A novel, hands-free ultrasound patch for continuous monitoring of quantitative Doppler in the carotid artery

Quantitative Doppler ultrasound of the carotid artery has been proposed as an instantaneous surrogate for monitoring rapid changes in left ventricular output. Tracking immediate changes in the arterial Doppler spectrogram has value in acute care settings such as the emergency department, operating room and critical care units. We report a novel, hands-free, continuous-wave Doppler ultrasound patch that adheres to the neck and tracks Doppler blood flow metrics in the common carotid artery using an automated algorithm. String and blood-mimicking test objects demonstrated that changes in velocity were accurately measured using both manually and automatically traced Doppler velocity waveforms. In a small usability study with 22 volunteer users (17 clinical, 5 lay), all users were able to locate the carotid Doppler signal on a volunteer subject, and, in a subsequent survey, agreed that the device was easy to use. To illustrate potential clinical applications of the device, the Doppler ultrasound patch was used on a healthy volunteer undergoing a passive leg raise (PLR) as well as on a congestive heart failure patient at resting baseline. The wearable carotid Doppler patch holds promise because of its ease-of-use, velocity measurement accuracy, and ability to continuously record Doppler spectrograms over many cardiac and respiratory cycles.

Comorbid Medical Problems and Motivational Interviewing

As HIV treatments become more effective and accessible, people living with HIV (PLWH) are achieving longer lifespans; however, this aging population also faces a greater risk of age-related co-morbidities. Many chronic diseases affect people living with HIV disproportionately, including diabetes, ischemic heart disease, and congestive heart failure. Patient-centered healthcare should aim to optimize quality and length of life while also considering the person’s value system. Motivational interviewing (MI) has been effective in helping PLWH to better manage chronic diseases requiring behavioral modification in both high- and low-resource settings. MI is a useful approach in the complex care of PLWH and medical co-morbidities. MI can promote self-management integrating HIV care as well as other co-morbidities in the context of social and cultural factors. This chapter discusses the application of MI to achieve better control of co-morbid medical conditions in PLWH.

PENGALAMAN PERAWAT MELAKUKAN LATIHAN AKTIFITAS FISIK PADA PASIEN CONGESTIVE HEART FAILURE

People with congestive heart failure (CHF) need a comprehensive rehabilitative program to restore physical abilities post-attacks and prevent re-attacks. Physical exercise in congestive heart failure (CHF) patients is aimed at optimizing the physical capacity of the body, providing counseling to patients and families in preventing worsening and helping patients to return to physical activity as before congestive heart failure (CHF). This study aims to explore in depth the experience of nurses doing physical exercise exercises in congetive heart failure patients. The research design used is descriptive phenomenology. Participants in this study amounted to 6 participants selected by purposive sampling technique. The data collected were in-depth interviews completed with field notes and then made in verbatim and analyzed using Colaizzi's approach. The research results found four themes, namely: the implementation of physical exercise exercise congestive heart failure patient is not optimal; increased knowledge of nurses and patients; the need for support from the hospital; and expectations for the exercise of physical activity. The results showed that things that could affect physical exercise activity in congestive heart failure patients were standard operating procedures, nurse knowledge, hospital support; and expectations for the exercise of physical activity. This study provides an understanding of the nurse's understanding of physical activity exercises so that nurses are able to provide appropriate nursing care.Keywords: experience, physical activity exercise, congetive heart failure