scholarly journals Innovative telemonitoring system for cardiology: from science to routine operation

2010 ◽  
Vol 01 (02) ◽  
pp. 165-176 ◽  
Author(s):  
J. Morak ◽  
R. Modre ◽  
A. Kollmann ◽  
C. Ebner ◽  
FM. Fruhwald ◽  
...  
Keyword(s):  
Heart Failure ◽  
Data Transfer ◽  
Body Weight Gain ◽  
Near Field ◽  
Well Being ◽  
Lessons Learned ◽  
Management Tool ◽  
Home Based ◽  
Daily Data ◽  
Pressure Meter

Summary Objective: Results of the Austrian MOBITEL (MOBIle phone based TELemonitoring for heart failure patients) trial indicate that home-based telemonitoring improves outcome of chronic heart failure (CHF) patients and reduces both frequency and duration of hospitalizations. Based on lessons learned, we assessed the weak points to clear the way for routine operations. Methods: We analyzed the system with respect to recommendations of the ESC Guidelines and experiences gained throughout the trial to identify potential improvements. The following components have been identified: a patient terminal with highest usability, integrated way to document drug-intake and well-being, and automated event detection for worsening of CHF. As a consequence the system was extended by Near Field Communication (NFC) technology and by an event management tool. Results: Usability evaluation with 30 adults (14f, median 51y. IQR[45-65]) showed that 21 (8f) were able to immediately operate the system after reading a step-by-step manual. Eight (6f) needed one time demonstration and one man (80y) failed to operate the blood pressure meter. Routine operation of the revised system started in March 2009. Within 9 months, 15 patients (4f, median 74y. IQR[71-83], all NYHA-III) transmitted 17,149 items. 43 events were detected because of body weight gain of more then 2kg within 2 days. 49 therapy adjustments were documented. Three patients stopped using the system, two (1f) because of non-compliance and one (m, 82y) because of death. Overall, the rate of adherence to daily data transfer was 78%. Conclusion: First results confirm the applicability of the revised telemonitoring system in routine operation. Citation: Kastner P, MorakJ, Modre R, Kollmann A, Ebner C, Fruhwald FM, Schreier G. Innovative telemonitoring system for cardiology: from science to routine operation. Appl Clin Inf 2010; 1: 165–176 http://dx.doi.org/10.4338/ACI-2009-12-RA-0021

scholarly journals Sleep, Activity, and Well-Being In Persons With Dementia: Findings From the Healthy Patterns Trial

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 546-546
Author(s):  
Nancy Hodgson ◽  
Darina Petrovsky
Keyword(s):  
Quality Of Life ◽  
Neuropsychiatric Symptoms ◽  
Community Outreach ◽  
Well Being ◽  
Lessons Learned ◽  
Improve Quality ◽  
Home Based ◽  
Wake Patterns ◽  
One Year

Abstract Irregular sleep-wake patterns are common in persons living with dementia (PLWD), pose a great burden to caregivers, and are the principal causes of distress and institutionalization of PLWD. A growing body of research supports the importance of activity-based interventions to reduce the frequency and intensity of sleep wake disruption, reduce neuropsychiatric symptoms, and improve quality of life. To date, there are no studies linking sleep disruption and well-being with the nature and timing of activity. This session focuses on lessons learned from the Healthy Patterns Study - a randomized trial of a home-based activity intervention in 200 dyads of PLWD and their caregivers (NCT03682185). Session 1 focuses on the main findings from the clinical trial. Session 2 focuses on the cultural adaptation of the timed activity protocol to improve quality of life (QOL), improve sleep and reduce neuropsychiatric symptoms in older Latinos Session 3 describes the community outreach efforts used over a one-year period to recruit a diverse sample of PLWD and their caregivers for the Healthy Patterns trial. Session 4 examine the relationship between caregiver mastery and neuropsychiatric symptoms in PLWD. Together these findings highlight the complex role of sleep and wake activity in promoting well-being in persons with dementia.

scholarly journals A pilot randomised trial of home-based rehabilitation compared to usual care in patients with heart failure with preserved ejection fraction and their caregiver’s (REACH-HFpEF study): a process evaluation.

2020 ◽  
Author(s):  
Karen Smith ◽  
Chim Lang ◽  
Jenny Wingham ◽  
Julia Frost ◽  
Colin Greaves ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Process Evaluation ◽  
Qualitative Interviews ◽  
Randomised Trial ◽  
Well Being ◽  
Intervention Fidelity ◽  
Preserved Ejection Fraction ◽  
Home Based

Abstract Background: Whilst heart failure (HF) with preserved ejection fraction (HFpEF) affects almost 50 percent of the HF population, evidence-based treatment options remain limited. However, there is emerging growing evidence of the potential value of exercise-based cardiac rehabilitation. This study reports the process evaluation of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention for HFpEF patients and their caregivers conducted as part of the REACH-HFpEF pilot trial. This study reports the process evaluation conducted as part of the REACH-HFpEF trial. Methods: Mixed methods Pprocess evaluation sub study parallel to a single centre (Tayside, Scotland) pilot randomised controlled trial with qualitativequantitative assessment of both intervention fidelity delivery and a qualitative exploration of HFpEF patients’ and caregivers’ experiences. The Rehabilitation EnAblement in Chronic Heart Failure (REACH-HF) intervention consisted of self-help manual for patients and caregivers, facilitated over 12 weeks by trained healthcare professionals. Data included audio-recorded intervention sessions; demographic information; intervention fidelity scores; and qualitative interviews conducted following completion of intervention in a purposeful sample of 15 HFpEF patients and 7 caregivers.,Results: Intervention fidelity analysis was indicative of the adequate delivery of the majority of the REACH-HF components, with three items relating caregiver involvement (addressing emotional consequences of being a caregiver, caregiver health and well-being, and closure of the session) scoring poorly. Qualitative information from the facilitator interactions and interviews identified three key themes and a number of sub-themes for patients and caregivers: (1) understanding their condition (2) emotional consequences of HF, and (3) patients’ and caregivers’ responses to the REACH-HF intervention were uncovered by qualitative interviews. Different professional backgrounds and typical models of service delivery of facilitators demonstrate to possibility of delivering this through either our HF or CR services of a combination of the two.Conclusions: The REACH-HF home-based facilitated intervention for HFpEF appears feasible and well accepted model for delivery of a CR intervention, with the potential to address key unmet needs of patients and their caregivers who are often excluded from service provision and current CR programmes. Results of this study will inform a future recently funded full multicentre randomised clinical trial.

scholarly journals The Knowledge Status of Coastal and Marine Ecosystem Services - Challenges, Limitations and Lessons Learned From the Application of the Ecosystem Services Approach in Management

2021 ◽  
Vol 8 ◽  
Author(s):  
Pedro Manuel Carrasco De La Cruz
Keyword(s):  
Ecosystem Services ◽  
Spatial Data ◽  
Prediction Models ◽  
Marine Ecosystem ◽  
Well Being ◽  
Lessons Learned ◽  
Management Tool ◽  
Social Literacy ◽  
Supportive Role ◽  
Marine Ecosystem Services

The concept of ecosystem services (ES), first introduced in 1970’s, gained mainstream attention in 2005, when the Millennium Ecosystem Assessment formally proposed a definition for it. In spite of this attention, many aspects about the ES concept have remained controversial to date, i.e., their classification, value, generation, link to human well-being, and supportive role as management tool. This review explores the knowledge status of ecosystem services, focusing on those services generated in coastal and marine environments (CMES). A knowledge gap and an underdevelopment of tools to assess CMES is evident in the literature, especially when compared to the progress done in the assessment of land ES. Possible explanations reside on the yet small proportion that the research done on CMES represents for the ecosystem service framework (ESF), in part due to the intrinsic challenges of researching the marine environment, also due to the limited availability of spatial data on marine ecosystems. Nevertheless, the ES concept is getting more attention toward policy-makers and stakeholders, leading to the implementation of an ecosystem services approach (ESA) to the management and protection of CMES. Six lessons are rescued from the literature to improve the ESA: (1) integration of the ESA in a science-policy process; (2) more simplicity for the CMES prediction models; (3) move toward empowering of stakeholders; (4) integration of the value pluralism of CMES with less focus on money; (5) the link of ES to Human Well-being must not been forgotten; and (6) communication of results and social literacy are key.

scholarly journals The Translation and Cross-Cultural Adaptation of an Arabic Version of the Reminiscence Functions Scale

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 343-343
Author(s):  
Abdallah Abu Khait ◽  
Juliette Shellman
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Positive Impact ◽  
Well Being ◽  
Arab Countries ◽  
Lessons Learned ◽  
Arabic Version ◽  
Harmonization Process ◽  
Back Translation ◽  
Target Culture

Abstract The Reminiscence Functions Scale (RFS), a 43 item reliable and valid scale, measures eight specific reasons as to why individuals reminisce: (a) identity (b) death preparation; (c) problem-solving; (d) bitterness revival; (e) boredom reduction; (f) intimacy maintenance; (g) conversation; and (h) teach/Inform others. Research indicates that certain reminiscence functions have a positive impact on the mental-health and well-being of older adults. However, no known studies have been conducted in Arab countries examining the relationship between reminiscence functions and mental health outcomes due to the lack of an Arabic version of the RFS. The purpose of this study was to translate the RFS from English to Arabic (Modern Standard Arabic), back-translate from Arabic to English, and compare the two English versions for equivalence and accuracy through a multi-step translation method. A team of bilingual, bicultural, Arabic speaking experts assembled to conduct the forward, back translation and harmonization process. In the next step, professionals with expertise in linguistics communication sciences and disorders, Arabic literature, geriatric nursing, and medicine reviewed the translated documents to assess the content (relevant to the target culture) and semantic equivalencies (similarity of meaning in the target culture). Challenges that occurred during the study included finding nuanced translation equivalences for Likert scale responses, translation of idioms such as “when time is heavy on my hands”, and logistical issues such as coordinating virtual meetings for the team of experts. Lessons learned during the translation process and implications for use of the RFS-Arabic version with Jordanian older adults will be presented.

scholarly journals Effect of dietary supplementation of seaweed (Ulva lactuca) and Azolla on growth performance, haematological and serum biochemical parameters of Aseel chicken

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Vijayalingam Thavasi Alagan ◽  
Rajesh Nakulan Vatsala ◽  
Ilavarasan Sagadevan ◽  
Vairamuthu Subbiah ◽  
Venkataramanan Ragothaman
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Growth Performance ◽  
Body Weight Gain ◽  
Control Diet ◽  
Dietary Supplementation ◽  
Well Being ◽  
Ulva Lactuca ◽  
Feed Conversion ◽  
Serum Biochemical

Abstract Background An effort was made to assess the effectiveness of dietary supplementation of Ulva lactuca (U. lactuca), a seaweed and Azolla individually and in combination on different physiological parameters of Aseel chicken. A total of 40 Aseel chicks of 8 weeks old were allocated into four groups, C1 (control), T1 (Azolla alone), T2 (seaweed alone) and T3 (seaweed plus Azolla). Aseel chicks in C1 were fed with formulated grower feed alone, birds in T1 had control diet with 5% Azolla, birds in T2 had control diet with 3% U. lactuca and birds in T3 had control diet admixtured with 5% of Azolla and 3% of U. lactuca. Parameters were recorded for a continuous period of 2 months in 15 days interval. Results The growth performance was found to be significant (P ≤ 0.05) during 30 days of feed trials and highly significant (P ≤ 0.01) during 45 and 60 days of treatment. Birds in T3 had a higher body weight gain, shank length and feed conversion efficiency followed with T1 and T2 compared to C1. PCV, RBC, WBC and heterophil counts were not influenced (P ≥ 0.05) by dietary treatments. Uric acid, creatinine, AST, glucose, triglycerides and magnesium levels revealed a high significant (P ≤ 0.01) variation, and cholesterol level showed significant (P ≤ 0.05) changes during 30th and 60th day of feed trials between the control and treatment groups. Total protein, globulin, phosphorus and electrolytes like Na, K and Cl levels were not significant (P ≥ 0.05) during 30th day and were highly significant (P ≤ 0.01) during the 60th day of the trial. Conclusions It could be noted that inclusion of U. lactuca and Azolla as feed supplement in grower chicken had a better body weight gain when given in combination (U. lactuca and Azolla) rather than supplemented with the sole entity. Based on the haematological and serum biochemical analysis, the supplementation of U. lactuca and Azolla at the levels included in this trial did not pose any threat to the physiological well-being of Aseel chicken.

scholarly journals Acceptability, Feasibility and Preliminary Evaluation of a Novel, Personalised, Home-Based Physical Activity Intervention for Chronic Heart Failure (Active-at-Home-HF): a Pilot Study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nduka C. Okwose ◽  
Leah Avery ◽  
Nicola O’Brien ◽  
Sophie Cassidy ◽  
Sarah J. Charman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Heart Failure ◽  
Pilot Study ◽  
Chronic Heart Failure ◽  
Physical Activity Intervention ◽  
Step Count ◽  
Home Based ◽  
At Home

Abstract Purpose Less than 10% of heart failure patients in the UK participate in cardiac rehabilitation programmes. The present pilot study evaluated feasibility, acceptability and physiological effects of a novel, personalised, home-based physical activity intervention in chronic heart failure. Methods Twenty patients (68 ± 7 years old, 20% females) with stable chronic heart failure due to reduced left ventricular ejection fraction (31 ± 8 %) participated in a single-group, pilot study assessing the feasibility and acceptability of a 12-week personalised home-based physical activity intervention aiming to increase daily number of steps by 2000 from baseline (Active-at-Home-HF). Patients completed cardiopulmonary exercise testing with non-invasive gas exchange and haemodynamic measurements and quality of life questionnaire pre- and post-intervention. Patients were supported weekly via telephone and average weekly step count data collected using pedometers. Results Forty-three patients were screened and 20 recruited into the study. Seventeen patients (85%) completed the intervention, and 15 (75%) achieved the target step count. Average step count per day increased significantly from baseline to 3 weeks by 2546 (5108 ± 3064 to 7654 ± 3849, P = 0.03, n = 17) and was maintained until week 12 (9022 ± 3942). Following completion of the intervention, no adverse events were recorded and quality of life improved by 4 points (26 ± 18 vs. 22 ± 19). Peak exercise stroke volume increased by 19% (127 ± 34 vs. 151 ± 34 m/beat, P = 0.05), while cardiac index increased by 12% (6.8 ± 1.5 vs. 7.6 ± 2.0 L/min/m2, P = 0.19). Workload and oxygen consumption at anaerobic threshold also increased by 16% (49 ± 16 vs. 59 ± 14 watts, P = 0.01) and 10% (11.5 ± 2.9 vs. 12.8 ± 2.2 ml/kg/min, P = 0.39). Conclusion The Active-at-Home-HF intervention is feasible, acceptable and effective for increasing physical activity in CHF. It may lead to improvements in quality of life, exercise tolerance and haemodynamic function. Trial Registration www.clinicaltrials.gov NCT0367727. Retrospectively registered on 17 September 2018.

scholarly journals Responding to unforeseen disasters in a large health system

2020 ◽  
Author(s):  
Ryan J Hannan ◽  
Margaret K Lundholm ◽  
Dennis Brierton ◽  
Noelle R M Chapman
Keyword(s):  
Supply Chain ◽  
Health System ◽  
Disaster Response ◽  
Well Being ◽  
Lessons Learned ◽  
Strategic Decision ◽  
Pharmacy Services ◽  
Efficient System ◽  
Team Members

Abstract Purpose To describe how health systems may respond to sudden changes in operations by leveraging existing resources and to share one organization’s experience responding to the coronavirus disease (COVID-19) pandemic. Summary In a health system based in Illinois and Wisconsin, pharmacy services are provided by a single, integrated department responsible for all aspects of pharmaceutical care within the organization. Hospital, retail, ambulatory care, and population health services are all managed under one leadership team. All pertinent ancillary services are also managed within the department, including informatics, supply chain, and drug policy. During the COVID-19 pandemic, the pharmacy services leadership has successfully managed volume and capacity challenges by redirecting resources to where they are needed. A disaster response framework based on Federal Emergency Management Agency guidance was put in place, and change management principles were used to rapidly operationalize change. Components of the nimble response have included quickly increasing capacity, thoughtful and timely communication to all team members, strategic decision making with available data, creating an agile pool of labor, and maintaining an efficient system supply chain. Well-being and resilience are emphasized alongside reflection on lessons learned. Some changes made in the urgent response to the pandemic are being considered for long-term implementation. Conclusion Organizations have the potential to respond to almost any situation if they are integrated and teams work together to build flexibility. The keys to success are thoughtful maximization of existing resources and strong communication.

scholarly journals Development of a Positive Psychology Program (LAVENDER) for Preserving Medical Student Well-being: A Single-Arm Pilot Study

2021 ◽  
Vol 10 ◽  
pp. 216495612098848
Author(s):  
Elaine O Cheung ◽  
Ian Kwok ◽  
Allison B Ludwig ◽  
William Burton ◽  
Xinzi Wang ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Positive Psychology ◽  
Positive Emotion ◽  
Albert Einstein College ◽  
Albert Einstein ◽  
Well Being ◽  
Preliminary Evidence ◽  
Lessons Learned ◽  
Psychology Program

Background Mental health tends to worsen over the course of medical school, with steep declines in well-being in students’ clerkship year (M3). Positive emotion promotes adaptive coping to stress and may help preserve medical student well-being. Objective This study describes the development of LAVENDER (Leveraging Affect and Valuing Empathy for Nurturing Doctors’ Emotional Resilience), a program aimed at increasing positive emotion to preserve well-being in medical students. Methods We conducted a single-arm pilot of LAVENDER, a positive psychology intervention developed for medical students delivered in an interactive classroom format to a cohort of 157 third-year medical students at the Albert Einstein College of Medicine. Our primary outcome was the acceptability of LAVENDER. We also examined preliminary efficacy using measures of emotion, stress and burnout collected at each intervention session. Results LAVENDER showed good acceptability: 76% of participants agreed that the LAVENDER skills were useful and 72% agreed that they would recommend the LAVENDER program to others. Qualitative feedback suggested that medical students enjoyed the program and found the skills to be useful for coping with stress, but also reported the following barriers to engagement: lack of time to practice the skills, resistance to the mandatory nature of the wellness sessions, and difficulty integrating the skills in daily life. We did not find support for the preliminary efficacy of LAVENDER for improving medical student well-being in students’ clerkship year. Participants showed decreases in positive emotion and increases in symptoms of burnout over the intervention period ( ps < .01). Conclusion The current paper describes the development and a single-arm pilot test of LAVENDER, a positive psychology program tailored for medical students. Although we found preliminary evidence for the acceptability of LAVENDER, we did not find support for the preliminary efficacy. Lessons learned and next steps for the program are discussed.

scholarly journals Evaluation of a Brief Intervention to Improve the Nursing Care of Young Children in a High HIV and AIDS Setting

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Linda M. Richter ◽  
Tamsen J. Rochat ◽  
Celia Hsiao ◽  
Thembelihle H. Zuma
Keyword(s):  
Young Children ◽  
Well Being ◽  
Hiv And Aids ◽  
Child Interaction ◽  
Home Based ◽  
Care And Support ◽  
Nurse Burnout ◽  
Before And After ◽  
Infant Pain ◽  
Outcomes For Children

The HIV epidemic in South Africa is putting great strain on health services, including the inpatient care of young children. Caregivers and young children (107 pairs) and 17 nurses participated in an intervention to improve the care of young children in hospital in a high HIV and AIDS setting. The intervention addressed caregiver expectations about admission and treatment, responsive feeding, coping with infant pain and distress, assistance with medical procedures, and preparation for discharge and home care. Following a preparatory and piloting phase, measures of nurse burnout, caregiver physical and emotional well-being, and caregiver-child interaction were made before and after intervention. No changes were found between before and after intervention on assessments of caregiver wellbeing. However, mothers in the postintervention phase rated nurses as more supportive; mother-child interaction during feeding was more relaxed and engaged, and babies were less socially withdrawn. While the intervention proved useful in improving certain outcomes for children and their caregivers, it did not address challenging hospital and ward administration or support needed by caregivers at home following discharge. To address the latter need, the intervention has been extended into the community through home-based palliative care and support.

scholarly journals How has technology been used to deliver cardiac rehabilitation during the COVID-19 pandemic? An international cross-sectional survey of healthcare professionals conducted by the BACPR

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046051
Author(s):  
Alasdair F O'Doherty ◽  
Helen Humphreys ◽  
Susan Dawkes ◽  
Aynsley Cowie ◽  
Sally Hinton ◽  
...  
Keyword(s):  
High Risk ◽  
Cardiac Rehabilitation ◽  
Technology Use ◽  
Healthcare Professionals ◽  
Hospital Admissions ◽  
Well Being ◽  
Rehabilitation Service ◽  
High Risk Patients ◽  
Home Based ◽  
Risk Patients

ObjectiveTo investigate whether exercise-based cardiac rehabilitation services continued during the COVID-19 pandemic and how technology has been used to deliver home-based cardiac rehabilitation.DesignA mixed methods survey including questions about exercise-based cardiac rehabilitation service provision, programme diversity, patient complexity, technology use, barriers to using technology, and safety.SettingInternational survey of exercise-based cardiac rehabilitation programmes.ParticipantsHealthcare professionals working in exercise-based cardiac rehabilitation programmes worldwide.Main outcome measuresThe proportion of programmes that continued providing exercise-based cardiac rehabilitation and which technologies had been used to deliver home-based cardiac rehabilitation.ResultsThree hundred and thirty eligible responses were received; 89.7% were from the UK. Approximately half (49.3%) of respondents reported that cardiac rehabilitation programmes were suspended due to COVID-19. Of programmes that continued, 25.8% used technology before the COVID-19 pandemic. Programmes typically started using technology within 19 days of COVID-19 becoming a pandemic. 48.8% did not provide cardiac rehabilitation to high-risk patients, telephone was most commonly used to deliver cardiac rehabilitation, and some centres used sophisticated technology such as teleconferencing.ConclusionsThe rapid adoption of technology into standard practice is promising and may improve access to, and participation in, exercise-based cardiac rehabilitation beyond COVID-19. However, the exclusion of certain patient groups and programme suspension could worsen clinical symptoms and well-being, and increase hospital admissions. Refinement of current practices, with a focus on improving inclusivity and addressing safety concerns around exercise support to high-risk patients, may be needed.

Sign in / Sign up

Export Citation Format

Share Document