scholarly journals Psychoeducational Interventions for Family Caregivers of Seniors across Their Life Trajectory: An Evidence-Based Research Program to Inform Clinical Practice

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Francine Ducharme
Keyword(s):  
Clinical Practice ◽  
Family Caregivers ◽  
The Elderly ◽  
Intervention Programs ◽  
Industrialized Countries ◽  
Future Directions ◽  
The Past ◽  
Life Trajectory ◽  
Psychoeducational Interventions

Family caregivers of the elderly are growing in number and the care they are called upon to deliver in industrialized countries is becoming increasingly demanding and complex. Empirical research shows that the caregiving situation can have a significant impact on the health of these caregivers often on account of stress, physical and psychological exhaustion, and a sense of being overwhelmed. In this context, the quality of life of these caregivers depends in large part on professional educational and support interventions. The purpose of this paper is to present three innovative psychoeducational intervention programs developed and empirically tested by the research team of the Université de Montréal’s (Québec, Canada) Chair in Nursing Care for Seniors and Their Families over the past fifteen years. These interventions have been developed together with family caregivers experiencing different stressful situations across their care trajectory. The results of evaluative studies of these programs provide evidence to inform professional clinical practice. Future directions for caregiving research are discussed.

scholarly journals Features of the clinical course of cardiovascular pathology on the background of thyrotoxicosis

2019 ◽  
Keyword(s):  
Clinical Course ◽  
Endemic Goiter ◽  
The Elderly ◽  
Early Complications ◽  
Cardiovascular Pathology ◽  
The Past ◽  
Cardiac Symptoms ◽  
Long Time ◽  
Frequent Absence

Relevance of the topicofthyroid diseases is duetothein crease in their number in the world and in Ukraine inparticular over the past 5 years, as well as the fact that the total frequency of various forms of thyroid pathology, even outside the zones of endemic goiter, is about 20% of the total morbidity. On the example of a clinical case, the question of diagnostics, management tactics and features of the clinical course of cardiovascular pathology on the background of thyrotoxicosis in the absence of adequate therapy for a long time are considered. Thyrotoxicosis leads to the occurrence of early complications of the cardiovascular system, which determine the further prognosis of the patient’s quality of life. The heart effects of Thyrotoxicosisare most dangerous for the elderly, and they (the heart effects of Thyrotoxicosis) often dominate the clinical picture in them (the elderly). Difficulties in their diagnosis are due, among other things, to the frequent absence of ophthalmopathy. When atrial fibrillation develops, the presence of cardiac symptoms may increase, indicating an accelerated development of heart failure. Therefore, the management of patients with cardiovascular disease on the background of thyrotoxicosis has its own peculiarities, which should be taken into account during treatment.

scholarly journals Recent Advances in the Discovery of Biomarkers for Canine Osteosarcoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Anita K. Luu ◽  
Geoffrey A. Wood ◽  
Alicia M. Viloria-Petit
Keyword(s):  
Clinical Practice ◽  
Standard Treatment ◽  
Predictive Biomarkers ◽  
Response To Treatment ◽  
Liquid Biopsies ◽  
Future Directions ◽  
Diagnostic Biomarkers ◽  
Canine Osteosarcoma ◽  
The Past ◽  
Biomarker Research

Canine osteosarcoma (OSA) is an aggressive malignancy that frequently metastasizes to the lung and bone. Not only has there been essentially no improvement in therapeutic outcome over the past 3 decades, but there is also a lack of reliable biomarkers in clinical practice. This makes it difficult to discriminate which patients will most benefit from the standard treatment of amputation and adjuvant chemotherapy. The development of reliable diagnostic biomarkers could aid in the clinical diagnosis of primary OSA and metastasis; while prognostic, and predictive biomarkers could allow clinicians to stratify patients to predict response to treatment and outcome. This review summarizes biomarkers that have been explored in canine OSA to date. The focus is on molecular biomarkers identified in tumor samples as well as emerging biomarkers that have been identified in blood-based (liquid) biopsies, including circulating tumor cells, microRNAs, and extracellular vesicles. Lastly, we propose future directions in biomarker research to ensure they can be incorporated into a clinical setting.

Using a Smartphone as a Track and Fall Detector

2015 ◽  
pp. 272-295
Author(s):  
Chia-Yin Ko ◽  
Fang-Yie Leu ◽  
I-Tsen Lin
Keyword(s):  
Social Networks ◽  
Emergency Medical Services ◽  
Real Time ◽  
Family Caregivers ◽  
Fall Detection ◽  
The Elderly ◽  
Elderly Individual ◽  
Communication Services ◽  
People With Dementia

This chapter proposes a smartphone-based system for both indoor and outdoor monitoring of people with dementia. The whole system comprises wandering detection, safety-zone monitoring, fall detection, communication services, alert notifications, and emergency medical services. To effectively track the elderly, the proposed system uses a smartphone camera to take real-time pictures along the user's path as he or she moves about. Those photos, accompanied with time and GPS signals, are delivered to and stored on the Cloud system. When necessary, family caregivers can download those data to quickly find a way to help the elderly individual. Additionally, this study uses tri-axial accelerometers to examine falls. To assure individuals' data is safeguarded appropriately, an RSA method has been adopted by the system to encrypt stored data. This reliable and minimally intrusive system provides people with dementia with an opportunity to maintain their social networks and to improve their quality of lives.

scholarly journals Tapentadol Prolonged Release for Severe Chronic Osteoarthritis Pain in the Elderly—A Subgroup Analysis of Routine Clinical Practice Data

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Andreas Schwittay ◽  
Melanie Sohns ◽  
Birgit Heckes ◽  
Christian Elling
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Elderly Patients ◽  
Subgroup Analysis ◽  
The Elderly ◽  
Routine Clinical Practice ◽  
Prolonged Release ◽  
Younger Patients ◽  
Quality Of Life Measures

Background. Tapentadol prolonged release (PR) has been shown effective and generally well tolerated in a broad range of chronic pain conditions. This subgroup analysis investigated its benefits for elderly patients with severe chronic osteoarthritis (OA) pain in routine clinical practice. Patients and Methods. Data of all patients with chronic OA pain were extracted from the database of a prospective, 3-month noninterventional tapentadol PR trial. The data of elderly OA patients (>65 years of age; n = 752) were compared with the data of younger OA patients (≤65 years; n = 282). Results. Almost all patients (elderly 98.7% and younger patients 99.3%) had received long-term analgesic medication prior to the start of tapentadol PR treatment but presented with severe pain accompanied by considerable impairments in sleep quality and quality of life measures. Tapentadol PR provided effective pain relief in both patient groups, with slightly better outcomes in younger patients. However, the mean baseline pain intensity of 7.1 (SD 1.5) was reduced by 3.8 points (p≤0.001), and sleep and quality of life measures had also markedly improved in the elderly: quality of sleep by 3 points, quality of life by 3.4 points, social activities by 3 points, and independence by 2.7 points (p≤0.001 for all measures; 11-point scale). At the end of observation, 68% of the elderly had clinically relevant pain reductions of at least 50% (vs baseline), and 87.9% attained either their intended pain reduction target and/or an additional individual treatment target (both predefined during baseline examination). Only 8.4% of the elderly experienced adverse drug reactions, most frequently nausea (2.7% of patients) and dizziness (1.5%). Conclusion. Tapentadol PR provided effective and well-tolerated treatment of severe chronic OA pain for elderly patients in routine clinical practice. The favorable tolerability profile in particular suggests tapentadol PR as a treatment option before classical strong opioids are considered.

scholarly journals Machine Learning Interpretability: A Survey on Methods and Metrics

Electronics ◽  
2019 ◽  
Vol 8 (8) ◽  
pp. 832 ◽  
Author(s):  
Diogo V. Carvalho ◽  
Eduardo M. Pereira ◽  
Jaime S. Cardoso
Keyword(s):  
Machine Learning ◽  
Social Impact ◽  
Research Field ◽  
Learning Systems ◽  
Future Directions ◽  
The Past ◽  
Current State ◽  
Black Boxes ◽  
Interpretable Models

Machine learning systems are becoming increasingly ubiquitous. These systems’s adoption has been expanding, accelerating the shift towards a more algorithmic society, meaning that algorithmically informed decisions have greater potential for significant social impact. However, most of these accurate decision support systems remain complex black boxes, meaning their internal logic and inner workings are hidden to the user and even experts cannot fully understand the rationale behind their predictions. Moreover, new regulations and highly regulated domains have made the audit and verifiability of decisions mandatory, increasing the demand for the ability to question, understand, and trust machine learning systems, for which interpretability is indispensable. The research community has recognized this interpretability problem and focused on developing both interpretable models and explanation methods over the past few years. However, the emergence of these methods shows there is no consensus on how to assess the explanation quality. Which are the most suitable metrics to assess the quality of an explanation? The aim of this article is to provide a review of the current state of the research field on machine learning interpretability while focusing on the societal impact and on the developed methods and metrics. Furthermore, a complete literature review is presented in order to identify future directions of work on this field.

scholarly journals Elderly Who Care for Elderly: DoubleVulnerability and Quality of Life

2020 ◽  
Vol 30 ◽  
Author(s):  
Letícia Decimo Flesch ◽  
Samila Sathler Tavares Batistoni ◽  
Anita Liberalesso Neri ◽  
Meire Cachioni
Keyword(s):  
Quality Of Life ◽  
Cognitive Vulnerability ◽  
The Elderly ◽  
Demographic Variables ◽  
Health Evaluation ◽  
Self Assessment ◽  
The Past ◽  
Perceived Burden ◽  
Elderly Caregivers

Abstract Elderly caregivers of other elderly people suffer from double vulnerability because they must deal with demands for care and for their own health. The objective of this study was to identify the association between double vulnerability and quality of life of elderly caregivers. The 148 participants were evaluated in relation to socio-demographic variables, quality of life, health self-assessment, perceived burden, measures of physical health of the caregiver and physical and cognitive vulnerability of the elderly who is the target of care. The hierarchical multivariate analysis showed that the elderly caregivers with the highest risk of worse quality of life were those with three or more diseases, with medium or high burden and with a worse health evaluation compared to the past. Greater health weakness is expected over the course of ageing; therefore, to study elderly caregivers, the perception of changes in health is a more pertinent measure than just the assessment of immediate health.

scholarly journals It’s time to eliminate the mismatch between pediatric training and practice

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Frank Oberklaid
Keyword(s):  
Clinical Practice ◽  
Training Programs ◽  
Evidence Based ◽  
Community Settings ◽  
Service Delivery Models ◽  
The Past ◽  
Repeated Calls ◽  
Delivery Models ◽  
Pediatric Morbidity

AbstractThe quality of pediatric clinical practice is dependent on the training received during residency. It is assumed that the content of the training will adequately prepare pediatricians for the sorts of problems and issues they will be asked to manage in community settings. While over the past several decades there have been major changes in pediatric morbidity, there is evidence that training and service delivery models have not evolved; there is a significant mismatch between training and evidence-based clinical practice. A recent paper published in this journal (1) drew attention to the inadequacy of pediatricians’ training in child development. The reality of major gaps in the content and experiences of pediatric training in Israel are widely held, and there have been repeated calls for an increased focus on community child health and developmental and behavioural pediatrics. While it appears that finally there are some small initial steps to this end, it is strongly recommended that there be a long overdue, radical rethink of pediatric training programs.

scholarly journals Drug-eluting Biliary Stent

2020 ◽  
Vol 25 (1) ◽  
pp. 11-17
Author(s):  
Sung Ill Jang ◽  
Dong Ki Lee
Keyword(s):  
Biliary Drainage ◽  
Development Process ◽  
Primary Treatment ◽  
Biliary Stent ◽  
Biliary Stents ◽  
Stent Patency ◽  
Future Directions ◽  
The Past ◽  
Drug Eluting

Biliary drainage is necessary to improve the survival or quality of life of patients with malignant biliary obstruction. In the past, surgery was the primary treatment for biliary drainage, but recently, endoscopic or percutaneous stent implantation has been recognized as the main treatment. Various materials and structures have been devised and developed to increase the patency of the biliary stent. In the development of these stents, drug-eluting biliary stents with an anti-tumoral agent (DES) have emerged to increase the stent patency period by chemically inhibiting tumor growth in the stent through the change of the coating material. The DESs have been proved to be stable through several animal and clinical trials, but their effectiveness has not been demonstrated. We will discuss the development process, problems, and future directions of DES that has been clinically applied.

scholarly journals Mechanisms for QoE optimisation of Video Traffic: A review paper

2020 ◽  
Author(s):  
qahhar muhammad qadir ◽  
Alexander A. Kist ◽  
ZHONGWEI ZHANG
Keyword(s):  
Quality Of Experience ◽  
Review Paper ◽  
End Users ◽  
The Internet ◽  
Video Traffic ◽  
Future Directions ◽  
The Past ◽  
New Methods ◽  
Increasing Demand

Transmission of video traffic over the Internet has grown exponentially in the past few years<br>with no sign of waning. This increasing demand for video services has changed user expectation of quality. Various mechanisms have been proposed to optimise the Quality of Experience (QoE) of end users’ video. Studying these approaches are necessary for new methods to be proposed or combination of existing ones to be tailored. We discuss challenges facing the optimisation of QoE for video traffic in this paper. It surveys and classifies these mechanisms based on their functions. The limitation of each of them is identified and future directions are highlighted.

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