scholarly journals Organization of psychological activities in italian cardiac rehabilitation and prevention Survey on the implementation of guidelines for psychological activities in cardiac rehabilitation and prevention

2016 ◽  
Vol 70 (1) ◽  
Author(s):  
Marinella Sommaruga ◽  
Roberto Tramarin ◽  
Gianluigi Balestroni ◽  
Ornella Bettinardi ◽  
Massimo Miglioretti ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Psychological Assessment ◽  
Comprehensive Evaluation ◽  
Psychological Intervention ◽  
Eating Behaviour ◽  
Educational Interventions ◽  
Staffing Level ◽  
The Family

The present study was developed as part of a comprehensive evaluation of the state of the art of knowledge and implementation of the Italian Guidelines for psychological activities in Cardiac Rehabilitation, published in 2003 by the Working Group of Psychology of the Italian Society of Cardiac Rehabilitation (GICR). Methods. A questionnaire was designed to collect detailed information on facilities, organization, staffing level, professional background and activities carried out by psychologists working in Italian Cardiac Rehabilitation Units (CRU). Out of 144 Italian CRU (inventory 2004), 107 reported structured psychological programmes. The questionnaires were sent by conventional mail to the referring psychologist of these 107 CRU; they were invited to participate in the survey on a purely voluntary basis. Results. Responses were received from 70 (65.4%) of 107 CRU. 55 CRU (79.8%) report a good knowledge of the published GL; 10.1% declare that the psychologists did not know the current GL. 84.5% consider the GL to be fully applicable, while 15.5% believe that they are only partly applicable. Psychological assessment is performed through clinical interview (94.3%) and psychometric tests (81.4%). 92.8% of the CRU use screening instruments in order to evaluate psychosocial risk factors, in particular anxiety and depression (64.3%). Quality of life (22.8%) and cognitive impairment (17.1%) are not routinely assessed. Educational interventions are planned in 87.1% of the CR programme and are extended to the family members (51%) as well as counselling (57%). Psychological programme includes smoking (56%) and eating behaviour (55%) group interventions. Stress management is routinely planned in 69% of the CRU. Psychological intervention tailored to individual needs of the patients is performed in 62.9% CRU. Written final reports are available in 88.6% cases. The follow-up is carried out by 48.6% of the CRU, 15.7% in a structured way. Conclusions. The survey shows wide discrepancies in the provision of psychological activities in Italian CRU. Nevertheless psychological assessment and interventions seem acceptably coherent with current national GL on CR.

scholarly journals HGG-47. DECREASED GROWTH VELOCITY WITH LONG TERM USE OF BRAFV600e AND MEK INHIBITION IN A PATIENT WITH ANAPLASTIC GANGLIOGLIOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii352-iii352
Author(s):  
Hung Tran ◽  
Robert Cooper
Keyword(s):  
Growth Velocity ◽  
Direct Result ◽  
Chromosomal Microarray ◽  
Mek Inhibition ◽  
Follow Up Study ◽  
The Family ◽  
The Relationship

Abstract PURPOSE To describe decreased growth velocity with long term use of BRAFV600e and MEK inhibition in a patient with anaplastic ganglioglioma. RESULTS 4-year-old patient was found to have a 6 x 4.6 x 5 cm mass in the hypothalamus. Pathology consistent with anaplastic ganglioglioma and chromosomal microarray revealed a BRAFV600e mutation. Patient started on dabrafenib and trametinib and tumor decreased 85% after 3 months. She is stable without significant toxicities 39 months on therapy, and is now 8 years old. Patient had been growing at the 25% for weight and 12% for height but is now 65% for weight and 0.5% for height. It is difficult to tease out the relationship between the tumor, the location of the tumor, and the BRAF and MEK inhibitors and their effect on growth. Discussions with the family and endocrinology are ongoing but being <1% for height will lead to decrease in quality of life. CONCLUSIONS Further follow-up study is needed to determine if this is truly a long-term toxicity, or if this may just be a direct result of the location of the tumor. Would supplementation with growth hormone in this patient lead to losing control of a high grade tumor, or would it simply replace a hormone that is not produced?

scholarly journals Abordagem do Doente com Psoríase pela Medicina Geral e Familiar: Algoritmo de Referenciação e Gestão Partilhada com a Dermatologia

2020 ◽  
Vol 33 (13) ◽  
Author(s):  
Tiago Torres ◽  
Martinha Henrique ◽  
Hugo Oliveira ◽  
Madalena Rodrigues ◽  
Paulo Ferreira ◽  
...  
Keyword(s):  
Family Physician ◽  
Family Physicians ◽  
High Impact ◽  
Psoriatic Patient ◽  
Shared Management ◽  
Systemic Treatments ◽  
The Family ◽  
Topical Treatments

Introduction: The implementation of models capable of improving referral quality, limiting the growth of waiting lists in hospitals, and ensuring the best possible treatment and follow-up of the psoriatic patient is of the utmost importance.Material and Methods: A panel of Family Physicians and Dermatologists discussed and created a simple and effective algorithm of referral for patients with psoriasis.Results: The proposed algorithm starts when the Family Physician suspects of psoriasis. In case of diagnostic doubt, the patient should be referred to Dermatology. In case of a confirmed diagnosis, the Family Physician should assess the patient’s severity and responder profile, evaluate comorbidities and assess the presence of psoriatic arthritis. If psoriasis is mild, topical treatments should be initiated, and if there is no clinical improvement or worsening of the disease, the patient should be referred to Dermatology. If psoriasis is moderate to severe, is located in high impact locations, or in pediatric age, the patient should be referred to Dermatology. In order to enable shared management in terms of follow-up and treatment of these patients, it is critical that the Family Physician has the necessary knowledge regarding the systemic treatments used in psoriasis and their side effects.Discussion and Conclusion: Only a shared management of the psoriatic patient can allow for the best treatment and follow-up of these patients, a more rational use of available medical resources, thus giving the patient the best possible quality of life.

scholarly journals Exercise-based cardiac rehabilitation in patients with reduced left ventricular ejection fraction: The Cardiac Rehabilitation Outcome Study in Heart Failure (CROS-HF): A systematic review and meta-analysis

2019 ◽  
Vol 27 (9) ◽  
pp. 929-952 ◽  
Author(s):  
Birna Bjarnason-Wehrens ◽  
R Nebel ◽  
K Jensen ◽  
M Hackbusch ◽  
M Grilli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Relative Risk ◽  
Left Ventricular Ejection Fraction ◽  
Confidence Interval ◽  
Cardiac Rehabilitation ◽  
Left Ventricular ◽  
Left Ventricular Ejection

Background In heart failure with reduced left ventricular ejection fraction (HFrEF) patients the effects of exercise-based cardiac rehabilitation on top of state-of-the-art pharmacological and device therapy on mortality, hospitalization, exercise capacity and quality-of-life are not well established. Design The design of this study involved a structured review and meta-analysis. Methods Evaluation of randomised controlled trials of exercise-based cardiac rehabilitation in HFrEF-patients with left ventricular ejection fraction ≤40% of any aetiology with a follow-up of ≥6 months published in 1999 or later. Results Out of 12,229 abstracts, 25 randomised controlled trials including 4481 HFrEF-patients were included in the final evaluation. Heterogeneity in study population, study design and exercise-based cardiac rehabilitation-intervention was evident. No significant difference in the effect of exercise-based cardiac rehabilitation on mortality compared to control-group was found (hazard ratio 0.75, 95% confidence interval 0.39–1.41, four studies; 12-months follow-up: relative risk 1.29, 95% confidence interval 0.66–2.49, eight studies; six-months follow-up: relative risk 0.91, 95% confidence interval 0.26–3.16, seven studies). In addition there was no significant difference between the groups with respect to ‘hospitalization-for-any-reason’ (12-months follow-up: relative risk 0.79, 95% confidence interval 0.41–1.53, four studies), or ‘hospitalization-due-to-heart-failure’ (12-months follow-up: relative risk 0.59, 95% confidence interval 0.12–2.91, four studies; six-months follow-up: relative risk 0.84, 95% confidence interval 0.07–9.71, three studies). All studies show improvement of exercise capacity. Participation in exercise-based cardiac rehabilitation significantly improved quality-of-life as evaluated with the Kansas City Cardiomyopathy Questionnaire: (six-months follow-up: mean difference 1.94, 95% confidence interval 0.35–3.56, two studies), but no significant results emerged for quality-of-life measured by the Minnesota Living with Heart Failure Questionnaire (nine-months or more follow-up: mean difference –4.19, 95% confidence interval –10.51–2.12, seven studies; six-months follow-up: mean difference –5.97, 95% confidence interval –16.17–4.23, four studies). Conclusion No association between exercise-based cardiac rehabilitation and mortality or hospitalisation could be observed in HFrEF patients but exercise-based cardiac rehabilitation is likely to improve exercise capacity and quality of life.

scholarly journals Impact of Alzheimer’s disease on the family caregiver’s long-term quality of life: results from an ALSOVA follow-up study

2015 ◽  
Vol 25 (3) ◽  
pp. 687-697 ◽  
Author(s):  
Tarja H. Välimäki ◽  
Janne A. Martikainen ◽  
Kristiina Hongisto ◽  
Saku Väätäinen ◽  
Harri Sintonen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Follow Up Study ◽  
The Family

Literature review: nutritional factors influencing academic achievement in school age children

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Pattaneeya Prangthip ◽  
Yee Mon Soe ◽  
Jean Faulan Signar
Keyword(s):  
Transition Period ◽  
Economic Status ◽  
Eating Behaviour ◽  
School Age Children ◽  
Nutritional Factors ◽  
Adolescent Students ◽  
Balanced Diet ◽  
The Family ◽  
Knowledge And Attitude

Abstract Background and objective Adolescence is a transition period involving tremendous physical, psychological and cognitive growth. For appropriate growth of adolescents in these aspects, a correct quantity and quality of nourishment is required, as a lack of such nourishment among adolescents can lead to various degrees of malnutrition, which may have implications on their health as well as their academic achievements. Materials and methods This review examines the research topics around factors that influence the nutritional status of adolescent students which can affect their academic performance. Results Some of the vital factors include knowledge and attitude about nutrition, eating behaviour, physical activity, socio-economic status of the family, the surrounding environment at school and home, the frequency and timing of meals, nutritional contents and amount of food intake. Conclusion Students who consume a balanced diet perform better in exams, show better behaviour as well as attendance at school and get their assigned tasks done more thoroughly compared with those who do not consume a balanced diet.

Smartphone app as a follow-up tool after cardiac rehabilitation: Single-arm feasibility study (Preprint)

2018 ◽  
Author(s):  
Pernille Lunde ◽  
Birgitta Blakstad Nilsson ◽  
Astrid Bergland ◽  
Asta Bye
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Cardiac Rehabilitation ◽  
Potential Effect ◽  
Goal Achievement ◽  
Recruitment Rate ◽  
Floor Effect

BACKGROUND Long-term maintenance of preventive activities is fundamental for achieving improved outcomes of cardiac rehabilitation (CR). Despite this, it is shown to be a major challenge for many patients to follow recommendations and thereby adhere to a heart-friendly lifestyle. Smartphone applications (apps) have been emphasized as potential tools to promote preventive activities after attendance in a CR program. Before commencing a trial to assess the potential effect of using an app for long-term adherence to preventive activities after attendance in CR, a study to assess the feasibility of the intervention is warranted. OBJECTIVE To assess the feasibility of an intervention where an app is used as a tool enabling individualized and monitored follow-up for patients after attendance in a CR program. METHODS Experimental, pre-post single arm trial, lasting for 12 weeks. All patients received access to an app aimed to guide people to change or to maintain a heart friendly lifestyle. During the study period, they got weekly, individualized follow-up through the app, based on their own goalsetting. Feasibility outcome assessed were adherence to the intervention, recruitment rate, resource requirements and efficacy regarding capability to detect a difference on quality of life (QoL), health status and perceived goal achievement as well as evaluating ceiling and floor effect in these outcomes. Criteria’s for success were preset to be able to evaluate whether the intervention were feasible in a potential future RCT. RESULTS All 14 patients included in the study used the app to promote preventive activities throughout the study. Satisfaction with the technology were high and the patients found the technology based follow-up intervention both useful and motivational. In total, 71% of the patients completed CR were eligible for a potential RCT as well as for the present study. Ceiling effect was achieved in more than 50% of the patients in questionnaires evaluating quality of life (SF-36 and COOP/WONCA) and health status (EQ-5D). Overall self-rated health status (EQ VAS) and perceived goal achievement were found to be able to detect a difference through the study. CONCLUSIONS Individual follow-up intervention through an app after attendance in CR is feasible. All patients used the app for preventive activities and found the follow-up intervention through an app as both useful and motivating for adherence to a heart-friendly lifestyle. Several points of guidance from the patients in the current study has been taken along and have contributed to the final design of the RCT now in the field.

scholarly journals Evaluating process and effectiveness of a low-intensity CBT intervention for women with gynaecological cancer (the EPELIT Trial)

2021 ◽  
Vol 3 ◽  
pp. 12
Author(s):  
Nicholas J. Hulbert-Williams ◽  
Lee Hulbert-Williams ◽  
Ryan James Flynn ◽  
Rosina Pendrous ◽  
Carey MacDonald-Smith ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Unmet Needs ◽  
Psychological Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Intervention Programme ◽  
Intervention Delivery

Background: Improving survival from gynaecological cancers is creating an increasing clinical challenge for long-term distress management. Psychologist-led interventions for cancer survivors can be beneficial, but are often costly. The rise of the Psychological Wellbeing Practitioner (PWP) workforce in the UK might offer a cheaper, but equally effective, intervention delivery method that is more sustainable and accessible. We aimed to test the effectiveness of a PWP co-facilitated intervention for reducing depression and anxiety, quality of life and unmet needs. Methods: We planned this trial using a pragmatic, non-randomised controlled design, recruiting a comparator sample from a second clinical site. The intervention was delivered over six-weekly sessions; data were collected from participants at baseline, weekly during the intervention, and at one-week and three-month follow-up. Logistical challenges meant that we only recruited 8 participants to the intervention group, and 26 participants to the control group. Results: We did not find significant, between-group differences for depression, quality of life or unmet needs, though some differences at follow-up were found for anxiety (p<.001). Analysis of potential intervention mediator processes indicated the potential importance of self-management self-efficacy. Low uptake into the psychological intervention raises questions about (a) patient-driven needs for group-based support, and (b) the sustainability of this intervention programme. Conclusions: This study failed to recruit to target; the under-powered analysis likely explains the lack of significant effects reported, though some trends in the data are of interest. Retention in the intervention group, and low attrition in the control group indicate acceptability of the intervention content and trial design; however a small baseline population rendered this trial infeasible in its current design. Further work is required to answer our research questions, but also, importantly, to address low uptake for psychological interventions in this group of cancer survivors. Trial registration: ClinicalTrials.gov, NCT03553784 (registered 14 June 2018).

scholarly journals Avaliação da adesão e qualidade de vida de portadores de HIV sob seguimento farmacoterapêutico / Evaluation of adhesion and quality of life of HIV carriers under pharmacoterapeutical follow up

2017 ◽  
Vol 7 (2) ◽  
pp. 3-9 ◽  
Author(s):  
Larissa Rocha Arruda de Souza ◽  
Ananda Pullini Matarazo ◽  
Matheus Pereira de Araújo ◽  
Oriana Sabatina D'Alessandro Romano ◽  
Ricardo Radighieri Rascado ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Viral Load ◽  
Pharmaceutical Care ◽  
Laboratory Tests ◽  
Educational Interventions ◽  
Form Analysis ◽  
Significant Difference ◽  
Before And After

Introdução: O seguimento farmacoterapêutico (STF) de pacientes com HIV tem grande importância, pois contribui para adesão ao tratamento. Objetivos: Avaliar adesão e qualidade de vida em pacientes em uso de terapia antirretroviral através de questionários padronizados, durante a assistência intensiva da equipe farmacêutica. Métodos: Foram acompanhados 15 pacientes HIV positivos que frequentam o Centro de Testagem e Aconselhamento. Cada paciente recebeu o seguimento por sete meses: 1º Encontro: aplicação dos questionários de adesão e qualidade de vida; aplicação do formulário de atenção farmacêutica; análise dos exames laboratoriais (carga viral e contagem de linfócitos T Cd4). 2º Encontro: apresentação do plano de metas e proposta de diário para o registro de tomada da medicação. 3º Encontro: acompanhamento do plano de metas; verificação de problemas relacionados aos medicamentos (PRM); intervenções educativas. 4º Encontro: acompanhamento do plano de metas; verificação de PRM; intervenções educativas sobre a medicação. 5º Encontro: aplicação dos questionários de adesão e qualidade de vida; análise dos exames laboratoriais. Resultados: A média de idade foi de 42,5 ± 8,8 anos. Em relação à contagem de linfócitos T-CD4 antes e após o STF, houve aumento estatisticamente significativo (p=0,0048) deste parâmetro. A carga viral de 13 dos 15 pacientes se tornou indetectável ou reduziu. Não houve diferença estatisticamente significativa na adesão e qualidade de vida quando comparados o antes e o depois do seguimento. Conclusão: A atenção farmacêutica mostrou-se importante para os pacientes com HIV, pois os mesmos apresentaram melhora significativa em seus parâmetros clínicos.Palavras-chave: Atenção farmacêutica; Seguimento farmacoterapêutico; HIVABSTRACTIntroduction: Pharmacotherapeutic follow-up study of HIV infected patients is of great importance as it contributes to treatment adherence. Aims: To evaluate adherence and quality of life in patients using antiretroviral therapy through standardized questionnaires, during the intensive care of the pharmaceutical team. Methods: Fifteen HIV positive patients attending the Testing and Counseling Center were followed. Each patient was followed-up for seven months: 1st Meeting: application of adherence questionnaires and quality of life; application of the pharmaceutical care form; analysis of laboratory tests (viral load and CD4 T lymphocyte counts). 2nd Meeting: presentation of the goals' plan and proposal of a diary for the registration of medication taking; 3rd Meeting: follow-up of the goals' plan; checking of problems related to medicines (PRM); educational interventions on medication. 4th Meeting: follow-up of the targets plan; PRM checking; educational interventions on medication. 5th Meeting: application of adhesion questionnaires and quality of life; analysis of laboratory tests. Results: The mean age was 42.5 ± 8.8 years. Regarding the T-CD4 lymphocyte count before and after pharmacotherapeutic follow-up, there was an increase in this statistically significant parameter (p=0.0048). The viral load of 13 of the 15 patients became undetectable or reduced. There was no statistically significant difference in adherence and quality of life when compared to before and after follow-up. Conclusion: Pharmaceutical Care has proved to be an important practice for HIV patients, for they have shown a significant improvement in their clinical parameters.Keywords: Pharmaceutical care; Pharmacotherapeutic follow-up; HIV

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