (237/826) no performance of the treatment intervention per the prescribed protocol regime, 26.8% (221/826) extraneous data, 8.6% (71/826) suspected fabrication, and 7.6% (63/826) questionable validity. Under ITT analysis, 38.4% (346/900) of all returned logs were <85% accurate, 25.0% (225/900) were 85%–99% accurate, and 36.6% (329/900) were 100% accurate. Mean overall participant adherence rates were: 22.0% at <85% accuracy, 53.0% at 85%–99% accuracy, and 25.0% at 100% accuracy. Under the mITT analysis, 54.0% (483/900) of returned logs were deemed adherent with ≥85% accuracy.ConclusionThis study found good rates of adherence. Under ITT analysis, 78.0% of participants were deemed adherent to the study protocol with ≥85% accuracy in documenting daily self-monitoring of skin temperatures in response to a topically applied experimental cooling cuff intervention for the prevention of venous leg ulcers.

Developing models of haemophilia care

Developing models of haemophilia care

Evaluation of Dexterity in Insulin-Treated Patients with Type 1 and Type 2 Diabetes Mellitus

Daily routine for insulin-treated patients with diabetes mellitus requires correct performance of self-monitoring of blood glucose and insulin injections several times a day. Dexterity skills may play an important role in the performance efficacy of these procedures. We collected data of insulin-treated (>10 years) patients with different age ranges [healthy controls, 14 female/11 male, age (mean ± standard deviation) 55 ± 7 years; type 1 diabetes mellitus (T1DM) patients, 12/13, 45 ± 9 years, disease duration 23.9 ± 6.5 years; T2DM patients, 8/17, 64 ± 6 years, 16.2 ± 6.9 years; T2DM patients (>70 years of age), 9/16, 75 ± 4 years, 19.7 ± 7.0 years]. After assessment of neuropathy (temperature, pain, and vibration perception), the patients participated in two dexterity test batteries [Jebsen-Taylor hand-function test (JHFT) and motoric performance series (MPS)]. Patients with type 2 diabetes showed disturbed vibration perception as compared to the other groups. The dexterity results were influenced by age to a large extent. Older T2DM patients performed worst in the majority of the subtests (e.g., JHFT, writing nondominant hand: control, 40.8 ± 11.7 s; T1DM, 46.3 ± 50.9 s, not significant versus control; old T2DM, 68.1 ± 29.5 s, p < .05; young T2DM, 52.5 ± 26.2 s, p < .05). Patients with type 1 diabetes showed similar JHFT and MPS results than the 10-year-older control subjects and performed outside of the age-dependent normal reference range. Manual skills and dexterity differed between the groups, and age-corrected reduced skills were common in both T1DM and T2DM patients in this study. Our findings underline the importance of considering dexterity and manual skills when designing medical devices for patients with diabetes mellitus.

일 병원 제2형 당뇨병환자의 자가혈당검사 수행 및 활용 실태

Purpose: This study was conducted to investigate performance of self-monitoring of blood glucose and the utilization of results for people with type II diabetes. Method: Data was collected from 177 patients with type II diabetes using a questionnaire from August to September, 2009. Result: Most participants performed self-monitoring of blood glucose in the correct way while some misused the lancet or test strips. In the utilization of results for self-monitoring blood glucose data, 62% of participants always recorded the data, 46% always understood the cause for hyperglycemia or hypoglycemia, 25% changed their diet, 23% regulated their exercise-amount, and 11% of participants adjusted the drug dosage. There were significant differences in the performance of self-monitoring of blood glucose and the utilization of results according to the characteristics in the self-monitoring subjects such as awareness of HbA1c, target fasting glucose level, target fasting glucose level 2 hours after meal etc. Conclusion: Systemic self-monitoring of blood glucose education which includes the utilization of self-monitoring of blood glucose needs to be developed for type II diabetic patients.

Quality assessment of patients' self-monitoring of blood glucose in community pharmacies.

To evaluate diabetes patients' self-monitoring of blood glucose using a community pharmacy-based quality assurance procedure, to investigate whether the procedure improved the quality of the patient performance of self monitoring of blood glucose, and to examine the opinions of the patients taking part in the study. The results of patient blood glucose measurements were compared to the results obtained with HemoCue Glucose 201(+) by pharmacy employees in 16 Norwegian community pharmacies. Patient performance was monitored using an eight item checklist. Patients whose blood glucose measurements differed from pharmacy measurements by more than 20% were instructed in the correct use of their glucometer. The patients then re-measured their blood glucose. If the results were still outside the set limits, the control procedure was repeated with a new lot of glucometer strips, and then with a new glucometer. The patients returned for a follow-up visit after three months. During the first visit, 5% of the 338 patients had measurements that deviated from pharmacy blood glucose values by more than 20% and user errors were observed for 50% of the patients. At the second visit, there was no significant change in the analytical quality of patient measurements, but the percentage of patients who made user errors had decreased to 29% (p < 0.001). Eighty-five percent of the patients reported that they used their blood glucose results to adjust medication, exercise or meals. Fifty-one percent of the patients reported a greater trust in their measurements after the second visit. Eighty percent of patients wished to have their measurements assessed yearly. Of these patients, 83% preferred to have the assessment done at the community pharmacy. A community pharmacy-based quality assessment procedure of patients' self monitoring of blood glucose significantly reduced the number of user errors. The analytical quality of the patients' measurements was good and did not improve further during the study. The high analytical quality might be explained by a selection bias of participating patients. Patients also reported increased confidence in their blood glucose measurements after their measurements had been assessed at the pharmacy.

Home blood pressure self-monitoring: diagnostic performance in white-coat hypertension

To determine the diagnostic performance of home blood pressure self-monitoring in white-coat hypertension using a 3-day reading program. One hundred and ninety nontreated patients recently diagnosed with mild-moderate hypertension, selected consecutively at four primary healthcare centers in the city of Barcelona, were included. Each patient underwent morning and night home blood pressure self-monitoring with readings in triplicate for three consecutive days, followed by 24-h ambulatory blood pressure monitoring. The normality cut-off point value for home blood pressure self-monitoring and daytime ambulatory blood pressure monitoring was 135/85 mmHg. Sixty-three patients were diagnosed with white-coat hypertension with home blood pressure self-monitoring (34.8%; 95% confidence interval: 27.9-42.2) and 74 with ambulatory blood pressure monitoring (41.6%; 95% confidence interval: 33.7-48.4). No statistically significant differences were observed between home blood pressure self-monitoring values and those of diurnal ambulatory blood pressure monitoring [137.4 (14.3)/82.1 (8.3) mmHg vs. 134.8 (11.3)/81.3 (9.5) mmHg]. Home blood pressure self-monitoring diagnostic performance parameters were sensitivity 50.0% (95% confidence interval: 38.3-61.7), specificity 75.7% (95% confidence interval: 66.3-83.2), positive and negative predictive values 58.7% (95% confidence interval: 45.6-70.8) and 68.6% (95% confidence interval: 59.4-76.7), respectively, and positive and negative probability coefficients 2.05 and 0.66, respectively. Analysis of different normality cut-off points using a receiver operating characteristic curve failed to produce significant improvement in the diagnostic performance of home blood pressure self-monitoring. The diagnostic accuracy of a 3-day home blood pressure self-monitoring reading program in white-coat hypertension was poor. Ambulatory blood pressure monitoring continues to be the test of choice for this indication.

Self-Monitored Blood Glucose: a Common Pitfall

To assess the frequency of user error in selecting the appropriate code for glucose meter strips during performance of self-monitoring of blood glucose. The glucose meter code and corresponding glucose strip code were examined in 335 different patients during routine clinic visits. All patients had received instructions in meter use from a clinic nurse, a diabetes educator, or a pharmacist. Of the 335 patients, 134 were excluded from analysis because of unavailability of the meter or strip container or unreadability of the code on the strip container. Age, sex, type of diabetes, treatment method, and most recent glycated hemoglobin (HbA1c) value (before the observation period) were compared for patients with the correct (matching) codes and those for whom the codes did not match. Of the 201 study patients, 26 had type 1 diabetes mellitus and 175 had type 2 diabetes. Overall, 107 patients were being treated with insulin, 16 by continuous subcutaneous insulin infusion. Matching glucose meter and strip codes were found in 169 patients (84%); 32 (16%) had incorrect (nonmatching) codes (P<0.0001). The mean HbA1c was higher in patients with incorrect codes (8.2% versus 7.7%), but the difference was not significant (P = 0.4688). Twelve percent of patients with type 1 diabetes and 17% of patients with type 2 diabetes had incorrect codes; this difference was not significant (P = 0.3674). Codes were incorrect in 12% of patients with type 2 diabetes treated with insulin, in comparison with 20% of those treated with orally administered agents (P = 0.2338). No significant difference was noted between the groups on the basis of age or sex. A considerable number of patients with diabetes fail to use glucose meters properly. Clinical decisions based on these data can result in adverse events. We found no significant difference in patients having the wrong code on glucose meters when compared for age,

Intelligent materials for environment and people

Priorities of R&D of materials and technology for the 21st Century are issues related to global environment and techno-democracy or public co-operation with technology. Keywords are simplicity, integration of structural reliability and functional capability, ecology, etc. The author established Ken-materials Research Consortium in 1993 for this purpose. Examples are carbon fibers and glass fiber co-reinforced plastics (CFGFRP) with improvement of mechanical performance and capability of self-monitoring of damage developed by Yanagida et al., soil–ceramics by INAX where humidity and temperature adjusting capability like soil and mechanical strength like ceramics are achieved to save energy during fabrication and during actual duties, electric cable trolleys for Shin Kansen able to monitor damage without additional sensors by JR Tokai, etc. Details of these materials and activities of the Consortium will be introduced.

Optimization Of Insulin Therapy In Patients With Gestational Diabetes

ObjectiveTo discuss the new criteria for screening and diagnosis of gestational diabetes and present recommendations for patient management. MethodsVarious strategies for detecting gestational diabetes historically and currently are reviewed, and approaches for optimizing patient and neonatal outcome are discussed. ResultsRather than testing for gestational diabetes selectively, universal screening of pregnant women between 24 and 28 weeks of gestation with use of a glucose challenge test and 1-hour assessment has been shown to decrease the rate of occurrence of neonatal macrosomia. Performance of both preprandial and postprandial selfmonitoring of blood glucose levels helps to prevent pronounced postprandial glucose excursions and minimize the risk of neonatal macrosomia. In comparison with regular human insulin, insulin lispro has yielded significantly better metabolic control and a reduction in hypoglycemic episodes before breakfast in patients with gestational diabetes. ConclusionWomen with gestational diabetes who are not optimally managed with diet and exercise need insulin therapy. Insulin lispro is associated with fewer hypoglycemic events and attenuates the postprandial response greater than does regular human insulin. (Endocr Pract. 2000;6:98-100)