Developing Instructional Support for MEDSReM-2 Through Human Factors Design Principles

Appropriate instruction is critical for ensuring the MEDSReM-2 system (i.e., smartphone app, blood pressure monitor, online portal) will be easily and effectively used and will, therefore, be more likely to be adopted. We will present our iterative processes for developing instructional support for MEDSReM 2 using human factors design principles (e.g., task analyses, comparative analyses, expert evaluation of mock-ups with screen flows). The instructional supports include user manuals, videos, as well as instructions within the MEDSReM 2 app. We will also highlight design principles used to empower the user and the benefits of using an interdisciplinary approach (i.e., gerontology, cognitive psychology, educational psychology, design, community health) to develop instructional support for older adult users.

Physical Frailty is Correlated with Worse Quality of Life in Older Adults with Hypertension

Background Hypertension is one of the commonest chronic cardiovascular diseases in older adults. Frailty and hypertension often coexist in older people, but few studies have explored frailty in older hypertensive adults. We aimed to explore the correlation of frailty with quality of life in older hypertensive adults. Method: We enrolled 291 patients with hypertension aged ≥60 years. Ambulatory blood pressure monitor was performed. Physical frailty was assessed by Fried phenotype. Quality of life was assessed by SF-36. Results Forty-eight (16.5%) patients were frail. Compared with non-frail older hypertensive patients, frail patients were older, had lower education levels, a higher rate of living alone, and a longer duration of hypertension. Moreover, they had lower diastolic blood pressure (DBP) and mean arterial pressure (MAP), and higher pulse pressure, more chronic diseases, a higher proportion of calcium channel blockers (CCBs) usage, and worse quality of life. Frailty scores were positively correlated with pulse pressure, and negatively correlated with DBP and MAP. The SF-36 score was negatively correlated with frailty scores and positively correlated with grip strength and walking speed. After adjusting for age, the SF-36 score was negatively correlated with frailty and positively correlated with walking speed. Frailty, when adjusted for age, duration of hypertension, DBP and comorbidity, had a significant effect on the SF-36 score. Conclusion Frailty was associated with worse quality of life of older adults with hypertension. Frailty prevention and intervention may help improve the quality of life of older hypertensive adults. Keywords: frailty, older adults, hypertension, quality of life

Método indirecto para estimar el consumo máximo de oxígeno en supervivientes de cáncer de mama y controles sanos (Indirect method for estimating maximum oxygen consumption in breast cancer survivors and healthy controls)

El objetivo de este estudio fue comparar la predicción del V̇O2máx. entre mujeres sobrevivientes de cáncer de mama y un grupo control (GC) de mujeres sin antecedentes de cáncer. Estudio de caso-control en que diecisiete mujeres en el grupo sobrevivientes de cáncer de mama (49.4 ± 8.9 años, índice de masa corporal [IMC] de 27.8 ± 2.7 kg·m-2) y 17 en el GC (47.9 ± 7.4 años, IMC de 26.2 ± 4.4 kg·m-2) fueron evaluadas. La prueba de caminata de seis minutos (PC6M) se evaluó con monitor de frecuencia cardíaca, tensiómetro digital, oxímetro de pulso y escala de Borg. El V̇O2máx. se estimó con ecuación que consideró la distancia recorrida, el peso corporal y la edad. El grupo de sobrevivientes caminó 34.8 metros más que el GC (p = .15; d = .51). También mostró una tendencia (p = .05), con un tamaño del efecto moderado (d = .76), hacia un aumento del V̇O2máx. (1.74 ± .26 L·min-1) comparado con el GC (1.56 ± .21 L·min-1). No hubo diferencias entre los grupos para las variables de frecuencia cardíaca, presión arterial y esfuerzo percibido durante la prueba (p > .05). Las participantes que recorrieron más distancia tuvieron más probabilidades de un mayor V̇O2máx. (odds ratio = 12.7; p = .002). Existieron diferencias en el V̇O2máx. entre los dos grupos, esta aptitud física debería considerarse para el tratamiento y control post-operatorio. Abstract. The aim of the study was to compare the prediction of the V̇O2max in breast cancer survivors and a control group (CG) of women without a history of cancer. It is a case-control study. Seventeen women in the breast cancer survivors (49.4 ± 8.9 years, body mass index [BMI] of 27.8 ± 2.7 kg·m-2) and 17 in the CG (47.9 ± 7.4 years, BMI of 26.2 ± 4.4 kg·m-2) were evaluated. The six-minute walk test (SMWT) was evaluated with a heart rate monitor, digital blood pressure monitor, pulse oximeter and the Borg scale. The V̇O2max it was estimated with an equation that considered the distance traveled, body weight and age. The survivors group walked 34.8 meters more than the CG (p = .15). In addition, group showed a trend (p = .05), with a moderate effect size (d = .76), towards an increase in V̇O2max (1.74 ± .26 L·min-1) compared to the CG (1.56 ± .21 L·min-1). There were no differences between the groups for the variables of heart rate, blood pressure and perceived exertion during the test (p > .05). The participants who covered the longest distance had a better chance of a V̇O2max higher (odds ratio = 12.7; p = .002). There were differences in the V̇O2max between groups, this physical fitness should be considered for post-operated treatment and monitoring.

Social Contagion of Vasovagal Symptoms in Blood Donors: Interactions With Empathy

Background Vasovagal reactions (VVRs) are commonly experienced in medical situations such as blood donation. Many believe that psychosocial contagion can contribute to the development of VVRs, but this is largely clinical lore. Purpose The goal of the present investigation was to examine the physiological effects of observing another experience a reaction, focusing on the potential moderating effects of empathy. Methods This study was part of a randomized controlled trial of behavioral techniques on the prevention of VVRs in blood donors. The sample was composed of 530 healthy university students. Measures of symptoms were obtained with the Blood Donation Reactions Inventory (BDRI) and through observation. Physiological variables were measured using respiratory capnometry and a digital blood pressure monitor. The Affective and Cognitive Measure of Empathy was administered to 230 participants. Results Donors who witnessed another experiencing a reaction were more likely to spontaneously report symptoms during the blood draw, to be treated for a reaction, to score higher on the BDRI, and to exhibit smaller compensatory heart rate increases. Donors with higher affective empathy reported more symptoms, exhibited hyperventilation, and were more likely to be treated. Donors with higher cognitive empathy were less likely to require treatment if they witnessed a reaction. Conclusion These results suggest that psychosocial contagion of physical symptoms can occur. The moderating effects of empathy differed depending on the subtype of empathy. Perhaps a better cognitive understanding of how other people are feeling functions as a coping response, whereas feeling sympathetic about others’ distress increases one’s own.

Further Analysis on Solution Treatment for Diabetes of Patients at Hospitals in Vietnam

In recent years in Vietnam, preventing and treatment for diabetes of patients in hospitals has been rising as hot issues because the number of patients with diabetes tend to increase much. Our study uses mainly statistics and qualitative analysis synthesis and inductive methods, together with quantitative analysis with data and statistics. Vu Thanh Binh et al (2021) said that Monitoring blood pressure with a continuous blood pressure monitor to carry around to detect masked hypertension (MH) in type 2 diabetes patients who are on outpatient treatment at Thai Binh Medical University Hospital, Thai Binh, Vietnam. Our study results indicated that diabetes including type 1 and type 2 and can be identified at early stages and have prevention treatment solutions such as physical exercises, eating food with lipid, and Reduce the amount of foods with high starch and sugar content. Lat but not least, Strengthening knowledge and skills of nurses and doctors and quality of human resources operating in the field of diabetes. Finally, our paper will propose policy implications and recommendations.

Adherence Level to Arterial Hypertension Treatment: A Cross-Sectional Patient Survey and Retrospective Analysis of the NHS Prescription Database

One of the major problems in cardiology practice is poor adherence to antihypertensive medication. This study aimed to evaluate medication adherence; we also aim to investigate the predictors of intentional and unintentional non-adherence. We issued a survey containing questions about patient demographics, blood pressure control, pharmaceutical care, and adherence level to medication. Retrospective analysis of the prescription database of the National Health Service of the Republic of Latvia was performed. The prevalence of non-adherence was 45.9%. The lowest adherence rate (38.2%) was found among patients taking medication for 2–4.9 years. Even though 84.7% of respondents had a blood pressure monitor at home, only 25.3% of them reported measuring blood pressure regularly. There were differences between the groups of adherent patients in terms of the patients’ net income (p = 0.004), medication co-payments (p = 0.007), and whether the pharmacist offered to reduce the costs of drug therapy (p = 0.002). Roughly half of the prescriptions (50.4%) containing perindopril were purchased by patients from pharmacies. The medication adherence level and blood pressure control at home were assessed as low. Intentionally non-adherent respondents discontinued their medication because of fear of getting used to medicines. The pharmacists’ behaviour in terms of offering to reduce the costs of medications used was influenced by socio-economic factors.

Evaluation of 30-Minute Office Blood Pressure in a Diverse Urban Population

BACKGROUND Previous studies have shown benefits of 30-minute office blood pressure (OBP-30) but did not report on race and gender. The purpose of this study was to determine if similar effects are seen in a diverse urban population. METHODS Patients with diabetes and/or cardiovascular disease (age 18–89) were invited to participate. Blood pressure was measured using standard procedure (SOBP). Patients were left alone in an exam room connected to an automated office blood pressure monitor which obtained BP readings every 5 minutes for 30 minutes. The last 5 measurements were averaged for the OBP-30 measurement. Primary outcomes were BPs measured using SOBP and OBP-30. Multivariate logit methods were used to estimate the average probability of having a BP measured <140/90 mm Hg (BPM <140/90) for the 2 measurement methods. Differences were computed across methods, in total and by sex and race, all other factors held constant. RESULTS The adjusted probability of having a BPM <140/90 was 47.1% using SOBP and 66.7% using OBP-30 (P < 0.01). Using SOBP, females had a 26.2 PP lower probability of having a BPM <140/90 (P < 0.001) than males. Relative to white patients, Black patients had a 43.9 PP lower (P < 0.001) and other races a 38.5 PP lower (P < 0.001) probability of having a BPM <140/90 using SOBP. Using OBP-30, these differences narrowed and became statistically insignificant. CONCLUSIONS OBP-30 may increase the probability of BPM meeting goals, especially in females and patients who are Black, indigenous, or persons of color.