Implementing Healthcare Information Security: Standards Can Help.

Implementing healthcare information security: standards can help.

Stud Health Technol Inform. 2013; 186: 195-9
Orel A, Bernik I

Using widely spread common approaches to systems security in health dedicated controlled environments, a level of awareness, confidence and acceptance of relevant standardisation is evaluated. Patients’ information is sensitive, so putting appropriate organisational techniques as well as modern technology in place to secure health information is of paramount importance. Mobile devices are becoming the top priorities in advanced information security planning with healthcare environments being no exception. There are less and less application areas in healthcare without having a need for a mobile functionality which represents an even greater information security challenge. This is also true in emergency treatments, rehabilitation and homecare just to mention a few areas outside hospital controlled environments. Unfortunately quite often traditional unsecured communications principles are still in routine use for communicating sensitive health related information. The security awareness level with users, patients and care professionals is not high enough so potential threats and risks may not be addressed and the respective information security management is therefore weak. Standards like ISO/IEC 27000 ISMS family, the ISO/IEC 27799 information security guidelines in health are often not well known, but together with legislation principles such as HIPAA, they can help. HubMed – rehab

Diagnostic decision support of heart rate turbulence in sleep apnea syndrome.

Stud Health Technol Inform. 2013; 186: 150-4
D’Addio G, De Felice A, Balzano G, Zotti R, Iannotti P, Bifulco P, Cesarelli M

Obstructive sleep apnea syndrome (OSAS) is characterized by repeated upper-airway obstruction during sleep. It is diagnosed by polysomnographic studies, scoring OSAS severity by an apneas/hypopneas index associated to worse prognosis, mainly for an increased cardiovascular morbidity. Cardiac autonomic impairments involved in the development of cardiovascular disease in OSAS can be assessed by heart rate turbulence (HRT) analysis and aim of the paper is to show the increased medical decision support by HRT evaluation in OSAS patients. HRT has been assessed in 274 polysomnographic recordings of mild-to-severe OSAS patients and an overall cardiorespiratory risk scoring (CRRIS) index has been proposed on the base of both OSAS severity and HRT assessment. Results showed that, while the only polysomnografic analysis would have equally ranked OSAS patients within their mild-to-severe classification, CRRIS index allows to identify a 19% of severe-OSAS patients at very high risk of sudden cardiac death, a 13% of moderate-OSAS patients with a risk level comparable to those of severe, and a 17% of mild-OSAS patients with evidence of an autonomic impairment. CRRIS index, detecting patients at greater probability of worsening could give to the physician a very useful medical decision support in the follow up of this particular chronic disease. HubMed – rehab

Handling intra-cluster correlation when analyzing the effects of decision support on health care process measures.

Stud Health Technol Inform. 2013; 186: 22-7
Peek N, Goud R, de Keizer N

The clinical worksite constitutes a naturally clustered environment, posing challenges in the statistical analysis of quality improvement interventions such as computerized decision support. Ignoring clustering in the analysis may lead to biased effect estimates, underestimating the variance and hence type I errors. This paper presents a secondary analysis on data from a previously published, cluster randomized trial in cardiac rehabilitation. We compared six different statistical analysis methods (weighted and unweighted t-test; adjusted ?² test; normal and multilevel logistic regression analysis; and generalized estimation equations). There were considerable differences in both point estimates and p-values derived by the methods, and differences were larger with increasing intracluster correlation. HubMed – rehab

Systematic review of core muscle activity during physical fitness exercises.

J Strength Cond Res. 2013 Mar 28;
Martuscello JM, Nuzzo JL, Ashley CD, Campbell BI, Orriola JJ, Mayer JM

A consensus has not been reached among strength and conditioning specialists regarding what physical fitness exercises are most effective to stimulate activity of the core muscles. Thus, the purpose of this paper was to systematically review the literature on the electromyographic (EMG) activity of three core muscles (lumbar multifidus, transverse abdominis, quadratus lumborum) during physical fitness exercises in healthy adults. CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed, SPORTdiscus, and Web of Science databases were searched for relevant articles using a search strategy designed by the investigators. Seventeen studies enrolling 252 participants met the review’s inclusion/exclusion criteria. Physical fitness exercises were partitioned into five major types: traditional core, core stability, ball/device, free weight, and non-core free weight. Strength of evidence was assessed and summarized for comparisons among exercise types. The major findings of this review with moderate levels of evidence indicate that lumbar multifidus EMG activity is greater during free weight exercises compared with ball/device exercises, and similar during core stability and ball/device exercises. Transverse abdominis EMG activity is similar during core stability and ball/device exercises. No studies were uncovered for quadratus lumborum EMG activity during physical fitness exercises. The available evidence suggests that strength and conditioning specialists should focus on implementing multi-joint free weight exercises, rather than core-specific exercises, in order to adequately train the core muscles in their athletes and clients. HubMed – rehab

Dr. Haggerty’s Health Tip from County Line Chiropractic Medical & Rehab Centers – WWW.COUNTYLINECHIRO.COM Meet Dr. Haggerty from County Line Chiropractic Medical & Rehab Centers. Dr. Haggerty is sharing a quick health tip. This health tip …