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Sample records for support rescues patients

  1. GIS Support for Flood Rescue

    DEFF Research Database (Denmark)

    Liang, Gengsheng; Mioc, Darka; Anton, François

    2007-01-01

    Under flood events, the ground traffic is blocked in and around the flooded area due to damages to roads and bridges. The traditional transportation network may not always help people to make a right decision for evacuation. In order to provide dynamic road information needed for flood rescue, we...... to retrieve the shortest and safest route in Fredericton road network during flood event. It enables users to make a timely decision for flood rescue. We are using Oracle Spatial to deal with emergency situations that can be applied to other constrained network applications as well....... developed an adaptive web-based transportation network application using Oracle technology. Moreover, the geographic relationships between the road network and flood areas are taken into account. The overlay between the road network and flood polygons is computed on the fly. This application allows users...

  2. Guidance of Autonomous Amphibious Vehicles for Flood Rescue Support

    Directory of Open Access Journals (Sweden)

    Shankarachary Ragi

    2013-01-01

    Full Text Available We develop a path-planning algorithm to guide autonomous amphibious vehicles (AAVs for flood rescue support missions. Specifically, we develop an algorithm to control multiple AAVs to reach/rescue multiple victims (also called targets in a flood scenario in 2D, where the flood water flows across the scene and the targets move (drifted by the flood water along the flood stream. A target is said to be rescued if an AAV lies within a circular region of a certain radius around the target. The goal is to control the AAVs such that each target gets rescued while optimizing a certain performance objective. The algorithm design is based on the theory of partially observable Markov decision process (POMDP. In practice, POMDP problems are hard to solve exactly, so we use an approximation method called nominal belief-state optimization (NBO. We compare the performance of the NBO approach with a greedy approach.

  3. Postmodernity and a hypertensive patient: rescuing value from nihilism.

    Science.gov (United States)

    Smith, S

    1998-01-01

    Much of postmodern philosophy questions the assumptions of Modernity, that period in the history of the Western world since the Enlightment. These assumptions are that truth is discoverable through human reason; that certain knowledge is possible; and furthermore, that such knowledge will provide a basis for the ineluctable progress of Mankind. The Enlightenment project is underwritten by the conviction that knowledge gained through the scientific method is secure. In so far as biomedicine inherits these assumptions it becomes fair game for postmodern deconstruction. Today, perhaps more than ever, plural values compete, and contradictory approaches to health, for instance, garner support and acquire supremacy through consumer choice and media manipulation rather than evidence-based science. Many doctors feel a tension between meeting the needs of the patient face to face, and working towards the broader health needs of the public at large. But if the very foundations of medical science are questioned, by patients, or by doctors themselves, wherein lies the value of their work? This paper examines the issues that the anti-foundationalist thrust of postmodernism raises, in the light of a case of mild hypertension. The strict application of medical protocol, derived from a nomothetic, statistical perspective, seems unlikely to furnish value in the treatment of an individual. The anything goes, consumerist approach, however, fares no better. The author argues that whilst value cannot depend on any rationally predetermined parameters, it can be rescued, and emerges from the process of the meeting with the patient. PMID:9549679

  4. Nurses to Their Nurse Leaders: We Need Your Help After a Failure to Rescue Patient Death.

    Science.gov (United States)

    Bacon, Cynthia Thornton

    The purpose of this study was to describe nurses' needs and how they are being met and not met after caring for surgical patients who died after a failure to rescue (FTR). A qualitative, phenomenologic approach was used for the interview and analysis framework. Methods to ensure rigor and trustworthiness were incorporated into the design. The investigator conducted semistructured 1:1 interviews with 14 nurses. Data were analyzed using Colaizzi's methods. Four themes were identified: (1) coping mechanisms are important; (2) immediate peer and supervisor feedback and support are needed for successful coping; (3) subsequent supervisor support is crucial to moving on; and (4) nurses desire both immediate support and subsequent follow-up from their nurse leaders after every FTR death. Nurses' needs after experiencing an FTR patient death across multiple practice areas and specialties were remarkably similar and clearly identified and articulated. Coping mechanisms vary and are not uniformly effective across different groups. Although most nurses in this study received support from their peers after the FTR event, many nurses did not receive the feedback and support that they needed from their nurse leaders. Immediate nurse leader support and follow-up debriefings should be mandatory after patient FTR deaths. Developing an understanding of nurses' needs after experiencing an FTR event can assist nurse leaders to better support nurses who experience FTR deaths. Insight into the environment surrounding FTR deaths also provides a foundation for future research aimed at improving patient safety and quality through an improved working environment for nurses.

  5. Clinical emergency treatment of 68 critical patients with severe organophosphorus poisoning and prognosis analysis after rescue.

    Science.gov (United States)

    Dong, Hui; Weng, Yi-Bing; Zhen, Gen-Shen; Li, Feng-Jie; Jin, Ai-Chun; Liu, Jie

    2017-06-01

    This study reports the clinical emergency treatment of 68 critical patients with severe organophosphorus poisoning, and analyzes the prognosis after rescue.The general data of 68 patients with severe organophosphorus poisoning treated in our hospital were retrospectively analyzed. These patients were divided into 2 groups: treatment group, and control group. Patients in the control group received routine emergency treatment, while patients in the treatment group additionally received hemoperfusion plus hemodialysis on the basis of routine emergency treatment. The curative effects in these 2 groups and the prognosis after rescue were compared.Compared with the control group, atropinization time, recovery time of cholinesterase activity, recovery time of consciousness, extubation time, and length of hospital stay were shorter (P poisoning rebound rate was significantly lower (P treatment group.Hemoperfusion and hemodialysis on the basis of routine emergency treatment for critical patients with organophosphorus poisoning can improve rescue outcomes and improve the prognosis of patients, which should be popularized.

  6. A SOUND SOURCE LOCALIZATION TECHNIQUE TO SUPPORT SEARCH AND RESCUE IN LOUD NOISE ENVIRONMENTS

    Science.gov (United States)

    Yoshinaga, Hiroshi; Mizutani, Koichi; Wakatsuki, Naoto

    At some sites of earthquakes and other disasters, rescuers search for people buried under rubble by listening for the sounds which they make. Thus developing a technique to localize sound sources amidst loud noise will support such search and rescue operations. In this paper, we discuss an experiment performed to test an array signal processing technique which searches for unperceivable sound in loud noise environments. Two speakers simultaneously played a noise of a generator and a voice decreased by 20 dB (= 1/100 of power) from the generator noise at an outdoor space where cicadas were making noise. The sound signal was received by a horizontally set linear microphone array 1.05 m in length and consisting of 15 microphones. The direction and the distance of the voice were computed and the sound of the voice was extracted and played back as an audible sound by array signal processing.

  7. The lived experience of rescuing people who have driven into floodwater: Understanding challenges and identifying areas for providing support.

    Science.gov (United States)

    Keech, Jacob J; Smith, Stephanie R; Peden, Amy E; Hagger, Martin S; Hamilton, Kyra

    2018-06-11

    Drowning is a major public health issue, with risk increasing during times of flood. Driving though floodwater is a major risk factor for flood-related drowning and injury, and despite widespread public health campaigns, many people continue to undertake this risky behaviour and require rescue. We aimed to identify key challenges faced by emergency services personnel when rescuing those who have driven into floodwater, and to identify strategies for supporting rescuers in this important role. Australian flood rescue operators (N=8) who had previously rescued a driver who had driven through floodwater, participated in semi-structured interviews. Data were analysed using thematic analysis. Four challenges emerged from their experiences: Involvement of untrained personnel, varying information provided by emergency telephone operators, behaviour of drivers complicating the rescue, people sightseeing floods or flood rescues, or ignoring closed roads providing sources of distraction and frustration. We propose five strategies for translating these results into practice, including: training and protocol development for (1) emergency personnel and (2) telephone operators, (3) training for rescuers regarding non-compliant rescuees, (4) educating the public, and (5) increasing compliance with closed roads. Current findings provide valuable insights into how rescuers can be supported in performing their roles, and implementation of these strategies has the potential to reduce fatalities occurring due to driving through floodwater. SO WHAT?: The strategies presented have the potential to reduce the frequency and improve the outcomes of floodwater rescues, aiding in the prevention of injury and death. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Cost and Operational Effectiveness Analysis of Aiternative Force Structures for Fulfillment of the United States Marine Corps Operational Support Airlift and Search and Rescue Missions

    National Research Council Canada - National Science Library

    Chase, Eric

    2000-01-01

    This thesis provides a preliminary cost and operational effectiveness analysis of alternative force structures for the United States Marine Corps operational support airlift and search and rescue missions...

  9. Blueprint for Implementing New Processes in Acute Care: Rescuing Adult Patients With Intraosseous Access.

    Science.gov (United States)

    Chreiman, Kristen M; Kim, Patrick K; Garbovsky, Lyudmila A; Schweickert, William D

    2015-01-01

    The intraosseous (IO) access initiative at an urban university adult level 1 trauma center began from the need for a more expeditious vascular access route to rescue patients in extremis. The goal of this project was a multidisciplinary approach to problem solving to increase access of IO catheters to rescue patients in all care areas. The initiative became a collaborative effort between nursing, physicians, and pharmacy to embark on an acute care endeavor to standardize IO access. This is a descriptive analysis of processes to effectively develop collaborative strategies to navigate hospital systems and successfully implement multilayered initiatives. Administration should empower nurse to advance their practice to include IO for patient rescue. Intraosseous access may expedite resuscitative efforts in patients in extremis who lack venous access or where additional venous access is required for life-saving therapies. Limiting IO dwell time may facilitate timely definitive venous access. Continued education and training by offering IO skill laboratory refreshers and annual e-learning didactic is optimal for maintaining proficiency and knowledge. More research opportunities exist to determine medication safety and efficacy in adult patients in the acute care setting.

  10. The Effectiveness of Group Therapy on Rescuing Patients with Cancer

    Directory of Open Access Journals (Sweden)

    Hossein Malekzadeh Fini

    2017-09-01

    Full Text Available Recent studies show that the cancer has several negative results. The anxiety, depression and disappointment are more common than the others.  Hopefully thinking and cancer in two ways are related together. First the hopeful people use The problem-focused coping strategies more than the others and show less anxious and more agreement to diagnosis and treatment of cancer. So the goal of this survey is the effect of group hope therapy on reciliency of cancer patients. In this survey the Quasi-experiment and pre-test and pro test with control group is used. The society are all of the cancer patients who are coming to Kashan Imam Hassan institution and 16 of them are chose by available sampling and randomly put in two trial and control group. The trial group participated in nine group consultation sessions and the control group had no education. For toleration testing the Conroy Davidson questionnaire 2003 is used. Data are analysed by co variance analysis. The results show that the group hope therapy had a meaning full effect on toleration and the idea of personal competency, negative affection tolerance and acceptation of positive changing and spiritual control and affection s are affected the scales. Hope let people to have no stress and enable them to try to reach to their goals, the hope therapy try to enable people to have a view beyond the current situation and pain and suffering. So the toleration is not more than tolerance of the difficult situations and every things that make better the situation of cancer patients will increase the toreciliency.

  11. Patient support systems

    International Nuclear Information System (INIS)

    Braden, A.B.; McBride, T.R.; Styblo, D.J.; Taylor, S.K.; Richey, J.B.

    1979-01-01

    A patient support system for use in computerized tomography (CT) is described. The system is particularly useful for CT scanning of the brain and also of the abdominal area. The support system consists of two moveable tables which may be translated into position for X-ray scanning of the patient's body and which may be translated incrementally and automatically to obtain scans at adjacent locations. For use with brain scans, the second table is replaced by a detachable restraint assembly which is described in detail. The support system is so designed that only a small volume of low density material will intercept the X-ray beam. (UK)

  12. Environmental modeling to support Elizio Leao ship rescue operation; Modelagem atmosferica e hidrodinamica em apoio a operacao de resgate da embarcacao Elizio Leao

    Energy Technology Data Exchange (ETDEWEB)

    Torres Junior, Audalio R. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Lab. de Modelagem de Processos Marinhos e Atmosfericos (LAMMA); Silva, Mariana P.R.; Silva, Ricardo M. da; Assad, Luiz Paulo de F.; Decco, Hatsue T. de; Landau, Luiz [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Lab. de Metodos Computacinais em Engenharia (LAMCE); Silva Junior, Ronaldo da [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2008-07-01

    On October 7th, 2007, the Elizio Leao ship broke carrying 19,812.9 gallons of oil near the Marajo Island has mobilized the PIATAM Mar (Potenciais Impactos do Transporte de Petroleo e Derivados na Zona Costeira Amazonica) modeling team for an execution of hydrodynamic and atmospheric prognostics that could support the ship rescue operation. In this work some results are presented as the operational methodology which has been applied to support the rescue team's needs. (author)

  13. Ten years of helicopter emergency medical services in Germany: do we still need the helicopter rescue in multiple traumatised patients?

    Science.gov (United States)

    Andruszkow, Hagen; Hildebrand, Frank; Lefering, Rolf; Pape, Hans-Christoph; Hoffmann, Reinhard; Schweigkofler, Uwe

    2014-10-01

    Helicopter emergency medical service (HEMS) has been established in the preclinical treatment of multiple traumatised patients despite an ongoing controversy towards the potential benefit. Celebrating the 20th anniversary of TraumaRegister DGU(®) of the German Trauma Society (DGU) the presented study intended to provide an overview of HEMS rescue in Germany over the last 10 years analysing the potential beneficial impact of a nationwide helicopter rescue in multiple traumatised patients. We analysed TraumaRegister DGU(®) including multiple traumatised patients (ISS ≥ 16) between 2002 and 2012. In-hospital mortality was defined as main outcome. An adjusted, multivariate regression with 13 confounders was performed to evaluate the potential survival benefit. 42,788 patients were included in the present study. 14,275 (33.4%) patients were rescued by HEMS and 28,513 (66.6%) by GEMS. Overall, 66.8% (n=28,569) patients were transported to a level I trauma centre and 28.2% (n=12,052) to a level II trauma centre. Patients rescued by HEMS sustained a higher injury severity compared to GEMS (ISS HEMS: 29.5 ± 12.6 vs. 27.5 ± 11.8). Helicopter rescue teams performed more on-scene interventions, and mission times were increased in HEMS rescue (HEMS: 77.2 ± 28.7 min. vs. GEMS: 60.9 ± 26.9 min.). Linear regression analysis revealed that the frequency of HEMS rescue has decreased significantly between 2002 and 2012. In case of transportation to level I trauma centres a decrease of 1.7% per year was noted (p<0.001) while a decline of 1.6% per year (p<0.001) was measured for level II trauma centre admissions. According to multivariate logistic regression HEMS was proven a positive independent survival predictor between 2002 and 2012 (OR 0.863; 95%-CI 0.800-0.930; Nagelkerkes-R(2) 0.539) with only little differences between each year. This study was able to prove an independent survival benefit of HEMS in multiple traumatised patients during the last 10 years. Despite this

  14. Blood glucose response to rescue dextrose in hypoglycemic, critically ill patients receiving an insulin infusion.

    Science.gov (United States)

    Murthy, Manasa S; Duby, Jeremiah J; Parker, Patricia L; Durbin-Johnson, Blythe P; Roach, Denise M; Louie, Erin L

    2015-08-01

    There is inadequate guidance for clinicians on selection of the optimal dextrose 50% (D50W) dose for hypoglycemia correction in critically ill patients. The purpose of this study was to determine the blood glucose (BG) response to D50W in critically ill patients. A retrospective analysis was conducted of critically ill patients who received D50W for hypoglycemia (BG 150 mg/dL), resulting in a 6.8% rate of overcorrection; 49% of hypoglycemic episodes (230/470) corrected to a BG >100 mg/dL. A multivariable GEE analysis showed a significantly higher BG response in participants with diabetes (0.002) but a lower response in those with recurrent hypoglycemia (P = 0.049). The response to D50W increased with increasinginsulin infusion rate (P = 0.022). Burn patients experienced a significantly larger BG response compared with cardiac, medical, neurosurgical, or surgical patients. The observed median effect of D50W on BG was approximately 4 mg/dL per gram of D50W administered. Application of these data may aid in rescue protocol development that may reduce glucose variability associated with hypoglycemic episodes and the correction. © The Author(s) 2015.

  15. Blocking of an intronic splicing silencer completely rescues IKBKAP exon 20 splicing in familial dysautonomia patient cells

    DEFF Research Database (Denmark)

    Bruun, Gitte H; Bang, Jeanne Mv; Christensen, Lise L

    2018-01-01

    designed splice switching oligonucleotides (SSO) that blocks the intronic hnRNP A1 binding site, and demonstrate that this completely rescues splicing of IKBKAP exon 20 in FD patient fibroblasts and increases the amounts of IKAP protein. We propose that this may be developed into a potential new specific...

  16. Metabolic rescue in pluripotent cells from patients with mtDNA disease.

    Science.gov (United States)

    Ma, Hong; Folmes, Clifford D L; Wu, Jun; Morey, Robert; Mora-Castilla, Sergio; Ocampo, Alejandro; Ma, Li; Poulton, Joanna; Wang, Xinjian; Ahmed, Riffat; Kang, Eunju; Lee, Yeonmi; Hayama, Tomonari; Li, Ying; Van Dyken, Crystal; Gutierrez, Nuria Marti; Tippner-Hedges, Rebecca; Koski, Amy; Mitalipov, Nargiz; Amato, Paula; Wolf, Don P; Huang, Taosheng; Terzic, Andre; Laurent, Louise C; Izpisua Belmonte, Juan Carlos; Mitalipov, Shoukhrat

    2015-08-13

    Mitochondria have a major role in energy production via oxidative phosphorylation, which is dependent on the expression of critical genes encoded by mitochondrial (mt)DNA. Mutations in mtDNA can cause fatal or severely debilitating disorders with limited treatment options. Clinical manifestations vary based on mutation type and heteroplasmy (that is, the relative levels of mutant and wild-type mtDNA within each cell). Here we generated genetically corrected pluripotent stem cells (PSCs) from patients with mtDNA disease. Multiple induced pluripotent stem (iPS) cell lines were derived from patients with common heteroplasmic mutations including 3243A>G, causing mitochondrial encephalomyopathy and stroke-like episodes (MELAS), and 8993T>G and 13513G>A, implicated in Leigh syndrome. Isogenic MELAS and Leigh syndrome iPS cell lines were generated containing exclusively wild-type or mutant mtDNA through spontaneous segregation of heteroplasmic mtDNA in proliferating fibroblasts. Furthermore, somatic cell nuclear transfer (SCNT) enabled replacement of mutant mtDNA from homoplasmic 8993T>G fibroblasts to generate corrected Leigh-NT1 PSCs. Although Leigh-NT1 PSCs contained donor oocyte wild-type mtDNA (human haplotype D4a) that differed from Leigh syndrome patient haplotype (F1a) at a total of 47 nucleotide sites, Leigh-NT1 cells displayed transcriptomic profiles similar to those in embryo-derived PSCs carrying wild-type mtDNA, indicative of normal nuclear-to-mitochondrial interactions. Moreover, genetically rescued patient PSCs displayed normal metabolic function compared to impaired oxygen consumption and ATP production observed in mutant cells. We conclude that both reprogramming approaches offer complementary strategies for derivation of PSCs containing exclusively wild-type mtDNA, through spontaneous segregation of heteroplasmic mtDNA in individual iPS cell lines or mitochondrial replacement by SCNT in homoplasmic mtDNA-based disease.

  17. Space Rescue

    Science.gov (United States)

    Muratore, John F.

    2007-01-01

    Space Rescue has been a topic of speculation for a wide community of people for decades. Astronauts, aerospace engineers, diplomats, medical and rescue professionals, inventors and science fiction writers have all speculated on this problem. Martin Caidin's 1964 novel Marooned dealt with the problems of rescuing a crew stranded in low earth orbit. Legend at the Johnson Space Center says that Caidin's portrayal of a Russian attempt to save the American crew played a pivotal role in convincing the Russians to join the real joint Apollo-Soyuz mission. Space Rescue has been a staple in science fiction television and movies portrayed in programs such as Star Trek, Stargate-SG1 and Space 1999 and movies such as Mission To Mars and Red Planet. As dramatic and as difficult as rescue appears in fictional accounts, in the real world it has even greater drama and greater difficulty. Space rescue is still in its infancy as a discipline and the purpose of this chapter is to describe the issues associated with space rescue and the work done so far in this field. For the purposes of this chapter, the term space rescue will refer to any system which allows for rescue or escape of personnel from situations which endanger human life in a spaceflight operation. This will span the period from crew ingress prior to flight through crew egress postlanding. For the purposes of this chapter, the term primary system will refer to the spacecraft system that a crew is either attempting to escape from or from which an attempt is being made to rescue the crew.

  18. 007 to the Rescue – Cognitive Fit of Operations Research and Agent-based Decision Support

    NARCIS (Netherlands)

    Krauth, Elfriede I.; van Hillegersberg, Jos; van de Velde, Steef L.

    2007-01-01

    Adoption rates of traditional Operations Research (OR) based decision support systems (DSS) suffer from perceived complexity of the underlying model and its detrimental effect on user-friendliness. The mental effort required to understand abstract models can hinder adoption. This barrier may seem

  19. Low dose tubulin-binding drugs rescue peroxisome trafficking deficit in patient-derived stem cells in Hereditary Spastic Paraplegia

    Directory of Open Access Journals (Sweden)

    Yongjun Fan

    2014-05-01

    Full Text Available Hereditary Spastic Paraplegia (HSP is a genetically heterogeneous group of disorders, diagnosed by progressive gait disturbances with muscle weakness and spasticity, for which there are no treatments targeted at the underlying pathophysiology. Mutations in spastin are a common cause of HSP. Spastin is a microtubule-severing protein whose mutation in mouse causes defective axonal transport. In human patient-derived olfactory neurosphere-derived (ONS cells, spastin mutations lead to lower levels of acetylated α-tubulin, a marker of stabilised microtubules, and to slower speed of peroxisome trafficking. Here we screened multiple concentrations of four tubulin-binding drugs for their ability to rescue levels of acetylated α-tubulin in patient-derived ONS cells. Drug doses that restored acetylated α-tubulin to levels in control-derived ONS cells were then selected for their ability to rescue peroxisome trafficking deficits. Automated microscopic screening identified very low doses of the four drugs (0.5 nM taxol, 0.5 nM vinblastine, 2 nM epothilone D, 10 µM noscapine that rescued acetylated α-tubulin in patient-derived ONS cells. These same doses rescued peroxisome trafficking deficits, restoring peroxisome speeds to untreated control cell levels. These results demonstrate a novel approach for drug screening based on high throughput automated microscopy for acetylated α-tubulin followed by functional validation of microtubule-based peroxisome transport. From a clinical perspective, all the drugs tested are used clinically, but at much higher doses. Importantly, epothilone D and noscapine can enter the central nervous system, making them potential candidates for future clinical trials.

  20. Low dose tubulin-binding drugs rescue peroxisome trafficking deficit in patient-derived stem cells in Hereditary Spastic Paraplegia

    Science.gov (United States)

    Fan, Yongjun; Wali, Gautam; Sutharsan, Ratneswary; Bellette, Bernadette; Crane, Denis I.; Sue, Carolyn M.; Mackay-Sim, Alan

    2014-01-01

    ABSTRACT Hereditary Spastic Paraplegia (HSP) is a genetically heterogeneous group of disorders, diagnosed by progressive gait disturbances with muscle weakness and spasticity, for which there are no treatments targeted at the underlying pathophysiology. Mutations in spastin are a common cause of HSP. Spastin is a microtubule-severing protein whose mutation in mouse causes defective axonal transport. In human patient-derived olfactory neurosphere-derived (ONS) cells, spastin mutations lead to lower levels of acetylated α-tubulin, a marker of stabilised microtubules, and to slower speed of peroxisome trafficking. Here we screened multiple concentrations of four tubulin-binding drugs for their ability to rescue levels of acetylated α-tubulin in patient-derived ONS cells. Drug doses that restored acetylated α-tubulin to levels in control-derived ONS cells were then selected for their ability to rescue peroxisome trafficking deficits. Automated microscopic screening identified very low doses of the four drugs (0.5 nM taxol, 0.5 nM vinblastine, 2 nM epothilone D, 10 µM noscapine) that rescued acetylated α-tubulin in patient-derived ONS cells. These same doses rescued peroxisome trafficking deficits, restoring peroxisome speeds to untreated control cell levels. These results demonstrate a novel approach for drug screening based on high throughput automated microscopy for acetylated α-tubulin followed by functional validation of microtubule-based peroxisome transport. From a clinical perspective, all the drugs tested are used clinically, but at much higher doses. Importantly, epothilone D and noscapine can enter the central nervous system, making them potential candidates for future clinical trials. PMID:24857849

  1. High Dose Cyclophosphamide without Stem Cell Rescue in 207 Patients with Aplastic anemia and other Autoimmune Diseases

    Science.gov (United States)

    DeZern, Amy E.; Petri, Michelle; Drachman, Daniel B.; Kerr, Doug; Hammond, Edward R.; Kowalski, Jeanne; Tsai, Hua-Ling; Loeb, David M.; Anhalt, Grant; Wigley, Fredrick; Jones, Richard J.; Brodsky, Robert A.

    2011-01-01

    High-dose cyclophosphamide has long been used an anticancer agent, a conditioning regimen for hematopoietic stem cell transplantation and as potent immunosuppressive agent in autoimmune diseases including aplastic anemia. High-dose cyclophosphamide is highly toxic to lymphocytes but spares hematopoietic stem cells because of their abundant levels of aldehyde dehydrogenase, the major mechanism of cyclophosphamide inactivation. High dose cyclophosphamide therapy induces durable remissions in most patients with acquired aplastic anemia. Moreover, high-dose cyclophosphamide without hematopoietic stem cell rescue has shown activity in a variety of other severe autoimmune diseases. Here we review the history of cyclophosphamide as is applies to aplastic anemia (AA) and other autoimmune diseases. Included here are the historical data from early patients treated for AA as well as an observational retrospective study in a single tertiary care hospital. This latter component was designed to assess the safety and efficacy of high-dose cyclophosphamide therapy without stem cell rescue in patients with refractory autoimmune diseases. We analyzed fully the 140 patients with severe, progressive autoimmune diseases treated. All patients discussed here received cyclophosphamide, 50 mg/kg per day for 4 consecutive days. Response, relapse and overall survival were measured. Response was defined as a decrease in disease activity in conjunction with a decrease or elimination of immune modulating drugs. Relapse was defined as worsening disease activity and/or a requirement of an increase in dose of, or administration of new, immunosuppressive medications. Hematologic recovery occurred in all patients. The overall response rate of the was 95%, and 44% of those patients remain progression-free with a median follow up time of 36 (range 1–120) months for the 140 patients analyzed together. The overall actuarial and event free survival across all diseases at 60 months is 90.7% and 20

  2. Pharmacological rescue of mitochondrial deficits in iPSC-derived neural cells from patients with familial Parkinson's disease

    DEFF Research Database (Denmark)

    Cooper, Oliver; Seo, Hyemyung; Andrabi, Shaida

    2012-01-01

    , or the LRRK2 kinase inhibitor GW5074. Analysis of mitochondrial responses in iPSC-derived neural cells from PD patients carrying different mutations provides insight into convergence of cellular disease mechanisms between different familial forms of PD and highlights the importance of oxidative stress...... of reactive oxygen species, mitochondrial respiration, proton leakage, and intraneuronal movement of mitochondria. Cellular vulnerability associated with mitochondrial dysfunction in iPSC-derived neural cells from familial PD patients and at-risk individuals could be rescued with coenzyme Q(10), rapamycin...

  3. The Chemical Chaperone Phenylbutyrate Rescues MCT8 Mutations Associated With Milder Phenotypes in Patients With Allan-Herndon-Dudley Syndrome.

    Science.gov (United States)

    Braun, Doreen; Schweizer, Ulrich

    2017-03-01

    Mutations in the thyroid hormone transporter monocarboxylate transporter 8 (MCT8) prevent appropriate entry of thyroid hormones into brain cells during development and cause severe mental retardation in affected patients. The current treatment options are thyromimetic compounds that enter the brain independently of MCT8. Some MCT8-deficient patients (e.g., those carrying MCT8delF501) will not be as severely affected as most others. We have shown that the MCT8delF501 protein has decreased protein stability but important residual function once it reaches the plasma membrane. We were able to rescue protein expression and the function of MCT8delF501 in a Madin-Darby canine kidney cell model by application of the chemical chaperone sodium phenylbutyrate (NaPB), a drug that has been used to treat patients with cystic fibrosis and urea cycle defects for extended periods of time. In the present study, we have extended our previous study and report on the NaPB-dependent rescue of a series of other pathogenic MCT8 mutants associated with milder patient phenotypes. We show that NaPB can functionally rescue the expression and activities of Ser194Phe, Ser290Phe, Leu434Trp, Arg445Cys, Leu492Pro, and Leu568Pro mutations in MCT8 in a dose-dependent manner. The soy isoflavone genistein, a dietary supplement, which was effective in MCT8delF501, was also effective in increasing the expression and transport of these MCT8 mutants; however, the effect size differed among mutants. Kinetic analyses revealed that the Michaelis constants of the mutants toward the primary substrate 3,3',5-triiodothyronine were not much different from the wild-type value, suggesting that these mutants are not impaired in their interaction with substrate but rather destabilized by the mutation and degraded. Copyright © 2017 by the Endocrine Society.

  4. Efficacy of just-in-time plerixafor rescue for Hodgkin's lymphoma patients with poor peripheral blood stem cell mobilization.

    Science.gov (United States)

    Yuan, Shan; Nademanee, Auayporn; Kaniewski, Mark; Palmer, Joycelynne; Shayani, Sepideh; Wang, Shirong

    2014-08-01

    Plerixafor is a Food and Drug Administration-approved agent for improving peripheral blood stem cell (PBSC) mobilization in filgrastim (granulocyte-colony-stimulating factor [G-CSF])-stimulated patients with multiple myeloma and non-Hodgkin's lymphoma. Limited information is available on its use in Hodgkin's lymphoma (HL) patients. We describe our experience with plerixafor as an immediate rescue agent in HL patients with poor PBSC mobilization. We retrospectively reviewed the collection data of 27 consecutive HL patients at our center in whom plerixafor was added to rescue a failing PBSC collection after G-CSF and chemotherapy (26) or G-CSF alone (1). Plerixafor was added in 11 patients due to peripheral blood (PB) CD34+ counts that persisted below the threshold (>10 × 10(6) /L) to initiate collection (median, 1.47 × 10(6) ; range 0 × 10(6) -6.28 × 10(6) /L) and in 16 patients due to low collection yields, who had a median yield of 0.33 × 10(6) (0.14 × 10(6) -0.65 × 10(6) ) CD34+ cells/kg on the last collection before plerixafor administration. After a median of 2 (range, 2-4) collections with plerixafor, the patients collected a median of 1.82 × 10(6) (0.52 × 10(6) -11.14 × 10(6) ) CD34+ cells/kg. The addition of plerixafor enabled 20 patients (74.1%) to reach the 2.0 × 10(6) CD34+ cells/kg minimum required for autologous stem cell transplantation (ASCT) during the same collection cycle. Subsequent remobilization in three patients with plerixafor enabled all three to reach this goal. Plerixafor can be used in HL patients with poor mobilization as a rescue agent and boosts mobilization sufficiently in most patients in the same collection attempt, thus not only permitting ASCT, but also avoiding remobilization and the associated costs, treatment delays, and patient inconvenience. © 2014 AABB.

  5. Nutritional support of reptile patients.

    Science.gov (United States)

    De Voe, Ryan S

    2014-05-01

    Providing nutritional support to reptile patients is a challenging and often misunderstood task. Ill reptiles are frequently anorexic and can benefit greatly from appropriate nutrition delivered via a variety of assist-feeding techniques. Neonatal reptiles can also be very challenging patients because many fail to thrive without significant efforts to establish normal feeding behaviors. This article presents ideas supporting the benefit of timely nutritional support as well as specific recommendations for implementation of assist feeding. Also discussed are a few nutritional issues that affect captive reptile species. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. The problem with rescue medicine.

    Science.gov (United States)

    Jecker, Nancy S

    2013-02-01

    Is there a rational and ethical basis for efforts to rescue individuals in dire straits? When does rescue have ethical support, and when does it reflect an irrational impulse? This paper defines a Rule of Rescue and shows its intuitive appeal. It then proceeds to argue that this rule lacks support from standard principles of justice and from ethical principles more broadly, and should be rejected in many situations. I distinguish between agent-relative and agent-neutral reasons, and argue that the Rule of Rescue qualifies only in a narrow range of cases where agent-relative considerations apply. I conclude that it would be wise to set aside the Rule of Rescue in many cases, especially those involving public policies, where it has only weak normative justification. The broader implications of this analysis are noted.

  7. Patient positioning and supporting arrangement

    International Nuclear Information System (INIS)

    Heavens, M.; James, R.C.; Slinn, D.S.

    1980-01-01

    This patent specification describes an E.M.I. claim relating to a patient positioning and support arrangement for a computerised axial tomography system, the arrangement comprising a curved platter upon which the patient can be disposed, a table having a curved groove to accommodate the platter, and means for driving the platter slidably along the groove; the platter being formed of a substantially rigid platform shaped to conform to the groove, and a shroud, secured to the platter and disposed between the platter and the surface of the groove, so as to permit the platter to slide smoothly. (U.K.)

  8. Follow-up of relapsed B-cell lymphoma patients treated with iodine-131-labeled anti-CD20 antibody and autologous stem-cell rescue

    International Nuclear Information System (INIS)

    Liu, S Y.; Eary, Janet F.; Petersdorf, S H.; Martin, P J.; Maloney, D G.; Applebaum, F. R.; Matthews, D. C.; Bush, S A.; Durack, L. D.; Fisher, Darrell R.; Gooley, T A.; Bernstein, I. D.; Press, O. W.

    1997-01-01

    Radioimmunotherapy (RIT) is a promising treatment approach for B-cell lymphomas. This is our first opportunity to report long-term follow-up data and late toxicities in 29 patients treated with myeloablative doses of iodine-131-anti-CD20 antibody (anti-B1) and autologous stem-cell rescue. PATIENTS AND METHODS: Trace-labeled biodistribution studies first determined the ability to deliver higher absorbed radiation doses to tumor sites than to lung, liver, or kidney at varying amounts of anti-B1 protein (0.35, 1.7, or 7 mg/kg). Twenty- nine patients received therapeutic infusions of single-agent (131)I- anti-B1, given at the protein dose found optimal in the biodistribution study, labeled with amounts of (131)I (280 to 785 mCi[10.4 to 29.0 GBq]) calculated to deliver specific absorbed radiation doses to the normal organs, followed by autologous stem-cell support. RESULTS: Major responses occurred in 25 patients (86%), with 23 complete responses (CRs; 79%). The nonhematopoietic do se-limiting toxicity was reversible cardiopulmonary insufficiency, which occurred in two patients at RIT doses that delivered > or = 27 Gy to the lungs. With a median follow-up time of 42 months, the estimated overall and progression-free survival rates are 68% and 42%, respectively. Currently, 14 of 29 patients remain in unmaintained remissions that range from 27+ to 87+ months after RIT. Late toxicities have been uncommon except for elevated thyroid-stimulating hormone (TSH) levels found in approximately 60% of the subjects. Two patients developed second malignancies, but none have developed myelodysplasia (MDS). CONCLUSION: Myeloablative (131)I-anti- B1 RIT is relatively well tolerated when given with autologous stem- cell support and often results in prolonged remission durations with few late toxicities

  9. Mouthpiece ventilation in Duchenne muscular dystrophy: a rescue strategy for noncompliant patients

    OpenAIRE

    Fiorentino, Giuseppe; Annunziata, Anna; Cauteruccio, Rosa; Frega, Gianfranco Scotto di; Esquinas, Antonio

    2016-01-01

    ABSTRACT Objective: To evaluate mouthpiece ventilation (MPV) in patients with Duchenne muscular dystrophy (DMD) who are noncompliant with noninvasive ventilation (NIV). Methods: We evaluated four young patients with DMD who had previously refused to undergo NIV. Each patient was reassessed and encouraged to try MPV. Results: The four patients tolerated MPV well and were compliant with NIV at home. MPV proved to be preferable and more comfortable than NIV with any other type of interface. T...

  10. Effect of edaravone on favorable outcome in patients with acute cerebral large vessel occlusion: subanalysis of RESCUE-Japan Registry.

    Science.gov (United States)

    Miyaji, Yuki; Yoshimura, Shinichi; Sakai, Nobuyuki; Yamagami, Hiroshi; Egashira, Yusuke; Shirakawa, Manabu; Uchida, Kazutaka; Kageyama, Hirohito; Tomogane, Yusuke

    2015-01-01

    The data of the nationwide prospective registry of acute cerebral large vessel occlusion (LVO; RESCUE-Japan Registry) were analyzed to know the effect of edaravone, a free radical scavenger, on clinical outcome at 90 days after onset. In this registry, patients with acute cerebral LVO admitted within 24 h after onset were prospectively registered. The effect of various factors including endovascular treatment (EVT), intravenous recombinant tissue plasminogen activator (IV rt-PA), and other medication including edaravone on favorable outcome (modified Rankin scale 0-1) was analyzed. Of the 1,454 registered patients, 1,442 patients (99.2%) had the information of edaravone were analyzed. In total, edaravone group had more patients with favorable outcome compared to non-edaravone group (22.9% vs. 13.8%, p = 0.0006). Edaravone increased favorable outcome in patients treated with IV rt-PA (29.4% vs. 11.1%, p = 0.0107), but not with EVT (21.2% vs. 13.9%, p = 0.309). Logistic regression analysis revealed that higher National Institutes of Health Stroke Scale (NIHSS) score on admission [odds ratio (OR) 0.875, 95% confidence interval (CI) 0.858-0.894] and advanced age (OR 0.963, 95%CI 0.952-0.975) were significantly related to unfavorable outcome. In contrast, IV rt-PA (OR 2.489, 95%CI 1.867-3.319), EVT (OR 1.375, 95%CI 1.013-1.865), and edaravone (OR 1.483, 95%CI 1.027-2.143) were significantly associated with favorable outcome. This analysis indicated that IV rt-PA, EVT, and edaravone were effective to obtain favorable outcome in patients with acute LVO. Combination IV rt-PA with edaravone was more effective.

  11. Mouthpiece ventilation in Duchenne muscular dystrophy: a rescue strategy for noncompliant patients

    Directory of Open Access Journals (Sweden)

    Giuseppe Fiorentino

    Full Text Available ABSTRACT Objective: To evaluate mouthpiece ventilation (MPV in patients with Duchenne muscular dystrophy (DMD who are noncompliant with noninvasive ventilation (NIV. Methods: We evaluated four young patients with DMD who had previously refused to undergo NIV. Each patient was reassessed and encouraged to try MPV. Results: The four patients tolerated MPV well and were compliant with NIV at home. MPV proved to be preferable and more comfortable than NIV with any other type of interface. Two of the patients required overnight NIV and eventually agreed to use a nasal mask during the night. Conclusions: The advantages of MPV over other types of NIV include fewer speech problems, better appearance, and less impact on the patient, eliminating the risk of skin breakdown, gastric distension, conjunctivitis, and claustrophobia. The use of a mouthpiece interface should be always considered in patients with DMD who need to start NIV, in order to promote a positive approach and a rapid acceptance of NIV. Using MPV during the daytime makes patients feel safe and more likely to use NIV at night. In addition, MPV increases treatment compliance for those who refuse to use other types of interfaces.

  12. Rescue Manual. Module 6.

    Science.gov (United States)

    Ohio State Univ., Columbus. Instructional Materials Lab.

    This learner manual for rescuers covers the current techniques or practices required in the rescue service. The sixth of 10 modules contains 4 chapters: (1) industrial rescue; (2) rescue from a confined space; (3) extrication from heavy equipment; and (4) rescue operations involving elevators. Key points, an introduction, and conclusion accompany…

  13. [Design and application of portable rescue vehicle].

    Science.gov (United States)

    Guo, Ying; Qi, Huaying; Wang, Shen

    2017-12-01

    The disease of critically ill patients was with rapid changes, and at any time faced the risk of emergency. The current commonly used rescue vehicles were larger and bulky implementation, which were not conducive to the operation, therefore the design of a portable rescue vehicle was needed. This new type of rescue vehicle is multi-layer folding structure, with small footprint, large storage space, so a variety of first aid things can be classified and put, easy to be cleaned and disinfected. In the rescue process, the portable rescue vehicles can be placed in the required position; box of various emergency items can be found at a glance with easy access; the height of the infusion stand can adjust freely according to the user height; the rescue vehicle handle can be easy to pull and adjust accord with human body mechanics principle. The portable rescue vehicle facilitates the operation of medical staff, and is worthy of clinical application.

  14. Pectoral Fascial (PECS) I and II Blocks as Rescue Analgesia in a Patient Undergoing Minimally Invasive Cardiac Surgery.

    Science.gov (United States)

    Yalamuri, Suraj; Klinger, Rebecca Y; Bullock, W Michael; Glower, Donald D; Bottiger, Brandi A; Gadsden, Jeffrey C

    Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient undergoing minimally invasive mitral valve repair. In this case, a 78-year-old man, with no history of chronic pain, underwent mitral valve repair via right anterior thoracotomy for severe mitral regurgitation. After extubation, he complained of 10/10 pain at the incision site that was minimally responsive to intravenous opioids. He required supplemental oxygen because of poor pulmonary mechanics, with shallow breathing and splinting due to pain, and subsequent intensive care unit readmission. Ultrasound-guided Pecs I and II blocks were performed on the right side with 30 mL of 0.2% ropivacaine with 1:400,000 epinephrine. The blocks resulted in near-complete chest wall analgesia and improved pulmonary mechanics for approximately 24 hours. After the single-injection blocks regressed, a second set of blocks was performed with 266 mg of liposomal bupivacaine mixed with bupivacaine. This second set of blocks provided extended analgesia for an additional 48 hours. The patient was weaned rapidly from supplemental oxygen after the blocks because of improved analgesia. Pectoral nerve blocks have been described in the setting of breast surgery to provide chest wall analgesia. We report the first successful use of Pecs blocks to provide effective chest wall analgesia for a patient undergoing minimally invasive cardiac surgery with thoracotomy. We believe that these blocks may provide an important nonopioid option for the management of pain during recovery from minimally invasive cardiac surgery.

  15. Mouthpiece ventilation in Duchenne muscular dystrophy: a rescue strategy for noncompliant patients.

    Science.gov (United States)

    Fiorentino, Giuseppe; Annunziata, Anna; Cauteruccio, Rosa; Frega, Gianfranco Scotto di; Esquinas, Antonio

    2016-01-01

    To evaluate mouthpiece ventilation (MPV) in patients with Duchenne muscular dystrophy (DMD) who are noncompliant with noninvasive ventilation (NIV). We evaluated four young patients with DMD who had previously refused to undergo NIV. Each patient was reassessed and encouraged to try MPV. The four patients tolerated MPV well and were compliant with NIV at home. MPV proved to be preferable and more comfortable than NIV with any other type of interface. Two of the patients required overnight NIV and eventually agreed to use a nasal mask during the night. The advantages of MPV over other types of NIV include fewer speech problems, better appearance, and less impact on the patient, eliminating the risk of skin breakdown, gastric distension, conjunctivitis, and claustrophobia. The use of a mouthpiece interface should be always considered in patients with DMD who need to start NIV, in order to promote a positive approach and a rapid acceptance of NIV. Using MPV during the daytime makes patients feel safe and more likely to use NIV at night. In addition, MPV increases treatment compliance for those who refuse to use other types of interfaces. Avaliar a ventilação bucal (VB) em pacientes com distrofia muscular de Duchenne (DMD) não aderentes à ventilação não invasiva (VNI). Foram avaliados quatro pacientes jovens com DMD que anteriormente recusaram-se a se submeter à VNI. Cada paciente foi reavaliado e encorajado a tentar VB. Os quatro pacientes toleraram bem a VB e aderiram ao uso de VNI em casa. O uso de VB provou ser uma alternativa preferível e mais confortável que o uso de VNI com qualquer outro tipo de interface. Dois dos pacientes necessitaram de VNI noturna e eventualmente aceitaram utilizar uma máscara nasal durante a noite. As vantagens da VB sobre outros tipos de VNI incluem menores problemas na fala, melhor aparência e menor impacto no paciente, eliminando o risco de lesões na pele, distensão gástrica, conjuntivite e claustrofobia. O uso da

  16. Live birth after rescue in vitro maturation–intracytoplasmic sperm injection in type 1 diabetes, polycystic ovary syndrome patient using clomiphene–antagonist protocol

    Directory of Open Access Journals (Sweden)

    Samundi Sankari

    2018-01-01

    Full Text Available Infertility in patients with polycystic ovary syndrome (PCOS associated with diabetes leads to challenging situations seeking alternative treatments. In vitro maturation (IVM followed by intracytoplasmic sperm injection (ICSI could overcome the challenges with promising pregnancies in such patients. In the treatment of a 32-year-old diabetic woman who also had PCOS, single immature oocyte was retrieved. Rescue IVM followed by ICSI yielded a grade 1 day 3 embryo which on transferring resulted in pregnancy and a healthy infant was delivered. Rescue IVM–ICSI could help in achieving pregnancy and live birth. Stimulation involving clomiphene and gonadotropin-releasing hormone antagonist is an effective and patient-friendly protocol for women with PCOS and diabetes and also for poor responders.

  17. Long-term outcomes of two rescue therapies in lamivudine-refractory patients with chronic hepatitis B: combined lamivudine and adefovir, and 1-mg entecavir

    Directory of Open Access Journals (Sweden)

    EunYoung Ze

    2014-09-01

    Full Text Available Background/AimsAdefovir (ADV and lamivudine (LAM combination therapy (ADV+LAM has been a useful option for patients with LAM-resistant (LAM-r chronic hepatitis B (CHB. However, the long-term outcomes of LAM+ADV and 1-mg entecavir (ETV rescue therapies have still been limited. The aim of this study was to determine the long-term outcomes of these two rescue therapies.MethodsSixty patients with LAM-r CHB underwent rescue therapy with LAM+ADV (n=36 or 1-mg ETV (n=24. We determined the duration of rescue therapy, timing and type of mutation, undetectable serum hepatitis B virus (HBV DNA by PCR (lower limitation of detection, < 140 copies/mL, biochemical response (alanine aminotransferase < 40 IU/mL, and the incidence of hepatitis B virus e antigen (HBeAg seroconversion and virologic breakthrough.ResultsBaseline characteristics did not differ between the two therapy groups. The duration of rescue therapy was 56 months (range, 14-100 months in the ADV+LAM group and 42 months (range, 12-73 months in the ETV group (P=0.036. The cumulative rates of HBV DNA undetectability and HBeAg seroconversion up to 6 years were 88.6% and 43.0%, respectively, in the ADV+LAM group, and 45.8% and 31.8% in the ETV group. The rate of virologic breakthrough and resistance was 14.4% in the ADV+LAM group and 71.9% in the ETV group (P=0.001.ConclusionsCombination of LAM and ADV therapy for up to 6 years achieved modest rates of virological suppression and resistance. ETV is not an optimal therapy because the risk of viral breakthrough to ETV increases over time.

  18. Isoflurane rescue therapy for bronchospasm reduces intracranial pressure in a patient with traumatic brain injury.

    Science.gov (United States)

    Gradisek, Primoz; Dolenc, Simon

    2016-01-01

    To assess the unusual use of a volatile anaesthetic for treatment of life-threatening bronchospasm in a patient with traumatic brain injury (TBI). Case report. This study presents a previously healthy 30-year-old man with severe TBI and bronchospasm-induced acute hypercapnia. He was treated with inhaled isoflurane in combination with monitoring of intracranial pressure (ICP) and regional cerebral blood flow (rCBF). Three-day-long isoflurane treatment resolved drug-refractory bronchospasm, decreased airway pressure and improved gas exchange, even at a low end-tidal concentration (0.3-0.5 vol%). Although rCBF was increased by 18 ml min(-1) 100 g(-1) during isoflurane treatment, there was a significant decrease in ICP (21 (SD = 3) mmHg, 9 (SD = 5) mmHg, 2 (SD = 3) mmHg; during pre-treatment, treatment and post-treatment, respectively; p < 0.001). Improved autoregulation due to lower partial pressure of carbon dioxide, restoration of carbon dioxide reactivity, isoflurane-induced regional differences in rCBF and improved microcirculation may have been responsible for the prompt and long-lasting normalization of ICP. The patient had no TBI-related disability at 6 months post-injury. Isoflurane at a low dose can be an effective and safe treatment option for drug-refractory bronchospasm in a patient with traumatic intracranial hypertension, provided that multimodality neuromonitoring is used.

  19. A Pencil Rescues Impaired Performance on a Visual Discrimination Task in Patients with Medial Temporal Lobe Lesions

    Science.gov (United States)

    Knutson, Ashley R.; Hopkins, Ramona O.; Squire, Larry R.

    2013-01-01

    We tested proposals that medial temporal lobe (MTL) structures support not just memory but certain kinds of visual perception as well. Patients with hippocampal lesions or larger MTL lesions attempted to identify the unique object among twin pairs of objects that had a high degree of feature overlap. Patients were markedly impaired under the more…

  20. Failure to Rescue, Rescue Surgery and Centralization of Postoperative Complications: A Challenge for General and Acute Care Surgeons.

    Science.gov (United States)

    Zago, Mauro; Bozzo, Samantha; Carrara, Giulia; Mariani, Diego

    2017-01-01

    To explore the current literature on the failure to rescue and rescue surgery concepts, to identify the key items for decreasing the failure to rescue rate and improve outcome, to verify if there is a rationale for centralization of patients suffering postoperative complications. There is a growing awareness about the need to assess and measure the failure to rescue rate, on institutional, regional and national basis. Many factors affect failure to rescue, and all should be individually analyzed and considered. Rescue surgery is one of these factors. Rescue surgery assumes an acute care surgery background. Measurement of failure to rescue rate should become a standard for quality improvement programs. Implementation of all clinical and organizational items involved is the key for better outcomes. Preparedness for rescue surgery is a main pillar in this process. Centralization of management, audit, and communication are important as much as patient centralization. Celsius.

  1. Rescue localized intra-arterial thrombolysis for hyperacute MCA ischemic stroke patients after early non-responsive intravenous tissue plasminogen activator therapy

    International Nuclear Information System (INIS)

    Kim, Dong Joon; Kim, Dong Ik; Kim, Seo Hyun; Lee, Kyung Yeol; Heo, Ji Hoe; Han, Sang Won

    2005-01-01

    The outcome of patients who show no early response to intravenous (i.v.) tissue plasminogen activator (tPA) therapy is poor. The objective of this study was to evaluate the feasibility of rescue localized intra-arterial thrombolysis (LIT) therapy for acute ischemic stroke patients after an early non-responsive i.v. tPA therapy. Patients with proximal MCA occlusions who were treated by LIT (n=10) after failure of early response [no improvement or improvement of National Institute of Health Stroke Scale (NIHSS) scores of ≤3] to i.v. tPA therapy (0.9 mg/kg - 10% bolus and 90% i.v. infusion over 60 min) were selected. The recanalization rates, incidence of post-thrombolysis hemorrhage and clinical outcomes [baseline and discharge NIHSS scores, mortality, 3 months Barthel index (BI) and modified Rankin score (mRS)] were evaluated. Rescue LIT therapy was performed on ten MCA occlusion patients (male:female=3:7, mean age 71 years). The mean time between the initiation of i.v. tPA therapy and the initiation of intra-arterial urokinase (i.a. UK) was 117±25.0 min [time to i.v. tPA 137±32 min; time to digital subtraction angiography (DSA) 221±42 min; time to i.a. UK 260±46 min]. The baseline NIHSS scores showed significant improvement at discharge (median from 18 to 6). Symptomatic hemorrhage and, consequent, mortality were noted in 2/10 (20%) patients. Three months good outcome was noted in 4/10 (40%, mRS 0-2) and 3/10 (30%, BI ≥95). In conclusion, rescue LIT therapy can be considered as a treatment option for patients not showing early response to full dose i.v. tPA therapy. Larger scale studies for further validation of this protocol may be necessary. (orig.)

  2. Supportive care needs of Iranian cancer patients

    Directory of Open Access Journals (Sweden)

    Azad Rahmani

    2014-01-01

    Full Text Available Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59. Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran.

  3. Perceived Social Support among Mentally Ill Patients

    Directory of Open Access Journals (Sweden)

    Bandana Pokharel

    2014-06-01

    Full Text Available Introduction: Social support is the perception that one is cared for, has assistance available from significant others and its benefit is by buffering stress by influencing the ability to adjust and live with illness. Social support can uplift the quality and subjective wellbeing of people. The objective of this study was to examine the perceived social support and factors influencing it among mentally ill patients. Methods: A descriptive cross-sectional study was carried out. Ninety cases aged more than 18 years visiting outpatient of psychiatric department and diagnosed as a case of mental illness for at least a year were included. Instruments used were self-developed proforma and Multidimensional Scale of Perceived Social Support. Interview technique was used to collect the data. Results: Majority (60% of the patients perceive social support from family, 28% of the patients perceive social support from significant others. Regression analysis showed that the perceived social support is influenced by employment status, type of family one lives in and physical illness. It is not influenced by gender, subjective financial status and frequency of hospitalization. Conclusion: Perceived social support is influenced by employment status, type of family one lives in and physical illness. Majority (60% of the patients perceive social support from family.

  4. Extracorporeal respiratory support in adult patients

    Directory of Open Access Journals (Sweden)

    Thiago Gomes Romano

    Full Text Available ABSTRACT In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO, which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support. We discuss the history of respiratory support using ECMO in adults, as well as the clinical evidence; costs; indications; installation of the equipment; ventilator settings; daily care of the patient and the system; common troubleshooting; weaning; and discontinuation.

  5. Participation in online patient support groups endorses patients' empowerment

    NARCIS (Netherlands)

    van Uden-Kraan, C. F.; Drossaert, Constance H C; Taal, E; Seydel, E. R.; van de Laar, Mart A F J

    Objective: Although much has been expected of the empowering effect of taking part in online patient support groups, there is no direct evidence thus far for the effects of participation on patient empowerment. Hence our exploring to what extent patients feel empowered by their participation in

  6. A new approach to road accident rescue.

    Science.gov (United States)

    Morales, Alejandro; González-Aguilera, Diego; López, Alfonso I; Gutiérrez, Miguel A

    2016-01-01

    This article develops and validates a new methodology and tool for rescue assistance in traffic accidents, with the aim of improving its efficiency and safety in the evacuation of people, reducing the number of victims in road accidents. Different tests supported by professionals and experts have been designed under different circumstances and with different categories of damaged vehicles coming from real accidents and simulated trapped victims in order to calibrate and refine the proposed methodology and tool. To validate this new approach, a tool called App_Rescue has been developed. This tool is based on the use of a computer system that allows an efficient access to the technical information of the vehicle and sanitary information of the common passengers. The time spent during rescue using the standard protocol and the proposed method was compared. This rescue assistance system allows us to make vital information accessible in posttrauma care services, improving the effectiveness of interventions by the emergency services, reducing the rescue time and therefore minimizing the consequences involved and the number of victims. This could often mean saving lives. In the different simulated rescue operations, the rescue time has been reduced an average of 14%.

  7. Sea Surface Temperature data collected from buoys deployed world-wide in support of the U.S. Coast Guard Office of Search and Rescue (CG-SAR) program from 2004-03-24 to 2016-09-30 (NCEI Accession (0098145) (NCEI Accession 0098145)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This NCEI accessions contains Sea Surface Temperature (SST) data collected from buoys deployed in support of the U.S. Coast Guard Office of Search and Rescue...

  8. Support needs of Chinese immigrant cancer patients.

    Science.gov (United States)

    Leng, Jennifer; Lee, Trevor; Li, Yanjun; Stern, Charles; Chen, Mei Hsuan; Winkel, Gary; Gany, Francesca

    2014-01-01

    To enable better psychosocial, informational, and practical support of Chinese patients with cancer, this study was conducted to identify the specific support needs of Chinese immigrant cancer patients. The Cancer Portal Project at Memorial Sloan-Kettering Cancer Center's Center for Immigrant Health and Cancer Disparities is a patient navigation program that assists underserved and minority cancer patients in obtaining social and economic assistance at ten New York City cancer clinics. This need assessment was conducted as part of the Portal Project. Sixty-four questions were added to the existing Portal Intake Form about the needs and preferences for Chinese-language support and survivorship services. Descriptive analysis was performed, as well as an exploratory principal component's factor analysis to determine if there were any patterns in the services and programs in which patients were interested. Ninety-six patients were approached for participation; 59 agreed to participate. Eighty-eight percent of participants were born in China. Ninety-seven percent preferred to speak Mandarin, Cantonese, or Fujianese in the healthcare setting. When asked about general interest in support programs, 53 % of the participants were "very interested," 27 % were "maybe interested," and 17 % were "not interested." Programs in which more participants were "very interested" included those that would provide information about obtaining financial assistance (79 %) and social assistance (74 %), information on treatment options (67 %), help in coping with the burden of illness on the family (65 %), and information about general healthcare (63 %). The factor analysis resulted in the identification of five factors: social/financial/treatment and care issues, nutrition and exercise/networking/general health care, coping with fear and stress, herbs and dietary supplements, and acupuncture and acupressure. In this study, 80 % of the participants expressed interest in programs tailored for

  9. Rescue patient from tracheal obstruction by dislocated bronchial stent during tracheostomy surgery with readily available tools: A case report.

    Science.gov (United States)

    Chang, Hung-Yu; Man, Kee-Ming; Liao, Kate Hsiurong; Chiang, Yi-Ying; Chen, Kuen-Bao

    2017-09-01

    Airway stenting is a well-established method that relieves symptoms and maintains airway patency in patients with airway obstruction. Serious complications caused by airway stents such as stent dislocation and airway obstruction during surgery are life-threatening. An 80-year-old man was treated with bronchial stent for left bronchus obstruction caused by metastatic esophageal cancer. During tracheostomy surgery, he suffered from acute tracheal obstruction caused by dislocated bronchial stent. Esophageal cancer, left bronchus obstruction, respiratory failure, tracheal obstruction. Threading a 5.0-sized endotracheal tube combined with an Eschmann tracheal tube introducer to prop up the collapsed stent. The bronchial stent was re-expanded and threaded into right main bronchus and ventilation restored. Patient with airway stent undergoing surgery with airway involved should be performed under the support of a backup physician and equipment that are capable of handling potentially life-threatening complications of airway stent. If not, in the emergent situation of tracheal obstruction due to tracheal/bronchial stent, protruding through the stent with a suitable, small-sized endotracheal tube with Eschmann tracheal tube introducer may be an alternative skill for saving life weighted with possible complications.

  10. [Organising nutritional support for patients with anorexia].

    Science.gov (United States)

    Satori, Nadine

    Nutritional care in the Eating Disorder unit of Sainte-Anne general hospital in Paris, is organised around a care model based on cognitive behavioural therapy. Hospitalisation is generally prepared beforehand and aims to draw on patients' resources enabling them to clarify a request for help. A care contract can be drawn up to provide step-by-step support for the patient in terms of the goals to achieve. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Preventing persistent organ support in ICU patients

    NARCIS (Netherlands)

    de Lange, D W; Flaatten, H

    Editorial to: Mehoff et al. Use of life support in acutely admitted ICU patients. An international cohort study. Acta Anaesthesiologica Scandinavica 2017;….etc. Conflict of interest Both authors declared no conflict of interest regarding the preparation of this manuscript.

  12. Combat Rescue Helicopter (CRH)

    Science.gov (United States)

    2015-12-01

    Selected Acquisition Report (SAR) RCS: DD-A&T(Q&A)823-479 Combat Rescue Helicopter (CRH) As of FY 2017 President’s Budget Defense Acquisition...Name Combat Rescue Helicopter (CRH) DoD Component Air Force Responsible Office References SAR Baseline (Development Estimate) Defense Acquisition... Helicopter (CRH) system will provide Personnel Recovery (PR) forces with a vertical takeoff and landing aircraft that is quickly deployable and

  13. Decision support for patient care: implementing cybernetics.

    Science.gov (United States)

    Ozbolt, Judy; Ozdas, Asli; Waitman, Lemuel R; Smith, Janis B; Brennan, Grace V; Miller, Randolph A

    2004-01-01

    The application of principles and methods of cybernetics permits clinicians and managers to use feedback about care effectiveness and resource expenditure to improve quality and to control costs. Keys to the process are the specification of therapeutic goals and the creation of an organizational culture that supports the use of feedback to improve care. Daily feedback on the achievement of each patient's therapeutic goals provides tactical decision support, enabling clinicians to adjust care as needed. Monthly or quarterly feedback on aggregated goal achievement for all patients on a clinical pathway provides strategic decision support, enabling clinicians and managers to identify problems with supposed "best practices" and to test hypotheses about solutions. Work is underway at Vanderbilt University Medical Center to implement feedback loops in care and management processes and to evaluate the effects.

  14. Nutritional support for malnourished patients with cancer.

    Science.gov (United States)

    Baldwin, Christine

    2011-03-01

    Cancer and its treatments frequently have a negative impact on the weight and nutritional status of patients. Weight loss is associated with reduced survival and poorer outcomes of treatment but is not well characterized and frequently confused with cachexia, which may complicate the interpretation of studies of nutritional support. The aims of this review were to examine the impact of cancer on nutritional status and to review the role of simple oral nutritional interventions and novel agents. The terms weight loss, malnutrition and cachexia refer to different entities and new definitions have recently been proposed that take account of the role of the underlying inflammatory processes. Oral nutritional interventions are widely recommended for malnourished cancer patients, but the evidence for their benefits to clinical, nutritional and patient-centred outcomes is limited. Meta-analysis has highlighted the variability in response to simple nutritional interventions of different cohorts of cancer patients and suggested that improvements in nutritional endpoints and aspects of quality of life may be achieved in some patients. Recent research has largely focused on treatments aiming to modulate the inflammatory processes associated with cachexia, but to date has not identified a single treatment with clear efficacy. Studies characterizing the potential for nutritional support in combination with anti-inflammatory agents in defined patient groups are defined to advance the evidence base in this area.

  15. Supporting the Support System: How Assessment and Communication Can Help Patients and Their Support Systems.

    Science.gov (United States)

    Harkey, Jane; Young, Jared; Carter, Jolynne Jo; Demoratz, Michael

    The benefits of having a support system, such as social relationships with close friends and family, have been well documented for patients with serious health issues. As scientific evidence has shown, individuals who have the lowest level of involvement in social relationships face a greater mortality risk. Support systems, however, are not infallible. Relationship stress can have a negative impact on people-patient and caregiver alike-behaviorally, psychosocially, and physiologically. The purpose of this article is to encourage case managers who take a patient-centered approach to also consider the existence and extent of the support system, as well as any stresses or tensions that are observable within the support system. Although the case manager is ethically obliged to advocate for the individual receiving case management services, that advocacy can be extended to the support system for the good of all. This discussion applies to numerous case management practices and work settings including (but not limited to) hospital-based case management, home health, geriatrics, catastrophic case management, mental health, palliative care, and end of life/hospice. As part of the assessment phase of the case management process, case managers determine the extent of the patient's support system or social support network such as family and close friends. Although their advocacy is primarily for the patient receiving case management services, case managers also become aware of the needs of the support system members as they face their loved one's serious illness, severe injury, geriatric care demands, or end of life. Case managers can use their communication skills, especially motivational interviewing, with patients and their support systems to identify stresses and issues that can impact the pursuit of health goals. In addition, case managers ensure that individuals and their support systems are kept informed such as about the health condition, stage of disease, plan of

  16. Early nutritional support in severe traumatic patients.

    Science.gov (United States)

    Chuntrasakul, C; Siltharm, S; Chinswangwatanakul, V; Pongprasobchai, T; Chockvivatanavanit, S; Bunnak, A

    1996-01-01

    Multiple trauma is associated with altered metabolism, wasting of the lean body mass and compromised wound healing. Nutritional support is one way to improve the condition of these critically ill patients. We performed a prospective randomized study on the effect of early nutritional support in severely injured patients admitted to the Division of Traumatic Surgery, Siriraj Hospital between June 1992 and January 1994. Thirty-eight severe traumatic patients with ISS between 20-40 were randomly divided into control and study group. The 17 patients in the control group were treated in the conventional method with administration of hypo caloric intravenous regimen and supplement with oral diet as soon as the bowel function was returned. The 21 patients of the study group were fed either by enteral or parenteral feeding or both with an appropriate caloric and protein requirement as soon as hemodynamic status was stabilized. We found the study group had a lower mortality rate, a lower complication rate, a shorter period of ICU stay, and an earlier weaning from the ventilator than the control group. The study group also lost less weight than the control group. Nitrogen balance in the study group was significantly lower than the control group.

  17. Rescue US energy innovation

    Science.gov (United States)

    Anadon, Laura Diaz; Gallagher, Kelly Sims; Holdren, John P.

    2017-10-01

    President Trump has proposed severe cuts to US government spending on energy research, development and demonstration, but Congress has the `power of the purse' and can rescue US energy innovation. If serious cuts are enacted, the pace of innovation will slow, harming the economy, energy security and global environmental quality.

  18. Rescue workers and trauma

    DEFF Research Database (Denmark)

    Romano, Eugenia; Elklit, Ask

    2017-01-01

    Introduction: This study investigates which factors had the biggest impact on developing distress in rescue workers who were involved in a firework factory explosion. Method: Four hundred sixty-five rescuers were assessed using items investigating demographic factors, organizational variables, so...

  19. Patient aggression perceived by community support workers.

    Science.gov (United States)

    Gale, Christopher; Hannah, Annette; Swain, Nicola; Gray, Andrew; Coverdale, John; Oud, Nico

    2009-12-01

    Objective: Aggression by patients is a known risk factor for hospital workers. Within New Zealand, the bulk of ongoing care for physical and mental disabilities and health issues is not hospital based, but contracted to various non-governmental agencies. The rate of client aggression towards care workers from these organizations, to our knowledge, has not been assessed. Method: Two hundred and forty-two support workers in non-governmental agencies caring for people with disabilities responded to an anonymous mailed survey on client aggression, personal distress, and communication style. Results: Most support workers did experience verbal forms of aggression or destructive behaviour, fewer experienced physical aggression, and a minority were injured, sexually harassed, stalked or harassed by means of formal complaint. The median total violence score was five (interquartile range 12.25). A higher total violence score (using the POPAS-NZ) was associated with age and gender, the primary disability of clients, and the numbers of hours worked. The length of time worked was not associated with total violence risk. Communication style, after correcting for other factors, was a predictor of aggression. Almost 6% of care workers reported distress symptoms at a level associated with clinically significant stress reactions. Conclusions: Patient aggression is common among care workers, and can cause distress in the minority. We suggest that further research to clarify risk factors and develop interventions for care workers is needed.

  20. Extracorporeal respiratory support in adult patients.

    Science.gov (United States)

    Romano, Thiago Gomes; Mendes, Pedro Vitale; Park, Marcelo; Costa, Eduardo Leite Vieira

    2017-01-01

    In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support. We discuss the history of respiratory support using ECMO in adults, as well as the clinical evidence; costs; indications; installation of the equipment; ventilator settings; daily care of the patient and the system; common troubleshooting; weaning; and discontinuation. RESUMO Em pacientes com insuficiência respiratória grave (hipoxêmica ou hipercápnica), o suporte somente com ventilação mecânica pode ser insuficiente para suas necessidades, especialmente quando se tenta evitar o uso de parâmetros ventilatórios que possam causar danos aos pulmões. Nesses pacientes, extracorporeal membrane oxygenation (ECMO, oxigenação extracorpórea por membrana), que também é muito eficaz na remoção de dióxido de carbono do sangue, pode manter a vida, permitindo o uso de ventilação pulmonar protetora. No presente artigo de revisão, objetivamos explorar alguns dos aspectos mais relevantes do suporte respiratório por ECMO. Discutimos a história do suporte respiratório por ECMO em adultos; evidências clínicas; custos; indicações; instalação do equipamento; parâmetros ventilatórios; cuidado diário do paciente e do sistema; solução de problemas comuns; desmame e descontinuação.

  1. Sugammadex rescue following prolonged rocuronium neuromuscular blockade with ‘recurarisation’ in a patient with severe renal failure

    Science.gov (United States)

    Lobaz, Steven; Sammut, Mario; Damodaran, Anand

    2013-01-01

    We describe our experience of a 71-year-old patient with severe renal failure, who exhibited an unusually prolonged rocuronium-induced neuromuscular blockade (>4 h) and apparent recurarisation, following emergency rapid sequence induction (RSI). At the end of operation, 45 min post induction, train-of-four (TOF) testing had been 4/4 prior to wake up. No respiratory effort was seen 150 min postinduction, despite further neostigmine/glycopyrrolate and repeat TOF 4/4. The patient was resedated and transferred to the intensive care unit (ICU). At 180 min postinduction, fade was evident on TOF, suggestive of rocuronium reblockade. At 285 min, the patient was extubated safely following sugammadex administration and discharged uneventfully from the ICU. An important lesson to recognise is the potential for extremely prolonged neuromuscular blockade following rocuronium in patients with severe renal failure, particularly when using the higher doses (1.2 mg/kg) required for RSI, and that TOF in such cases may not be reliable in detecting residual blockade. PMID:23396837

  2. Clinical and economic analysis of rescue intracytoplasmic sperm injection cycles.

    Science.gov (United States)

    Shalom-paz, Einat; Alshalati, Jana; Shehata, Fady; Jimenez, Luis; Son, Weon-Young; Holzer, Hananel; Tan, Seang Lin; Almog, Benny

    2011-12-01

    To identify clinical and embryological factors that may predict success in rescue intracytoplasmic sperm injection (ICSI) cycles (after total fertilization failure has occurred) and to evaluate the cost effectiveness of rescue ICSI strategy. Additionally, follow-up of 20 rescue ICSI pregnancies is reported. Retrospective analysis of total fertilization failure cycles. University-based tertiary medical center. In total, 92 patients who had undergone conventional in-vitro fertilization (IVF) cycles with total fertilization failure were included. The patients were divided into two subgroups: those who conceived through rescue ICSI and those who did not. The pregnant members of the rescue ICSI subgroup were found to be significantly younger (32.9 ± 4.2 vs. 36.3 ± 4.5, respectively, p = 0.0035,) and to have better-quality embryos than those who did not conceive (cumulative embryo score: 38.3 ± 20.4 vs. 29.3 ± 14.7, p = 0.025). Cost effectiveness analysis showed 25% reduction in the cost per live birth when rescue ICSI is compared to cycle cancellation approach. The pregnancies follow-up did not show adverse perinatal outcome. Rescue ICSI is an option for salvaging IVF cycles complicated by total fertilization failure. Success in rescue ICSI was found to be associated with younger age and higher quality of embryos. Furthermore, the cost effectiveness of rescue ICSI in terms of total fertilization failure was found to be worthwhile.

  3. Nutritional support in patients with systemic sclerosis.

    Science.gov (United States)

    Ortiz-Santamaria, Vera; Puig, Celia; Soldevillla, Cristina; Barata, Anna; Cuquet, Jordi; Recasens, Asunción

    2014-01-01

    Systemic sclerosis (SSc) is a chronic multisystem autoimmune disease which involves the gastrointestinal tract in about 90% of cases. It may contribute to nutritional deterioration. To assess whether the application of a nutritional support protocol to these patients could improve their nutritional status and quality of life. Single center prospective study, performed on an outpatient basis, in a county hospital. The Malnutrition Universal Screening Tool (MUST) was used to screen risk for malnutrition. Health questionnaire SF-36 and the Hospital Anxiety and Depression Scale were used to assess quality of life and psychopathology respectively. Weight, height, energy and protein requirements, macronutrient intake and nutritional biochemical parameters were evaluated. Nutritional intervention was performed in patients at risk for malnutrition. Of the 72 patients, 12.5% were at risk for malnutrition. Iron deficiency anemia (18.35%) and vitamin D deficiency (54%) were the most frequently observed nutritional deficits. The questionnaires on psychopathology and quality of life showed a high prevalence of anxiety and depression, and lower level poor quality of life in the physical and mental component. No significant improvements were observed in the weight, food intake, nutritional biochemical parameters, psychopathology and quality of life follow-up. Dietary intervention was able to maintain body weight and food intake. Iron deficiency anemia and vitamin D deficiency improved with iron and vitamine D supplements. No deterioration was observed in psychological assessment or quality of life. Studies with larger numbers of patients are needed to assess the efficacy of this intervention. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  4. Organizations of food redistribution and rescue.

    Science.gov (United States)

    Mousa, T Y; Freeland-Graves, J H

    2017-11-01

    Food insecurity affects 13.4% of the USA population, despite the fact that 30-40% of all food is deposited in a landfill. Food rescue nutrition is the process of redistribution of surplus food to the impoverished. The aim of this study is to document the extent of involvement of organizations in food rescue nutrition. In this cross-sectional study, a survey about organizations involved in food rescue nutrition was developed, validated, and then tested. Directors of 100 organizations involved in food rescue nutrition from eight Southwestern States in the USA participated in this research. These organizations provided an average of 2 million kg of food to more than 40,000 clients each month. Food assistance programs had an average of eight workers and 3081 volunteers. In addition to food, these organizations provided other services such as clothing, clinical, and childcare. The agencies encountered several challenges, including lack of resources that resulted in reducing food portions and turning away clients. The extent of involvement of community-based programs in food rescue nutrition was strong in eight Southwestern states in the USA. Organizations involved in food redistribution helped alleviate food insecurity in their clients. Sustainability of these charitable networks was dependent on availability of resources and sufficient volunteers. Health professionals should encourage these organizations by providing support through donations of time, money, and/or food. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  5. Extracorporeal life support in pediatric cardiac patients

    Directory of Open Access Journals (Sweden)

    Matteo Di NARDO

    2016-10-01

    Full Text Available Extracorporeal Life Support (ECLS is a valuable tool in the management of neonates and older children with severe cardiac or respiratory failure. In this review, we focus on ECLS when used for neonatal and pediatric cardiac disease. Strict selection of patients and timely deployment are necessary to optimize outcomes. Although every attempt should be made to deploy ECLS urgently rather than emergently, extracorporeal cardiopulmonary resuscitation (ECPR is being increasingly used and reasonable survival rates have been achieved after initiation of ECLS during active compressions of the chest following in-hospital cardiac arrest. Contraindications to ECLS are falling over time, although lethal chromosomal abnormalities, severe irreversible brain injury, and extremely low gestational age and weight (<32 weeks gestation or <1.5 kg remain firm contraindications.

  6. Early Home Supported Discharge of Stroke Patients:

    DEFF Research Database (Denmark)

    Larsen, Torben; Olsen, T. Skyhøj; Sørensen, Jan

    2006-01-01

    : A systematic literature search for randomized trials (RCTs) on "early supported discharge" was closed in April 2005. RCTs on EHSD without information on (i) death or institution at follow-up, (ii) change in Barthél Index, (iii) length of hospital stay, (iv) intensity of home rehabilitation, or (v) baseline...... data are excluded. Seven RCTs on EHSD with 1,108 patients followed 3-12 months after discharge are selected for statistical meta-analysis of outcomes. The costs are calculated as a function of the average number of home training sessions. Economic evaluation is organized as a test of dominance (both...... of death is not significant. Length of stay is significantly reduced by 10 days (CI, 2.6-18 days). All outcomes have a nonsignificant positive covariance. The median number of home sessions is eleven, and the average cost per EHSD is 1,340 USD. The "action mechanism" and financial barriers to EHSD...

  7. Microtubule catastrophe and rescue.

    Science.gov (United States)

    Gardner, Melissa K; Zanic, Marija; Howard, Jonathon

    2013-02-01

    Microtubules are long cylindrical polymers composed of tubulin subunits. In cells, microtubules play an essential role in architecture and motility. For example, microtubules give shape to cells, serve as intracellular transport tracks, and act as key elements in important cellular structures such as axonemes and mitotic spindles. To accomplish these varied functions, networks of microtubules in cells are very dynamic, continuously remodeling through stochastic length fluctuations at the ends of individual microtubules. The dynamic behavior at the end of an individual microtubule is termed 'dynamic instability'. This behavior manifests itself by periods of persistent microtubule growth interrupted by occasional switching to rapid shrinkage (called microtubule 'catastrophe'), and then by switching back from shrinkage to growth (called microtubule 'rescue'). In this review, we summarize recent findings which provide new insights into the mechanisms of microtubule catastrophe and rescue, and discuss the impact of these findings in regards to the role of microtubule dynamics inside of cells. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Pediatric Supportive Care (PDQ®)—Patient Version

    Science.gov (United States)

    Pediatric supportive care is an important aspect of cancer care as children and adolescents face unique challenges compared to adult patients. Learn more about supportive care for pediatric patients during and after treatment in this expert-reviewed summary.

  9. Acute Complications After High-Dose Chemotherapy and Stem-Cell Rescue in Pediatric Patients With High-Risk Neuroblastoma Treated in Countries With Different Resources

    Directory of Open Access Journals (Sweden)

    Mahmoud M. Elzembely

    2018-03-01

    Full Text Available Purpose: High-dose chemotherapy with autologous stem-cell rescue (SCR is a key component of high-risk neuroblastoma (HRNB therapy. Carboplatin, etoposide, and melphalan (CEM or busulfan and melphalan (Bu/Mel are the most evaluated, effective high-dose chemotherapy for HRNB on the basis of results from major cooperative group studies. Toxicity profiles vary between these regimens, and practice variation exists regarding the preferred high-dose therapy (HDT. We sought to evaluate the safety of HDT and autologous SCR for HRNB in a resource-limited country (Egypt compared with the resource-rich United States. Patients and Methods: We performed a retrospective comparative review of single CEM-based HDT/SCR outcomes through day 100 for HRNB at the Fred Hutchinson Cancer Research Center (FH in the United States (2005 to 2015 versus Bu/Mel-based HDT at El-Sheikh Zayed Specialized Hospital (SZ in Egypt (2009 to 2015. Results: Forty-four patients at FH and 77 patients at SZ were reviewed. Pretransplant hepatic comorbidities were significantly higher at SZ (29 of 77 v nine of 44; P = .05, with 19 of 77 patients at SZ having hepatitis infection. Engraftment was delayed after SZ-Bu/Mel therapy compared with FH-CEM therapy for neutrophils (median 12 days v 10 days, respectively; P < .001 and platelets (median 20 days v 18 days, respectively; P < .001. Sinusoidal obstruction syndrome occurred later, after SZ-Bu/Mel therapy (median 19 days v 7 days; P = .033, and four of eight cases were fatal (six of eight patients had underlying hepatitis infection, whereas three of three cases after FH-CEM therapy were moderately severe. Resource utilization associated with the number of days with fever, antibiotic use, and the number of transfusions administered was significantly higher after FH-CEM therapy than after SZ-Bu/Mel therapy. Conclusion: Use of autologous stem-cell transplantation is feasible in the context of a resource-limited country.

  10. 21 CFR 868.6820 - Patient position support.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6820 Patient position support. (a) Identification. A patient position support is a device intended to maintain the position of an anesthetized... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Patient position support. 868.6820 Section 868...

  11. [Medical rescue of China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake].

    Science.gov (United States)

    Liu, Ya-hua; Yang, Hui-ning; Liu, Hui-liang; Wang, Fan; Hu, Li-bin; Zheng, Jing-chen

    2013-05-01

    To summarize and analyze the medical mission of China National Earthquake Disaster Emergency Search and Rescue Team (CNESAR) in Lushan earthquake, to promote the medical rescue effectiveness incorporated with search and rescue. Retrospective analysis of medical work data by CNESAR from April 21th, 2013 to April 27th during Lushan earthquake rescue, including the medical staff dispatch and the wounded case been treated. The reasonable medical corps was composed by 22 members, including 2 administrators, 11 doctors [covering emergency medicine, orthopedics (joints and limbs, spinal), obstetrics and gynecology, gastroenterology, cardiology, ophthalmology, anesthesiology, medical rescue, health epidemic prevention, clinical laboratory of 11 specialties], 1 ultrasound technician, 5 nurses, 1 pharmacist, 1 medical instrument engineer and 1 office worker for propaganda. There were two members having psychological consultants qualifications. The medical work were carried out in seven aspects, including medical care assurance for the CNESAR members, first aid cooperation with search and rescue on site, clinical work in refugees' camp, medical round service for scattered village people, evacuation for the wounded, mental intervention, and the sanitary and anti-epidemic work. The medical work covered 24 small towns, and medical staff established 3 medical clinics at Taiping Town, Shuangshi Town of Lushan County and Baoxing County. Medical rescue, mental intervention for the old and kids, and sanitary and anti-epidemic were performed at the above sites. The medical corps had successful evacuated 2 severe wounded patients and treated the wounded over thousands. Most of the wounded were soft tissue injuries, external injury, respiratory tract infections, diarrhea, and heat stroke. Compared with the rescue action in 2008 Wenchuan earthquake, the aggregation and departure of rescue team in Lushan earthquake, the traffic control order in disaster area, the self-aid and buddy aid

  12. The rule of rescue.

    Science.gov (United States)

    McKie, John; Richardson, Jeff

    2003-06-01

    Jonsen coined the term "Rule of Rescue"(RR) to describe the imperative people feel to rescue identifiable individuals facing avoidable death. In this paper we attempt to draw a more detailed picture of the RR, identifying its conflict with cost-effectiveness analysis, the preference it entails for identifiable over statistical lives, the shock-horror response it elicits, the preference it entails for lifesaving over non-lifesaving measures, its extension to non-life-threatening conditions, and whether it is motivated by duty or sympathy. We also consider the measurement problems it raises, and argue that quantifying the RR would probably require a two-stage procedure. In the first stage the size of the individual utility gain from a health intervention would be assessed using a technique such as the Standard Gamble or the Time Trade-Off, and in the second the social benefits arising from the RR would be quantified employing the Person Trade-Off. We also consider the normative status of the RR. We argue that it can be defended from a utilitarian point of view, on the ground that rescues increase well-being by reinforcing people's belief that they live in a community that places great value upon life. However, utilitarianism has long been criticised for failing to take sufficient account of fairness, and the case is no different here: fairness requires that we do not discriminate between individuals on morally irrelevant grounds, whereas being "identifiable" does not seem to be a morally relevant ground for discrimination.

  13. Water Supply Systems For Aircraft Fire And Rescue Protection

    Science.gov (United States)

    1995-01-01

    This Advisory Circular (AC) provides guidance for the selection : of a water source and standards for the design of a distribution system to : support aircraft rescue and fire fighting (ARFF) service operations on : airports.

  14. Rescuing--a universal phenomenon.

    Science.gov (United States)

    Little, John

    2014-12-01

    Rescuing, where the person is delivered from the immediacy of their conundrum by another, complicates management. The object of this paper is to understand the difficulty in relinquishing the rescuing role. Rescuing is a universal phenomenon in parenting, teaching and therapy that has developed over time through a variety of interwoven social, economic, psychological and clinical variables. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  15. The meaning of social support for the critically ill patient.

    Science.gov (United States)

    Hupcey, J E

    2001-08-01

    Social support has been shown to be important for the critically ill patient. However, what constitutes adequate support for these patients has not been investigated. Thus, the purpose of this qualitative study was to investigate patients' perceptions of their need for and adequacy of the social support received while they were critically ill. Thirty adult patients who were critical during some point of their stay in the intensive care unit (ICU) stay were interviewed, once stable. Interviews were tape-recorded and began with an open-ended question regarding the ICU experience. This was followed by open-ended focused questions regarding social support, such as 'Who were your greatest sources of social support while you were critically ill?' 'What did they do that was supportive or unsupportive?' Data were analyzed according to Miles and Huberman (1994). The categories that emerged were need for social support based on patient perceptions (not number of visitors), quality of support (based on perceptions of positive and negative behaviors of supporters) and lack of support. This study found that quality of support was more important than the actual number of visitors. Patients with few visitors may have felt supported, while those with numerous visitors felt unsupported. Patients who felt unsupported also were more critical of the staff and the care they received. Nurses need to individually assess patients regarding their need for support, and assist family/friends to meet these needs.

  16. Neurotrauma and the rule of rescue.

    Science.gov (United States)

    Honeybul, S; Gillett, G R; Ho, K M; Lind, C R P

    2011-12-01

    The rule of rescue describes the powerful human proclivity to rescue identified endangered lives, regardless of cost or risk. Deciding whether or not to perform a decompressive craniectomy as a life-saving or 'rescue' procedure for a young person with a severe traumatic brain injury provides a good example of the ethical tensions that occur in these situations. Unfortunately, there comes a point when the primary brain injury is so severe that if the patient survives they are likely to remain severely disabled and fully dependent. The health resource implications of this outcome are significant. By using a web-based outcome prediction model this study compares the long-term outcome and designation of two groups of patients. One group had a very severe injury as adjudged by the model and the other group a less severe injury. At 18 month follow-up there were significant differences in outcome and healthcare requirements. This raises important ethical issues when considering life-saving but non-restorative surgical intervention. The discussion about realistic outcome cannot be dichotomised into simply life or death so that the outcome for the patient must enter the equation. As in other 'rescue situations', the utility of the procedure cannot be rationalised on a mere cost-benefit analysis. A compromise has to be reached to determine at what point either the likely outcome would be unacceptable to the person on whom the procedure is being performed or the social utility gained from the rule of rescue intervention fails to justify the utilitarian value and justice of equitable resource allocation.

  17. AToMS: A Ubiquitous Teleconsultation System for Supporting AMI Patients with Prehospital Thrombolysis

    Directory of Open Access Journals (Sweden)

    Bruno S. P. M. Correa

    2011-01-01

    Full Text Available The latest population-based studies in the medical literature worldwide indicate that acute myocardial infarction (AMI patients still experience prolonged delay to be rescued, which often results in morbidity and mortality. This paper reports from a technological standpoint a teleconsultation and monitoring system named AToMS. This system addresses the problem of prehospital delivery of thrombolysis to AMI patients by enabling the remote interaction of the paramedics and a cardiologist available at a Coronary Care Unit (CCU. Such interaction allows the diagnosis of the patient eligibility to the immediate application of thrombolysis, which is meant to reduce the delay between the onset of symptoms and the eventual application of proper treatment. Such delay reduction is meant to increase the AMI patient's chances of survival and decrease the risks of postinfarction sequels. The teleconsultation is held with the support of wireless and mobile technologies, which also allows the cardiologist to monitor the patient while he/she is being taken to the nearest CCU. All exchanged messages among paramedics and cardiologists are recorded to render an auditable system. AToMS has been deployed in a first stage in the city of Rio de Janeiro, where the medical team involved in the project has conducted commissioned tests.

  18. Emergency rescue in accidents with HDR afterloading units

    International Nuclear Information System (INIS)

    Kaulich, T.W.; Nuesslin, F.; Becker, G.; Lamprecht, U.; Bamberg, M.

    1999-01-01

    Problem: HDR brachyradiotherapy has minimized the exposure to radiation of the personnel working in this field. Nonetheless there are periodically reported troubles with afterloading units concerning the retraction of sources that require immediate action for the limitation of possible damage. Legal Principles according to the German Regulation Concerning Protection against Radiation (Strahlenschutzverordnung=StrlSchV): If in afterloading brachyradiotherapy the radiation source remains extended through malfunction we deal with an emergency according to the StrlSchV. The rescue personnel should be chosen in accordance with Paragraph 50 StrlSchV. Organization of the Rescue of the Patient: The quickest possible rescue of a patient in an emergency demands an unequivocal definition of responsibilities. Our recommendations in this instance: The physicist is responsible for the organization of the emergency rescue. The radiation oncologist in charge informs himself about the necessary emergency measures before starting the treatment and carries out the emergency rescue. If the physicist diagnoses a failure in the retraction of the source he tries to remove the failure. If he doesn't succeed in retracting the source the radiation oncologist carries out the rescue of the patient. The organizational structure of the clinic allowing, the emergency physician should invariably be the physician who placed the applicator. In the emergency rescue the radiation oncologist should be protected by a lead barrier and use manipulators. Dose Assessment in Personnel and Patient: The radiation exposure of the rescue personnel is calculated from the photon-equivalence dose H x with the help of the dose-rate constant of 192 Ir. According to the same procedure there can be evaluated the local radiation exposure of the patient concerned. Conclusions: Generally speaking, all considerations regarding the topic of emergency rescue should always start out from a worst-case scenario. Of all the

  19. Sex, Deportation and Rescue

    DEFF Research Database (Denmark)

    Plambech, Sine

    2017-01-01

    recirculating the claim that human trafficking is the “third largest” criminal economy after drugs and weapons. Based on ethnographic fieldwork among Nigerian sex worker migrants conducted in Benin City, Nigeria, in 2011 and 2012, this study brings together four otherwise isolated migration economies......This contribution explores the economies interlinked by the migration of Nigerian women sex workers. The literature and politics of sex work migration and human trafficking economies are commonly relegated to the realm that focuses on profits for criminal networks and pimps, in particular...... – facilitation, remittances, deportation, and rescue – and suggests that we have to examine multiple sites and relink these in order to more fully understand the complexity of sex work migration. Drawing upon literature within transnational feminist analysis, critical human trafficking studies, and migration...

  20. Rescuing Quadratic Inflation

    CERN Document Server

    Ellis, John; Sueiro, Maria

    2014-01-01

    Inflationary models based on a single scalar field $\\phi$ with a quadratic potential $V = \\frac{1}{2} m^2 \\phi^2$ are disfavoured by the recent Planck constraints on the scalar index, $n_s$, and the tensor-to-scalar ratio for cosmological density perturbations, $r_T$. In this paper we study how such a quadratic inflationary model can be rescued by postulating additional fields with quadratic potentials, such as might occur in sneutrino models, which might serve as either curvatons or supplementary inflatons. Introducing a second scalar field reduces but does not remove the pressure on quadratic inflation, but we find a sample of three-field models that are highly compatible with the Planck data on $n_s$ and $r_T$. We exhibit a specific three-sneutrino example that is also compatible with the data on neutrino mass difference and mixing angles.

  1. Early Home Supported Discharge of Stroke Patients:

    DEFF Research Database (Denmark)

    Larsen, Torben; Olsen, T. Skyhøj; Sørensen, Jan

    2006-01-01

    OBJECTIVES: A comprehensive and systematic assessment (HTA) of early home-supported discharge by a multidisciplinary team that plans, coordinates, and delivers care at home (EHSD) was undertaken and the results were compared with that of conventional rehabilitation at stroke units. METHODS......: A systematic literature search for randomized trials (RCTs) on "early supported discharge" was closed in April 2005. RCTs on EHSD without information on (i) death or institution at follow-up, (ii) change in Barthél Index, (iii) length of hospital stay, (iv) intensity of home rehabilitation, or (v) baseline...... are discussed. CONCLUSIONS: EHSD is evidenced as a dominant health intervention. However, financial barriers between municipalities and health authorities have to be overcome. For qualitative reasons, a learning path of implementation is recommended where one stroke unit in a region initiates EHSD...

  2. A concept for optimizing avalanche rescue strategies using a Monte Carlo simulation approach.

    Directory of Open Access Journals (Sweden)

    Ingrid Reiweger

    Full Text Available Recent technical and strategical developments have increased the survival chances for avalanche victims. Still hundreds of people, primarily recreationists, get caught and buried by snow avalanches every year. About 100 die each year in the European Alps-and many more worldwide. Refining concepts for avalanche rescue means to optimize the procedures such that the survival chances are maximized in order to save the greatest possible number of lives. Avalanche rescue includes several parameters related to terrain, natural hazards, the people affected by the event, the rescuers, and the applied search and rescue equipment. The numerous parameters and their complex interaction make it unrealistic for a rescuer to take, in the urgency of the situation, the best possible decisions without clearly structured, easily applicable decision support systems. In order to analyse which measures lead to the best possible survival outcome in the complex environment of an avalanche accident, we present a numerical approach, namely a Monte Carlo simulation. We demonstrate the application of Monte Carlo simulations for two typical, yet tricky questions in avalanche rescue: (1 calculating how deep one should probe in the first passage of a probe line depending on search area, and (2 determining for how long resuscitation should be performed on a specific patient while others are still buried. In both cases, we demonstrate that optimized strategies can be calculated with the Monte Carlo method, provided that the necessary input data are available. Our Monte Carlo simulations also suggest that with a strict focus on the "greatest good for the greatest number", today's rescue strategies can be further optimized in the best interest of patients involved in an avalanche accident.

  3. Rescue of failed filtering blebs with ab interno trephination.

    Science.gov (United States)

    Shihadeh, Wisam A; Ritch, Robert; Liebmann, Jeffrey M

    2006-06-01

    We evaluated the effectiveness of ab interno automated trephination as a technique for rescuing failed mature filtering blebs. A retrospective chart review of 40 failed blebs of 38 patients who had a posttrephination follow-up period of at least 3 months was done. With success defined as intraocular pressure (IOP) control with other modalities of management. Complications were few. We believe that ab interno trephination is an excellent option for rescuing selected failed filtering blebs.

  4. Filgrastim as a Rescue Therapy for Persistent Neutropenia in a Case of Dengue Hemorrhagic Fever with Acute Respiratory Distress Syndrome and Myocarditis

    Directory of Open Access Journals (Sweden)

    Desh Deepak

    2011-01-01

    Full Text Available Pathogenesis of dengue involves suppression of immune system leading to development of characteristic presentation of haematological picture of thrombocytopenia and leucopenia. Sometimes, this suppression in immune response is responsible for deterioration in clinical status of the patient in spite of all specific and supportive therapy. Certain drugs like steroids are used for rescue therapy in conditions like sepsis. We present a novel use of filgrastim as a rescue therapy in a patient with dengue hemorrhagic fever (DHF with acute respiratory distress syndrome (ARDS, myocarditis, and febrile neutropenia and not responding to standard management.

  5. Emergency Air Rescue System in Romania

    Directory of Open Access Journals (Sweden)

    Tranca Sebastian

    2018-03-01

    Full Text Available The helicopter, as a means of transport, has facilitated a significant decrease in intervention time at the site of request, increasing the chances of survival of the critical patient. Since 2003, SMURD has managed to form a fleet composed of nine helicopters and two airplanes. From an operational and strategic point of view, the SMURD intervention unit, set up seven Aeromedical Operational Bases (A.O.B. equipped with helicopters and materials necessary for their operation. There is a dynamic increase in the number of air rescue missions in Romania, with most missions being carried out by the air rescue bases in Târgu Mureş and Bucharest. Specialty literature has clearly demonstrated the positive impact on the survival of critical patients assisted by airborne crews, so it is necessary for the Romanian air rescue system to grow up. It is necessary to increase the number of air bases, purchase new helicopters and to continue the training programs of both pilots and medical personnel.

  6. Improving inpatient environments to support patient sleep.

    Science.gov (United States)

    DuBose, Jennifer R; Hadi, Khatereh

    2016-10-01

    Although sleep is important for healing, sleep deprivation is a major concern for patients in hospitals. The purpose of this review is to consolidate the observational and interventional studies that have been done to understand exogenous, non-pharmacological strategies for improving sleep in hospitals. We searched Medline, CINAHL, PsycINFO and the Web of Science databases for peer-reviewed articles published between 1970 and 2015 in English. A title review of 13,113 articles from four databases resulted in 783 articles that were further culled to 277 based on a review of the abstracts. The net result after reading the articles and a hand search was 42 articles. From each article we recorded the independent variables, methods used for measuring sleep and specific sleep outcomes reported. Noise is a modifiable cause of some sleep disruptions in hospitals, and when reduced can lead to more sleep. Earplugs and eye masks may help, but changing the sound and light environment is more effective. Calming music in the evening has been shown to be effective as well as daytime bright light exposure. Nursing care activities cause sleep disruption, but efforts at limiting interventions have not been demonstrated to improve sleep conditions. The research is hard to consolidate due to the multitude of independent variables and outcome metrics, but overall points to the potential for making meaningful improvements in the quality of patient sleep. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Knee osteoarthritis and perceived social support amongst patients in ...

    African Journals Online (AJOL)

    Background: Knee osteoarthritis is a chronic disease affecting the lives of patients and their families, with the family characteristics moderating the illness course. The perceived social support received by a patient helps in determining the health and functionality of the patient. Methods: A cross-sectional study was ...

  8. A versatile sensor network for urban search and rescue operations

    Science.gov (United States)

    Känsälä, Klaus; Korkalainen, Marko; Mäyrä, Aki

    2011-11-01

    The presentation is based in the research work carried out in EU funded project SGL for USaR (Second Generation Locator for Urban Search and Rescue Operations). The aim of this project is to develop wireless standalone communication system with embedded sensor network which can be globally used in rescue operations after accidents or terrorist attacks. The system should be able to operate without external support for several days: it should have autonomy with power supply and communication. The devices must be lightweight so that rescue team can easily carry them and finally they must be easy to install and use. The range of the wireless communication must cover an area of several square kilometers. The embedded sensor system must be able to detect sings of life but also detect hazards threatening the rescue operators thus preventing more accidents. It should also support positioning and digital mapping as well as the management of the search and rescue operation. This sensor network for urban search and rescue operations has been tested on a field conditions and it has proven to be robust and reliable and provides an energy efficient way of communication and positioning on harsh conditions.

  9. 46 CFR 133.135 - Rescue boats.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Rescue boats. 133.135 Section 133.135 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS Requirements for All OSVs § 133.135 Rescue boats. (a) Each OSV must carry at least one rescue boat. Each rescue...

  10. 46 CFR 199.262 - Rescue boats.

    Science.gov (United States)

    2010-10-01

    ... SYSTEMS FOR CERTAIN INSPECTED VESSELS Additional Requirements for Cargo Vessels § 199.262 Rescue boats. (a) Each cargo vessel must carry at least one rescue boat. Each rescue boat must be approved under approval... 46 Shipping 7 2010-10-01 2010-10-01 false Rescue boats. 199.262 Section 199.262 Shipping COAST...

  11. Cancer patients and the provision of informational social support.

    Science.gov (United States)

    Robinson, James D; Tian, Yan

    2009-07-01

    Research into the impact of social support on health-care patients has focused on the benefits of receiving social support. Although recipients benefit from social support, there are also potential benefits to the providers of social support that have gone relatively unexplored. The purpose of this investigation was to examine the relationship between the reception and provision of informational social support by cancer patients. Based on the work of Gouldner (1960), this investigation attempts to examine the role reciprocity plays within the social support process. The norm of reciprocity is conceptualized as a generalized moral belief rather than as a simple pattern of exchange between caregivers and care receivers. Use of reciprocity as a generalized moral belief instead of a pattern of behavioral exchange between providers and recipients of social support allows a more thorough integration theoretically and more methodical examination of the role the relationship between providers and recipients plays in this process. Specifically, this investigation employs the notion of optimal matching as part of the mechanism underlying the satisfactions derived from informational social support. The results of the logistic regression analyses suggest that reciprocity is a viable explanation of the mechanism underlying the desire to provide social support to others among cancer patients and among adults who have never been diagnosed with cancer. This relationship between the reception and the provision of informational social support remains even after controlling for age, education, gender, race, social integration, and cancer diagnosis. Implications for the social support literature are discussed.

  12. Patients' and parents' views regarding supportive care in childhood cancer.

    Science.gov (United States)

    Tenniglo, L J A; Loeffen, E A H; Kremer, L C M; Font-Gonzalez, A; Mulder, R L; Postma, A; Naafs-Wilstra, M C; Grootenhuis, M A; van de Wetering, M D; Tissing, W J E

    2017-10-01

    Intensive therapies in pediatric malignancies increased survival rates but also occurrence of treatment-related morbidities. Therefore, supportive care fulfills an increasingly important role. In planning development of guidelines with incorporation of shared decision making, we noticed that little is known about the needs and preferences of patients and their parents. Our goals were therefore to investigate (1) which supportive care topics patients and parents regard as most important and (2) the preferred role they wish to fulfill in decision making. This qualitative study consisted of three focus groups (two traditional, one online) with patients and parents of two Dutch pediatric oncology centers. Data were transcribed as simple verbatim and analyzed using thematic analysis. Eleven adolescent patients and 18 parents shared detailed views on various aspects of supportive care. Themes of major importance were communication between patient and physician (commitment, accessibility, proactive attitude of physicians), well-timed provision of information, and the suitability and accessibility of psychosocial care. In contrast to prioritized supportive care topics by medical professionals, somatic issues (e.g., febrile neutropenia) were infrequently addressed. Patients and parents preferred to be actively involved in decision making in selected topics, such as choice of analgesics and anti-emetics, but not in, e.g., choice of antibiotics. Children with cancer and parents were provided a valuable insight into their views regarding supportive care and shared decision making. These results have important implications towards improving supportive care, both in selecting topics for guideline development and incorporating preferences of patients and parents herein.

  13. Participation of chronic patients in medical consultations: patients' perceived efficacy, barriers and interest in support

    NARCIS (Netherlands)

    Henselmans, Inge; Heijmans, Monique; Rademakers, Jany; van Dulmen, Sandra

    2015-01-01

    Chronic patients are increasingly expected to participate actively in medical consultations. This study examined (i) patients' perceived efficacy and barriers to participation in consultations, (ii) patients' interest in communication support and (iii) correlates of perceived efficacy and barriers,

  14. To the Rescue?

    Science.gov (United States)

    Mayer, Caroline E.

    2010-01-01

    Faced with large and continued cuts in state funding, U.S. public postsecondary institutions are looking for new ways to both communicate their needs and garner support. They are calling on longtime supporters, enlisting new allies, developing strategic alliances, and crafting new messages and campaigns--all to underscore the importance of higher…

  15. Checklist and Decision Support in Nutritional Care for Burned Patients

    Science.gov (United States)

    2016-10-01

    able to construct a checklist of a clinical and physiologic model and then a computerised decision support system that will perform two functions: the...the provision of nutritional therapy, and assessment of use by nursing and physician staff KEYWORDS Nutrition, severe burn, decision support... clinical testing. Checklist and Decision Support in Nutritional Care for Burned Patients Proposal Number: 12340011 W81XWH-12-2-0074 PI: Steven E

  16. Sense of social support in chonic pain patients

    Directory of Open Access Journals (Sweden)

    Ancane G.

    2012-10-01

    Full Text Available Statistical data show that one in five adults of the European citizen suffer from some type of chronic pain. One of the most common types of chronic pain is chronic low back and neck pain. Emotional factors are currently viewed as important determinants in pain perception and behaviour. The perceived social and emotional support have impact to the individual’s adaptation to chronic disease (Cohen, Wills, 1985. The material: 110 chronic low back pain (CLBP patients (48 male and 62 female; in age from 24 to 60 years, mean: 44.2±8, 0 and pilot study of 23 chronic neck pain (CNP patients (19 female and 4 male; in age from 35 to 60 years, mean: 48, 1 ±6. The assessment methods: structured interview; Hospital Anxiety and Depression Scale (HADS. SF-36 ® Health Survey: assessment of emotional and social support. Results and conclusions: CLBP patients in presence of symptoms of depression and elevated level of anxiety matched for socio-demographic features had less sense of social support and marked pain impact to daily activities, lower self rating health relating quality of life. In CLBP patients the sense of social and emotional support had relevant interaction with level of participation in daily activities both in patients with and without mental health problems. This fact has to be considered in process of rehabilitation and in managing of health care of CLBP patients. The results of CNP patients pilot study revealed interesting trend that chronic back and neck pain patients seems to be quite different according to sense of social and emotional support, therefore sense of social and emotional support in different chronic pain patients need further research to improve the process and results of rehabilitation in these patients.

  17. Making interactive decision support for patients a reality.

    NARCIS (Netherlands)

    Evans, R.W.; Elwyn, G.; Edwards, A.

    2004-01-01

    Interactive decision support applications might help patients to make difficult decisions about their health care. They lie in the context of traditional decision aids, which are known to have effects on a number of patient outcomes, including knowledge and decisional conflict. The problem of

  18. The impact of critical incidents on mental health : An exploratory pilot study into the moderating effects of social support on the impact of adverse events in Dutch rescue workers.

    NARCIS (Netherlands)

    Bakker, H.; Gaillard, A.W.K.; van Veldhoven, M.J.P.M.

    2016-01-01

    This study investigated mental health- and work-related problems of 67 rescue workers (police officers and medical emergency drivers) caused by the accumulation of critical incidents during their career. Using Hobfoll’s theory of conservation of resources, this is one of the first studies in The

  19. Interest in internet lung cancer support among rural cardiothoracic patients.

    Science.gov (United States)

    Quin, Jacquelyn; Stams, Victor; Phelps, Beth; Boley, Theresa; Hazelrigg, Stephen

    2010-05-01

    The Internet may provide an alternative option for rural lung cancer patients who lack access to on-site cancer support; however, Internet access and use among rural patients is unknown. An anonymous waiting-room survey was administered to all outpatient cardiothoracic surgery patients over 3 mo. Survey questions included age, gender, and diagnosis, possession of a home computer and Internet service, estimated Internet use, and use of the Internet for health information. Patients with known or suspected lung cancer were asked to indicate their interest in on-site and Internet cancer support. There were 597 returned surveys (response rate 96%). The mean age was 64.6 y (SE 0.55), and 58% were men. Diagnoses included known or possible lung cancer (15.4%), lung disease (9.5%), heart disease (30.4%), other diagnoses (13.9%), and undetermined (30.6%). There were 343 patients (57.4%) with a home computer and 299 (50.1%) with home Internet service. Average Internet use was 8.5 h per wk (n = 298), and 225 patients used the Internet for health information. Of the 92 patients with lung cancer, 10 indicated interest in on-site support services while 37 expressed interest in Internet-based support. Based on survey results, a slight majority of rural patients have a home computer and Internet access. Internet use for health information appears relatively common. Overall interest for support services among lung cancer patients appears modest with a greater interest in Internet-based services compared with on-site support. Copyright 2010 Elsevier Inc. All rights reserved.

  20. Patient-Oriented Design of Online Support Communities

    OpenAIRE

    Krcmar, Helmut;Leimeister, Jan Marco

    2014-01-01

    This paper focuses on the process of designing and implementing an online support community for patients. After an introduction we describe a process for translating the socio-technical needs of cancer patients into system requirements as well as the development steps towards a functioning community platform for cancer patients. We combine a generic iterative process model for systems development with a prototyping approach towards an engineering process model for community platforms for canc...

  1. Joseph Conrad's tormented Rescue (fantasy).

    Science.gov (United States)

    Freedman, William

    2014-02-01

    Joseph Conrad was a notoriously tormented writer for whom the creative act was often a punishment severe enough to drive him into paralyzing depressions that delayed the completion of his novels, sometimes for years. By far the most agonizing of these projects was The Rescue, a novel he began in 1898, abandoned a year later, tried unsuccessfully to continue several times over the next two decades, but was only able to resume in 1918 and to complete, after another tortured two-year struggle, in 1920. An explanation for this incapacity, that is powerfully suggested by the novel's evocative title and perhaps unintentionally ironic subtitle (A Romance of the Shallows) has not yet been explored. Using Freud's 1910 essay on the rescue fantasy, "Contributions to the Psychology of Love: A Special Type of Choice of Object Made by Men," and Emanuel Berman's instructive revision and expansion of the concept in his 2003 American Imago essay, "Ferenczi, Rescue, and Utopia," I argue that a substantial explanation for Conrad's tormented history with The Rescue is ascribable to its quite remarkably faithful treatment of a rescue fantasy with deep and disabling resonance for its author. More specifically, the difficulty was compounded by the novel's dramatization of the soul-crushing conflict between two such fantasies: one in the service of the masculine ideal of unflinching dedication to a heroic purpose, the other promising satisfaction to the equally potent demands of emotional and sexual desire. Features of Conrad's narrative fit so tightly and consistently with the theory as Freud (and Abraham) proposed and as Berman elaborated it that The Rescue offers itself as one of those rare and reinforcing instances wherein the literary text seems to validate the psychoanalytic theory at least as persuasively as the theory "understands" the text.

  2. HyPR Device: Mobile Support for Hybrid Patient Records

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2014-01-01

    The patient record is one of the central artifacts in medical work that is used to organize, communicate and coordinate important information related to patient care. In many hospitals a double record consisting of an electronic and paper part is maintained. This practice introduces a number of c......PR device decreases configuration work, supports mobility in clinical work and increases awareness on patient data.......The patient record is one of the central artifacts in medical work that is used to organize, communicate and coordinate important information related to patient care. In many hospitals a double record consisting of an electronic and paper part is maintained. This practice introduces a number...... introduce the HyPR Device, a device that merges the paper and electronic patient record into one system. We provide results from a clinical simulation with eight clinicians and discuss the functional, design and infrastructural requirements of such hybrid patient records. Our study suggests that the Hy...

  3. CERN Fire Brigade rescue simulation

    CERN Multimedia

    Maximilien Brice

    2004-01-01

    The CERN Fire Brigade is made up of experienced firemen from all of the 20 Member States. In these images they are seen at a 'Discovery Monday' held at the Microcosm exhibition. Here visitors learn how the Fire Brigade deal with various situations, including a simulated cave rescue performed by the Hazardous Environments Response Team.

  4. The RESCueH Programme

    DEFF Research Database (Denmark)

    Søgaard Nielsen, Anette; Nielsen, Bent; Andersen, Kjeld

    2016-01-01

    Excessive alcohol consumption is one of the most important lifestyle factors affecting the disease burden in the Western world. The results of treatment in daily practice are modest at best. The aim of the RESCueH programme is to develop and evaluate methods, which are as practice-near as possible...

  5. Self-Rescue Mask Training

    CERN Multimedia

    2013-01-01

    Nine new self-rescue mask instructors have been trained since early 2013, which provides CERN with a total of 26 self-rescue mask instructors to date. This will allow us to meet the increasing training needs caused by the Long Shut Down LS1.   The self-rescue mask instructors have trained 1650 persons in 2012 and about 500 persons since the beginning of the year on how to wear the masks properly. We thank all the instructors and all the persons that made this training possible. Please remember that the self-rescue masks training sessions are scheduled as follows: Basic course: Tuesday and Thursday mornings (2 sessions – 8.30 AM and 10.30 AM), duration:  1.30 hour, in French and English – registration via CERN online training catalogue – Course code 077Y00. Refresher training : Monday mornings (2 sessions – 8.30 AM and 10.30 AM), duration: 1.30 hour , in French and English – registration via CERN online training catalogue &...

  6. [The psychological and social support in patients with psoriasis].

    Science.gov (United States)

    Makara-Studzińska, Marta; Ziemecki, Piotr; Ziemecka, Anna; Partyka, Iwona

    2013-09-01

    The meaning of non medical forms of support in the treatment of psoriasis is discussed in the paper. Related with psoriasis negative self image and feeling of stigmatization cause various mental disorders. Stress, depression, mental condition affect the appearance of psoriasis. Because of numerous studies and identify the factors and relationships important for psoriasis, patients can take the appropriate psychological and social support. Relaxation techniques, cognitive-behavioral therapy and support groups have a positive effect on the treatment of psoriasis. They reduce the level of stress in the patient, learn emotional control, adequate self-esteem, which leads to the acceptance of the disease and improve the quality of life of the patient.

  7. Survival Outcomes Following the Use of Extracorporeal Membrane Oxygenation as a Rescue Technology in Critically Ill Patients: Results From Pennsylvania 2007-2015.

    Science.gov (United States)

    Huesch, Marco D; Foy, Andrew; Brehm, Christoph

    2018-01-01

    To examine real-world outcomes of survival, length of stay, and discharge destination, among all adult extracorporeal membrane oxygenation admissions in one state over nearly a decade. Retrospective analysis of administrative discharge data. State-wide administrative discharge data from Pennsylvania between 2007 and 2015. All 2,948 consecutive patients billed under a Diagnosis-Related Grouper 3 grouper and in whom a procedural code for extracorporeal membrane oxygenation was present, admitted between the beginning of 2007 and the end of 2015 to hospitals regulated by the state of Pennsylvania. Admitting diagnoses were coded as respiratory, cardiac, cardiac arrest, or uncategorized based on administrative data. Unadjusted in-hospital mortality, length of stay, and discharge destination. Summary statistics and tests of differences by age 65 years or older and by admitting diagnosis were performed. Outcomes by age were plotted using running-mean smoothed graphs. Over the 9-year period, the average observed death rate was 51.7%. Among all survivors, 14.6% went home to self-care and a further 15.2% to home health care. Of all survivors, 43.8% were readmitted within 1 month, and 60.6% within 1 year. Among elderly survivors, readmission rates were 52.3% and 65.5% within 1 month and 1 year, respectively. The likelihood of dying in-hospital increased with age that of being discharged home or to postacute care decreased. In a "usual clinical practice" setting, short-term outcomes are similar to those observed in clinical trials such as Conventional Ventilation or ECMO for Severe Adult Respiratory Failure, in registries such as extracorporeal life support organization, and in smaller single-site studies. More data on longer term follow-up are needed to allow clinicians to better inform patient selection and care.

  8. [Medical treatment support to tuberculous patients--from the standpoint of community support].

    Science.gov (United States)

    2001-11-01

    A symposium with "Medical Treatment Support to Tuberculous Patients--From the standpoint of community support" as its theme was held at the 76th Annual Meeting of the Japanese Society for Tuberculosis (April 20, 2001). "Once, It is infected with tuberculosis, one have to complete medication with a sensitive antituberculosis drug by observing the prescribed dose and duration for successful treatment". For this to be promoted community, it is necessary that (1) to manage patient's medication by medical facilities, (2) to support patient's medication by health center and (3) to support patient's living by welfare offices. Not that each facilities takes such responsibilities alone, but various community must fulfill them continuously in liaison with one another. On what measures should be taken to that end, reports based on practical examples from Nagoya City, Yokohama City and Kanagawa Prefecture have been compiled as follows. 1. It was in-office liaison by conference that supported the DOTS activities of health nurses. 2. It is cooperating, without health, medical treatment, and welfare going out, as follows. (1) A system for hospitals and clinics to carry out DOTS treatment consistently has been kept in good condition. (2) For a patient to take a drug in front of a nurse has become common, causing the patients to be motivated. (3) Assignment of MSW and nurses in charge of DOTS sent from hospitals has make it possible to offer or exchange information smoothly among those concerned. (4) A system for many persons concerned to support patients timely has been kept in good condition. This resulted in an increase in the cure rate of tuberculosis in the areas which have day laborers' lodgings. 3. By DOTS for in-patients, the number of self-discharges has decreased by 1/3, and the treatment completion rate was 94%. 4. In promotion of DOTS for the patients who have health problems other than tuberculosis, the role MSW plays is great. 5. As conditions for supporting DOTS

  9. Optimal support techniques when providing mechanical ventilation to patients with acute respiratory distress syndrome.

    Science.gov (United States)

    Parissopoulos, Stelios; Mpouzika, Meropi DA; Timmins, Fiona

    2017-01-01

    Adult respiratory distress syndrome (ARDS) is a type of acute diffuse lung injury characterized by severe inflammation, increased pulmonary vascular permeability and a loss of aerated lung tissue. The effects of high fraction of inspired oxygen (FiO 2 ) include oxygen toxicity manifested by damage to the lung parenchyma in the acute phase of lung injury. There is still a high mortality rate among this group of patients, so clinically sensitive evidence-based interventions are paramount to maximize survival chances during critical care. The aim of this article is to explore the current opinion concerning optimal mechanical ventilation support techniques for patients with acute respiratory distress syndrome. A literature search of clinical trials and observation studies, reviews, discussion papers, meta-analyses and clinical guidelines written in English up to 2015, derived from the databases of Scopus, CINAHL, Cochrane Library databases and PubMed was conducted. Low tidal volume, pressure limitation and prone positioning in severe ARDS patients appear to be of some benefit. More research is required and further development and use of standardized protocols is an important strategy for reducing practice variations across disciplines, as well as giving clear guidelines to nurses practising in critical care. There is also evidence that this syndrome is under-diagnosed and the utilization of lung protective ventilation is still variable. It is important that nurses have underlying knowledge of both aetiology of ARDS and ventilation management, and that they monitor patients very closely. The adoption of a low tidal ventilation protocol, which is based on quality evidence guidelines, the value of rescue therapies and patient observation practices in the overall patient management, and the need to place emphasis on long-term patient outcomes, all these emerge as key factors for consideration and future research. However, there is also a need for more research that would

  10. Radiation oncology: An Irish hospitals approach to supporting patients

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Caragh [Cork University Hospital (Ireland)], E-mail: caragh.miller@tcd.ie

    2009-02-15

    Despite advances in medical technology, cancer is still one of the leading causes of death globally, leaving many patients to deal with the emotional and psychological aspects associated with cancer and its treatment [Department of Health and Children. A strategy for cancer control in Ireland. National Cancer Forum. Dublin; 2006]. The recognition and management of psychological conditions are an integral part of comprehensive cancer care. As a result, the Health Services Executive as part of the continuing expansion of Cork Radiation Oncology Department created the role of Information and Support Radiation Therapist. This post was specially created during June 2005 to facilitate the smooth entry into the treatment for patients and family members experiencing radiotherapy for the first time. Working alongside the oncology nurses and other health professionals the Information and Support Radiation Therapist aims to provide vital education/information and support to patients and their families. The provision of this new service for patients enables departments to adopt a holistic approach to treatment. This research identifies the cancer services and psychological support services in Ireland. Up-to-date audits of the new patient services established in the Cork Radiation Oncology Department and their psychological contribution towards cancer development and treatment are also discussed.

  11. Radiation oncology: An Irish hospitals approach to supporting patients

    International Nuclear Information System (INIS)

    Miller, Caragh

    2009-01-01

    Despite advances in medical technology, cancer is still one of the leading causes of death globally, leaving many patients to deal with the emotional and psychological aspects associated with cancer and its treatment [Department of Health and Children. A strategy for cancer control in Ireland. National Cancer Forum. Dublin; 2006]. The recognition and management of psychological conditions are an integral part of comprehensive cancer care. As a result, the Health Services Executive as part of the continuing expansion of Cork Radiation Oncology Department created the role of Information and Support Radiation Therapist. This post was specially created during June 2005 to facilitate the smooth entry into the treatment for patients and family members experiencing radiotherapy for the first time. Working alongside the oncology nurses and other health professionals the Information and Support Radiation Therapist aims to provide vital education/information and support to patients and their families. The provision of this new service for patients enables departments to adopt a holistic approach to treatment. This research identifies the cancer services and psychological support services in Ireland. Up-to-date audits of the new patient services established in the Cork Radiation Oncology Department and their psychological contribution towards cancer development and treatment are also discussed

  12. Compliance with nutrition support guidelines in acutely burned patients.

    Science.gov (United States)

    Holt, Brennen; Graves, Caran; Faraklas, Iris; Cochran, Amalia

    2012-08-01

    Adequate and timely provision of nutritional support is a crucial component of care of the critically ill burn patient. The goal of this study was to assess a single center's consistency with Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition (SCCM/ASPEN) guidelines for nutritional support in critically ill patients. Acutely burned patients >45kg in weight admitted to a regional burn center during a two-year period and who required 5 or more days of full enteral nutritional support were eligible for inclusion in this retrospective review. Specific outcomes evaluated include time from admission to feeding tube placement and enteral feeding initiation and percent of nutritional goal received within the first week of hospital stay. Descriptive statistics were used for all analyses. IRB approval was obtained. Thirty-seven patients were included in this retrospective review. Median age of patients was 44.9 years (IQR: 24.2-55.1), and median burn injury size was 30% (IQR: 19-47). Median time to feeding tube placement was 31.1h post admission (IQR: 23.6-50.2h), while median time to initiation of EN was 47.9h post admission (IQR: 32.4-59.9h). The median time required for patients to reach 60% of caloric goal was 3 days post-admission (IQR: 3-4.5). The median time for initiation of enteral nutrition was within the SCCM/ASPEN guidelines for initial nutrition in the critically ill patient. This project identified a 16h time lag between placement of enteral access and initiation of enteral nutrition. Development of a protocol for feeding tube placement and enteral nutrition management may optimize early nutritional support in the acutely injured burn patient. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  13. Kundalini yoga as a support therapy for cancer patients

    OpenAIRE

    Kröneck, Mia

    2016-01-01

    This study was designed to describe cancer patient’s experience of kundalini yoga and its effect on their internal coping resources. The intention of this study is to put forward kundalini yoga as a support therapy for cancer patients for improving their wellbeing during active cancer treatment. This is a descriptive study. An academic literature review was conducted for cancer, cancer treatment, internal coping resources and yoga as therapy topics. Four voluntary female cancer patients (...

  14. African American Patients' Psychosocial Support Needs and Barriers to Treatment: Patient Needs Assessment.

    Science.gov (United States)

    Davey, Maureen P; Bilkins, Brianna; Diamond, Guy; Willis, Alliric I; Mitchell, Edith P; Davey, Adam; Young, Faith M

    2016-09-01

    This study assessed adult patient's psychosocial support needs and treatment barriers in an urban diverse cancer center. A needs assessment was conducted with a convenience sample of adult oncology patients (n = 113; 71.7 % African American). Most patients were parenting school-age children and worried about them (96 %); 86.7 % would attend a family support program. Among patients who were married or partnered (68 %), 63.7 % were concerned about communication, coping, and emotional support; 53.9 % would attend a couple support program. Patients identified similar treatment barriers: transportation, babysitting for younger children, convenience of time/place, and refreshments. Findings suggest that behavioral health care providers should be available to screen cancer patients and improve access to appropriate psychosocial oncology support programs.

  15. Ontological Reasoning for Human-Robot Teaming in Search and Rescue Missions

    NARCIS (Netherlands)

    Bagosi, T.; Hindriks, k.V.; Neerincx, M.A.

    2016-01-01

    In search and rescue missions robots are used to help rescue workers in exploring the disaster site. Our research focuses on how multiple robots and rescuers act as a team, and build up situation awareness. We propose a multi-agent system where each agent supports one member, either human or robot.

  16. Mid-Term report 'Establishing bonds for the advancement of the Rescue League'

    NARCIS (Netherlands)

    Riaño, I.; Visser, A.

    2014-01-01

    The RoboCup Rescue Simulation League aims to benchmark the intelligence of software agents and robots on their capabilities to make autonomously the right decisions in a disaster response scenario. The UvA Rescue and Distribot team have come together to work co-operatively to support this aim in two

  17. Final report 'Establishing bonds for the advancement of the Rescue League'

    NARCIS (Netherlands)

    Riaño, I.; Visser, A.

    2014-01-01

    The RoboCup Rescue Simulation League aims to benchmark the intelligence of software agents and robots on their capabilities to make autonomously the right decisions in a disaster response scenario. The UvA Rescue and Distribot team have come together to work co-operatively to support this aim in two

  18. Pediatric advanced life support and sedation of pediatric dental patients.

    Science.gov (United States)

    Kim, Jongbin

    2016-03-01

    Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

  19. 46 CFR 199.202 - Rescue boats.

    Science.gov (United States)

    2010-10-01

    ... SYSTEMS FOR CERTAIN INSPECTED VESSELS Additional Requirements for Passenger Vessels § 199.202 Rescue boats... 46 Shipping 7 2010-10-01 2010-10-01 false Rescue boats. 199.202 Section 199.202 Shipping COAST... least one rescue boat approved under approval series 160.156 that is equipped as specified in table 199...

  20. Rope rescue in National fire-fighting and rescue system

    OpenAIRE

    SOCHACKI MARIAN

    2008-01-01

    Автор описывает организацию, функционирование и место системы спасения с высоты в Государственной спасательно-гасящей системе.The author describes organization, working and place of rope rescue in National Firefighting and Rescue System (KSRG).

  1. Patients on weaning trials classified with support vector machines

    International Nuclear Information System (INIS)

    Garde, Ainara; Caminal, Pere; Giraldo, Beatriz F; Schroeder, Rico; Voss, Andreas; Benito, Salvador

    2010-01-01

    The process of discontinuing mechanical ventilation is called weaning and is one of the most challenging problems in intensive care. An unnecessary delay in the discontinuation process and an early weaning trial are undesirable. This study aims to characterize the respiratory pattern through features that permit the identification of patients' conditions in weaning trials. Three groups of patients have been considered: 94 patients with successful weaning trials, who could maintain spontaneous breathing after 48 h (GSucc); 39 patients who failed the weaning trial (GFail) and 21 patients who had successful weaning trials, but required reintubation in less than 48 h (GRein). Patients are characterized by their cardiorespiratory interactions, which are described by joint symbolic dynamics (JSD) applied to the cardiac interbeat and breath durations. The most discriminating features in the classification of the different groups of patients (GSucc, GFail and GRein) are identified by support vector machines (SVMs). The SVM-based feature selection algorithm has an accuracy of 81% in classifying GSucc versus the rest of the patients, 83% in classifying GRein versus GSucc patients and 81% in classifying GRein versus the rest of the patients. Moreover, a good balance between sensitivity and specificity is achieved in all classifications

  2. The supportive care needs for prostate cancer patients in Sarawak.

    Science.gov (United States)

    Cheah, Whye Lian; Ling, Ngok Chuo; Chang, Kam Hock

    2016-02-01

    This cross-sectional study aimed to determine the prevalence of unmet supportive care needs among prostate cancer patients. The cross-sectional study was conducted among all prostate cancer patients at the Sarawak General Hospital. Interview was done using the Supportive Care Needs Survey-Short Form (SCNS-SF) and the Health Service Utilization Questionnaires (HSUQ). Data were analysed using Statistical Package for the Social Sciences (SPSS) 20. A total of ninety-five patients participated, with majority were aged 65 and above and of primary educational level. The two most frequently reported unmet supportive care needs were "informed about cancer which is under control or diminishing" and "informed about things you can do to help yourself to get well" under the domain Health System and Information. Respondents who were older (65 years and above) had significant lower unmet needs in psychology (P<0.01), and sexuality compared to the younger group below 65 years (P<0.01). Except for physical and daily living, respondents with primary school level had significant lower unmet needs in all domains compared to secondary school level. Respondents with known stages of cancer had higher unmet needs in all domains compared to those who did not know. Healthcare providers should provide more responsive, emotionally sensitive and client-centered care to patients with prostate cancer, particularly in the area of Health System and Information, and psychological support.

  3. Online peer support for patients with somatic diseases

    NARCIS (Netherlands)

    Kraan, C.F.

    2008-01-01

    With the availability of the Internet, so rose the opportunity to share concerns and experiences with peers online. In this thesis the meaning of online support groups for patients with rheumatoid arthritis, fibromyalgia and breast cancer was examined from different perspectives. To this aim, six

  4. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS)

    DEFF Research Database (Denmark)

    de By, Theo M M H; Mohacsi, Paul; Gummert, Jan

    2015-01-01

    other founding international members. It aims to promote scientific research to improve care of end-stage heart failure patients with ventricular assist device or a total artificial heart as long-term mechanical circulatory support. Likewise, the organization aims to provide and maintain a registry...

  5. Diabetes self-management support for patients with low health literacy: Perceptions of patients and providers

    NARCIS (Netherlands)

    Fransen, Mirjam P.; Beune, Erik J. A. J.; Baim-Lance, Abigail M.; Bruessing, Raynold C.; Essink-Bot, Marie-Louise

    2015-01-01

    The aim of the present study was to explore perceptions and strategies of health care providers regarding diabetes self-management support for patients with low health literacy (LHL), and to compare their self-management support with the needs of patients with LHL and type 2 diabetes. This study

  6. Supportive and non-supportive interactions in families with a type 2 diabetes patient

    DEFF Research Database (Denmark)

    Bennich, Birgitte B; Røder, Michael E; Overgaard, Dorthe

    2017-01-01

    changes and diabetes self-management. The purpose of this integrative review was to summarise and assess published studies on the intra-family perspective of supportive and non-supportive interactions in families with a type 2 diabetes patient. METHODS: Included in the review were published qualitative......BACKGROUND: Type 2 diabetes and its management affect the patient and the close family potentially causing either psychological distress or increased sense of responsibility and collaboration in these families. Interactions between patient and family play an important role in maintaining lifestyle...... of reference lists. Quality assessment, data extraction and analysis were undertaken on all included studies. RESULTS: We identified five eligible research papers. Employing content analysis three categories describing interactions were refined: Impact of practical action, impact of emotional involvement...

  7. Information security requirements in patient-centred healthcare support systems.

    Science.gov (United States)

    Alsalamah, Shada; Gray, W Alex; Hilton, Jeremy; Alsalamah, Hessah

    2013-01-01

    Enabling Patient-Centred (PC) care in modern healthcare requires the flow of medical information with the patient between different healthcare providers as they follow the patient's treatment plan. However, PC care threatens the stability of the balance of information security in the support systems since legacy systems fall short of attaining a security balance when sharing their information due to compromises made between its availability, integrity, and confidentiality. Results show that the main reason for this is that information security implementation in discrete legacy systems focused mainly on information confidentiality and integrity leaving availability a challenge in collaboration. Through an empirical study using domain analysis, observations, and interviews, this paper identifies a need for six information security requirements in legacy systems to cope with this situation in order to attain the security balance in systems supporting PC care implementation in modern healthcare.

  8. Supporting cancer patients and their relatives through storytelling

    DEFF Research Database (Denmark)

    la Cour, Karen; Ledderer, Loni; Hansen, Helle Ploug

    2016-01-01

    observations, informal conversations and follow-up interviews conducted one month after completing the intervention. Analysis was performed drawing on narrative theory combined with social practice theory. The results demonstrate that the use of storytelling and metaphors intertwined with other course...... activities, such as dancing and arts & crafts, provided the patients and their relatives with strategies to manage cancer-related concerns, which they were later able to apply in their everyday lives. The study results may be useful to other professionals in clinical practice for rehabilitation purposes......Previous research on psychosocial support for cancer-related concerns has primarily focused on either patients or their relatives, although limited research is available on how patients and their relatives can be supported together. The aim of this article is to explore the use of storytelling...

  9. The need for psycho-oncological support for melanoma patients

    Science.gov (United States)

    Mayer, Simone; Teufel, Martin; Schaeffeler, Norbert; Keim, Ulrike; Garbe, Claus; Eigentler, Thomas Kurt; Zipfel, Stephan; Forschner, Andrea

    2017-01-01

    Abstract Despite an increasing number of promising treatment options, only a limited number of studies concerning melanoma patients’ psycho-oncological distress have been carried out. However, multiple screening tools are in use to assess the need for psycho-oncological support. This study aimed first to identify parameters in melanoma patients that are associated with a higher risk for being psycho-oncologically distressed and second to compare patients’ self-evaluation concerning the need for psycho-oncological support with the results of established screening tools. We performed a cross-sectional study including 254 melanoma patients from the Center for Dermatooncology at the University of Tuebingen. The study was performed between June 2010 and February 2013. Several screening instruments were included: the Distress Thermometer (DT), Hospital Anxiety and Depression Scale and the patients’ subjective evaluation concerning psycho-oncological support. Binary logistic regression was performed to identify factors that indicate the need for psycho-oncological support. Patients’ subjective evaluation concerning the need for psycho-oncological support, female gender, and psychotherapeutic or psychiatric treatment at present or in the past had the highest impact on values above threshold in the DT. The odds ratio of patients’ self-evaluation (9.89) was even higher than somatic factors like female gender (1.85), duration of illness (0.99), or increasing age (0.97). Patients’ self-evaluation concerning the need for psycho-oncological support indicated a moderate correlation with the results of the screening tools included. In addition to the results obtained by screening tools like the DT, we could demonstrate that patients’ self-evaluation is an important instrument to identify patients who need psycho-oncological support. PMID:28906378

  10. Rescuing the Regent Theatre

    Directory of Open Access Journals (Sweden)

    Louise Blake

    2005-10-01

    Full Text Available Melbourne’s Regent and Plaza theatres opened in Collins Street in 1929. For more than forty years, these grand picture palaces were among Melbourne’s most treasured cinemas, favourites together with the Capitol Theatre in Swanston Street and the State Theatre in Flinders Street. Often called ‘palaces of dreams’, they were part of a glamorous entertainment era, when a night out at the movies was an event, and an afternoon matinee was a treat. Not even the Regent’s two-year closure, as a result of the fire that destroyed the auditorium in 1945, could dampen the enthusiasm of its Melbourne audiences. By the 1960s, however, the grand picture palaces were no longer in vogue and were becoming uneconomical to run. The State Theatre closed in 1962 and was later converted into two theatres. The Capitol closed in 1964, but when it re-opened eighteen months later a shopping arcade had been built in the lower part of the auditorium. After investigating the option of converting the Regent into two theatres, its owner, Hoyts, opted to develop a smaller multi-cinema complex in Bourke Street instead. The company sold the Regent and Plaza theatres to the City of Melbourne in 1969 and in 1970 the doors of the Regent and Plaza closed for what many people thought was the last time. Melbourne City Council bought the Regent and Plaza in order to control development around the site of the proposed City Square on the corner of Swanston and Collins Streets. The theatres seemed destined to fall victim to the wrecker’s ball. But if the 1960s was the decade of development, the 1970s was the decade of preservation. Protests against the demolition of historic buildings occurred around Australia, often with the controversial support of the building unions. The architectural profession debated the issues of preservation versus development of dynamic modern buildings. Both the State and Federal Governments were forced to introduce legislation to protect the nation

  11. Genetic Information, the Principle of Rescue, and Special Obligations.

    Science.gov (United States)

    Liao, S Matthew; Mackenzie, Jordan

    2018-05-01

    In "Genetic Privacy, Disease Prevention, and the Principle of Rescue," Madison Kilbride argues that patients have a duty to warn biological family members about clinically actionable adverse genetic findings. The duty does not stem from the special obligations that we may have to family members, she argues, but rather follows from the principle of rescue, which she understands as the idea that one ought to prevent, reduce, or mitigate the risk of harm to another person when the expected harm is serious and the cost or risk to oneself is sufficiently moderate. We doubt, however, whether the principle of rescue can ground a duty to warn in the cases Kilbride envisages, and we suggest that Kilbride may have underappreciated the role that special obligations could play in generating a duty to warn family members. © 2018 The Hastings Center.

  12. [Suspension of Respiratory Support in Patients with Amyotrophic Lateral Sclerosis].

    Science.gov (United States)

    Silberberg, Agustín A; Robetto, Josefina; Achával, Mora

    2018-01-01

    Decision making in advanced Amyotrophic Lateral Sclerosis (ALS) patients keeps on being a controversial issue. The aim of this work is to discuss ethical implications of withdrawing respiratory support treatment in patients with ALS. Through a bibliographic search on Pubmed database (2010-2016) we investigated whether or not the use of Non-Invasive Ventilation (NIV) and Mechanical Ventilation (MV) would increase survival and quality of life. We included 38 review articles. From these papers, results and ethical implications of initiating and mainly withdrawing respiratory support were analyzed. Survival time increased with NIV and with MV. Quality of life, above all according to physiological criteria, improved with NIV but regarding MV it remained controversial. Implementation and future withdrawal of MV seemed open to medical and ethical discussion. From a perspective of the intrinsic dignity of every human being, whatever its quality of life was, and knowing that no effective therapies for the underlying disease are available, the decision to remove MV in a patient with advanced ALS requires: knowledge of the will of the patient and, above all, evaluating whether this respiratory support measure is becoming objectively disproportionate.

  13. Initial assessment and treatment of refugees in the Mediterranean Sea (a secondary data analysis concerning the initial assessment and treatment of 2656 refugees rescued from distress at sea in support of the EUNAVFOR MED relief mission of the EU).

    Science.gov (United States)

    Kulla, M; Josse, F; Stierholz, M; Hossfeld, B; Lampl, L; Helm, M

    2016-05-20

    As a part of the European Union Naval Force - Mediterranean Operation Sophia (EUNAVFOR Med), the Federal Republic of Germany is contributing to avoid further loss of lives at sea by supplying two naval vessels. In the study presented here we analyse the medical requirements of such rescue missions, as well as the potential benefits of various additional monitoring devices in identifying sick/injured refugees within the primary onboard medical assessment process. Retrospective analysis of the data collected between May - September 2015 from a German Naval Force frigate. Initial data collection focused on the primary medical assessment and treatment process of refugees rescued from distress at sea. Descriptive statistics, uni- and multivariate analysis were performed. The study has received a positive vote from the Ethics Commission of the University of Ulm, Germany (request no. 284/15) and has been registered in the German Register of Clinical Studies (no. DRKS00009535). A total of 2656 refugees had been rescued. 16.9 % of them were classified as "medical treatment required" within the initial onboard medical assessment process. In addition to the clinical assessment by an emergency physician, pulse rate (PR), core body temperature (CBT) and oxygen saturation (SpO2) were evaluated. Sick/injured refugees displayed a statistically significant higher PR (114/min vs. 107/min; p refugee boats. A cut-off value of clinical importance could not be found. Predominant diagnoses have been dermatological diseases (55.4), followed by internal diseases (27.7) and trauma (12.1 %). None of the refugees classified as "healthy" within the primary medical assessment process changed to "medical treatment required" during further observation. The initial medical assessment by an emergency physician has proved successful. PR, CBT and SpO2 didn't have any clinical impact to improve the identification of sick/injured refugees within the primary onboard assessment process.

  14. A Clinical Decision Support System for Breast Cancer Patients

    Science.gov (United States)

    Fernandes, Ana S.; Alves, Pedro; Jarman, Ian H.; Etchells, Terence A.; Fonseca, José M.; Lisboa, Paulo J. G.

    This paper proposes a Web clinical decision support system for clinical oncologists and for breast cancer patients making prognostic assessments, using the particular characteristics of the individual patient. This system comprises three different prognostic modelling methodologies: the clinically widely used Nottingham prognostic index (NPI); the Cox regression modelling and a partial logistic artificial neural network with automatic relevance determination (PLANN-ARD). All three models yield a different prognostic index that can be analysed together in order to obtain a more accurate prognostic assessment of the patient. Missing data is incorporated in the mentioned models, a common issue in medical data that was overcome using multiple imputation techniques. Risk group assignments are also provided through a methodology based on regression trees, where Boolean rules can be obtained expressed with patient characteristics.

  15. Compliance with Supportive Periodontal Treatment in Patients with Dental Implants.

    Science.gov (United States)

    Hu, Kai-Fang; Lin, Ying-Chu; Ho, Kun-Yen; Chou, Yu-Hsiang

    The need for dental implants is increasing, and supportive periodontal treatment can achieve long-term success and prevent peri-implantitis. Contributing factors to noncompliance with long-term scheduled supportive periodontal treatment remain unclear. To investigate whether demographic and clinical characteristics are associated with noncompliance, the authors analyzed data for patients who had received dental implants. The authors recruited patients participating in a supportive periodontal treatment program after receiving permanent prostheses on implants placed from 2005 to 2013. Demographic data and dental treatment histories were collected. Compliance was defined as a record of participation in a standard supportive periodontal treatment program for at least 1 year. The chi-square test, log-rank test, Kaplan-Meier survival curve, and Cox proportional hazards model were used for statistical analysis. The study included 120 patients (259 implants, 60% compliance). The two groups (compliant and noncompliant) differed significantly in frequency distributions for sex (P = .0017), educational level (P = .0325), and histories of substance use (P = .0016), periodontitis (P = .0005), and root planing or flap surgery (P = .0002). The Kaplan-Meier survival curves and log-rank test showed that increases in cumulative continuation rates were significantly associated with male sex (P = .0025); body mass index ≥ 24 kg/m² (P = .0093); and a history of periodontitis (P implant placement, root planing or flap surgery was the crucial factor in determining compliance with supportive periodontal treatment. However, well-designed large-scale studies with a larger sample size are needed to confirm the findings of this study.

  16. Importance of teamwork, communication and culture on failure-to-rescue in the elderly.

    Science.gov (United States)

    Ghaferi, A A; Dimick, J B

    2016-01-01

    Surgical mortality increases significantly with age. Wide variations in mortality rates across hospitals suggest potential levers for improvement. Failure-to-rescue has been posited as a potential mechanism underlying these differences. A review was undertaken of the literature evaluating surgery, mortality, failure-to-rescue and the elderly. This was followed by a review of ongoing studies and unpublished work aiming to understand better the mechanisms underlying variations in surgical mortality in elderly patients. Multiple hospital macro-system factors, such as nurse staffing, available hospital technology and teaching status, are associated with differences in failure-to-rescue rates. There is emerging literature regarding important micro-system factors associated with failure-to-rescue. These are grouped into three broad categories: hospital resources, attitudes and behaviours. Ongoing work to produce interventions to reduce variations in failure-to-rescue rates include a focus on teamwork, communication and safety culture. Researchers are using novel mixed-methods approaches and theories adapted from organizational studies in high-reliability organizations in an effort to improve the care of elderly surgical patients. Although elderly surgical patients experience failure-to-rescue events at much higher rates than their younger counterparts, patient-level effects do not sufficiently explain these differences. Increased attention to the role of organizational dynamics in hospitals' ability to rescue these high-risk patients will establish high-yield interventions aimed at improving patient safety. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  17. Portable, space-saving medical patient support system

    Science.gov (United States)

    Bzorgi,; Fariborz, [Knoxville, TN

    2011-02-01

    A support platform having a stowed configuration and a deployed configuration on a floor. The support platform is related to stretcher devices that are used for transporting, confining, or conducting medical procedures on medical patients in medical emergencies. The support platform typically includes a work surface that has a geometric extent. A base that typically includes a plurality of frame members is provided, and the frame members are disposed across the geometric extent of, and proximal to, the work surface in the stowed configuration. The frame members are typically disposed on the floor in the deployed configuration. There is a foldable bracing system engaged with the work surface and engaged with the base. At least a portion of the foldable bracing system is disposed substantially inside at least a portion of the plurality of frame members in the stowed configuration. Further, the foldable bracing system is configured for translocation of the work surface distal from the base in the deployed configuration.

  18. Safety of meglumine gadoterate (Gd-DOTA)-enhanced MRI compared to unenhanced MRI in patients with chronic kidney disease (RESCUE study)

    Energy Technology Data Exchange (ETDEWEB)

    Deray, Gilbert [Pitie Salpetriere Hospital, Department of Nephrology, Paris cedex 13 (France); Rouviere, Olivier [Hopital E. Herriot, Universite de Lyon, Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Lyon (France); Universite Lyon 1, faculte de medecine Lyon Est, Lyon (France); Bacigalupo, Lorenzo [E.O. Ospedali Galliera, Radiology Department, Genova (Italy); Maes, Bart [Heilig Hartziekenhuis Roeselare, Department of Nephrology, Roeselare (Belgium); Hannedouche, Thierry [University Hospitals, Department of Nephrology, Strasbourg (France); Vrtovsnik, Francois [Bichat Hospital, Department of Nephrology, Paris (France); Rigothier, Claire [Pellegrin Hospital, Department of Nephrology Transplantation Dialysis, Bordeaux (France); Billiouw, Jean-Marie [Onze Lieve Vrouw Ziekenhuis, Department of Nephrology, Aalst (Belgium); Campioni, Paolo [Azienda Ospedaliero-Universitaria Sant' Anna, Ferrara (Italy); Ferreiros, Joaquin [Hospital Clinico de San Carlos, Servicio de Radiodiagnostico, Madrid (Spain); Devos, Daniel [Gent University Hospital, Department of Radiology, Gent (Belgium); Alison, Daniel [Trousseau Hospital, Department of Radiology, Tours (France); Glowacki, Francois [University Hospitals, Department of Nephrology, Lille (France); Boffa, Jean-Jacques [Tenon Hospital, Department of Nephrology and Dialysis, Paris (France); Marti-Bonmati, Luis [University of Valencia, Department of Radiology, Valencia (Spain)

    2013-05-15

    To prospectively compare the renal safety of meglumine gadoterate (Gd-DOTA)-enhanced magnetic resonance imaging (MRI) to a control group (unenhanced MRI) in high-risk patients. Patients with chronic kidney disease (CKD) scheduled for MRI procedures were screened. The primary endpoint was the percentage of patients with an elevation of serum creatinine levels, measured 72 {+-} 24 h after the MRI procedure, by at least 25 % or 44.2 {mu}mol/l (0.5 mg/dl) from baseline. A non-inferiority margin of the between-group difference was set at -15 % for statistical analysis of the primary endpoint. Main secondary endpoints were the variation in serum creatinine and eGFR values between baseline and 72 {+-} 24 h after MRI and the percentage of patients with a decrease in eGFR of at least 25 % from baseline. Patients were screened for signs of nephrogenic systemic fibrosis (NSF) at 3-month follow-up. Among the 114 evaluable patients, one (1.4 %) in the Gd-DOTA-MRI group and none in the control group met the criteria of the primary endpoint [{Delta} = -1.4 %, 95%CI = (-7.9 %; 6.7 %)]. Non-inferiority was therefore demonstrated (P = 0.001). No clinically significant differences were observed between groups for the secondary endpoints. No serious safety events (including NSF) were noted. Meglumine gadoterate did not affect renal function and was a safe contrast agent in patients with CKD. (orig.)

  19. Safety of meglumine gadoterate (Gd-DOTA)-enhanced MRI compared to unenhanced MRI in patients with chronic kidney disease (RESCUE study)

    International Nuclear Information System (INIS)

    Deray, Gilbert; Rouviere, Olivier; Bacigalupo, Lorenzo; Maes, Bart; Hannedouche, Thierry; Vrtovsnik, Francois; Rigothier, Claire; Billiouw, Jean-Marie; Campioni, Paolo; Ferreiros, Joaquin; Devos, Daniel; Alison, Daniel; Glowacki, Francois; Boffa, Jean-Jacques; Marti-Bonmati, Luis

    2013-01-01

    To prospectively compare the renal safety of meglumine gadoterate (Gd-DOTA)-enhanced magnetic resonance imaging (MRI) to a control group (unenhanced MRI) in high-risk patients. Patients with chronic kidney disease (CKD) scheduled for MRI procedures were screened. The primary endpoint was the percentage of patients with an elevation of serum creatinine levels, measured 72 ± 24 h after the MRI procedure, by at least 25 % or 44.2 μmol/l (0.5 mg/dl) from baseline. A non-inferiority margin of the between-group difference was set at -15 % for statistical analysis of the primary endpoint. Main secondary endpoints were the variation in serum creatinine and eGFR values between baseline and 72 ± 24 h after MRI and the percentage of patients with a decrease in eGFR of at least 25 % from baseline. Patients were screened for signs of nephrogenic systemic fibrosis (NSF) at 3-month follow-up. Among the 114 evaluable patients, one (1.4 %) in the Gd-DOTA-MRI group and none in the control group met the criteria of the primary endpoint [Δ = -1.4 %, 95%CI = (-7.9 %; 6.7 %)]. Non-inferiority was therefore demonstrated (P = 0.001). No clinically significant differences were observed between groups for the secondary endpoints. No serious safety events (including NSF) were noted. Meglumine gadoterate did not affect renal function and was a safe contrast agent in patients with CKD. (orig.)

  20. Response to Therapeutic Plasma Exchange as a Rescue Treatment in Clinically Isolated Syndromes and Acute Worsening of Multiple Sclerosis: A Retrospective Analysis of 90 Patients.

    Directory of Open Access Journals (Sweden)

    Johannes Ehler

    Full Text Available Experience with therapeutic plasma exchange (TPE for acute relapses in clinically isolated syndrome (CIS or multiple sclerosis (MS patients has been derived from small and inhomogeneous patient populations so far. In the present study, we retrospectively evaluated features associated with TPE response in a larger cohort of CIS and MS patients with acute worsening of disease.Ninety CIS and MS patients with acute relapses or acute worsening of symptoms were firstly treated with TPE. The population consisted of 62 women and 28 men with a median age of 38 years (range 18-69 years.Primary endpoint was the clinical response to TPE, focused on the functional improvement of the target neurologic deficit. Secondary endpoint was an improvement in expanded disability status scale (EDSS scoring.A clinical response to TPE was observed in 65 out of 90 patients (72.2%, with marked improvement in 18 (20.0% and moderate improvement in 47 out of 90 patients (52.2%. The median EDSS was reduced from 3.75 before to 3.0 after TPE (p = 0.001. Response to TPE was significantly more frequent in patients with relapsing courses of disease (CIS, RR-MS, p = 0.001, no disease modifying drugs (p = 0.017, gadolinium-positive (Gd+ MRI lesions (p = 0.001 and EDSS ≤ 5.0 before TPE (p = 0.014. In the multiple logistic regression analysis only the detection of Gd+ MRI lesions was significantly altered (p = 0.004.Clinical response to TPE was achieved in the majority of our patients. We identified clinical and diagnostic features in CIS and MS relapses that might be helpful to identify patients responding to TPE. Gd+ MRI lesions before treatment were the best predictor of the response to TPE in our cohort.

  1. Rescue apparatus for a high working oil derrick

    Energy Technology Data Exchange (ETDEWEB)

    Prokopov, O.P.; Yagudin, S.Z.

    1980-05-18

    In order to improve reliability of the rescue apparatus a device for lowering a basket is made in the form of a collapsible forked support installed in the vertical plane inclined away from the tower. Its lower ends are attached by hinges to the base of the derrick. The upper end is connected to the derrick by means of a fastener. The apparatus has brakes with shock straps for receiving forked support.

  2. 96 Week Follow-Up of HIV-Infected Patients in Rescue with Raltegravir Plus Optimized Backbone Regimens: A Multicentre Italian Experience

    OpenAIRE

    Capetti, Amedeo; Landonio, Simona; Meraviglia, Paola; Di Biagio, Antonio; Lo Caputo, Sergio; Sterrantino, Gaetana; Ammassari, Adriana; Menzaghi, Barbara; Franzetti, Marco; De Socio, Giuseppe Vittorio; Pellicanò, Giovanni; Mazzotta, Elena; Soria, Alessandro; Meschiari, Marianna; Trezzi, Michele

    2012-01-01

    BACKGROUND: Long term efficacy of raltegravir (RAL)-including regimens in highly pre-treated HIV-1-infected patients has been demonstrated in registration trials. However, few studies have assessed durability in routine clinical settings. METHODS: Antiretroviral treatment-experienced patients initiating a RAL-containing salvage regimen were enrolled. Routine clinical and laboratory follow-up was performed at baseline, week 4, 12, and every 12 weeks thereafter. Data were censored at week 96. R...

  3. The role of social support in dialysis patients' feelings of autonomy and self-esteem: is support more beneficial for patients with specific illness perceptions?

    Science.gov (United States)

    Jansen, Daphne L; Rijken, Mieke; Kaptein, Ad A; Boeschoten, Elisabeth W; Dekker, Friedo W; Groenewegen, Peter P

    2014-09-01

    The purpose of this study was to investigate whether effects of various types of support on dialysis patients' perceived autonomy and self-esteem depend on patients' perceived concerns and personal control regarding their illness. One hundred sixty-six patients completed written questionnaires. Main and interaction effects of support, concern, and personal control on autonomy and self-esteem were examined using linear regression analyses. General emotional support was positively related to autonomy in highly concerned patients (p autonomy (p emotional support (p autonomy appears to depend on patients' illness perceptions, whereas the role of support in patients' self-esteem does not. These findings suggest that dialysis patients' personal views about their illness can provide insight into whether patients could benefit from support, and that the provision of support should be tailored to patients' individual needs.

  4. Depression and family support in breast cancer patients

    Directory of Open Access Journals (Sweden)

    Su JA

    2017-09-01

    Full Text Available Jian-An Su,1–3,* Dah-Cherng Yeh,4,* Ching-Chi Chang,5,* Tzu-Chin Lin,6,7 Ching-Hsiang Lai,8 Pei-Yun Hu,8 Yi-Feng Ho,9 Vincent Chin-Hung Chen,1,2 Tsu-Nai Wang,10,11 Michael Gossop12 1Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; 2Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan; 4Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; 5Institute of Medicine, Chung Shan Medical University and Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; 6Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; 7Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 8Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan; 9Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou,Taiwan; 10Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan; 11Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 12King’s College London, Institute of Psychiatry, London, UK *These authors contributed equally to this work Background: Breast cancer is the most common cancer in women. Among the survivors, depression is one of the most common psychiatric comorbidities. This paper reports the point prevalence of major depressive disorder among breast cancer patients and the association between family support and major depressive disorder.Methods: Clinical data were collected from a breast cancer clinic of a general hospital in central Taiwan. Participants included 300 patients who were older than 18 years and diagnosed with breast cancer. Among these individuals, we used Mini International Neuropsychiatric Interview (a structural diagnostic tool for

  5. Monitoring and Information Fusion for Search and Rescue Operations in Large-Scale Disasters

    National Research Council Canada - National Science Library

    Nardi, Daniele

    2002-01-01

    ... for information fusion with application to search-and-rescue and large scale disaster relief. The objective is to develop and to deploy tools to support the monitoring activities in an intervention caused by a large-scale disaster...

  6. The Data Rescue @ Home Project

    Science.gov (United States)

    Stickler, A.; Allan, R.; Valente, M. A.; Tinz, B.; Brönnimann, S.

    2012-04-01

    Climate science as a whole as well as reanalyses as a special case can significantly profit from the recovery, imaging and digitisation of historical observations. The importance of this fact is reflected in large, global data rescue projects and initiatives such as the Atmospheric Circulation Reconstructions over the Earth (ACRE, www.met-acre.org) or the EU FP7 ERA-CLIM project (www.era-clim.eu). From the time before 1957, there are still large amounts of surface data e.g. from former colonies and from overseas territories of European countries )e.g. Portugal, France and Germany) that need to be rescued. Also in case of the very early upper-air observations before the 1930s, even Europe and North America still hold an important quantity of data to be recovered in digital form. Here, we present the web platform "Data Rescue @ Home" (www.data-rescue-at-home.org), which has been developed at ETH Zurich and Oeschger Centre for Climate Change Research, and which has been designed to take advantage of the voluntary assistance of the thousands of people on the web who are interested in climate or old weather data. On the website, these volunteers can enter meteorological data shown on digital images into entry masks that resemble the original. By registering, the users get access to their personal digitisation statistics and help optimising the project. At the moment, 4 digitisation projects are online: One project is dealing with German upper-air data from the Second World War period. In a second project, station data from Tulagi (Solomon Islands) is being digitised. Finally, two collaborative projects have been included: One in cooperation with the Instituto Dom Luiz (Univ. Lisbon, Portugal), where Portuguese station data from Angra (Azores) is digitised, and a further one in cooperation with the German Meteorological Service (DWD), in which precipitation data from former German colonies is being digitised. On our poster, we will report on the status of the projects

  7. Communication elements supporting patient safety in psychiatric inpatient care.

    Science.gov (United States)

    Kanerva, A; Kivinen, T; Lammintakanen, J

    2015-06-01

    Communication is important for safe and quality health care. The study provides needed insight on the communication elements that support patient safety from the psychiatric care view. Fluent information transfer between the health care professionals and care units is important for care planning and maintaining practices. Information should be documented and implemented accordingly. Communication should happen in an open communication culture that enables discussion, the opportunity to have debriefing discussions and the entire staff can feel they are heard. For effective communication, it is also important that staff are active themselves in information collecting about the essential information needed in patient care. In mental health nursing, it is important to pay attention to all elements of communication and to develop processes concerning communication in multidisciplinary teams and across unit boundaries. The study aims to describe which communication elements support patient safety in psychiatric inpatient care from the viewpoint of the nursing staff. Communication is an essential part of care and one of the core competencies of the psychiatric care. It enables safe and quality patient care. Errors in health care are often connected with poor communication. The study brings needed insight from the psychiatric care view to the topic. The data were gathered from semi-structured interviews in which 26 nurses were asked to describe the elements that constitute patient safety in psychiatric inpatient care. The data were analysed inductively from the viewpoint of communication. The descriptions connected with communication formed a main category of communication elements that support patient safety; this main category was made up of three subcategories: fluent information transfer, open communication culture and being active in information collecting. Fluent information transfer consists of the practical implementation of communication; open communication

  8. Evaluation of Web-Based Ostomy Patient Support Resources.

    Science.gov (United States)

    Pittman, Joyce; Nichols, Thom; Rawl, Susan M

    To evaluate currently available, no-cost, Web-based patient support resources designed for those who have recently undergone ostomy surgery. Descriptive, correlational study using telephone survey. The sample comprised 202 adults who had ostomy surgery within the previous 24 months in 1 of 5 hospitals within a large healthcare organization in the Midwestern United States. Two of the hospitals were academic teaching hospitals, and 3 were community hospitals. The study was divided into 2 phases: (1) gap analysis of 4 Web sites (labeled A-D) based on specific criteria; and (2) telephone survey of individuals with an ostomy. In phase 1, a comprehensive checklist based on best practice standards was developed to conduct the gap analysis. In phase 2, data were collected from 202 participants by trained interviewers via 1-time structured telephone interviews that required approximately 30 minutes to complete. Descriptive analyses were performed, along with correlational analysis of relationships among Web site usage, acceptability and satisfaction, demographic characteristics, and medical history. Gap analysis revealed that Web site D, managed by a patient advocacy group, received the highest total content score of 155/176 (88%) and the highest usability score of 31.7/35 (91%). Two hundred two participants completed the telephone interview, with 96 (48%) reporting that they used the Internet as a source of information. Sixty participants (30%) reported that friends or family member had searched the Internet for ostomy information on their behalf, and 148 (75%) indicated they were confident they could get information about ostomies on the Internet. Of the 90 participants (45%) who reported using the Internet to locate ostomy information, 73 (82%) found the information on the Web easy to understand, 28 (31%) reported being frustrated during their search for information, 24 (27%) indicated it took a lot of effort to get the information they needed, and 39 (43%) were

  9. Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea

    DEFF Research Database (Denmark)

    Schoos, Mikkel Malby; Kelbæk, Henning; Pedersen, Frants

    2014-01-01

    BACKGROUND: Since 2005, ST-elevation myocardial infarction (STEMI) patients from the island of Bornholm in the Baltic Sea have been transferred for primary percutaneous coronary intervention (pPCI) by an airborne service. We describe the result of pPCI as part of the Danish national reperfusion s...

  10. Advances in search and rescue at sea

    Science.gov (United States)

    Breivik, Øyvind; Allen, Arthur Addoms; Maisondieu, Christophe; Olagnon, Michel

    2013-01-01

    A topical collection on "Advances in Search and Rescue at Sea" has appeared in recent issues of Ocean Dynamics following the latest in a series of workshops on "Technologies for Search and Rescue and other Emergency Marine Operations" (2004, 2006, 2008, and 2011), hosted by IFREMER in Brest, France. Here, we give a brief overview of the history of search and rescue at sea before we summarize the main results of the papers that have appeared in the topical collection.

  11. Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community

    Directory of Open Access Journals (Sweden)

    Masoumeh Abbasi Shavazi

    2016-07-01

    Full Text Available Background: Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS. Methods: To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr’s coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. Results: The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. Conclusion: The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study.

  12. 96 Week Follow-Up of HIV-Infected Patients in Rescue with Raltegravir Plus Optimized Backbone Regimens: A Multicentre Italian Experience

    Science.gov (United States)

    Capetti, Amedeo; Landonio, Simona; Meraviglia, Paola; Di Biagio, Antonio; Lo Caputo, Sergio; Sterrantino, Gaetana; Ammassari, Adriana; Menzaghi, Barbara; Franzetti, Marco; De Socio, Giuseppe Vittorio; Pellicanò, Giovanni; Mazzotta, Elena; Soria, Alessandro; Meschiari, Marianna; Trezzi, Michele; Sasset, Lolita; Celesia, Benedetto Maurizio; Zucchi, Patrizia; Melzi, Sara; Ricci, Elena; Rizzardini, Giuliano

    2012-01-01

    Background Long term efficacy of raltegravir (RAL)-including regimens in highly pre-treated HIV-1-infected patients has been demonstrated in registration trials. However, few studies have assessed durability in routine clinical settings. Methods Antiretroviral treatment-experienced patients initiating a RAL-containing salvage regimen were enrolled. Routine clinical and laboratory follow-up was performed at baseline, week 4, 12, and every 12 weeks thereafter. Data were censored at week 96. Results Out of 320 patients enrolled, 292 (91.25%) subjects maintained their initial regimen for 96 weeks; 28 discontinued prematurely for various reasons: death (11), viral failure (8), adverse events (5), loss to follow-up (3), consent withdrawal (1). Eight among these 28 subjects maintained RAL but changed the accompanying drugs. The mean CD4+ T-cell increase at week 96 was 227/mm3; 273 out of 300 patients (91%), who were still receiving RAL at week 96, achieved viral suppression (HIV-1 RNA 4 (n = 40), CD4+ T-cell gain was similar across strata: +270, +214, +216, and +240 cells/mm3, respectively, as was the proportion of subjects with undetectable viral load. Laboratory abnormalities (elevation of liver enzymes, total cholesterol and triglycerides) were rare, ranging from 0.9 to 3.1%. The mean 96-week total cholesterol increase was 23.6 mg/dL. Conclusions In a routine clinical setting, a RAL-based regimen allowed most patients in salvage therapy to achieve optimal viral suppression for at least 96 weeks, with relevant immunologic gain and very few adverse events. PMID:22808029

  13. 96 Week follow-up of HIV-infected patients in rescue with raltegravir plus optimized backbone regimens: a multicentre Italian experience.

    Directory of Open Access Journals (Sweden)

    Amedeo Capetti

    Full Text Available BACKGROUND: Long term efficacy of raltegravir (RAL-including regimens in highly pre-treated HIV-1-infected patients has been demonstrated in registration trials. However, few studies have assessed durability in routine clinical settings. METHODS: Antiretroviral treatment-experienced patients initiating a RAL-containing salvage regimen were enrolled. Routine clinical and laboratory follow-up was performed at baseline, week 4, 12, and every 12 weeks thereafter. Data were censored at week 96. RESULTS: Out of 320 patients enrolled, 292 (91.25% subjects maintained their initial regimen for 96 weeks; 28 discontinued prematurely for various reasons: death (11, viral failure (8, adverse events (5, loss to follow-up (3, consent withdrawal (1. Eight among these 28 subjects maintained RAL but changed the accompanying drugs. The mean CD4+ T-cell increase at week 96 was 227/mm(3; 273 out of 300 patients (91%, who were still receiving RAL at week 96, achieved viral suppression (HIV-1 RNA 4 (n = 40, CD4+ T-cell gain was similar across strata: +270, +214, +216, and +240 cells/mm(3, respectively, as was the proportion of subjects with undetectable viral load. Laboratory abnormalities (elevation of liver enzymes, total cholesterol and triglycerides were rare, ranging from 0.9 to 3.1%. The mean 96-week total cholesterol increase was 23.6 mg/dL. CONCLUSIONS: In a routine clinical setting, a RAL-based regimen allowed most patients in salvage therapy to achieve optimal viral suppression for at least 96 weeks, with relevant immunologic gain and very few adverse events.

  14. Refusal of implant supported mandibular overdentures by elderly patients.

    Science.gov (United States)

    Ellis, Janice S; Levine, Alissa; Bedos, Christophe; Mojon, Phillippe; Rosberger, Zeer; Feine, Jocelyne; Thomason, J Mark

    2011-03-01

      The aim of this study was to gain greater in-depth understanding of why elderly patients who are currently dissatisfied with conventional dentures decline implant treatment.   There is strong evidence from high-quality randomised controlled trials to support the use of implant-supported overdentures for the restoration of the edentulous mandible. However, whilst recruiting for randomised clinical trials, researchers have found that a high proportion of potential subjects decline participation, despite the removal of financial constraints.   The study adopted a qualitative approach to provide a rich and deep understanding of people's reasons for refusal. Data were collected through focus group interviews in a two-centre study based in Montreal, Canada and Newcastle, UK. A semi-structured interview schedule was used and iteratively developed as analysis identified themes from previous focus groups. Transcripts of focus groups were coded and emergent themes determined.   Two main themes emerged; patients' fear and anxiety (relating to the pain of surgery, complications of the procedure and immediate post-surgical denture use), and the appropriateness of the procedure in an elderly person.   Fears of pain, complications and social embarrassment, exacerbated by age, are important factors that help explain refusal of implants by elderly patients. © 2010 The Gerodontology Society and John Wiley & Sons A/S.

  15. Melanocytes from patients affected by Ullrich congenital muscular dystrophy and Bethlem myopathy have dysfunctional mitochondria that can be rescued with cyclophilin inhibitors

    Directory of Open Access Journals (Sweden)

    Alessandra eZulian

    2014-11-01

    Full Text Available Ullrich congenital muscular dystrophy and Bethlem myopathy are caused by mutations in collagen VI genes, which encode an extracellular matrix protein; yet mitochondria play a major role in disease pathogenesis through a short circuit caused by inappropriate opening of the permeability transition pore, a high conductance channel which causes a shortage in ATP production. We find that melanocytes do not produce collagen VI yet they bind it at the cell surface, suggesting that this protein may play a trophic role and that its absence may cause lesions similar to those seen in skeletal muscle. We show that mitochondria in melanocytes of Ullrich congenital muscular dystrophy and Bethlem myooathy patients display increased size, reduced matrix density and disrupted cristae, findings that suggest a functional impairment. In keeping with this hypothesis, mitochondria (i underwent anomalous depolarization after inhibition of the F-ATP synthase with oligomycin, and (ii displayed decreased respiratory reserve capacity. The non-immunosuppressive cyclophilin inhibitor NIM811 prevented mitochondrial depolarization in response to oligomycin in melanocytes from both Ullrich congenital muscular dystrophy and Bethlem myopathy patients, and partially restored the respiratory reserve of melanocytes from one Bethlem myopathy patient. These results match our recent findings on melanocytes from patients affected by Duchenne muscular dystrophy (Pellegrini et al., 2013 Melanocytes--a novel tool to study mitochondrial dysfunction in Duchenne muscular dystrophy. J Cell Physiol 228, 1323-1331, and suggest that skin biopsies may represent a minimally invasive tool to investigate mitochondrial dysfunction and to evaluate drug efficacy in collagen VI-related myopathies and possibly in other muscle wasting conditions like aging sarcopenia.

  16. Hybrid Patient Record – Supporting Hybrid Interaction in Clinical Wards

    DEFF Research Database (Denmark)

    Houben, Steven; Schmidt, Mathias; Frost, Mads

    2015-01-01

    Despite the widespread dissemination of the electronic health record, the paper medical record remains an important central artefact in modern clinical work. A number of new technological solutions have been proposed to mitigate some of the configuration, mobility and awareness problems that emerge...... when using this dual record setup. In this paper, we present one such technology, the HyPR device, in which a paper record is augmented with an electronic sensing platform that is designed to reduce the configuration overhead, provide awareness cues and support mobility across the patient ward. Our...

  17. Diabetes self-management support for patients with low health literacy: Perceptions of patients and providers.

    Science.gov (United States)

    Fransen, Mirjam P; Beune, Erik J A J; Baim-Lance, Abigail M; Bruessing, Raynold C; Essink-Bot, Marie-Louise

    2015-05-01

    The aim of the present study was to explore perceptions and strategies of health care providers regarding diabetes self-management support for patients with low health literacy (LHL), and to compare their self-management support with the needs of patients with LHL and type 2 diabetes. This study serves as a problem analysis for systematic intervention development to improve diabetes self-management among patients with LHL. This qualitative study used in-depth interviews with general practitioners (n = 4), nurse practitioners (n = 5), and patients with LHL (n = 31). The results of the interviews with health care providers guided the patient interviews. In addition, we observed 10 general practice consultations. Providers described patients with LHL as uninvolved and less motivated patients who do not understand self-management. Their main strategy to improve self-management was to provide standard information on a repeated basis. Patients with LHL seemed to have a different view of diabetes self-management than their providers. Most demonstrated a low awareness of what self-management involves, but did not express needing more information. They reported several practical barriers to self-management, although they seemed reluctant to use the information provided to overcome them. Providing and repeating information does not fit the needs of patients with LHL regarding diabetes self-management support. Health care providers do not seem to have the insight or the tools to systematically support diabetes self-management in this group. Systematic intervention development with a focus on skills-based approaches rather than cognition development may improve diabetes self-management support of patients with LHL. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  18. [Nutritional assessment and perioperative nutritional support in gastric cancer patients].

    Science.gov (United States)

    Seo, Kyung Won; Yoon, Ki Young

    2013-04-01

    Weight loss and malnutrition are common in cancer patients. Although weight loss is predominantly due to loss of fat mass, the morbidity risk is given by the decrease in muscle mass. The assessment of nutritional status is essential for a diagnosis of nutritional compromise and required for the multidisciplinary approach. Subjective global assessment (SGA) is made by the patients nutritional symptoms and weight loss. The objective assessment, a significant weight loss (>10%) for 6 months is considered an indicator of nutritional deficiency. The mean body index, body fat mass and body protein mass are decreased as cancer stage increases. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count are decreased in advanced cancer stage. Daily energy intake, cabohyderate and Vit B1 intake is decreased according to cancer stage. The patients are divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss%, 6 month weight loss%, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake protein and energy malnutrition. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase in stomach cancer associated morbidity and mortality. The authors concluded that nutritional assessment should be done in cancer patients preoperatively, and with adequate nutritional support, the morbidity and mortality would be decreased.

  19. Impaired epithelial differentiation of induced pluripotent stem cells from ectodermal dysplasia-related patients is rescued by the small compound APR-246/PRIMA-1MET.

    Science.gov (United States)

    Shalom-Feuerstein, Ruby; Serror, Laura; Aberdam, Edith; Müller, Franz-Josef; van Bokhoven, Hans; Wiman, Klas G; Zhou, Huiqing; Aberdam, Daniel; Petit, Isabelle

    2013-02-05

    Ectodermal dysplasia is a group of congenital syndromes affecting a variety of ectodermal derivatives. Among them, ectrodactyly, ectodermal dysplasia, and cleft lip/palate (EEC) syndrome is caused by single point mutations in the p63 gene, which controls epidermal development and homeostasis. Phenotypic defects of the EEC syndrome include skin defects and limbal stem-cell deficiency. In this study, we designed a unique cellular model that recapitulated major embryonic defects related to EEC. Fibroblasts from healthy donors and EEC patients carrying two different point mutations in the DNA binding domain of p63 were reprogrammed into induced pluripotent stem cell (iPSC) lines. EEC-iPSC from both patients showed early ectodermal commitment into K18(+) cells but failed to further differentiate into K14(+) cells (epidermis/limbus) or K3/K12(+) cells (corneal epithelium). APR-246 (PRIMA-1(MET)), a small compound that restores functionality of mutant p53 in human tumor cells, could revert corneal epithelial lineage commitment and reinstate a normal p63-related signaling pathway. This study illustrates the relevance of iPSC for p63 related disorders and paves the way for future therapy of EEC.

  20. HDAC6 Inhibitors Rescued the Defective Axonal Mitochondrial Movement in Motor Neurons Derived from the Induced Pluripotent Stem Cells of Peripheral Neuropathy Patients with HSPB1 Mutation

    Directory of Open Access Journals (Sweden)

    Ji-Yon Kim

    2016-01-01

    Full Text Available The Charcot-Marie-Tooth disease 2F (CMT2F and distal hereditary motor neuropathy 2B (dHMN2B are caused by autosomal dominantly inherited mutations of the heat shock 27 kDa protein 1 (HSPB1 gene and there are no specific therapies available yet. Here, we assessed the potential therapeutic effect of HDAC6 inhibitors on peripheral neuropathy with HSPB1 mutation using in vitro model of motor neurons derived from induced pluripotent stem cells (iPSCs of CMT2F and dHMN2B patients. The absolute velocity of mitochondrial movements and the percentage of moving mitochondria in axons were lower both in CMT2F-motor neurons and in dHMN2B-motor neurons than those in controls, and the severity of the defective mitochondrial movement was different between the two disease models. CMT2F-motor neurons and dHMN2B-motor neurons also showed reduced α-tubulin acetylation compared with controls. The newly developed HDAC6 inhibitors, CHEMICAL X4 and CHEMICAL X9, increased acetylation of α-tubulin and reversed axonal movement defects of mitochondria in CMT2F-motor neurons and dHMN2B-motor neurons. Our results suggest that the neurons derived from patient-specific iPSCs can be used in drug screening including HDAC6 inhibitors targeting peripheral neuropathy.

  1. Data Rescue Case Studies from the Cryosphere

    Science.gov (United States)

    Fetterer, F. M.

    2017-12-01

    A simple definition of the cryosphere is "where the world is frozen", or where water takes the form of snow and ice. The cryosphere is shrinking as the Earth warms. Data, particularly old data, document this in often eye-opening fashion. A photograph of Alaska's Muir Glacier taken in 1902 next to one taken in 2005 has impact that a line graph of air temperature anomalies from a weather station can't match, even though temperature data are fundamental to climate research and to understanding the glacier retreat captured in the photographs. Whaling logbooks from the late 1800s, maps of sea ice shared internationally in the 1930s, and satellite images of the polar oceans from the 1960s are not as immediately thought-provoking as are glacier photographs, but when preserved and documented they provide a record of sea ice coverage that is more than 100 years long. We developed a data product from these and other sources that is used in meteorological reanalysis and to answer questions about ice in the Arctic prior to 1978, when commonly used satellite-data-derived sea ice records begin. Preserving glacier photographs and making them available online, and publishing a gridded sea ice data product that builds on the preservation work of others are examples of data rescue projects that benefit scientific research and mobilize knowledge. These and other case studies suggest that even absent secure funding and an organizational setting that supports data rescue, important data make the transition from someone's office to archived and online with metadata because scientists are impassioned about the data they collect and want others to be able to use these data. In these cases from the cryosphere, student interns, collaborations with librarians, and cooperation with colleagues in other data centers have made it possible to preserve data at low cost.

  2. 46 CFR 133.140 - Stowage of rescue boats.

    Science.gov (United States)

    2010-10-01

    ... SYSTEMS Requirements for All OSVs § 133.140 Stowage of rescue boats. (a) Rescue boats must be stowed as follows: (1) Each rescue boat must be ready for launching in not more than 5 minutes. (2) Each rescue boat... 46 Shipping 4 2010-10-01 2010-10-01 false Stowage of rescue boats. 133.140 Section 133.140...

  3. Hand gestures support word learning in patients with hippocampal amnesia.

    Science.gov (United States)

    Hilverman, Caitlin; Cook, Susan Wagner; Duff, Melissa C

    2018-06-01

    Co-speech hand gesture facilitates learning and memory, yet the cognitive and neural mechanisms supporting this remain unclear. One possibility is that motor information in gesture may engage procedural memory representations. Alternatively, iconic information from gesture may contribute to declarative memory representations mediated by the hippocampus. To investigate these alternatives, we examined gesture's effects on word learning in patients with hippocampal damage and declarative memory impairment, with intact procedural memory, and in healthy and in brain-damaged comparison groups. Participants learned novel label-object pairings while producing gesture, observing gesture, or observing without gesture. After a delay, recall and object identification were assessed. Unsurprisingly, amnesic patients were unable to recall the labels at test. However, they correctly identified objects at above chance levels, but only if they produced a gesture at encoding. Comparison groups performed well above chance at both recall and object identification regardless of gesture. These findings suggest that gesture production may support word learning by engaging nondeclarative (procedural) memory. © 2018 Wiley Periodicals, Inc.

  4. Rescuing the ischemic penumbra: Our experience

    Directory of Open Access Journals (Sweden)

    Milosavljević Tamara

    2013-12-01

    Full Text Available Objectives: Over one million strokes per year are occurring in Europe. Brain stroke is one of the most important death and disability causes in Europe and USA. The main role of perfusion is to determine the border of insult core and ischemic penumbra. Penumbra can be saved with thrombolytic therapy but core have irreversible injuries and represent death of brain cells. Aim: to determine the role of CT brain perfusion in cases of acute brain stroke and following thrombolytic therapy. Methods: We examined 64 patients with acute brain stroke who received thrombolytic therapy after that. All patients were examining on 16 MDCT with 50 ml of iodine contrast agent following the standard procedure for CT perfusion. Patients were 34 male and 30 female with middle age of 64 years. MRI was made after thrombolytic therapy and compare with perfusion results before therapy. Results: Using an artery and a vein as reference three parameters were measured - blood flow (CBF, blood volume (CBV and mean transit time (MTT, for each patient. Hemorrhagic was find in 9 (14.01% patients after thrombolytic therapy. 4 (6.25% other patients develop new stroke of same but mostly other side of brain. 8 (12.50% more patients finished lethally. From other 42 patients with thrombolytic therapy we can positively say that in 31 (48.44% patients penumbra was rescued. For other 11 (17.19% stroke was same size like firstly involved core and penumbra but not bigger. Conclusion: CT perfusion plays major role by showing a curable parts of tissue in brain strokes.

  5. Early supported discharge services for stroke patients: a meta-analysis of individual patients' data.

    Science.gov (United States)

    Langhorne, Peter; Taylor, Gillian; Murray, Gordon; Dennis, Martin; Anderson, Craig; Bautz-Holter, Erik; Dey, Paola; Indredavik, Bent; Mayo, Nancy; Power, Michael; Rodgers, Helen; Ronning, Ole Morten; Rudd, Anthony; Suwanwela, Nijasri; Widen-Holmqvist, Lotta; Wolfe, Charles

    Stroke patients conventionally undergo a substantial part of their rehabilitation in hospital. Services have been developed that offer patients early discharge from hospital with rehabilitation at home (early supported discharge [ESD]). We have assessed the effects and costs of such services. We did a meta-analysis of data from individual patients who took part in randomised trials that recruited patients with stroke in hospital to receive either conventional care or any ESD service intervention that provided rehabilitation and support in a community setting with the aim of shortening the duration of hospital care. The primary outcome was death or dependency at the end of scheduled follow-up. Outcome data were available for 11 trials (1597 patients). ESD services were mostly provided by specialist multidisciplinary teams to a selected group (median 41%) of stroke patients admitted to hospital. There was a reduced risk of death or dependency equivalent to six (95% CI one to ten) fewer adverse outcomes for every 100 patients receiving an ESD service (p=0.02). The hospital stay was 8 days shorter for patients assigned ESD services than for those assigned conventional care (pstroke patients with mild to moderate disability. Appropriately resourced ESD services provided for a selected group of stroke patients can reduce long-term dependency and admission to institutional care as well as shortening hospital stays.

  6. Teaching Holocaust Rescue: A Problematic Pedagogy

    Science.gov (United States)

    Lindquist, David H.

    2008-01-01

    Determining how to teach about rescue during the Holocaust presents many dilemmas to teachers as they plan Holocaust curricula. Rescue is often overemphasized, and faulty perspectives about rescuers and their actions may cause students to develop distorted views about this aspect of Holocaust history. This article explores several factors that…

  7. Alveolar nerve repositioning with rescue implants for management of previous treatment. A clinical report.

    Science.gov (United States)

    Amet, Edward M; Uehlein, Chris

    2013-12-01

    The goal of modern implant dentistry is to return patients to oral health in a rapid and predictable fashion, following a diagnostically driven treatment plan. If only a limited number of implants can be placed, or some fail and the prosthetic phase of implant dentistry is chosen to complete the patient's treatment, the final outcome may result in partial patient satisfaction and is commonly referred to as a "compromise." Previous All-on-4 implant treatment for the patient presented here resulted in a compromise, with an inadequate support system for the mandibular prosthesis and a maxillary complete denture with poor esthetics. The patient was unable to function adequately and also was disappointed with the resulting appearance. Correction of the compromised treatment consisted of bilateral inferior alveolar nerve elevation and repositioning without bone removal for lateral transposition, to gain room for rescue implants for a totally implant-supported and stabilized prosthesis. Treatment time to return the patient to satisfactory comfort, function, facial esthetics, and speech was approximately 2 weeks. The definitive mandibular prosthesis was designed for total implant support and stability with patient retrievability. Adequate space between the mandibular bar system and the soft tissue created a high water bridge effect for self-cleansing. Following a short interim mandibular healing period, the maxillary sinuses were bilaterally grafted to compensate for bone inadequacies and deficiencies for future maxillary implant reconstruction. © 2013 by the American College of Prosthodontists.

  8. Economic Evaluation of a Patient-Directed Music Intervention for ICU Patients Receiving Mechanical Ventilatory Support.

    Science.gov (United States)

    Chlan, Linda L; Heiderscheit, Annette; Skaar, Debra J; Neidecker, Marjorie V

    2018-05-04

    Music intervention has been shown to reduce anxiety and sedative exposure among mechanically ventilated patients. Whether music intervention reduces ICU costs is not known. The aim of this study was to examine ICU costs for patients receiving a patient-directed music intervention compared with patients who received usual ICU care. A cost-effectiveness analysis from the hospital perspective was conducted to determine if patient-directed music intervention was cost-effective in improving patient-reported anxiety. Cost savings were also evaluated. One-way and probabilistic sensitivity analyses determined the influence of input variation on the cost-effectiveness. Midwestern ICUs. Adult ICU patients from a parent clinical trial receiving mechanical ventilatory support. Patients receiving the experimental patient-directed music intervention received a MP3 player, noise-canceling headphones, and music tailored to individual preferences by a music therapist. The base case cost-effectiveness analysis estimated patient-directed music intervention reduced anxiety by 19 points on the Visual Analogue Scale-Anxiety with a reduction in cost of $2,322/patient compared with usual ICU care, resulting in patient-directed music dominance. The probabilistic cost-effectiveness analysis found that average patient-directed music intervention costs were $2,155 less than usual ICU care and projected that cost saving is achieved in 70% of 1,000 iterations. Based on break-even analyses, cost saving is achieved if the per-patient cost of patient-directed music intervention remains below $2,651, a value eight times the base case of $329. Patient-directed music intervention is cost-effective for reducing anxiety in mechanically ventilated ICU patients.

  9. Social support and subjective health complaints among patients participating in an occupational rehabilitation program

    OpenAIRE

    Øyeflaten, Irene; Gabriele, Jeanne M.; Fisher, Edwin B.; Eriksen, Hege R.

    2010-01-01

    Objectives: To examine differences in rehabilitation patients' social support received from rehabilitation staff and from support providers outside rehabilitation, and to examine the relationships between social support and the patients' reports of subjective health complaints (SHC). Methods: 131 patients (68 % females, mean age 45 years) participating in a 4-week, inpatient, occupational rehabilitation program were included. All patients completed questionnaires on demographic variables, SHC...

  10. Assessment of patient support surfaces: principle, practice and limitations.

    Science.gov (United States)

    Rithalia, S

    2005-01-01

    Pressure ulcers cause great pain and suffering to patients as well as unnecessary strain on nursing staff. Their treatment is both costly and time consuming. Every effort therefore should be directed towards their prevention. Understanding of the aetiology of pressure ulcers is still incomplete and assessment of devices aimed at prevention is difficult. Over the years, numerous parameters, including interface pressure and transcutaneous blood gas measurements, have been used to evaluate mattresses and cushions. However, the quality of the data gathered is variable and its clinical interpretation remains unsatisfactory. It could be said that the science of evaluation of support surfaces is still at a formative stage, as clinical validation of many of the approaches has yet to be carried out.

  11. [Ebola crisis in Guinea: psychosocial support for patients and caregivers].

    Science.gov (United States)

    Benifei, Sarah; Facon-Delahaye, Aline; Vautier, Virginie

    2016-02-01

    The experience of the French military health service in the fight against the Ebola epidemic in Guinea, highlights the importance of what favours the emergence of an institutional life in a context of care faced with numerous constraints and extraordinary challenges. The meticulous drawing up of procedures and the juxtaposition of expertise goes hand in hand with the construction of a triangular care system (caregivers-patients-families). This relational approach ensures each player in this system is able to find their place and a balance between constraints and satisfactions, losses and successes, isolation and support. This balance seems to favour individual and group resilience. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Advances in ventilatory support of the pediatric surgical patient.

    Science.gov (United States)

    Hemmila, M R; Hirschl, R B

    1999-06-01

    Severe respiratory failure in newborn and pediatric patients is associated with significant morbidity and mortality. Basic science laboratory investigation has led to advances both in our understanding of ventilator-induced lung injury and in optimizing the supportive use of conventional ventilation strategies. Over the past few years, progress has been made in alternative therapies for ventilating both children and adults with severe respiratory failure. This review focuses on recent laboratory and clinical data detailing the techniques of permissive hypercapnia, high frequency oscillatory ventilation, inhaled nitric oxide, intratracheal pulmonary ventilation, and liquid ventilation. Some of these modalities are becoming commonplace, and others may have much to offer the clinician if their benefit is clearly demonstrated in future clinical trials.

  13. [Nutritional support response in critically ill patients; differences between medical and surgical patients].

    Science.gov (United States)

    Zamora Elson, M; Serón Arbeloa, C; Labarta Monzón, L; Garrido Ramírez de Arellano, I; Lander Azcona, A; Marquina Lacueva, M I; López Claver, J C; Escós Orta, J

    2012-01-01

    To assess the nutritional response of a group of critically ill patients, as well as the differences in the response to nutritional support between medical and surgical patients. One-year long retrospective study including critically ill patients on artificial nutrition for 7 days. Throughout the first week, three nutritional biochemical controls were done that included albumin, prealbumin, transferrin, cholesterol, and electrolytes. Other data gathered were: nutritional risk index, age, gender, weight, height, APACHE, delay of onset of nutritional support, access route, predicted and real caloric intake, medical or surgical patient, hospital stay, duration of the central venous catheter, urinary tube, and/or mechanical ventilation, incidence and density of incidence of nosocomial infections. Sixty-three patients were studied, 30 (47%) medical and 33 (53%) surgical/trauma patients, with a usage of EN higher among medical patients (16/30, 53% vs. 5/33, 15%), PN higher among surgical patients (25/33, 76%), and mixed nutrition similar in both groups (5 medical and 3 surgical patients) (p = 0.001). There were no differences between medical and surgical patients regarding: both predicted and real caloric and nitrogenous intake, APACHE, delay of onset of nutrition, phosphorus, magnesium or glucose levels, mortality and incidence of nosocomial infections. There were no differences either in hospital stay or use of mechanical ventilation, although these tended to be lower in surgical patients. The baseline biochemical parameters did not show differences between both groups, although they were worse among surgical patients. These patients presented during the study period steady albumin levels with improvement in the remaining parameters, whereas medical patients showed a decrease in albumin and transferrin levels, steady prealbumin levels, and slightly improvement in cholesterol levels. We have observed higher usage of PN among surgical patients, which showed worse

  14. Precision Rescue Behavior in North American Ants

    Directory of Open Access Journals (Sweden)

    Katherine Taylor

    2013-07-01

    Full Text Available Altruistic behavior, in which one individual provides aid to another at some cost to itself, is well documented. However, some species engage in a form of altruism, called rescue, that places the altruist in immediate danger. Here we investigate one such example, namely rescuing victims captured by predators. In a field experiment with two North American ant species, Tetramorium sp. E and Prenolepis imparis, individuals were held in artificial snares simulating capture. T. sp. E, but not P. imparis, exhibited digging, pulling, and snare biting, the latter precisely targeted to the object binding the victim. These results are the first to document precision rescue in a North American ant species; moreover, unlike rescue in other ants, T. sp. E rescues conspecifics from different colonies, mirroring their atypical social behavior, namely the lack of aggression between non-nestmate (heterocolonial conspecifics. In a second, observational study designed to demonstrate rescue from an actual predator, T. sp. E victims were dropped into an antlion's pit and the behavior of a single rescuer was observed. Results showed that T. sp. E not only attempted to release the victim, but also risked attacking the predator, suggesting that precision rescue may play an important role in this species' antipredator behavior.

  15. MIMIC II: a massive temporal ICU patient database to support research in intelligent patient monitoring

    Science.gov (United States)

    Saeed, M.; Lieu, C.; Raber, G.; Mark, R. G.

    2002-01-01

    Development and evaluation of Intensive Care Unit (ICU) decision-support systems would be greatly facilitated by the availability of a large-scale ICU patient database. Following our previous efforts with the MIMIC (Multi-parameter Intelligent Monitoring for Intensive Care) Database, we have leveraged advances in networking and storage technologies to develop a far more massive temporal database, MIMIC II. MIMIC II is an ongoing effort: data is continuously and prospectively archived from all ICU patients in our hospital. MIMIC II now consists of over 800 ICU patient records including over 120 gigabytes of data and is growing. A customized archiving system was used to store continuously up to four waveforms and 30 different parameters from ICU patient monitors. An integrated user-friendly relational database was developed for browsing of patients' clinical information (lab results, fluid balance, medications, nurses' progress notes). Based upon its unprecedented size and scope, MIMIC II will prove to be an important resource for intelligent patient monitoring research, and will support efforts in medical data mining and knowledge-discovery.

  16. Social support in the post-abortion recovery room: evidence from patients, support persons and nurses in a Vancouver clinic.

    Science.gov (United States)

    Veiga, Mariana B; Lam, Melanie; Gemeinhardt, Carla; Houlihan, Edwina; Fitzsimmons, Brian P; Hodgson, Zoë G

    2011-03-01

    The benefits of social support in post-surgical recovery are well documented; social support decreases preoperative stress and postoperative recovery time. However, a paucity of studies have examined the effect of social support in the context of pregnancy termination. This study is the first to examine the effect of postoperative accompaniment from the patient, support person and nurses' perspective. This study was carried out in two phases. In Phase I, no accompaniment was allowed in the post-anesthesia recovery room (PAR); in Phase II, accompaniment was permitted. All participants completed pre- and postoperative questionnaires. The perception of accompaniment was overwhelmingly positive in patients and support people. Patients in Phase II demonstrated a high (over 95%) acceptance of accompaniment in the recovery room. It was found that 96.8% reported they would choose to be accompanied in the recovery room again if they had to have another abortion. Support persons felt very strongly that their presence was helpful to the patient. The decrease in pre- to postoperative anxiety levels was significantly greater in those women who were accompanied. However, overall, nurses demonstrated a negative attitude towards accompaniment in the recovery room. In summary, the presence of a support person in the PAR was perceived in a positive manner by patients and support people. However, the reasoning behind the negative opinion of nurses requires further study before PAR accompaniment can be considered a possibility in the context of pregnancy termination. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Pediatric advanced life support and sedation of pediatric dental patients

    OpenAIRE

    Kim, Jongbin

    2016-01-01

    Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency ...

  18. Variation in Medicare Expenditures for Treating Perioperative Complications: The Cost of Rescue.

    Science.gov (United States)

    Pradarelli, Jason C; Healy, Mark A; Osborne, Nicholas H; Ghaferi, Amir A; Dimick, Justin B; Nathan, Hari

    2016-12-21

    Treating surgical complications presents a major challenge for hospitals striving to deliver high-quality care while reducing costs. Costs associated with rescuing patients from perioperative complications are poorly characterized. To evaluate differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. Retrospective cohort study using claims data from the Medicare Provider Analysis and Review files. We compared payments for patients who died vs patients who survived after perioperative complications occurred. Hospitals were stratified using average payments for patients who survived following complications, and payment components were analyzed across hospitals. Administrative claims database of surgical patients was analyzed at hospitals treating Medicare patients nationwide. This study included Medicare patients aged 65 to 100 years who underwent abdominal aortic aneurysm repair (n = 69 207), colectomy for cancer (n = 107 647), pulmonary resection (n = 91 758), and total hip replacement (n = 307 399) between 2009 and 2012. Data analysis took place between November 2015 and March 2016. Clinical outcome of surgery (eg, no complication, complication and death, or complication and survival) and the individual hospital where a patient received an operation. Risk-adjusted, price-standardized Medicare payments for an episode of surgery. Risk-adjusted perioperative outcomes were also assessed. The mean age for Medicare beneficiaries in this study ranged from 74.1 years (pulmonary resection) to 78.2 years (colectomy). The proportion of male patients ranged from 37% (total hip replacement) to 77% (abdominal aortic aneurysm repair), and most patients were white. Among patients who experienced complications, those who were rescued had higher price-standardized Medicare payments than did those who died for all 4 operations. Assessing variation across hospitals, payments for patients

  19. Demographic characteristics of patients using a fully integrated psychosocial support service for cancer patients

    Directory of Open Access Journals (Sweden)

    Hope Teresa

    2009-12-01

    Full Text Available Abstract Background Psychosocial support services are an important component of modern cancer treatment. A major challenge for all psychosocial services is the achievement of equity of use. Previous studies in the UK have found that women of higher socio-economic status with breast cancer were over-represented amongst those accessing support services. People with other cancer diagnoses, those from socio-economically deprived areas, and men, were under-represented. Findings The Oncology Health Service, Kingston Upon Hull, UK, delivers fully integrated psychosocial support and interventions. To assess equity of access in this service, a cross-sectional study of all patients with cancer accessing the service during a 5 day period was carried out. One hundred and forty-five patients attended. Forty four percent were male, and the types of cancer were broadly in the proportions expected on the basis of population prevalence (breast cancer 22%, colorectal cancer 21%, lung cancer 16%. Sixty six percent came from the three most deprived quintiles of the Townsend deprivation Index. Conclusions The fully integrated Oncology Health Service in Hull is accessed by a more diverse range of patients than previously reported for other services, and is an example of a model of service by which socially equitable use of psychosocial support in the National Health Service might be achieved.

  20. Amphibious Search and Rescue: Shaping the Future

    National Research Council Canada - National Science Library

    Dowling, Michael

    2002-01-01

    The current Amphibious Search and Rescue (ASAR) mission is outdated, lacks integration with the mission/doctrine of the amphibious force and fails to exploit the multi-mission and tactical capabilities of the MH-60S helicopter...

  1. Evolutionary rescue: linking theory for conservation and medicine.

    Science.gov (United States)

    Alexander, Helen K; Martin, Guillaume; Martin, Oliver Y; Bonhoeffer, Sebastian

    2014-12-01

    Evolutionary responses that rescue populations from extinction when drastic environmental changes occur can be friend or foe. The field of conservation biology is concerned with the survival of species in deteriorating global habitats. In medicine, in contrast, infected patients are treated with chemotherapeutic interventions, but drug resistance can compromise eradication of pathogens. These contrasting biological systems and goals have created two quite separate research communities, despite addressing the same central question of whether populations will decline to extinction or be rescued through evolution. We argue that closer integration of the two fields, especially of theoretical understanding, would yield new insights and accelerate progress on these applied problems. Here, we overview and link mathematical modelling approaches in these fields, suggest specific areas with potential for fruitful exchange, and discuss common ideas and issues for empirical testing and prediction.

  2. Partner support and distress in women with breast cancer : The role of patients' awareness of support and level of mastery

    NARCIS (Netherlands)

    Hinnen, Chris; Ranchor, Adelita V.; Baas, Pieter C.; Sanderman, Robbert; Hagedoorn, Mariet

    2009-01-01

    The aim of the present study was to investigate the associations between partners' ways of providing support (both active engagement and protective buffering) and distress in women with breast cancer as a function of patients' awareness of the support received and their sense of mastery. These

  3. Factors influencing mine rescue team behaviors.

    Science.gov (United States)

    Jansky, Jacqueline H; Kowalski-Trakofler, K M; Brnich, M J; Vaught, C

    2016-01-01

    A focus group study of the first moments in an underground mine emergency response was conducted by the National Institute for Occupational Safety and Health (NIOSH), Office for Mine Safety and Health Research. Participants in the study included mine rescue team members, team trainers, mine officials, state mining personnel, and individual mine managers. A subset of the data consists of responses from participants with mine rescue backgrounds. These responses were noticeably different from those given by on-site emergency personnel who were at the mine and involved with decisions made during the first moments of an event. As a result, mine rescue team behavior data were separated in the analysis and are reported in this article. By considering the responses from mine rescue team members and trainers, it was possible to sort the data and identify seven key areas of importance to them. On the basis of the responses from the focus group participants with a mine rescue background, the authors concluded that accurate and complete information and a unity of purpose among all command center personnel are two of the key conditions needed for an effective mine rescue operation.

  4. Participation of chronic patients in medical consultations: patients’ perceived efficacy, barriers and interest in support.

    NARCIS (Netherlands)

    Henselmans, I.; Heijmans, M.; Rademakers, J.; Dulmen, S. van

    2015-01-01

    Aims: Chronic patients are increasingly expected to participate actively in medical consultations. This study examined (i) patients' perceived efficacy and barriers to participation in consultations, (ii) patients' interest in communication support and (iii) correlates of perceived efficacy and

  5. Intensive Nutritional Counselling And Support And Clinical Outcomes In Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Alessio Molfino

    2012-06-01

    In conclusion, in HD patients, nutritional counselling and nutritional support positively affect nutritional status in hypophagic patients and make the risk of morbidity and mortality in anorexic patients comparable to non-anorexic.

  6. 49 CFR 238.114 - Rescue access windows.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Rescue access windows. 238.114 Section 238.114... § 238.114 Rescue access windows. (a) Number and location. Except as provided in paragraph (a)(1)(ii) of... rescue access windows. At least one rescue access window shall be located in each side of the car...

  7. Monte Carlo calculations supporting patient plan verification in proton therapy

    Directory of Open Access Journals (Sweden)

    Thiago Viana Miranda Lima

    2016-03-01

    Full Text Available Patient’s treatment plan verification covers substantial amount of the quality assurance (QA resources, this is especially true for Intensity Modulated Proton Therapy (IMPT. The use of Monte Carlo (MC simulations in supporting QA has been widely discussed and several methods have been proposed. In this paper we studied an alternative approach from the one being currently applied clinically at Centro Nazionale di Adroterapia Oncologica (CNAO. We reanalysed the previously published data (Molinelli et al. 2013, where 9 patient plans were investigated in which the warning QA threshold of 3% mean dose deviation was crossed. The possibility that these differences between measurement and calculated dose were related to dose modelling (Treatment Planning Systems (TPS vs MC, limitations on dose delivery system or detectors mispositioning was originally explored but other factors such as the geometric description of the detectors were not ruled out. For the purpose of this work we compared ionisation-chambers measurements with different MC simulations results. It was also studied some physical effects introduced by this new approach for example inter detector interference and the delta ray thresholds. The simulations accounting for a detailed geometry typically are superior (statistical difference - p-value around 0.01 to most of the MC simulations used at CNAO (only inferior to the shift approach used. No real improvement were observed in reducing the current delta-ray threshold used (100 keV and no significant interference between ion chambers in the phantom were detected (p-value 0.81. In conclusion, it was observed that the detailed geometrical description improves the agreement between measurement and MC calculations in some cases. But in other cases position uncertainty represents the dominant uncertainty. The inter chamber disturbance was not detected for the therapeutic protons energies and the results from the current delta threshold are

  8. Patient preferences for psychological support in inflammatory arthritis: A multicentre survey

    OpenAIRE

    Dures, E.; Almeida, C.; Caesley, J.; Peterson, A.; Ambler, N.; Morris, M.; Pollock, J.; Hewlett, S.

    2016-01-01

    Objectives: Inflammatory arthritis (IA) can lead to anxiety, depression, pain and fatigue. Psychological support can improve quality of life and self-management; and European and American guidelines recommend support be offered. This study examined patient views on psychological support for their IA.\\ud \\ud Methods: A questionnaire designed by researchers, patient partners and clinicians was administered to 2280 patients with IA.\\ud \\ud Results: 1210 patients responded (53%): 74% women; mean ...

  9. Sirolimus for rescue and primary immunosuppression in transplanted children receiving tacrolimus.

    Science.gov (United States)

    Sindhi, R; Webber, S; Venkataramanan, R; McGhee, W; Phillips, S; Smith, A; Baird, C; Iurlano, K; Mazariegos, G; Cooperstone, B; Holt, D W; Zeevi, A; Fung, J J; Reyes, J

    2001-09-15

    The role of sirolimus (SRL) as a rescue agent (n=42) and as a component of primary immunosuppression (n=8) was evaluated in a mixed population of 50 transplanted children receiving tacrolimus (liver: 26, heart: 5, intestinal: 5, liver-intestine: 9, lung: 1, bone marrow: 1, liver-kidney: 1, multivisceral: 1). Rescue indications for tacrolimus (TAC) failure were recurrent acute rejection and acute rejection complicating withdrawal of immunosuppression in posttransplant lymphoproliferative disorder (PTLD). Rescue indications for TAC toxicity were nephrotoxicity, pancreatitis, seizures, hypertrophic cardiomyopathy, and graft-versus-host disease. Mean age at rescue was 11.5 years and mean follow-up was 204 (range 18-800) days. As primary immunosuppression, SRL+TAC prevented early acute rejection in 7/8 children. The indication for rescue resolved in 33/42 children. In children with TAC toxicity, this was associated with decrease in TAC doses by 50%, significant improvements in renal function, and continuing decline in Epstein-Barr virus (EBV) viral load in PTLD patients. Serious adverse events led to discontinuation of SRL in 9/42 rescue patients, 3 of them also experienced acute rejection. Three additional children also experienced acute rejection on SRL therapy (overall incidence 6/50, 12%). Pharmacokinetic analysis in the first week of SRL administration suggested a short half-life (11.8+/-5.5 hr, n=21). SRL and reduced-dose TAC may achieve adequate immunosuppression without compromising renal function or enhancing EBV viremia significantly.

  10. ECMO for Cardiac Rescue after Accidental Intravenous Mepivacaine Application

    Directory of Open Access Journals (Sweden)

    Michael Froehle

    2012-01-01

    Full Text Available Mepivacaine is a potent local anaesthetic and used for infiltration and regional anaesthesia in adults and pediatric patients. Intoxications with mepivacaine affect mainly the CNS and the cardiovascular system. We present a case of accidental intravenous mepivacaine application and intoxication of an infant resulting in seizure, broad complex bradyarrhythmia, arterial hypotension and finally cardiac arrest. The patient could be rescued by prolonged resuscitations and a rapid initiation of ECMO and survived without neurological damage. The management strategies of this rare complication including promising other treatment options with lipid emulsions are discussed.

  11. Rescue Implantation of Expandable Cages for Severe Osteolysis and Cage Dislocation in the Lumbosacral Junction.

    Science.gov (United States)

    Schatlo, Bawarjan; Rohde, Veit; Solomiichuk, Volodymyr; von Eckardstein, Kajetan; Behm, Timo

    2017-11-01

    Osteolysis and implant loosening are commonly encountered problems after spinal instrumentation. In a patient who had previously undergone a posterior lumbar interbody fusion procedure, fusion did not occur, and a secondary cage dislocation led to an impingement of the L5 nerve root with severe radiculopathy. Revision surgery was performed. Intraoperatively, osteolysis was found to be so severe that conventional cages did not fill the void to allow for sufficient anterior column support. We used expandable transforaminal lumbar interbody fusion cages and implanted them bilaterally to replace the dislodged posterior lumbar interbody fusion cages. Clinical follow-up was uneventful. Imaging performed at 1 year showed satisfactory cage position and fusion. We propose the use of cages with the ability of ventral distraction in similar rescue interventions with cage dislocation and bone resorption. This may prevent a second surgery via a ventral approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Measures of Patient Activation and Social Support in a Peer-Led Support Network for Women With Cardiovascular Disease.

    Science.gov (United States)

    Witt, Dawn; Benson, Gretchen; Campbell, Susan; Sillah, Arthur; Berra, Kathy

    Social support has been associated with beneficial effects on many disease states and overall health and well-being. However, there is limited research exploring the impact of peer-led support models among women living with coronary heart disease. This study describes the structure of peer-led support groups offered by WomenHeart (WH): The National Coalition for Women Living with Heart Disease, and assesses WH participants' quality of life and social, emotional, and physical health. Participants were recruited from 50 WH groups. A 70-item online survey was administered, and the main analytic sample included 157 women. Multivariate logistic regression was used to examine the association between patient activation levels (lower activation levels: 1, 2 vs higher activation levels: 3, 4) and social support scores (range: lowest 8 to highest 34), adjusting for age. High levels of social support, patient activation, physical activity, and low levels of stress, anxiety, and depression were reported. Those who were at or above the median for the social support measures (indicating high levels of social support) had greater odds of high levels of patient activation (level 3 or 4) than individuals reporting low levels of social support (OR = 2.23; 95% CI, 1.04-4.76; P = .012). Women who regularly attended a support group by a trained peer leader were highly engaged in their health care and had low levels of stress, anxiety, and depression. These findings lend credibility to the value of the peer support model and could potentially be replicated in other disease states to enhance patient care.

  13. Self-reported differences in empowerment between lurkers and posters in online patient support groups.

    NARCIS (Netherlands)

    van Uden-Kraan, Cornelia F.; Drossaert, Constance H C; Taal, Erik; Seydel, Erwin R.; van de Laar, M.A.

    2008-01-01

    BACKGROUND: Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants' feelings of "being empowered." However, most studies of online patient support groups have

  14. Self-reported differences in empowerment between lurkers and posters in online patient support groups

    NARCIS (Netherlands)

    Kraan, C.F.; Drossaert, Constance H.C.; Taal, Erik; Seydel, E.R.; van de Laar, Mart A F J

    2008-01-01

    Background: Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants’ feelings of “being empowered.” However, most studies of online patient support groups have

  15. Nutrition support of the pediatric patient with AIDS.

    Science.gov (United States)

    Bentler, M; Stanish, M

    1987-04-01

    Maintaining optimal nutrition in the pediatric patient with Acquired Immune Deficiency Syndrome (AIDS) is challenging, but it may be one of the most effective therapies. Patients experience numerous complications that compromise nutritional status. Infection, fever, diarrhea, feeding problems, and decreased intake all contribute to malnutrition, which in turn predisposes the patient even more to infection and malabsorption. Nutrition assessment should be done routinely so that new problems may be identified and treated. High-calorie, high-protein feedings, vitamin supplementation, and, when necessary, gavage feedings or parenteral nutrition are recommended to improve nutritional status and prevent further deficits. Maintaining optimal nutrition in the pediatric patient with Acquired Immune Deficiency Syndrome (AIDS) poses a significant challenge to the health care team. Patients may experience numerous complications that compromise nutritional status. The patient is at high risk for opportunistic infections, especially of the lungs, central nervous system, gastrointestinal (GI) tract, and skin. Such infections are common causes of morbidity and mortality. Impaired nutritional status may further impair the patient's immunocompetence. A study by Kotler and Gaety demonstrated severe progressive malnutrition in adult AIDS patients, with the lowest measures of lean body mass occurring in those patients close to death at the time of the study. While no studies of children with AIDS have been done to date, we have subjectively observed feeding problems, weight loss, and malnutrition in most of the patients we have seen.

  16. Self-management support for peritoneal dialysis patients.

    Science.gov (United States)

    Sarian, Mari; Brault, Diane; Perreault, Nathalie

    2012-01-01

    The increasing prevalence of chronic illnesses and kidney disease, in particular, makes it necessary to adopt new approaches towards their management (Wagner, 1998). Evidence suggests that promoting self-management improves the health status of peritoneal dialysis (PD) patients, as they manage upwards of 90% of their own care. Patients who are unable to self-manage suffer from various complications. This project proposes an intervention aimed at improving self-management skills among PD patients. To promote self-management in peritoneal dialysis patients. This is achieved through the following objectives: (a) develop an algorithm that can improve patients' ability to solve the specific problem of fluid balance maintenance, (b) develop an educational session for patients on how to use the algorithm, and (c) develop an implementation strategy in collaboration with the PD nurse. Three measures evaluate the effectiveness of the intervention. First, a telephone call log shows that participating patients call the clinic less to inquire about fluid balance maintenance. Next, a pre- and post-intervention knowledge test measures definite knowledge increase. Finally, a Patient Satisfaction Questionnaire reveals overall satisfaction with the intervention. This project, which proved beneficial to our patient population, could be duplicated in other clinics. The algorithm "How do I choose a dialysis bag" and the slides of the educational sessions can be shared with PD nurses across the country for the benefit of PD patients.

  17. Boulder Food Rescue: An Innovative Approach to Reducing Food Waste and Increasing Food Security.

    Science.gov (United States)

    Sewald, Craig A; Kuo, Elena S; Dansky, Hana

    2018-05-01

    Food waste and food insecurity are both significant issues in communities throughout the U.S., including Boulder, Colorado. As much as 40% of the food produced in the U.S. goes uneaten and ends up in landfills. Nearly 13% of people in the Boulder region experience some level of food insecurity. Founded in 2011, Boulder Food Rescue supports community members to create their own food security through a participatory approach to an emergency food system. The organization uses a web-application "robot" to manage a schedule of volunteers. They coordinate with individuals at low-income senior housing sites, individual housing sites, family housing sites, after-school programs, and pre-schools to set up no-cost grocery programs stocked with food from local markets and grocers that would otherwise go to waste. Each site coordinator makes decisions about how, when, and where food delivery and distribution will occur. The program also conducts robust, real-time data collection and analysis. Boulder Food Rescue is a member and manager of the Food Rescue Alliance, and its model has been replicated and adapted by other cities, including Denver, Colorado Springs, Seattle, Jackson Hole, Minneapolis, Binghamton, and in the Philippines. Information for this special article was collected through key informant interviews with current and former Boulder Food Rescue staff and document review of Boulder Food Rescue materials. Boulder Food Rescue's open source software is available to other communities; to date, 40 cities have used the tool to start their own food rescue organizations. Boulder Food Rescue hopes to continue spreading this model to other cities that are considering ways to reduce food waste and increase food security. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by

  18. MULTIDISCIPLINARY APPROACH TO SUPPORTING TREATMENT COMPLIANCE IN TUBERCULOSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    T. V. Sherstneva

    2017-01-01

    Full Text Available The article presents the algorithm for working with tuberculosis patients in TB hospital, providing implementation of multidisciplinary patient-centered activities for early diagnostics of psychiatric and social disorders, therapy and rehabilitation of concurrent psychiatric disorders and addictions. Multidisciplinary approach to activities within TB unit is aimed at improvement of treatment compliance of tuberculosis patients. The training programme has been developed in order to improve competency of medical personnel on the issue of treatment interruption prevention and motivating patients to undergo the continuous treatment.

  19. Left ventricular assist device management in patients chronically supported for advanced heart failure.

    Science.gov (United States)

    Cowger, Jennifer; Romano, Matthew A; Stulak, John; Pagani, Francis D; Aaronson, Keith D

    2011-03-01

    This review summarizes management strategies to reduce morbidity and mortality in heart failure patients supported chronically with implantable left ventricular assist devices (LVADs). As the population of patients supported with long-term LVADs has grown, patient selection, operative technique, and patient management strategies have been refined, leading to improved outcomes. This review summarizes recent findings on LVAD candidate selection, and discusses outpatient strategies to optimize device performance and heart failure management. It also reviews important device complications that warrant close outpatient monitoring. Managing patients on chronic LVAD support requires regular patient follow-up, multidisciplinary care teams, and frequent laboratory and echocardiographic surveillance to ensure optimal outcomes.

  20. Knee osteoarthritis and perceived social support amongst patients in ...

    African Journals Online (AJOL)

    Temitope Ilori

    2016-06-29

    Jun 29, 2016 ... long been linked with health and illness; for instance married adults have a lower ... recover faster than unmarried adults.13 Social support can be defined as those ..... Martire LM, Lustig AP, Schulz R, Miller GE, Helgeson VS.

  1. Supporting Asian patients with metastatic breast cancer during ixabepilone therapy.

    Science.gov (United States)

    Bourdeanu, Laura; Wong, Siu-Fun

    2010-05-01

    Ixabepilone is currently FDA-approved in metastatic breast cancer, and most patients in the registrational trials were Caucasian. Studies in Asian populations receiving other cytotoxic agents have revealed differential pharmacokinetics and clinical outcomes. As such, clinicians should understand the possible contributions of Asian ethnicity and culture to the clinical profile of ixabepilone. Studies in Asian patients receiving other chemotherapeutics reported altered toxicity profiles for myelosuppression, neurotoxicity and gastrointestinal symptoms. Encouragingly, the limited clinical data in Asian patients receiving ixabepilone suggest that efficacy and toxicity in these women resemble those reported in the ixabepilone registrational trials. The reader will better understand how Asian genetics and culture may influence treatment outcomes and patient attitudes toward therapy and interaction with caregivers. Management of ixabepilone-related adverse events is also discussed with an emphasis on special considerations for Asian patients. Awareness of possible altered drug response in Asian patients will aid clinicians in monitoring for toxicity, recognizing the need for dose modification and educating patients. Sensitivity to cultural aspects that are unique to Asians may improve adherence, reporting of adverse events and trust among Asian patients receiving ixabepilone.

  2. Development of patient support devices for execution of clinical radiotherapy for cancer patients: A preliminary report

    Directory of Open Access Journals (Sweden)

    Babu N

    2006-01-01

    Full Text Available The present paper illustrates our attempt to design and test the reproducibility of low-cost patient positioning devices prepared in-house in our radiotherapy department. Rigid thermocole boards with angulations, scales and support were designed as breast, pelvis and head positioning devices. Reproducibility and accuracy were tested by serial electronic portal imaging detector imaging. The positioning devices (with or without superimposed moulds showed variations within 2-3 mm on serial treatment days which were within acceptable limits. It is therefore concluded that low-cost patient positioning devices for head, breast and pelvis (the common sites of treatments in radiotherapy can be fabricated from available materials in-house. These have been shown to be resulting in accurate immobilization, can be customized for particular techniques and are considerably cheaper than commercially available solutions.

  3. Endovascular rescue method for undesirably stretched coil.

    Science.gov (United States)

    Cho, Jae Hoon

    2014-10-01

    Undesirable detachment or stretching of coils within the parent artery during aneurysm embolization can be related with thrombus formation, which can be caused occlusion of parent artery or embolic event(s). To escape from this situation, several rescue methods have been reported. A case with undesirably stretched coil in which another rescue method was used, is presented. When the stretched coil is still located in the coil delivery microcatheter, the stretched coil can be removed safely using a snare and a handmade monorail microcatheter. After a snare is lodged in the handmade monorail microcatheter, the snare is introduced over the coil delivery micorcatheter and located in the distal part of the stretched coil. After then, the handmade monorail microcatheter captures the stretched coil and the snare as one unit. This technique using a handmade monorail microcatheter and a snare can be a good rescue modality for the undesirably stretched coil, still remained within the coil delivery microcatheter.

  4. Data Rescue in Collaboration with Federal Open Access Efforts

    Science.gov (United States)

    Avila, R.

    2017-12-01

    The recent calls to rescue scientific data is a real opportunity to collaborate with federal agencies which have been spending years managing research data and making it secure. The 2013 memos from the White House Office of Science and Technology Policy and Office of Management and Budget have spurred innovation across federal agencies to make publicly funded data accessible. Now is the time for stakeholders to take advantage of the groundwork laid by federal government, support the work to expand data sharing, thereby encouraging open science.

  5. Supporting the patient's role in guideline compliance: a controlled study.

    Science.gov (United States)

    Rosenberg, Stephen N; Shnaiden, Tatiana L; Wegh, Arnold A; Juster, Iver A

    2008-11-01

    Clinical messages alerting physicians to gaps in the care of specific patients have been shown to increase compliance with evidence-based guidelines. This study sought to measure any additional impact on compliance when alerting messages also were sent to patients. For alerts that were generated by computerized clinical rules applied to claims, compliance was determined by subsequent claims evidence (eg, that recommended tests were performed). Compliance was measured in the baseline year and the study year for 4 study group employers (combined membership >100,000) that chose to add patient messaging in the study year, and 28 similar control group employers (combined membership >700,000) that maintained physician messaging but did not add patient messaging. The impact of patient messaging was assessed by comparing changes in compliance from baseline to study year in the 2 groups. Multiple logistic regression was used to control for differences between the groups. Because a given member or physician could receive multiple alerts, generalized estimating equations with clustering by patient and physician were used. Controlling for differences in age, sex, and the severity and types of clinical alerts between the study and control groups, the addition of patient messaging increased compliance by 12.5% (P compliance with the evidence-based guidelines underlying the alerts.

  6. Management of aggressive periodontitis patient with implant supported prosthesis

    Directory of Open Access Journals (Sweden)

    Garima Jain

    2015-01-01

    Full Text Available Aggressive periodontitis (AgP comprises a group of rare, often severe, rapidly progressive forms of periodontitis which is characterized by an early age of clinical manifestations. It usually affects people under 30 years of age, but patients may be older. Microbiota associated are Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. The presence of highly pathogenic bacteria, severe periodontal bone destruction and the refractory nature of this disease tends to deter the clinician from placing implants in these patients. This case report demonstrates the placement of implants in a patient with AgP with successful 18 months follow-up.

  7. Effect of perceived social support and dispositional optimism on the depression of burn patients.

    Science.gov (United States)

    He, Fei; Zhou, Qin; Zhao, Zhijing; Zhang, Yuan; Guan, Hao

    2016-06-01

    Burn wounds have a significant impact on the mental health of patients. This study aimed to investigate the impact of perceived social support and dispositional optimism on depression of burn patients. A total of 246 burn patients accomplished the Multidimensional Scale of Perceived Social Support, the Revised Life Orientation Test, and Depression Scale. The results revealed that both perceived social support and optimism were significantly correlated with depression. Structural equation modeling indicated that optimism partially mediated the relationship between perceived social support and depression. Implications for prevention of depression in burn patients were discussed. © The Author(s) 2014.

  8. Knee osteoarthritis and perceived social support amongst patients in ...

    African Journals Online (AJOL)

    Temitope Ilori

    2016-06-29

    Jun 29, 2016 ... ... as marital or relationship status, and the number of children, appear to have a ... its health impact on patients with knee osteoarthritis who presented to .... Children. Spouse. Sibling. Parents. In-laws. Others. FREQUENCY %.

  9. Computer-supported patient involvement in heart rehabilitation

    DEFF Research Database (Denmark)

    Kensing, Finn

    2017-01-01

    are being collected through artifact and document analysis, and by interviews and observations in patients’ homes and in nurses’ offices over so far 6 months. The analysis is informed by medical phenomenology and by conceptual frameworks developed in earlier projects conducted by the author’s research group......Two of the five Danish regions, covering close to half of the population, are in the process of implementing a new EHR system. One of its sub-systems is a patient portal. The work-in-progress reported here is an exploratory study and a first level of analysis concerned with why, how and with which...... effects patients start to orient themselves towards this subsystem, and the degree to which this has an effect on the clinicians’ work. The overall approach is a multi-site ethnographic study involving 5 patients and 3 nurses responsible for a rehabilitation program for ischemic heart patients. Data...

  10. Patient satisfaction of tooth supported overdentures utilizing ball attachments

    OpenAIRE

    Nassar, Hossam I.

    2016-01-01

    Statement of problem: Teeth retained overdenture therapy is an alternative treatment rarely used in cases with few remaining teeth. Purpose: The aim of this study was to evaluate the patient satisfaction associated with teeth retained maxillary and mandibular overdentures utilizing ready made ball attachment. Materials and methods: Thirty patients treated with teeth retained overdenture utilizing ready made ball attachment. Participants completed a series of questionnaires (OHIP-14 ques...

  11. Psychological support for orthognathic patients -- what do orthodontists want?

    Science.gov (United States)

    Juggins, K J; Feinmann, C; Shute, J; Cunningham, S J

    2006-06-01

    (1) To evaluate consultant orthodontist opinion on referral of orthognathic patients to a liaison psychiatrist or psychologist and (2) To investigate the value of training orthodontic specialists in recognition of patients with psychological profiles that might affect orthognathic outcome. Questionnaire-based study. A structured questionnaire was distributed to all consultant orthodontists in the UK. Approximately 40% of consultants thought that up to 10% of their orthognathic patients would benefit from psychological assessment by appropriately trained personnel. Twenty per cent of consultants were not certain what proportion of their patients would benefit from referral and over half the respondents said they do not refer any orthognathic patients for assessment. The most common reasons for referral were past/current psychiatric history (36%), unrealistic expectations (32%), 'gut instinct' (14%), no significant clinical problem (13%). Reasons not to refer were: nobody to refer to (30.5%), fear of patient reacting badly (15.8%), not sure who to refer to (14.7%), response from mental health team not useful (12.4%), waiting list too long (9.6%). The majority of clinicians felt they would benefit from training in this field (84.7%), as over 80% reported no teaching or training in psychological assessment/management. Although we have no evidence to prove that interdisciplinary care is better for patients, clinical experience and reports from clinicians working in large centres, tells us there are probable advantages. The development of a training programme for both orthodontists and mental health teams would seem to be beneficial for both clinicians and patients.

  12. Palateless custom bar supported overdenture: A treatment modality to treat patient with severe gag reflex

    Directory of Open Access Journals (Sweden)

    Kunwarjeet Singh

    2012-01-01

    Conclusion: Palateless custom bar supported overdenture procedure can be successfully used for the management of patients with severe gag reflex with improved denture retention, stability, chewing efficiency and comfort of the patient.

  13. Supporting patient adherence to antiretrovirals using mobile phone reminders: patient responses from South India.

    Science.gov (United States)

    Sidney, Kristi; Antony, Jimmy; Rodrigues, Rashmi; Arumugam, Karthika; Krishnamurthy, Shubha; D'souza, George; De Costa, Ayesha; Shet, Anita

    2012-01-01

    There has been exponential growth in the use of mobile phones in India over the last few years, and their potential benefits as a healthcare tool has raised tremendous interest. We used mobile phone reminders to help support adherence to antiretroviral therapy (ART) among HIV patients at an infectious disease clinic in a tertiary hospital in Bangalore. Between March and June 2010, 139 adult HIV patients taking regular ART for at least a month received weekly reminders to support adherence. These reminders consisted of a weekly interactive call and a non-interactive neutral pictorial short message service (SMS). After four weeks of the intervention, participants were interviewed to study perceptions on preference, usefulness, potential stigma and privacy concerns associated with this intervention. Majority of the participants were urban (89%), and had at least a secondary education (85%). A total of 744 calls were made, 545 (76%) of which were received by the participants. In addition, all participants received the weekly pictorial SMS reminder. A month later, 90% of participants reported the intervention as being helpful as medication reminders, and did not feel their privacy was intruded. Participants (87%) reported that they preferred the call as reminders, just 11% favoured SMS reminders alone. Only 59% of participants viewed all the SMSs that were delivered, while 15% never viewed any at all. Participants also denied any discomfort or stigma despite 20% and 13%, respectively, reporting that another person had inadvertently received their reminder call or SMS. Mobile phone interventions are an acceptable way of supporting adherence in this setting. Voice calls rather than SMSs alone seem to be preferred as reminders. Further research to study the influence of this intervention on adherence and health maintenance is warranted.

  14. A Digital Framework to Support Providers and Patients in Diabetes Related Behavior Modification.

    Science.gov (United States)

    Abidi, Samina; Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

    2017-01-01

    We present Diabetes Web-Centric Information and Support Environment (D-WISE) that features: (a) Decision support tool to assist family physicians to administer Behavior Modification (BM) strategies to patients; and (b) Patient BM application that offers BM strategies and motivational interventions to engage patients. We take a knowledge management approach, using semantic web technologies, to model the social cognition theory constructs, Canadian diabetes guidelines and BM protocols used locally, in terms of a BM ontology that drives the BM decision support to physicians and BM strategy adherence monitoring and messaging to patients. We present the qualitative analysis of D-WISE usability by both physicians and patients.

  15. Family support and blood pressure pattern in adult patients ...

    African Journals Online (AJOL)

    The prevalence of hypertension is increasing worldwide but awareness, treatment and control rates are very poor. Hence, this study ... Data was analyzed using Stata statistical software (Version 10). Results: The mean age ... in clinical practice. Keywords: Hypertension, Family Support, Awareness, Control, Family Physician ...

  16. Screening of Nutritional Risk and Nutritional Support in General Surgery Patients: A Survey from Shanghai, China

    Science.gov (United States)

    Jia, Zhen-Yi; Yang, Jun; Tong, Da-Nian; Peng, Jia-Yuan; Zhang, Zhong-Wei; Liu, Wei-Jie; Xia, Yang; Qin, Huan-long

    2015-01-01

    To determine the prevalence of nutritional risk in surgical departments and to evaluate the impact of nutritional support on clinical outcomes. The nutritional risk in different surgical diseases and the different way of nutritional support on clinical outcomes in patients at nutritional risk remain unclear. Hospitalized patients from general surgical departments were screened using the Nutritional Risk Screening (NRS) 2002 questionnaire on admission. Data were collected on nutritional risk, complications, and length of stay (LOS). Overall, 5034 patients were recruited; the overall prevalence of nutritional risk on admission were 19.2%. The highest prevalence was found among patients with gastric cancer. At-risk patients had more complications and longer LOS than nonrisk patients. Of the at-risk patients, the complication rate was significantly lower and LOS was significantly shorter in the nutritional-support group than in the no-support group (20.9 versus 30.0%, P nutrition or who received support for 5 to 7 days, or daily support entailing 16 to 25 kcal/kg of nonprotein energy. Different surgical diseases have different levels of nutritional risk. The provision of nutritional support was associated with a lower complication rate and a shorter LOS for gastric, colorectal, and HPB cancer patients at nutritional risk. The improper use of nutritional support may not improve outcomes for at-risk patients. PMID:26011204

  17. Nutritional support of the hospitalized patIent

    African Journals Online (AJOL)

    1983-04-16

    Apr 16, 1983 ... one ofthe earliest attempts known was that of Sir Christopher. \\\\hen, to whom 50 much ofthe architectural elegance of London can be attributed, being ..... O'Keefe SJO, Abraham R, EI-Zayadi A, Marshall W, O"'is M, Williams R. Increased plasma tyrosine concentrations in patients with cirrhosis and fulmi-.

  18. An App Supporting Psoriasis Patients Improves Adherence to Topical Treatment

    DEFF Research Database (Denmark)

    Svendsen, M T; Andersen, F; Pottegård, A

    2018-01-01

    Physician's Global Assessment (LS-PGA), and quality of life was measured by Dermatology Life Quality Index (DLQI) scales at all visits. RESULTS: Intention to treat analyses using regression was performed. PRIMARY OUTCOME: more patients in the intervention group were adherent to Cal/BD cutaneous foam...

  19. Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Group).

    Science.gov (United States)

    Kim, Jae Kyoung; Jeong, Ina; Lee, Ji Yeon; Kim, Jung Hyun; Han, Ah Yeon; Kim, So Yeon; Joh, Joon Sung

    2018-03-07

    The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

  20. Rescuing Dogs in the Frederick Community | Poster

    Science.gov (United States)

    Many Frederick National Lab employees have a favorite cause to which they volunteer a significant amount of time. For Dianna Kelly, IT program manager/scientific program analyst, Office of Scientific Operations, and Courtney Kennedy, associate technical project manager, Business Enterprise Systems, that cause is dog rescue.

  1. Rescuing Downed Aircrews: The Value of Time

    Science.gov (United States)

    2015-01-01

    Make a tax -deductible charitable contribution at www.rand.org/giving/contribute www.rand.org Library of Congress Control Number: 2015955037 ISBN...Predictors of Survival and Evasion ............................................................ 40   Table 5.2. Regression Predictors...a damaged aircraft, and the ability to avoid immediate capture. Combat rescue records and anecdotal evidence show that if the pilot were able to

  2. Emergency Medical Rescue in a Radiation Environment

    International Nuclear Information System (INIS)

    Briesmeister, L.; Ellington, Y.; Hollis, R.; Kunzman, J.; McNaughton, M.; Ramsey, G.; Somers, B.; Turner, A.; Finn, J.

    1999-01-01

    Previous experience with emergency medical rescues in the presence of radiation or contamination indicates that the training provided to emergency responders is not always appropriate. A new course developed at Los Alamos includes specific procedures for emergency response in a variety of radiological conditions

  3. REM sleep rescues learning from interference

    Science.gov (United States)

    McDevitt, Elizabeth A.; Duggan, Katherine A.; Mednick, Sara C.

    2015-01-01

    Classical human memory studies investigating the acquisition of temporally-linked events have found that the memories for two events will interfere with each other and cause forgetting (i.e., interference; Wixted, 2004). Importantly, sleep helps consolidate memories and protect them from subsequent interference (Ellenbogen, Hulbert, Stickgold, Dinges, & Thompson-Schill, 2006). We asked whether sleep can also repair memories that have already been damaged by interference. Using a perceptual learning paradigm, we induced interference either before or after a consolidation period. We varied brain states during consolidation by comparing active wake, quiet wake, and naps with either non-rapid eye movement sleep (NREM), or both NREM and REM sleep. When interference occurred after consolidation, sleep and wake both produced learning. However, interference prior to consolidation impaired memory, with retroactive interference showing more disruption than proactive interference. Sleep rescued learning damaged by interference. Critically, only naps that contained REM sleep were able to rescue learning that was highly disrupted by retroactive interference. Furthermore, the magnitude of rescued learning was correlated with the amount of REM sleep. We demonstrate the first evidence of a process by which the brain can rescue and consolidate memories damaged by interference, and that this process requires REM sleep. We explain these results within a theoretical model that considers how interference during encoding interacts with consolidation processes to predict which memories are retained or lost. PMID:25498222

  4. Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief

    Science.gov (United States)

    Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

    2013-01-01

    Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12th, 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors. PMID:25206499

  5. Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief.

    Science.gov (United States)

    Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

    2013-07-15

    Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12(th), 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors.

  6. “These patients look lost” – Community pharmacy staff's identification and support of patients with limited health literacy

    NARCIS (Netherlands)

    Koster, Ellen S.; Philbert, Daphne; Blom, Lyda; Bouvy, Marcel L.

    2016-01-01

    Objective: To date, routine use of health literacy assessment in clinical settings is limited. The objective of this study was to explore if community pharmacy staff can identify patients with limited health literacy, how they identify patients and how they support patients to improve medication

  7. Perceived Social Support Change in Patients with Early-stage Breast Cancer and Controls

    Science.gov (United States)

    Thompson, Tess; Rodebaugh, Thomas L.; Pérez, Maria; Schootman, Mario; Jeffe, Donna B.

    2014-01-01

    Objective To identify variables associated with levels of and change in social support in a cohort of early-stage breast cancer patients and age-matched controls. Methods Telephone interviews measuring perceived social support and other demographic and psychosocial variables were conducted at 4–6 weeks and 6, 12, and 24 months after surgery (patients) or a normal/benign screening mammogram (controls). A latent trajectory model was used to model the intercept (starting point) and slope (changing) aspects of social support. Results Participants included 542 controls and 541 patients (77% White, 23% African American; mean age 57.7 [SD = 10.6]). Most participants reported high social support. Patients reported significantly higher levels of social support at baseline than controls. For patients, social support had a significant negative slope that significantly varied between individuals; the intercept of social support also varied significantly. Predictors of lower social support intercept in patients included not being married/partnered, being White, having lower perceived general health, and having higher negative affect (modeled as a latent variable defined by anxiety and depression symptom severity). Patients who were African American (vs. White) or had mastectomy (vs. lumpectomy) had steeper social support declines, and participants with both these characteristics had lower starting points as well as steeper declines. Social support among controls did not change significantly. Conclusions Clinicians might consider psychosocial interventions for patients reporting low social support around the time of diagnosis and surgical treatment, and for patients at risk for steeper declines in support, such as African Americans and women undergoing mastectomy. PMID:23477582

  8. Support needs of patients with COPD: a systematic literature search and narrative review.

    Science.gov (United States)

    Gardener, A Carole; Ewing, Gail; Kuhn, Isla; Farquhar, Morag

    2018-01-01

    Understanding the breadth of patients' support needs is important for the delivery of person-centered care, particularly in progressive long-term conditions such as chronic obstructive pulmonary disease (COPD). Existing reviews identify important aspects of managing life with COPD with which patients may need support (support needs); however, none of these comprehensively outlines the full range of support needs that patients can experience. We therefore sought to systematically determine the full range of support needs for patients with COPD to inform development of an evidence-based tool to enable person-centered care. We conducted a systematic search and narrative review of the literature. Medline (Ovid), EMBASE, PsycINFO, Cochrane Library, and CINAHL were systematically searched for papers which included data addressing key aspects of support need, as identified by patients with COPD. Relevant data were extracted, and a narrative analysis was conducted. Thirty-one papers were included in the review, and the following 13 domains (broad areas) of support need were identified: 1) understanding COPD, 2) managing symptoms and medication, 3) healthy lifestyle, 4) managing feelings and worries, 5) living positively with COPD, 6) thinking about the future, 7) anxiety and depression, 8) practical support, 9) finance work and housing, 10) families and close relationships, 11) social and recreational life, 12) independence, and 13) navigating services. These 13 domains of support need were mapped to three of the four overarching categories of need commonly used in relevant national strategy documents (ie, physical, psychological, and social); however, support needs related to the fourth category (spiritual) were notably absent. This review systematically identifies the comprehensive set of domains of support need for patients with COPD. The findings provide the evidence base for a tool to help patients identify and express their support needs, which underpins a proposed

  9. Association of Social Support and Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Gu, Linni; Wu, Shaomin; Zhao, Shuliang; Zhou, Huixuan; Zhang, Shengfa; Gao, Min; Qu, Zhiyong; Zhang, Weijun; Tian, Donghua

    2017-12-06

    The prevalence of diabetes is steadily increasing in China. When diabetes is uncontrolled, it generates dire consequences for health and well-being. Numerous studies have shown that health outcomes were associated with social support and medication adherence. Previous study confirmed that social support was associated with medication adherence in patients with heart failure, HIV diseases, and first-episode psychosis. However, the relationship between social support and medication adherence in patients with type 2 diabetes mellitus (T2DM) is remains unclear. This study aims to examine whether social support is associated with medication adherence in patients with T2DM. This study was conducted in the First Affiliated Hospital of the General Hospital of the People's Liberation Army (PLA). In Beijing, a systematic random sample of 412 patients with T2DM over 18 years was recruited at baseline, and demographic characteristics, clinical data and their assessment of social support were collected from medical records and self-reported questionnaires. 330 of these patients completed a self-report measure of medication adherence at the sixth month after baseline data collection. Regression analysis showed that social support presented a positive effect on medication adherence, additionally, support utilization and the subscale of social support exhibited a significantly strong influence on medication adherence in patients with T2DM. Although medication adherence was influenced by multiple factors, this finding confirmed that social support must be recognized as a core element in interventions aimed at improving in the management of patients with T2DM.

  10. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk

    DEFF Research Database (Denmark)

    Jie, Bin; Jiang, Zhu-Ming; Nolan, Marie T

    2012-01-01

    This multicenter, prospective cohort study evaluated the effect of preoperative nutritional support in abdominal surgical patients at nutritional risk as defined by the Nutritional Risk Screening Tool 2002 (NRS-2002).......This multicenter, prospective cohort study evaluated the effect of preoperative nutritional support in abdominal surgical patients at nutritional risk as defined by the Nutritional Risk Screening Tool 2002 (NRS-2002)....

  11. Patient factors that influence clinicians' decision making in self-management support : A clinical vignette study

    NARCIS (Netherlands)

    Bos-Touwen, Irene D.; Trappenburg, Jaap C A; Van Der Wulp, Ineke; Schuurmans, Marieke J.; De Wit, Niek J.

    2017-01-01

    BACKGROUND AND AIM: Self-management support is an integral part of current chronic care guidelines. The success of self-management interventions varies between individual patients, suggesting a need for tailored self-management support. Understanding the role of patient factors in the current

  12. Individual neuropsychological support and group sessions for relatives to TBI patients

    DEFF Research Database (Denmark)

    Siert, Lars

    TITLE: Individual neuropsychological support and group sessions for relatives to TBI patients. OBJECTIVE: To describe how the neuropsychologist work with early and ongoing individual support and group sessions for relatives to adult TBI patients in the acute and sub acute phase and after discharge...

  13. The relationship between family social support and quality of life in diabetic female patients

    Directory of Open Access Journals (Sweden)

    Ali Mousavi

    2017-06-01

    Full Text Available Life quality of diabetic patients is always affected by psychosocial problems, physical disorders, and life style changes. It seems that the perceived social support could intervene in improving the life quality of these patients. The present study was carried out aiming to examine the relation between family social support and life quality of female patients with diabetes. This was a cross-sectional study. The statistical population included 173 diabetic females who were randomly selected from patients referred to Kermanshah diabetes research center. Data were collected using life quality questionnaire (Short Form-36 as well as perceived social support scale. The data analysis indicated that there is a significant correlation between family support and life quality of patients. Furthermore, concerning the components of life quality, there is a significant correlation between family social support and physical performance, physical limitation, tiredness, emotional health, social performance, pain, and general health of patients. However, no significant relation was found between family support and limitation of patients. Results showed that there is a direct relation between family support and the life quality in females with diabetes. Hence, it can be concluded that giving the family support to the female diabetic patients can increase their quality of life.

  14. In vitro embryo rescue and plant regeneration following self ...

    African Journals Online (AJOL)

    In vitro embryo rescue and plant regeneration following self-pollination with irradiated ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... shows that pollen irradiation coupled with self-pollination and embryo rescue ...

  15. Expectations of a business rescue plan: international directives for ...

    African Journals Online (AJOL)

    Expectations of a business rescue plan: international directives for Chapter 6 implementation. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... Preliminary analysis of business rescue plans suggested that a significant ...

  16. Pervasive healthcare in the home Supporting patient motivation and engagement

    DEFF Research Database (Denmark)

    2010-01-01

    Currently, care and rehabilitation practices move, to a greater extent, out of hospitals and into private homes. This accelerating trend challenges healthcare systems and their patients. Heterogeneous settings such as private homes together with the diverse nature of the inhabitants and their con......Currently, care and rehabilitation practices move, to a greater extent, out of hospitals and into private homes. This accelerating trend challenges healthcare systems and their patients. Heterogeneous settings such as private homes together with the diverse nature of the inhabitants...... and their conditions create both technical and usability constraints and possibilities that can inform development of home-based care and rehabilitation applications. This workshop likes to investigate and discuss challenges, requirements and possibilities related to home-based healthcare applications, seen from...... environments such as private homes? Or, how can User Driven Innovation (UDI) and Participatory Design (PD) be used to create systems that are aesthetically and functionally accepted by persons subject to homebased healthcare and rehabilitation?...

  17. ARTERIAL HYPERTENSION AND MEDICAL SUPPORT OF PATIENTS WITH PERMANENT PACEMAKERS

    Directory of Open Access Journals (Sweden)

    T. A. Derienko

    2016-06-01

    Full Text Available The review is devoted to clinical problems of arterial hypertension (AH in patients with implanted pacemakers (EKS and cardiac resynchronization therapy (CRT. Indications for pacemaker implantation and CRT are considered, especially the purpose and effectiveness of angiotensin-converting enzyme (ACE inhibitors, angiotensin II receptor antagonists (ARA, sartans, beta-blockers (BAB, diuretics, calcium channel blockers. We prove that the CRT and cardiac pacing and do not cancel, bur modify drug therapy of AH.

  18. [Depression, social support and compliance in patients with chronic heart failure].

    Science.gov (United States)

    Reutlinger, Julia; Müller-Tasch, Thomas; Schellberg, Dieter; Frankenstein, Lutz; Zugck, Christian; Herzog, Wolfgang; Lossnitzer, Nicole

    2010-01-01

    Depressive patients with chronic heart failure (CHF) show less social integration and greater physical impairment as well as poorer compliance than non depressive CHF patients. Using multiple regression analyses, this study (n=84) investigated a potential mediating effect of depression on the relationship between compliance and both social support and physical functioning. Results did not support the hypothesized mediating effect of depression. However, the variables age, depression, left ventricular ejection fraction (LVEF) and social support were associated with self-reported compliance. Therefore, a lack of social support and depression should be considered as possible reasons, if patients are noncompliant during the treatment process. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Supportive care for head and neck cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Zenda, Sadamoto

    2015-01-01

    Recently (chemo-)radiotherapy has been widely used in head and neck cancer with definite evidence. As long survivor has increased, social problems associated with late toxicity have become more. Late toxicities induced by radiotherapy for head and neck lesion are often severe. Xerostomia is one of the severe late toxicities conventionally and dysphagia after chemoradiotherapy is a new topic. Some industrial development (ex. Intensity Modulated Radiotherapy: IMRT) play a great role in toxicity management. Multidisciplinary approach (cooperation between not only physicians but also nurses and dentists) is necessary to control toxicities. The research of supportive care will be needed same as definitive treatment in the future. (author)

  20. The coach program - a "joint" approach to patient education and support.

    Science.gov (United States)

    Shaked, Yael; Dickson, Patricia; Workman, Kathy

    2016-12-01

    Hospital lengths of stay for orthopaedic procedures are declining internationally. Discharge home from hospital following total joint replacement surgery can be stressful due to pain and physical restrictions. Thus, many patients report experiencing increased anxiety and feeling a sudden withdrawal of support from their medical team. The Coach Program maximizes human resources and family-centred care by formally integrating an individual whom the patient identifies as their primary support into their health care team. This unique and innovative program was designed to decrease patient anxiety, increase patient confidence, enhance coping with shorter hospital lengths of stay, and smooth the discharge planning process. Anecdotal feedback from patients and staff has been overwhelmingly positive. A pilot self-reported patient survey was conducted. Future steps include distribution and analysis of a more detailed survey to a broader patient population and finding ways to address the needs of patients with limited social support. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Sources of Social Support After Patient Assault as Related to Staff Well-Being.

    Science.gov (United States)

    Kelly, Erin L; Fenwick, Karissa M; Brekke, John S; Novaco, Raymond W

    2017-10-01

    Patient assault is a serious issue for the well-being of staff in psychiatric hospitals. To guide workplace responses to patient assault, more information is needed about social support from different sources and whether those supports are associated with staff well-being. The present study examines social support after patient assault from work-based and nonwork-based sources, and whether inpatient psychiatric staff desires support from them and perceive the support received as being effective. Received support across sources was examined in relations to staff well-being (physical health, mental health, anger, sleep quality) and perceptions of safety. Survey data was collected from 348 clinical staff in a large public forensic mental hospital. Among the 242 staff who reported an assault in the last year, 71% wanted support and 72% found effective support from at least one source. Generally, effective support from supervisors, coworkers, and their combination was associated with better well-being. Support from nonwork sources was related to less concerns about safety, but not to other well-being measures. However, 28% of staff did not receive effective support from any source postassault. Gaps in support as reported in this study and as found by other investigators call for systematic programming by hospital organizations to enhance the well-being of clinical staff, which in turn has implications for patient care.

  2. Effects of perceived autonomy support and basic need satisfaction on quality of life in hemodialysis patients.

    Science.gov (United States)

    Chen, Mei-Fang; Chang, Ray-E; Tsai, Hung-Bin; Hou, Ying-Hui

    2018-03-01

    Despite a growing understanding of health-related quality of life (HRQOL) and its determinants in hemodialysis (HD) patients, little is known about the effects and interrelationships concerning the perception of autonomy support and basic need satisfaction of HD patients on their HRQOL. Based on self-determination theory (SDT), this study examines whether HD patients' perceived autonomy support from health care practitioners (physicians and nurses) relates to the satisfaction of HD patients' basic needs and in turn influences their HRQOL. A questionnaire was administered to 250 Taiwanese HD patients recruited from multiclinical centers and regional hospitals in northern Taiwan. Structural equation modeling (SEM) analysis was conducted to examine the causal relationships between patient perceptions of autonomy support and HRQOL through basic need satisfaction. The empirical results of SEM indicated that the HD patients' perceived autonomy support increased the satisfaction of their basic needs (autonomy, competency, and relatedness), as expected. The higher degree of basic need satisfaction led to higher HRQOL, as measured by physical and mental component scores. Autonomy support from physicians and nurses contributes to improving HD patients' HRQOL through basic need satisfaction. This indicates that staff caring for patients with severe chronic diseases should offer considerable support for patient autonomy.

  3. Social support and responsiveness in online patient communities: impact on service quality perceptions.

    Science.gov (United States)

    Nambisan, Priya; Gustafson, David H; Hawkins, Robert; Pingree, Suzanne

    2016-02-01

    Hospitals frequently evaluate their service quality based on the care and services provided to patients by their clinical and non-clinical staff.(1,2) However, such evaluations do not take into consideration the many interactions that patients have in online patient communities with the health-care organization (HCO) as well as with peer patients. Patients' interactions in these online communities could impact their perceptions regarding the HCO's service quality. The objective of this pilot study was to evaluate the impact of social support and responsiveness that patients experience in an HCO's online community on patients' perceptions regarding the HCO's service quality. The study data are collected from CHESS, a health-care programme (Comprehensive Health Enhancement Support System) run by the Centre for Health Enhancement System Studies at the University of Wisconsin-Madison. Findings show that the social support and the responsiveness received from peer patients in the online patient communities will impact patients' perceptions regarding the service quality of the HCO even when the organizational members themselves do not participate in the online discussions. The results indicate that interactions in such HCO-provided online patient communities should not be ignored as they could translate into patients' perceptions regarding HCOs' service quality. Ways to improve responsiveness and social support in an HCO's online patient community are discussed. © 2014 John Wiley & Sons Ltd.

  4. Optimism, social support, and mental health outcomes in patients with advanced cancer.

    Science.gov (United States)

    Applebaum, Allison J; Stein, Emma M; Lord-Bessen, Jennifer; Pessin, Hayley; Rosenfeld, Barry; Breitbart, William

    2014-03-01

    Optimism and social support serve as protective factors against distress in medically ill patients. Very few studies have specifically explored the ways in which these variables interact to impact quality of life (QOL), particularly among patients with advanced cancer. The present study examined the role of optimism as a moderator of the relationship between social support and anxiety, depression, hopelessness, and QOL among patients with advanced cancer. Participants (N = 168) completed self-report assessments of psychosocial, spiritual, and physical well-being, including social support, optimism, hopelessness, depressive and anxious symptoms, and QOL. Hierarchical multiple regression analyses were conducted to determine the extent to which social support and optimism were associated with depressive and anxious symptomatology, hopelessness and QOL, and the potential role of optimism as a moderator of the relationship between social support and these variables. Higher levels of optimism were significantly associated with fewer anxious and depressive symptoms, less hopelessness, and better QOL. Higher levels of perceived social support were also significantly associated with better QOL. Additionally, optimism moderated the relationship between social support and anxiety, such that there was a strong negative association between social support and anxiety for participants with low optimism. This study highlights the importance of optimism and social support in the QOL of patients with advanced cancer. As such, interventions that attend to patients' expectations for positive experiences and the expansion of social support should be the focus of future clinical and research endeavors. Copyright © 2013 John Wiley & Sons, Ltd.

  5. Effects of Nutritional Support in Patients with Colorectal Cancer during Chemotherapy

    OpenAIRE

    Dobrila Dintinjana, Renata; Guina, Tina; Krznarić, Željko; Radić, Mladen; Dintinjana, Marijan

    2008-01-01

    Nutritional support, addressing the specific needs of this patient group, is required to help improve prognosis, and reduce the consequences of cancer-associated nutritional decline. Early intervention with nutritional supplementation has been shown to halt malnutrition, and may improve outcome in some patients. In our study we tried to assess the influence of nutritional support (counseling, oral liquids, megestrol acetate) on nutritional status and symptoms prevalence in patients ...

  6. Anger expression, partner support, and quality of life in cancer patients.

    Science.gov (United States)

    Julkunen, Juhani; Gustavsson-Lilius, Mila; Hietanen, Päivi

    2009-03-01

    Family members are the most important source of social support for cancer patients. The determinants of family support, however, are not well understood. In this study, the associations of anger-expression styles of both patients and their partners with patient-perceived partner support and the impact of these variables on long-term health-related quality of life (HRQL) of the patient were examined. The baseline data were collected at the time of diagnosis; a follow-up survey was conducted at 8 months. Questionnaires included the Spielberger AX scale, the Family Support scale, and the RAND-36 Health Survey. The sample comprised 153 patients and their partners. The theoretical model was tested with a path analysis using structural equation modeling, and gender differences were tested using multivariate analysis of covariance. Path analyses indicated that partner support was an important mediator, partly explaining the associations between anger-expression styles and HRQL. As hypothesized, anger control had a positive relationship with perceived partner support, while habitual inhibition of anger (anger-in) showed a negative correlation with partner support. Analyses by gender revealed some clear differences: for the male patients, the wife's high level of anger expression (anger-out) was significantly positively related to patient mental HRQL, whereas for the female patients, their husband's anger-out was negatively correlated with the patient's mental HRQL. In addition, patient's own anger-out had a more pronounced negative effect on HRQL for women as compared to men. The anger-expression styles of both patients and their partners seem to modify the family atmosphere, and together, they are important determinants of the long-term quality of life of the cancer patients. Interventions for couples facing cancer should include a focus on ways of dealing with anger and thereby support dyadic coping with cancer.

  7. The role of family nutritional support in Japanese patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Watanabe, Koin; Kurose, Takeshi; Kitatani, Naomi; Yabe, Daisuke; Hishizawa, Masahiro; Hyo, Takanori; Seino, Yutaka

    2010-01-01

    We investigated the role of family support in glycemic control by nutritional self-care behavior of Japanese patients with type 2 diabetes. One hundred twelve Japanese out-patients with type 2 diabetes were recruited for the study at Kansai Electric Power Hospital. Interviews were conducted and HbA1c and triglyceride levels were measured. HbA1c levels were significantly related to family nutritional support. Patients under 60 years old with family nutritional support showed significantly lower HbA1c than patients without family support (p1 week) showed similar outcomes in glycemic control. Patients who appreciate the support and follow the advice showed lower HbA1c (6.88 +/- 0.22%) than (7.43 +/- 0.23%) patients who appreciate the advice but sometimes feel emotional barriers. Family nutritional support is useful in improving metabolic outcome of diabetic patients. Self-care practice in disease management should be carefully adjusted to the family setting of type 2 diabetic patients. Emotional barriers to family support may affect the metabolic consequences, especially in the Japanese elderly.

  8. Psychosocial distress and need for supportive counselling in patients during radiotherapy

    International Nuclear Information System (INIS)

    Vries, A. de; Steixner, E.; Stzankay, A.; Iglseder, W.; Soellner, W.; Auer, V.; Schiessling, G.; Lukas, P.

    1998-01-01

    Purpose: Psychosocial distress and patient attitude towards psychosocial support as well as the correlations with clinical and sociodemographic characteristics should be assessed. Methods: The stress due to cancer was measured in a consecutive sample of tumor patients at the start of radiotherapy (n=117) by use of the Hornheide Questionnaire. In addition, the interest of these patients in professional psychosocial support was assesed with the help of the Questionnaire for Psychosocial Support. Results: Patients in the course of radiotherapy and patients with a poor prognosis and advanced disease were more strongly distressed. 32.7% of patients wished professional psychosocial support from the oncologist treating them, 40.6% of the patients wished support from the oncologist and additionally from a psychotherapist or social worker. Interest in professional psychosocial support correlated with the amount of distress, but not with sociodemographic variables. Conclusions: Results stress the importance of training programs for oncologists in order to improve their ability to detect psychosocial distress in cancer patients and to offer adequate emotional support to them. (orig.) [de

  9. Bioartificial liver assist devices in support of patients with liver failure.

    Science.gov (United States)

    Patzer II, John F; Lopez, Roberto C; Zhu, Yue; Wang, Zi-Fa; Mazariegos, George V; Fung, John J

    2002-02-01

    Bioartificial liver assist devices (BALs) offer an opportunity for critical care physicians and transplant surgeons to stabilize patients prior to orthotopic liver transplantation. Such devices may also act as a bridge to transplant, providing liver support to patients awaiting transplant, or as support for patients post living-related donor transplant. Four BAL devices that rely on hepatocytes cultured in hollow fiber membrane cartridges (Circe Biomedical HepatAssist(r), Vitagen ELADTM, Gerlach BELS, and Excorp Medical BLSS) are currently in various stages of clinical evaluation. Comparison of the four devices shows that several unique approaches based upon the same overall system architecture are possible. Preliminary results of the Excorp Medical BLSS Phase I safety evaluation at the University of Pittsburgh, after treating four patients (F, 41, acetominophen-induced, two support periods; M, 50, Wilson's disease, one support period; F, 53, acute alcoholic hepatitis, two support periods; F, 24, chemotherapy-induced, one support period, are presented. All patients presented with hypoglycemia and transient hypotension at the start of extracorporeal perfusion. Hypoglycemia was treated by IV dextrose and the transient hypotension responded positively to IV fluid bolus. Heparin anticoagulation was used only in the second patient. No serious or adverse events were noted in the four patients. Moderate Biochemical response to support was noted in all patients. More complete characterization of the safety of the BLSS requires completion of the Phase I safety evaluation.

  10. Uncertainty, Alert and Distress: The Precarious Position of NGO Search and Rescue Operations in the Central Mediterranean

    OpenAIRE

    Smith, Adam

    2017-01-01

    The international framework for maritime search and rescue relies on state actors establishing regions of responsibility supported by private shipmasters acting in compliance with traditional duties to rescue persons in distress at sea. Despite revisions to the framework’s foundational treaty, questions persist about the extent of state responsibilities and the interaction between those responsibilities and international human rights law. Over the past three years, non-governmenta...

  11. The need for psycho-oncological support for melanoma patients: Central role of patients' self-evaluation.

    Science.gov (United States)

    Mayer, Simone; Teufel, Martin; Schaeffeler, Norbert; Keim, Ulrike; Garbe, Claus; Eigentler, Thomas Kurt; Zipfel, Stephan; Forschner, Andrea

    2017-09-01

    Despite an increasing number of promising treatment options, only a limited number of studies concerning melanoma patients' psycho-oncological distress have been carried out. However, multiple screening tools are in use to assess the need for psycho-oncological support. This study aimed first to identify parameters in melanoma patients that are associated with a higher risk for being psycho-oncologically distressed and second to compare patients' self-evaluation concerning the need for psycho-oncological support with the results of established screening tools.We performed a cross-sectional study including 254 melanoma patients from the Center for Dermatooncology at the University of Tuebingen. The study was performed between June 2010 and February 2013. Several screening instruments were included: the Distress Thermometer (DT), Hospital Anxiety and Depression Scale and the patients' subjective evaluation concerning psycho-oncological support. Binary logistic regression was performed to identify factors that indicate the need for psycho-oncological support.Patients' subjective evaluation concerning the need for psycho-oncological support, female gender, and psychotherapeutic or psychiatric treatment at present or in the past had the highest impact on values above threshold in the DT. The odds ratio of patients' self-evaluation (9.89) was even higher than somatic factors like female gender (1.85), duration of illness (0.99), or increasing age (0.97). Patients' self-evaluation concerning the need for psycho-oncological support indicated a moderate correlation with the results of the screening tools included.In addition to the results obtained by screening tools like the DT, we could demonstrate that patients' self-evaluation is an important instrument to identify patients who need psycho-oncological support.

  12. Oncology healthcare professionals' perspectives on the psychosocial support needs of cancer patients during oncology treatment.

    Science.gov (United States)

    Aldaz, Bruno E; Treharne, Gareth J; Knight, Robert G; Conner, Tamlin S; Perez, David

    2017-09-01

    This study explored oncology healthcare professionals' perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients' acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients' experiences during oncology treatment.

  13. Perceived social support among patients with burn injuries: A perspective from the developing world.

    Science.gov (United States)

    Waqas, Ahmed; Turk, Marvee; Naveed, Sadiq; Amin, Atif; Kiwanuka, Harriet; Shafique, Neha; Chaudhry, Muhammad Ashraf

    2018-02-01

    Social support is among the most well-established predictors of post-burn psychopathology after burn. Despite a disproportionately large burden of burns in the developing world, the nature of social support among burn patients in this context remains elusive. We, therefore, seek to investigate social support and its biopsychosocial determinants among patients with burn injuries in Pakistan. A cross-sectional study of 343 patients presenting with burn injuries at four teaching hospitals in the Punjab province of Pakistan was conducted. Patient evaluation consisted of a multi-part survey of demographic status, clinical features, and social support as measured by the validated Urdu translation of the Multidimensional Scale of Perceived Social Support (MSPSS). Multiple regression analysis was performed to evaluate associations between patient characteristics and MSPSS score. Mean overall MSPSS score was 57.64 (std dev 13.57). Notable positive predictors of social support include male gender, Punjabi ethnicity, burn surface area, and ego resiliency. Our study reveals a troubling pattern of inadequate social support among certain subgroups of Pakistani burn patients. Addressing these inequities in the provision of social support must be prioritized as part of the global burn care agenda. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  14. Use of patient-reported outcomes in outpatient settings as a means of patient involvement and self-management support

    DEFF Research Database (Denmark)

    Mejdahl, Caroline; Nielsen, Berit Kjærside; Hjøllund, Niels Henrik Ingvar

    2016-01-01

    Rationale, aims and objectives: Patient-reported outcomes (PROs) are being implemented in clinical practice across different healthcare settings with varying purposes. Involving patients in reporting outcomes may increase their attention to symptoms and thereby support their self-management. The ...... to strengthen patient involvement and securing benefit from PROs.......Rationale, aims and objectives: Patient-reported outcomes (PROs) are being implemented in clinical practice across different healthcare settings with varying purposes. Involving patients in reporting outcomes may increase their attention to symptoms and thereby support their self......-management. The aim of the present study was to describe patients’ experiences with a web-based PRO system where patients complete a PRO questionnaire at home or in the outpatient clinic prior to a consultation. Moreover, the study aimed to explore how PROs influenced the interaction between patients and clinicians...

  15. Can social support work virtually? Evaluation of rheumatoid arthritis patients' experiences with an interactive online tool.

    Science.gov (United States)

    Kostova, Zlatina; Caiata-Zufferey, Maria; Schulz, Peter J

    2015-01-01

    There is strong empirical evidence that the support that chronic patients receive from their environment is fundamental for the way they cope with physical and psychological suffering. Nevertheless, in the case of rheumatoid arthritis (RA), providing the appropriate social support is still a challenge, and such support has often proven to be elusive and unreliable in helping patients to manage the disease. To explore whether and how social support for RA patients can be provided online, and to assess the conditions under which such support is effective. An online support tool was designed to provide patients with both tailored information and opportunities to interact online with health professionals and fellow sufferers. The general purpose was to identify where the support provided did - or did not - help patients, and to judge whether the determinants of success lay more within patients - their engagement and willingness to participate - or within the design of the website itself. The present study reports qualitative interviews with 19 users of the tool. A more specific purpose was to elaborate qualitatively on results from a quantitative survey of users, which indicated that any positive impact was confined to practical matters of pain management rather than extending to more fundamental psychological outcomes such as acceptance. Overall, online learning and interaction can do much to help patients with the everyday stresses of their disease; however, its potential for more durable positive impact depends on various individual characteristics such as personality traits, existing social networks, and the severity and longevity of the disease.

  16. Supported Employment for Veterans With Traumatic Brain Injury: Patient Perspectives.

    Science.gov (United States)

    Carlson, Kathleen F; Pogoda, Terri K; Gilbert, Tess A; Resnick, Sandra G; Twamley, Elizabeth W; O'Neil, Maya E; Sayer, Nina A

    2018-02-01

    To quantify the need for, and interest in, supported employment (SE) among recent military veterans with traumatic brain injury (TBI); and to examine characteristics associated with veterans' interest in SE. Stratified random sample of Iraq and Afghanistan War veterans confirmed to have TBI through the Veterans Health Administration (VHA) screening and evaluation system. Community-based via mailed survey. We recruited 1800 veterans with clinician-confirmed TBI (mild TBI: n=1080; moderate/severe TBI: n=720) through multiple mailings. Among 1451 surveys that were not returned undeliverable, N=616 (42%) responded. Not applicable. Veterans rated their interest in SE after reading a script describing the program. Additional measures assessed mental health and pain-related comorbidities, employment, financial/housing difficulties, demographics, and military service characteristics. Estimates were weighted to represent the population of veterans with VHA clinician-confirmed TBI. Unemployment was reported by 45% (95% confidence interval [CI], 43-47) of veterans with TBI. Although 42% (95% CI, 40-44) reported they would be interested in using SE if it were offered to them, only 12% had heard of SE (95% CI, 11-14) and interest in SE. However, those who were unemployed, looking for work, experiencing financial strain, or at risk for homelessness were more likely to be interested in SE. Our research highlights an important gap between veterans' vocational needs and interests and their use of SE. Systematically identifying and referring those with employment and financial/housing difficulties may help close this gap. Published by Elsevier Inc.

  17. Conservation and the 4 Rs, which are rescue, rehabilitation, release, and research.

    Science.gov (United States)

    Pyke, Graham H; Szabo, Judit K

    2018-02-01

    Vertebrate animals can be injured or threatened with injury through human activities, thus warranting their "rescue." Details of wildlife rescue, rehabilitation, release, and associated research (our 4 Rs) are often recorded in large databases, resulting in a wealth of available information. This information has huge research potential and can contribute to understanding of animal biology, anthropogenic impacts on wildlife, and species conservation. However, such databases have been little used, few studies have evaluated factors influencing success of rehabilitation and/or release, recommended actions to conserve threatened species have rarely arisen, and direct benefits for species conservation are yet to be demonstrated. We therefore recommend that additional research be based on data from rescue, rehabilitation, and release of animals that is broader in scope than previous research and would have community support. © 2017 Society for Conservation Biology.

  18. Lactate rescues neuronal sodium homeostasis during impaired energy metabolism.

    Science.gov (United States)

    Karus, Claudia; Ziemens, Daniel; Rose, Christine R

    2015-01-01

    Recently, we established that recurrent activity evokes network sodium oscillations in neurons and astrocytes in hippocampal tissue slices. Interestingly, metabolic integrity of astrocytes was essential for the neurons' capacity to maintain low sodium and to recover from sodium loads, indicating an intimate metabolic coupling between the 2 cell types. Here, we studied if lactate can support neuronal sodium homeostasis during impaired energy metabolism by analyzing whether glucose removal, pharmacological inhibition of glycolysis and/or addition of lactate affect cellular sodium regulation. Furthermore, we studied the effect of lactate on sodium regulation during recurrent network activity and upon inhibition of the glial Krebs cycle by sodium-fluoroacetate. Our results indicate that lactate is preferentially used by neurons. They demonstrate that lactate supports neuronal sodium homeostasis and rescues the effects of glial poisoning by sodium-fluoroacetate. Altogether, they are in line with the proposed transfer of lactate from astrocytes to neurons, the so-called astrocyte-neuron-lactate shuttle.

  19. Lactate rescues neuronal sodium homeostasis during impaired energy metabolism

    Science.gov (United States)

    Karus, Claudia; Ziemens, Daniel; Rose, Christine R

    2015-01-01

    Recently, we established that recurrent activity evokes network sodium oscillations in neurons and astrocytes in hippocampal tissue slices. Interestingly, metabolic integrity of astrocytes was essential for the neurons' capacity to maintain low sodium and to recover from sodium loads, indicating an intimate metabolic coupling between the 2 cell types. Here, we studied if lactate can support neuronal sodium homeostasis during impaired energy metabolism by analyzing whether glucose removal, pharmacological inhibition of glycolysis and/or addition of lactate affect cellular sodium regulation. Furthermore, we studied the effect of lactate on sodium regulation during recurrent network activity and upon inhibition of the glial Krebs cycle by sodium-fluoroacetate. Our results indicate that lactate is preferentially used by neurons. They demonstrate that lactate supports neuronal sodium homeostasis and rescues the effects of glial poisoning by sodium-fluoroacetate. Altogether, they are in line with the proposed transfer of lactate from astrocytes to neurons, the so-called astrocyte-neuron-lactate shuttle. PMID:26039160

  20. Launch-Off-Need Shuttle Hubble Rescue Mission: Medical Issues

    Science.gov (United States)

    Hamilton, Douglas; Gillis, David; Ilcus, Linda; Perchonok, Michele; Polk, James; Brandt, Keith; Powers, Edward; Stepaniak, Phillip

    2008-01-01

    The Space Shuttle Hubble repair mission (STS-125) is unique in that a rescue mission (STS-400) has to be ready to launch before STS-125 life support runs out should the vehicle become stranded. The shuttle uses electrical power derived from fuel cells that use cryogenic oxygen and hydrogen (CRYO) to run all subsystems including the Environmental Control System. If the STS-125 crew cannot return to Earth due to failure of a critical subsystem, they must power down all nonessential systems and wait to be rescued by STS-400. This power down will cause the cabin temperature to be 60 F or less and freeze the rest of the vehicle, preventing it from attempting a reentry. After an emergency has been declared, STS-125 must wait at least 7 days to power down since that is the earliest that STS-400 can be launched. Problem The delayed power down of STS-125 causes CYRO to be consumed at high rates and limits the survival time after STS-400 launches to 10 days or less. CRYO will run out sooner every day that the STS-400 launch is delayed (weather at launch, technical issues etc.). To preserve CRYO and lithium hydroxide (LiOH - carbon dioxide removal) the crew will perform no exercise to reduce their metabolic rates, yet each deconditioned STS-125 crewmember must perform an EVA to rescue himself. The cabin may be cold for 10 days, which may cause shivering, increasing the metabolic rate of the STS-125 crew. Solution To preserve LiOH, the STS-125 manifest includes nutrition bars with low carbohydrate content to maintain crew respiratory quotient (RQ) below 0.85 as opposed to the usual shuttle galley food which is rich in carbohydrates and keeps the RQ at approximately 0.95. To keep the crew more comfortable in the cold vehicle warm clothing also has been included. However, with no exercise and limited diet, the deconditioned STS-125 crew returning on STS-400 may not be able to egress the vehicle autonomously requiring a supplemented crash-and-rescue capability.

  1. Effect of nutritional support on terminally ill patients with cancer in a palliative care unit.

    Science.gov (United States)

    Amano, Koji; Morita, Tatsuya; Baba, Mika; Kawasaki, Muneyoshi; Nakajima, Shinichiro; Uemura, Minako; Kobayashi, Yuka; Hori, Moeko; Wakayama, Hiroshi

    2013-11-01

    The role of nutritional support on terminally ill patients with cancer in a palliative care unit has not been clarified. A total of 63 patients were retrospectively investigated; the patients receiving individualized nutritional support (intervention group [n = 22]) were compared to the others (control group [n = 41]). The intervention group received individualized nutritional support. There were no significant differences in the characteristics of patients between the groups. The prevalence of bedsores was significantly lower in the intervention group (14% vs 46%, P = .012). The prevalence of edema and the use of antibiotic therapies tended to be lower in the intervention group than in the control group (36% vs 54%, P = .19; 14% vs 27%, P = .34, respectively). Some terminally ill patients with cancer in a palliative care unit might benefit from nutritional support.

  2. ESA innovation rescues Ultraviolet Observatory

    Science.gov (United States)

    1995-10-01

    experience to have the opportunity to do an in-depth review of operational procedures established in 1978 and be given the chance to streamline these through the application of the tools available to engineers and scientists in 1995." The innovative arrangements were designed and developed at the ESA IUE Observatory, which is located in Spain at ESA's Villafranca Satellite Tracking Station in Villanueva de la Canada near Madrid. As a result, ESA is now performing all of WE's science observations (16 hours per day) from the Villafranca station. All the processing of the observations transmitted by the satellite and the subsequent rapid data distribution to the research scientists world-wide is now done from Villafranca. NASA does maintain its role in the programme in the area of operational spacecraft maintenance support, satellite communications and data re-processing for IUE's Final Archive. Thus the IUE Project could be extended and the final IUE observing program can now be implemented. In particular, this will involve critical studies on comets (e,g. on Comet Hale-Bopp), on stellar wind structures, on the enigmatic mini-quasars (which are thought to power the nuclei of Active Galaxies), as well as performing pre- studies which will optimize the utilization of the Hubble Space Telescope. Prof. R.M. Bonnet, Director of the ESA Science Programme comments "I am quite pleased that we have been able to secure the extension of our support for the scientists in Europe and the world to this highly effective mission. Also the scientists can be proud of the utilization of IUE, with more than 3000 learned publications and 200 Doctoral dissertations based on data from IUE. Through this they demonstrate in turn to be very appreciative of our efforts in the Science Programme".

  3. The effectiveness of support groups in Asian breast cancer patients: An integrative review

    Directory of Open Access Journals (Sweden)

    Fang-Yu Chou

    2016-01-01

    Full Text Available Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries. The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  4. The Effectiveness of Support Groups in Asian Breast Cancer Patients: An Integrative Review.

    Science.gov (United States)

    Chou, Fang-Yu; Lee-Lin, Frances; Kuang, Lily Y

    2016-01-01

    Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC) patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries). The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  5. Patient education and emotional support practices in abortion care facilities in the United States.

    Science.gov (United States)

    Gould, Heather; Perrucci, Alissa; Barar, Rana; Sinkford, Danielle; Foster, Diana Greene

    2012-01-01

    Little is known about how patient education and emotional support is provided at abortion facilities. This pilot study documents 27 facilities' practices in this aspect of abortion care. We conducted confidential telephone interviews with staff from 27 abortion facilities about their practices. The majority of facilities reported they rely primarily on trained nonclinician staff to educate patients and provide emotional support. As part of their informed consent and counseling processes, facilities reported that staff always provide patients with information about the procedure (96%), assess the certainty of their abortion decisions (92%), assess their feelings and provide emotional support (74%), and provide contraceptive health education (92%). Time spent providing these components of care varied across facilities and patients. When describing their facility's care philosophy, many respondents expressed support for "patient-centered," "supportive," "nonjudgmental" care. Eighty-two percent agreed that it is the facility's role to provide counseling for emotional issues related to abortion. All facilities valued informed consent, patient education, and emotional support. Although the majority of facilities considered counseling for emotional issues to be a part of their role, some did not. Future research should examine patients' preferences regarding abortion care and counseling and how different approaches to care affect women's emotional well-being after having an abortion. This information is important in light of current, widespread legislative efforts that aim to regulate abortion counseling, which are being proposed without an understanding of patient needs or facility practices. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  6. Combat Search and Rescue in Desert Storm

    Science.gov (United States)

    2006-09-01

    in the United States also sup- ported civil SAR. Almost daily, the veterans of Southeast Asia were called upon to rescue lost hikers and foundering ...Ridge in the Persian Gulf. Under the NRCC, Combined Task Force (CTF) 151 served as the regional SAR controller for Battle Force Zulu in the Persian...was ZULU + 3 [i.e., Greenwich Mean Time plus three hours]. Saudi Arabia local time was ZULU + 3:30. All times in the log extracts that follow are

  7. Positive and problematic support, stress and quality of life in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Mazzoni, Davide; Cicognani, Elvira

    2016-09-01

    Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Previous studies showed that perceived social support has an important role in enhancing patient's quality of life (QOL). However, the precise mechanisms through which social support exerts such an effect are not completely understood. The aim of this paper is to test two alternative models explaining the relationship between social support (positive and problematic) and two dimensions of QOL: Health-Related (HR-QOL) and Non-Health-Related (NHR-QOL). Model A (mediation) hypothesized that positive support would reduce stress while problematic support would increase stress), and that this in turn would reduce QOL. Model B (moderation) hypothesized that the effect of support on QOL would be moderated by the experience of stress in that more stressed individuals would show stronger effects. Three hundred and forty-four Italian patients with SLE completed an online questionnaire. Stress partially mediated the relationship between support and QOL dimensions (either HR-QOL and NHR-QOL) thus supporting Model B. As hypothesized, positive support reduced stress, while problematic support increased stress. These findings help to explain the complex relationship between social support, stress and QOL in patients with SLE.

  8. BRAIN-COMPUTER-INTERFACE – SUPPORTED MOTOR IMAGERY TRAININTG FOR PATIENTS WITH HEMIPARESIS

    Directory of Open Access Journals (Sweden)

    O. A. Mokienko

    2013-01-01

    Full Text Available The aim of study was to assess the feasibility of motor imagery supported brain-computer interface in patients with hemiparesis. 13 patients with central paresis of the hand and 15 healthy volunteers were learning to control EEG-based interface with feedback. No differences on interface control quality were found between patients and healthy subjects. The trainings were accompanied by the desynchronization of sensorimotor rhythm. In patients with cortical damage the source of EEG-activity was dislocated.

  9. Business rescue decision making through verifier determinants – ask the specialists

    Directory of Open Access Journals (Sweden)

    Marius Pretorius

    2013-11-01

    Full Text Available Orientation: Business rescue has become a critical part of business strategy decision making, especially during economic downturns and recessions. Past legislation has generally supported creditor-friendly regimes, and its mind-set still applies which increases the difficulty of such turnarounds. There are many questions and critical issues faced by those involved in rescue. Despite extensive theory in the literature on failure, there is a void regarding practical verifiers of the signs and causes of venture decline, as specialists are not forthcoming about what they regard as their “competitive advantage”. Research purpose: This article introduces the concept and role of “verifier determinants” of early warning signs, as a tool to confirm the causes of decline in order to direct rescue strategies and, most importantly, reduce time between the first observation and the implementation of the rescue. Motivation for the study: Knowing how specialist practitioners confirm causes of business decline could assist in deciding on strategies for the rescue earlier than can be done using traditional due diligence which is time consuming. Reducing time is a crucial element of a successful rescue. Research design and approach: The researchers interviewed specialist practitioners with extensive experience in rescue and turnaround. An experimental design was used to ensure the specialists evaluated the same real cases to extract their experiences and base their decisions on. Main findings: The specialists confirmed the use of verifier determinants and identified such determinants as they personally used them to confirm causes of decline. These verifier determinants were classified into five categories; namely, management, finance, strategic, banking and operations and marketing of the ventures under investigation. The verifier determinants and their use often depend heavily on subconscious (non-factual information based on previous experiences

  10. The Relationship between Stroke Patients Characteristics and Family Support with Compliance Rehabilitation

    Directory of Open Access Journals (Sweden)

    Irma Okta Wardhani

    2015-01-01

    Full Text Available Stroke is a cerebrovascular disease, it is brain function disorders associated with the disease of the blood vessels that supply the brain. The impact of stroke is paralysis. Family support is things that are needed to be considered in the treatment of stroke patients. It is very involved in the compliance rehabilitation of patients to prevent the re-occurrence of stroke. Characteristics of stroke patients may also affect the compliance rehabilitation. The purpose of this research is to determine the relationship between stroke patients characteristics and family support to compliance rehabilitation at the Medical Rehabilitation Unit RSU Haji Surabaya. This research was an analytic observational research with cross sectional design. The subjects of this research are taken using total population technique. The independent variables in this research is family support. The dependent variable is compliance rehabilitation. The results of this research are presented in the form of frequency distributions and calculate the strength of the relationship with Phi coefficient. The result of this research shows that there is a strong relationship between family support and compliance rehabilitation (r=0.582. There are weak relationship between ages (r=-0,027, gender (r=0,092, level of education (r= -0,295, work (r=0,098, and marital status (r=0,319. The conclusion is family support may affect compliance rehabilitation of stroke patients. It is recommended for health workers to provide counseling to improve family support in curing stroke patients. Keywords: depression, family support, compliance rehabilitation

  11. [Social support and cardiovascular health: Adaptation of a social support scale for hypertensive and diabetic patients in primary care, Chile].

    Science.gov (United States)

    Poblete, Fernando; Glasinovic, Andrés; Sapag, Jaime; Barticevic, Nicolás; Arenas, Artzy; Padilla, Oslando

    2015-10-01

    Validate an instrument to measure the Perceived Social Support in outpatients who are in treatment to hypertension and/or diabetes mellitus ii. Observational and exploratory design with mixed methods, qualitative and quantitative. Two community health centers from the municipality of Puente Alto (Santiago, Chile). Hypertensive and/or diabetic patients between 18 and 65 years old. A purposive sample was undertaken for the qualitative study, and a random sample for the final survey. Focus groups and semi-structured interviews were conducted to explore the constructs of social support as perceived by patients. According to expert opinion and literature review, a scale of social support was selected and a pilot study was conducted in 40 patients, then we interviewed in depth to some of those participants. The instrument was modified according the results of this process. The final version was applied to 250 participants. The construct existence was verified in the population. In the adaptation, one item was eliminated. The alpha of Cronbach was 0.89 and the factorial analysis had the same four factors from the original study. Nine new items obtained from the focal groups were added to the instrument, obtaining an alpha of Cronbach of 0.92. The final instrument has good psychometric proprieties, and is applicable in our population. The additional items from the qualitative study improve its internal consistency, but don't add new information about Perceived Social Support. This is consistent with other studies, and suggests the application of the original version of the instrument. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. Evaluation of Satisfaction Level in Patients With Mandibular Implant Supported Overdentures

    Directory of Open Access Journals (Sweden)

    Masoumeh khoshhal

    2016-01-01

    Full Text Available Background Implant-supported overdentures could have many benefits for patients, especially in the lower jaws. As a matter of fact, the most common reason for prescribing mandibular overdenture is dissatisfaction of patients with mandibular dentures usually because of a lack of retention, stability and function and speech difficulties. On the other hand, patients' expectations of overdenture treatments are their main disadvantage. Objectives The aim of this study was to evaluate the satisfaction of patients who had received mandibular implant supported overdenture treatment with different number of implants. Patients and Methods This study was a descriptive cross-sectional study. Twenty-five patients with a mean age of 62.7 years who had received mandibular implant supported overdenture treatment at the dental school of Hamadan University of Medical Sciences were enrolled. Among these patients, six had overdentures supported by one implant, nine had overdentures supported by two implants, two had overdentures supported by three implants, five had overdentures supported by four implants and three had overdentures supported by five implants. The visual analogue scale (VAS questionnaire was used to evaluate the general satisfaction, comfort, esthetic, fitness, satisfaction of chewing and social communication, and the data was analyzed by the analysis of variance (ANOVA test. Results All patients in all five groups were satisfied with their overdentures; however there was no significant relationship between the number of implants and fitness (P = 0.446, esthetic (P = 0.843, comfort (P = 0.805, satisfaction of chewing (P = 0.133, social communication (P = 0.322 and general satisfaction (P = 0.493. Conclusions There was no difference in satisfaction level of patients who had received mandibular overdentures with different number of implants.

  13. Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy.

    Science.gov (United States)

    Qiu, Miaozhen; Zhou, Yi-xin; Jin, Yin; Wang, Zi-xian; Wei, Xiao-li; Han, Hong-yu; Ye, Wen-feng; Zhou, Zhi-wei; Zhang, Dong-sheng; Wang, Feng-hua; Li, Yu-hong; Yang, Da-jun; Xu, Rui-hua

    2015-07-01

    The aim of our study is firstly to evaluate the prevalence and prognostic value of nutrition risk in gastric cancer patients and secondly to explore whether the nutrition support can prolong the survival of advanced gastric cancer patients. It contained two study periods. In the first period, we prospectively evaluated the nutritional risk of gastric adenocarcinoma patients from 2009 to 2011 using the method of European Nutritional Risk Screening (NRS) 2002. The Kaplan-Meier method and log-rank test were used to evaluate the prognostic value of high nutrition risk. The second period was between 2012 and 2013. We prospectively gave the nutrition support to stage IV gastric cancer patients whose NRS is ≥3. There were 830 patients in the first period, 50.7% patients with a NRS ≥ 3. Patients with NRS ≥ 3 presented a significantly higher percentage of stage IV diseases, elevated values of C-reactive protein, and hypoproteinemia. The median survival was significantly higher in NRS nutrition support. The median survival was 14.3 and 9.6 months for patients with and without NRS shift, respectively, P = 0.001. NRS ≥ 3 was an independent adverse prognostic factor in gastric cancer patients. For stage IV patients whose NRS ≥ 3, the nutrition support might be helpful to improve the prognosis.

  14. Nutritional support in patients with colorectal cancer during chemotherapy: does it work?

    Science.gov (United States)

    Dobrila-Dintinjana, Renata; Trivanovic, Dragan; Zelić, Marko; Radić, Mladen; Dintinjana, Marijan; Petranović, Duška; Toni, Valković; Vukelic, Jelena; Matijasic, Nusa

    2013-05-01

    Early intervention with nutritional supplementation has been shown to halt malnutrition and may improve outcome in some patients with colorectal cancer. The aim of this study was to investigate whether dietary counseling, oral nutrition and megestrol acetate during chemotherapy affected nutritional status and survival in patients with advanced disease. Six hundred and twenty-eight patients with colorectal advanced disease were included in the study from January 2000 through December 2009 and divided into one of two groups. Group I consisted of 315 patients who were monitored prospectively and were given nutritional support. Group II included 313 patients without nutritional counseling and support. After the completion of chemotherapy all patients were evaluated (BMI, NST, Appetite Loss Scale and ECOG). After the completion of chemotherapy, there were lower proportions of patients in Group I with a BMI=5, loss of appetite and decreased weight gain. Nutritional counseling and supplemental feeding temporarily halted weight loss and improved appetite. This improvement may have implications for patient survival. Patients with early nutritional support lived 19.1 months while patients in the control group had a survival of 12.4 months (p=0.022). This study demonstrated that concurrent individualized dietary counseling and nutritional support are effective in improving nutritional status thereby lessening chemotherapy-induced morbidity.

  15. Multimedia support in preoperative patient education for radical prostatectomy: the physicians' point of view.

    Science.gov (United States)

    Ihrig, Andreas; Herzog, Wolfgang; Huber, Christian G; Hadaschik, Boris; Pahernik, Sascha; Hohenfellner, Markus; Huber, Johannes

    2012-05-01

    To systematically assess the physicians' point of view of multimedia support in preoperative patient education for radical prostatectomy. We evaluated the view of physicians performing multimedia supported preoperative educations within a randomized controlled trial. Therein 8 physicians educated 203 patients for radical prostatectomy. All physicians rated multimedia supported education better than the standard procedure. Main reasons were better comprehensibility, the visual presentation, and greater ease in explaining complex issues. Objective time measurement showed no difference between both educations. The major disadvantage was the impression, that multimedia supported education lasted longer. Moreover, they had the impression that some details could be further improved. Given the choice, every physician would decide for multimedia support. Physicians appreciate multimedia support in preoperative education and contrary to their impression, multimedia support does not prolong patient education. Therefore, patients and physicians likewise profit from multimedia support for education and counseling. The readiness of physicians is a possible obstacle to this improvement, as their view is a key factor for the transition to everyday routine. Therefore, our results could alleviate this possible barrier for establishing multimedia supported education in clinical routine. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Rescue by peripheral blood mononuclear cells in dogs from bone marrow failure after total-body irradiation

    International Nuclear Information System (INIS)

    Zander, A.R.; Gray, K.N.; Hester, J.P.

    1984-01-01

    In order to determine the minimum dose of buffy coat cells necessary to achieve hematopoietic rescue following supralethal irradiation, mongrel dogs under general anesthesia were subjected to leukacytapheresis using three different techniques of cell separation. The buffy coats were frozen with dimethylsulfoxide and stored at -196 degrees C until transfused. Sixteen dogs were irradiated with 800 rads and were supported with antibiotics and transfusions of irradiated homologous blood. They were transfused with the frozen and thawed buffy coat cells, and, if they survived, they were followed for 100 days, sacrificed, and their tissues studied. The mean yield of mononuclear cells during leukocytapheresis ranged from 4.1 +/- 2.0 X 10(9) (mean +/- SD) to 6.0 +/- 4.0 X 10(9) for the three leukacytapheresis methods; one technique was not as satisfactory as the other two. Six of the 16 dogs fully recovered with evidence of marrow rescue; however, only one had a dose of mononuclear cells less than 11.1 X 10(9). These data indicate that seven to 17 leukacytapheresis procedures would be required to reconstitute a 70 kilogram patient. These preliminary findings suggest that, because the yields of transplantable cells with current technology are not adequate, the transplantation potential of buffy coat cells exposed to mobilizing agents should be evaluated

  17. The Evaluation of Nosocomial Infections in Pediatric Patients with Extracorporeal Membrane Oxygenation Support

    Directory of Open Access Journals (Sweden)

    Pelin Ayyıldız

    Full Text Available Abstract Introduction: Extracorporeal membrane oxygenation (ECMO has become a standard technique over the past few decades in intensive care unit (ICU. Objective: A review of pediatric patients who received ECMO support in the pediatric cardiac ICU was conducted to determine the incidence, risk factors and causal organisms related to acquired infections and assess the survival rates of ECMO patients with nosocomial infections. Methods: Sixty-six patients who received ECMO support in the pediatric cardiac ICU between January 2011 and June 2014 were included in the study. Demographic, echocardiographic, hemodynamic features and surgical procedures were reviewed. Results: Sixty-six patients received a total of 292.5 days of venoarterial ECMO support. Sixty were postoperative patients. Forty-five patients were weaned from ECMO support with an ECMO survival rate of 68.2%. The rate of infection was 116.2/1000 ECMO days. Prolonged ICU stay, duration of ventilation and ECMO were found associated with development of nosocomial infection and only the duration of ECMO was an independent risk factor for nosocomial infections in ECMO patients. Conclusion: The correction of the underlying process leading to ECMO support and shortening the length of ECMO duration together with stricter application of ECMO indications would improve the infection incidence and hospital surveillance of the patient group.

  18. Social support and self-management behaviour among patients with Type 2 diabetes

    DEFF Research Database (Denmark)

    Schiøtz, M. L.; Bøgelund, M.; Almdal, T.

    2012-01-01

    Aims To investigate the relationship between structural and functional social support and patient activation, diabetes-related emotional distress, perceived diabetes care, self-management behaviour and HbA 1c levels among patients with Type2 diabetes. Methods Self-administered questionnaires were...... emotional distress, negative assessment of care, less health-promoting eating habits and less frequent foot examinations. Conclusions Good social support is significantly associated with health-promoting behaviours and well-being among patients with Type2 diabetes. However, HbA 1c levels are higher...... for cohabitant persons, indicating barriers for social support. Intervention research is needed to investigate the causal relationship between social networks and health-promoting behaviours. This knowledge should be used in clinical practice when targeting and designing education, support and care for patients...

  19. Proteins and amino acids are fundamental to optimal nutrition support in critically ill patients

    NARCIS (Netherlands)

    Weijs, Peter JM; Cynober, Luc; DeLegge, Mark; Kreymann, Georg; Wernerman, Jan; Wolfe, Robert R

    2014-01-01

    In this review, we present the growing scientific evidence showing the importance of protein and amino acid provision in nutritional support and their impact on preservation of muscle mass and patient outcomes.

  20. Online communication and support for cancer patients: a relationship-centric design framework.

    Science.gov (United States)

    Weiss, Jacob B; Lorenzi, Nancy M

    2005-01-01

    Dealing with a cancer diagnosis and cancer treatment involves communication among clinicians, patients, families, friends and others affected by the illness. The hypothesis of this research is that an informatics system can effectively support the communication needs of cancer patients and their informal caregivers. Two design frameworks for online cancer communication are defined and compared. One is centered primarily on the users' interpersonal relationships, and the other is centered on the clinical data and cancer information. Five types of clinical and supportive relationships were identified and supported by in-depth interviews with cancer patients and their informal caregivers. Focusing the design of an online cancer communication system around the interpersonal relationships of patients and families may be an important step towards designing more effective paradigms for online cancer care and support.

  1. Content analysis and qualitative study of hemodialysis patients, family experience and perceived social support.

    Science.gov (United States)

    Aghakhani, Nader; Sharif, Farkhondeh; Molazem, Zahra; Habibzadeh, Hosein

    2014-03-01

    Various treatments such as hemodialysis prolong the life of chronic renal failure disease patients who must tolerate many physical, emotional, social and economic difficulties. Therefore, social support is considered as a vital area of investigation for such patients. In this qualitative research, a grounded theory approach was used and written as a content analysis form to study hemodialysis patients and family experience of perceived social support. Three nurses, 4 general practitioners, a specialist and two family members who participated were interviewed from April to September 2012 in Urmia, Iran. Interviews were guided to divulge the perception of changes in their lives, needs for social support for disease complications, and the type of treatment process. Purposive sampling continued up to data saturation. Data analysis was performed based on Strauss and Corbin Method. Constant comparison analysis was performed until data saturation. The research results are shown in 3 steps. In the first step, 113 categories and four main themes from 993 first codes were explored. Social support was explored based on the implications of five general themes including "Perceived Threats Caused by Disease Complications", "Searching for Social Support", "Accessible Social Support", "Beliefs and Values", and "Perceived Social Support". The core variable of our research is acceptance of the reality of the conditions caused by the disease. The research finalized our knowledge about patient problems regarding social support and revealed many problems of supporting patients by Health Team Members, family members and organizations. The findings suggest that individual aspects of patient experiences must be considered if social support is to be given and Healthcare Providers have to facilitate positive health services.

  2. Implementing shared governance in a patient care support industry: information technology leading the way.

    Science.gov (United States)

    Hartley, Lou Ann

    2014-06-01

    Implementing technology in the clinical setting is not a project but rather a journey in transforming care delivery. As nursing leaders in healthcare and patient care support organizations embrace technology to drive reforms in quality and efficiency, growing opportunities exist to share experiences between these industries. This department submission describes the journey to nursing shared governance from the perspective of an information technology-based company realizing the goal of supporting patient care.

  3. Rehabilitation with implant-supported overdentures in total edentulous patients: A review

    OpenAIRE

    Martínez–Lage-Azorín, Juan F.; Segura-Andrés, Gustavo; Faus-López, Joan; Agustín-Panadero, Rubén

    2013-01-01

    Objectives: The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. Material and methods: We performed a Medline search and review of pertinent articles on ...

  4. The effect of social support on the quality of life of patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    David Castro Costa

    2012-02-01

    Full Text Available OBJECTIVE: To determine the predictive value of social support on health related quality of life (HRQoL in multiple sclerosis (MS patients. METHODS: The sample is composed by 150 MS consecutive patients. We used the Medical Outcomes Study Social Support Survey to assess social support and the Health Status Questionnaire to assess HRQoL. For inferential analysis, we used the Multiple Linear Regression with stepwise selection of variables. RESULTS: The age, basic education, psychological support and disability explains 41.6% of the variance in physical function, 29.4% in physical performance and 30.6% in emotional performance. Age and psychological support explains 23.1% of the variance in physical function and 29.4% in vitality. CONCLUSION: This study demonstrated that social support is a predictor with a significant effect on HRQoL in MS.

  5. The association between supportive relatives and lower occurrence of anxiety and depression in heart patients

    DEFF Research Database (Denmark)

    Hansen, Camilla; Zinckernagel, Line; Schneekloth, Nanna

    2017-01-01

    BACKGROUND: Approximately 30-40% of heart patients develop anxiety and/or depression, which might influence recovery and long-term survival. Research has suggested that support from relatives may decrease anxiety and depression among heart patients; however, the results are inconsistent and often...... based on small study populations. AIM: The paper aimed to investigate the association between having supportive relatives and the occurrence of anxiety and depression in heart patients. METHODS: A population-based cross-sectional study among Danish patients diagnosed with ischemic heart disease, atrial...... fibrillation, heart failure, or heart valve disease. Presence of supportive relatives was measured as the degree to which the patients felt that they had relatives they could count on, while symptoms of anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Multiple logistic...

  6. The role of social support in anxiety and depression among Parkinson's disease patients.

    Science.gov (United States)

    Ghorbani Saeedian, Radka; Nagyova, Iveta; Krokavcova, Martina; Skorvanek, Matej; Rosenberger, Jaroslav; Gdovinova, Zuzana; Groothoff, Johan W; van Dijk, Jitse P

    2014-01-01

    To explore how social support is associated with anxiety and depression in Parkinson's disease (PD) patients controlling for gender, disease duration and disease severity. The sample consisted of 124 patients (52.4% male; mean age 68.1 ± 8.4 years; mean disease duration 6.3 ± 5.5 years). Anxiety and depression were measured with the Hospital Anxiety and Depression Scale, social support with the Multidimensional Scale of Perceived Social Support and disease severity with the Unified Parkinson Disease Rating Scale. Data were analyzed using linear regression. Gender, disease duration, disease severity and social support explained 31% of the total variance in anxiety in younger PD patients but did not significantly contribute to the explanation of depression. In the older group, this model explained 41% of the variance in depression but did not significantly contribute to the explanation of anxiety. PD patients experience the positive influence of social support differently according to age. In the younger group, disease duration plays the primary role regarding anxiety. In the older group, poor social support especially from friends is associated with more depression after controlling for the relevant variables. Implications of Rehabilitation PD is a disease of older age with a neurodegenerative character and treatment should focus on increasing quality of life. Anxiety and depression are common co-morbidities in PD patients. The support network should also be screened regularly and involved in enhancing the quality of life.

  7. Supportive Communication to Facilitate Chinese Patients' Adaptation to a Permanent Colostomy: A Qualitative Case Study Approach.

    Science.gov (United States)

    Tao, Hui; Songwathana, Praneed; Isaramalai, Sang-Arun; Wang, Qingxi

    2016-01-01

    This study, which is a part of action research, aims to explore how supportive communication can impact individuals' adaptation to a permanent colostomy in a Chinese cultural context. Two Chinese rectal cancer patients with complexity and difficulty in living with a permanent colostomy were selected using a qualitative case study approach. The researcher (H.T.) interacted with the participants along their journey from the preoperative period until the third postoperative month after discharge via face-to-face or telephone interviews. Content analysis was applied. Supportive communication was characterized by "communication as a supportive tool," which consisted of 4 elements: respect, description, empathy, and empowerment. The nursing strategies included (1) developing a collaborative relationship with patients and families; (2) understanding patients' concerns and problems; (3) discussing potential solutions; (4) encouraging patients to take action; (5) bringing out emotional expression; (6) normalizing negative emotions; and (7) protecting hope. The findings of this study informed that supportive communication is a valuable tool for nurses to provide informational and emotional support to Chinese patients in order to enhance their adaptation to living with a permanent colostomy. Developing an operational manual to enhance supportive communication for patients with colostomy is suggested.

  8. Supporting cancer patients with work-related problems through an oncological occupational physician: a feasibility study.

    Science.gov (United States)

    Zaman, A C G N M; Bruinvels, D J; de Boer, A G E M; Frings-Dresen, M H W

    2017-09-01

    To evaluate the feasibility of an oncological occupational physician (OOP) who is trained in oncological work-related problems, and in providing work-related support to cancer patients within the curative setting. We assessed facilitators and barriers that affect the activities of an OOP, and the satisfaction of the OOPs and patients with this new form of health care. Interviews were held with (1) OOPs (N = 13) to assess facilitators, barriers and their satisfaction with their ability to give supportive care and (2) cancer patients (N = 8) to assess their satisfaction concerning consulting an OOP. The main facilitators were positive feedback from health care providers and patients about the received care and support that the OOP had given, and the additional knowledge of the OOPs about cancer and work-related problems. Major barriers for being active as an OOP were lack of financial support for the OOP and the unfamiliarity of patients and health care providers with the specialised occupational physician. Both OOPs and the specialised knowledge and additional training of the OOPs facilitated providing support to cancer patients and survivors with work-related problems. Familiarity with the specialised occupational physician and financial support should be improved. © 2015 John Wiley & Sons Ltd.

  9. Effects of interactive patient smartphone support app on drug adherence and lifestyle changes in myocardial infarction patients: A randomized study.

    Science.gov (United States)

    Johnston, Nina; Bodegard, Johan; Jerström, Susanna; Åkesson, Johanna; Brorsson, Hilja; Alfredsson, Joakim; Albertsson, Per A; Karlsson, Jan-Erik; Varenhorst, Christoph

    2016-08-01

    Patients with myocardial infarction (MI) seldom reach recommended targets for secondary prevention. This study evaluated a smartphone application ("app") aimed at improving treatment adherence and cardiovascular lifestyle in MI patients. Multicenter, randomized trial. A total of 174 ticagrelor-treated MI patients were randomized to either an interactive patient support tool (active group) or a simplified tool (control group) in addition to usual post-MI care. Primary end point was a composite nonadherence score measuring patient-registered ticagrelor adherence, defined as a combination of adherence failure events (2 missed doses registered in 7-day cycles) and treatment gaps (4 consecutive missed doses). Secondary end points included change in cardiovascular risk factors, quality of life (European Quality of Life-5 Dimensions), and patient device satisfaction (System Usability Scale). Patient mean age was 58 years, 81% were men, and 21% were current smokers. At 6 months, greater patient-registered drug adherence was achieved in the active vs the control group (nonadherence score: 16.6 vs 22.8 [P = .025]). Numerically, the active group was associated with higher degree of smoking cessation, increased physical activity, and change in quality of life; however, this did not reach statistical significance. Patient satisfaction was significantly higher in the active vs the control group (system usability score: 87.3 vs 78.1 [P = .001]). In MI patients, use of an interactive patient support tool improved patient self-reported drug adherence and may be associated with a trend toward improved cardiovascular lifestyle changes and quality of life. Use of a disease-specific interactive patient support tool may be an appreciated, simple, and promising complement to standard secondary prevention. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Dietary counselling and nutritional support in oropharyngeal cancer patients treated with radiotherapy

    NARCIS (Netherlands)

    Vlooswijk, C.P.; Rooij, Van P.H.E.; Kruize, J.C.; Schuring, H.A.; Al-Mamgani, A.; Roos, De N.M.

    2016-01-01

    Background/Objectives:The need for dietary counselling and nutritional support in oropharyngeal cancer patients is generally accepted. However, evidence for the effectiveness is sparse. The aim of this study was to describe dietary counselling, nutritional support, body weight and toxicity during

  11. Predicting Resilience via Social Support and Illness Perceptions Among Patients Undergoing Hemodialysis

    Directory of Open Access Journals (Sweden)

    Reihane Hajmohammadi

    2017-07-01

    Full Text Available Background and Objectives Chronic renal disease is a threatening condition for the health, economic, and social status of the affected person and his/her family. Patients undergoing hemodialysis encounter mental and health problems; the current study aimed at predicting resilience via social support and illness perceptions among patients undergoing hemodialysis. Methods The current descriptive-correlational study had a statistical population including 308 patients undergoing hemodialysis in Kerman, Iran, in 2017. Based on the Krejcie-Morgan table, the minimum required sample size was 169. The sample was selected using a convenience sampling method. Data collection tools were the Connor-Davidson resilience scale, the medical outcome study (MOS social support survey developed by Sherbourne and Stewart, and the brief illness perception questionnaire developed by Broadbent et al. Data were analyzed using a Pearson correlation coefficient and a stepwise regression analysis via SPSS version 19. Results Results indicated that resilience was significantly and positively related to social support (r = 0.318, P < 0.05 and illness perceptions (r = 0.165, P < 0.05. Among the subscales of social support, emotional support, tangible support, and social interaction could predict resilience, and among the subscales of illness perceptions, only cognitive representation could predict resilience. Conclusions The obtained results demonstrated that resilience was significantly and positively related to social support and illness perceptions. Additionally, the subscales of social support and illness perceptions could predict resilience among the patients undergoing hemodialysis.

  12. Do Hospitals Support Second Victims? Collective Insights From Patient Safety Leaders in Maryland.

    Science.gov (United States)

    Edrees, Hanan H; Morlock, Laura; Wu, Albert W

    2017-09-01

    Second victims-defined as health care providers who are emotionally traumatized after a patient adverse event-may not receive needed emotional support. Although most health care organizations have an employee assistance program (EAP), second victims may be reluctant to access this service because of worries about confidentiality. A study was conducted to describe the extent to which organizational support for second victims is perceived as desirable by patient safety officers in acute care hospitals in Maryland and to identify existing support programs. Semistructured interviews (using existing and newly developed questions) were conducted with 43 patient safety representatives from 38 of the 46 acute care hospitals in Maryland (83% response rate). All but one of the responding hospitals offered EAP services to their employees, but there were gaps in the services provided related to timeliness, EAP staff's ability to relate to clinical providers, and physical accessibility. There were no valid measures in place to assess the effectiveness of EAP services. Participants identified a need for peer support, both for the second victim and potentially for individuals who provide that support. Six (16%) of the 38 hospitals had second victim support programs, which varied in structure, accessibility, and outcomes, while an additional 5 hospitals (13%) were developing such a program. Patient safety officers thought their organizations should reevaluate the support currently provided by their EAPs, and consider additional peer support mechanisms. Future research is needed to evaluate the effectiveness of these programs. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  13. Physical and psychosocial support requirements of 1,500 patients starting radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, K.; Czajka, A.; Luetgendorf-Cacig, C.; Schmid, M.P.; Komarek, E.; Poetter, R. [Medical Univ. of Vienna, Comprehensive Cancer Center, Vienna (Austria). Dept. of Radiation Oncology; Ponocny-Seliger, E. [Sigmund Freud Private Univ. Vienna (Austria). Dept. of Psychology; Doerr, W. [Medical Univ. of Vienna, Comprehensive Cancer Center, Vienna (Austria). Dept. of Radiation Oncology; Medical Univ. of Vienna (Austria). Christian Doppler Lab. for Medical Radiation Research for Radiation Oncology

    2013-05-15

    Background. The need for psychosocial support in cancer patients is estimated in the literature at 14-50%. At the Department of Radiation Oncology, Medical University of Vienna, approximately 3,000 patients are seen annually. Due to limited staff resources, highly distressed patients need to be selected for focused support. A multidisciplinary screening questionnaire covering physical, social and psychological problems and needs was successfully implemented in clinical routine. We present the results of a representative sample of 1,500 heterogeneous cancer patients before beginning radiotherapy. Patients and methods. The prevalence rates of physical, social and psychological problems and needs were evaluated. Independent risk factors for critical psychological distress were analyzed in a multivariate logistic regression model, in order to identify vulnerable subgroups for focused psychosocial support. Results. Critical psychological distress was found in 22% of the overall cohort, of whom only 26% reported a need for psychological information. Clinically relevant pain was suffered by 31%. Patients' most frequent complaints were weakness, sleeping difficulties and exhaustion. Consequently, 40% were impaired in activities and 35% reported a requirement for support in daily life. A need for further information was expressed by 37% of patients. Significant risk factors for critical psychological distress included pain, functional status, support requirements and patient-reported symptoms. Differences in tumor type, metastases and sociodemographic variables had no impact on critical psychological distress. Conclusion. Approximately one third of all patients beginning radiotherapy have physical, social and psychological problems and should receive focused psychosocial support. Multivariate analysis reveals that patients with impaired ''physical integrity'' are at a significantly higher risk of experiencing critical psychological distress. (orig.)

  14. Physical and psychosocial support requirements of 1,500 patients starting radiotherapy

    International Nuclear Information System (INIS)

    Kirchheiner, K.; Czajka, A.; Luetgendorf-Cacig, C.; Schmid, M.P.; Komarek, E.; Poetter, R.; Ponocny-Seliger, E.; Doerr, W.; Medical Univ. of Vienna

    2013-01-01

    Background. The need for psychosocial support in cancer patients is estimated in the literature at 14-50%. At the Department of Radiation Oncology, Medical University of Vienna, approximately 3,000 patients are seen annually. Due to limited staff resources, highly distressed patients need to be selected for focused support. A multidisciplinary screening questionnaire covering physical, social and psychological problems and needs was successfully implemented in clinical routine. We present the results of a representative sample of 1,500 heterogeneous cancer patients before beginning radiotherapy. Patients and methods. The prevalence rates of physical, social and psychological problems and needs were evaluated. Independent risk factors for critical psychological distress were analyzed in a multivariate logistic regression model, in order to identify vulnerable subgroups for focused psychosocial support. Results. Critical psychological distress was found in 22% of the overall cohort, of whom only 26% reported a need for psychological information. Clinically relevant pain was suffered by 31%. Patients' most frequent complaints were weakness, sleeping difficulties and exhaustion. Consequently, 40% were impaired in activities and 35% reported a requirement for support in daily life. A need for further information was expressed by 37% of patients. Significant risk factors for critical psychological distress included pain, functional status, support requirements and patient-reported symptoms. Differences in tumor type, metastases and sociodemographic variables had no impact on critical psychological distress. Conclusion. Approximately one third of all patients beginning radiotherapy have physical, social and psychological problems and should receive focused psychosocial support. Multivariate analysis reveals that patients with impaired ''physical integrity'' are at a significantly higher risk of experiencing critical psychological distress. (orig.)

  15. Support needs of patients with COPD: a systematic literature search and narrative review

    Directory of Open Access Journals (Sweden)

    Gardener AC

    2018-03-01

    Full Text Available A Carole Gardener,1 Gail Ewing,2 Isla Kuhn,3 Morag Farquhar4 1Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; 2Centre for Family Research, University of Cambridge, Cambridge, UK; 3University of Cambridge Medical School Library, University of Cambridge, Cambridge, UK; 4School of Health Sciences, University of East Anglia, Norwich, UK Introduction: Understanding the breadth of patients’ support needs is important for the delivery of person-centered care, particularly in progressive long-term conditions such as chronic obstructive pulmonary disease (COPD. Existing reviews identify important aspects of managing life with COPD with which patients may need support (support needs; however, none of these comprehensively outlines the full range of support needs that patients can experience. We therefore sought to systematically determine the full range of support needs for patients with COPD to inform development of an evidence-based tool to enable person-centered care.Methods: We conducted a systematic search and narrative review of the literature. Medline (Ovid, EMBASE, PsycINFO, Cochrane Library, and CINAHL were systematically searched for papers which included data addressing key aspects of support need, as identified by patients with COPD. Relevant data were extracted, and a narrative analysis was conducted.Results: Thirty-one papers were included in the review, and the following 13 domains (broad areas of support need were identified: 1 understanding COPD, 2 managing symptoms and medication, 3 healthy lifestyle, 4 managing feelings and worries, 5 living positively with COPD, 6 thinking about the future, 7 anxiety and depression, 8 practical support, 9 finance work and housing, 10 families and close relationships, 11 social and recreational life, 12 independence, and 13 navigating services. These 13 domains of support need were mapped to three of the four overarching categories of need

  16. Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study.

    Science.gov (United States)

    Cole, Judith A; Smith, Susan M; Hart, Nigel; Cupples, Margaret E

    2013-08-28

    Healthy lifestyles help to prevent coronary heart disease (CHD) but outcomes from secondary prevention interventions which support lifestyle change have been disappointing. This study is a novel, in-depth exploration of patient factors affecting lifestyle behaviour change within an intervention designed to improve secondary prevention for patients with CHD in primary care using personalised tailored support. We aimed to explore patients' perceptions of factors affecting lifestyle change within a trial of this intervention (the SPHERE Study), using semi-structured, one-to-one interviews, with patients in general practice. Interviews (45) were conducted in purposively selected general practices (15) which had participated in the SPHERE Study. Individuals, with CHD, were selected to include those who succeeded in improving physical activity levels and dietary fibre intake and those who did not. We explored motivations, barriers to lifestyle change and information utilised by patients. Data collection and analysis, using a thematic framework and the constant comparative method, were iterative, continuing until data saturation was achieved. We identified novel barriers to lifestyle change: such disincentives included strong negative influences of social networks, linked to cultural norms which encouraged consumption of 'delicious' but unhealthy food and discouraged engagement in physical activity. Findings illustrated how personalised support within an ongoing trusted patient-professional relationship was valued. Previously known barriers and facilitators relating to support, beliefs and information were confirmed. Intervention development in supporting lifestyle change in secondary prevention needs to more effectively address patients' difficulties in overcoming negative social influences and maintaining interest in living healthily.

  17. The moral agency of institutions: effectively using expert nurses to support patient autonomy.

    Science.gov (United States)

    Charles, Sonya

    2017-08-01

    Patient autonomy-with an emphasis on informed consent and the right to refuse treatment-is a cornerstone of modern bioethics. Within discussions about patient autonomy, feminist bioethicists have argued for a relational approach to autonomy. Under a relational framework, we must look beyond the individual moment of choice to include the role relationships and specific contexts can play in supporting or undermining autonomy. Given the day-to-day interactions they have with patients, nurses play a significant role in helping patients understand the nature of their illnesses and make truly informed decisions. However, the skills of expert nurses also support patient autonomy in more subtle ways. Specifically, nurses develop skills of attunement that help them to find subtle ways to support patient autonomy. However, in order to effectively do this, nurses need institutions that support their professional autonomy. In this paper, I look at the ways nurses have been inhibited in their professional autonomy both as a profession and as individual practitioners. I argue that turning our attention to institutions and the role they play in supporting or undermining nurses' autonomy can help promote nurses' professional autonomy and thereby enhance patient autonomy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year

    OpenAIRE

    GARGARI, M.; PRETE, V.; PUJIA, M.; CERUSO, F. M.

    2013-01-01

    Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year.

  19. The effect of computer-mediated social support in online communities on patient empowerment and doctor-patient communication.

    Science.gov (United States)

    Oh, Hyun Jung; Lee, Byoungkwan

    2012-01-01

    In the context of diabetes, this study tested a mechanism through which Korean diabetes patients' exchange of computer-mediated social support (CMSS) in diabetes online communities influences their sense of empowerment and intention to actively communicate with the doctor. Analysis of data from 464 Korean diabetes patients indicates significant relationships among diabetes patients' online community activities, perceived CMSS, sense of empowerment, and their intention to actively communicate with the doctor. Diabetes patients who have engaged more in online community activities perceived greater social support from other members of the community. Perceived CMSS significantly predicted their intention to actively communicate with the doctor through sense of empowerment. Sense of empowerment was a valid underlying mechanism that explains how patients' perceived CMSS influences their intention to actively communicate with the doctor. The implications for health communication research and practice are discussed.

  20. Social support as a predictor of perceived health status in patients with multiple sclerosis

    NARCIS (Netherlands)

    Krokavcova, Martina; van Dijk, Jitse P.; Nagyova, Iveta; Rosenberger, Jaroslav; Gavelova, Miriam; Middel, Berrie; Gdovinova, Zuzana; Groothoff, Johan W.

    2008-01-01

    Objective: The main aim of this study was to investigate whether different levels of perceived social support are associated with different levels of perceived health status in multiple sclerosis (MS) patients. Methods: Two hundred and seven MS patients (38.4 +/- 10.6 years, 66.2% female) completed

  1. The role of social support in anxiety and depression among Parkinson's disease patients

    NARCIS (Netherlands)

    Saeedian, Radka Ghorbani; Nagyova, Iveta; Krokavcova, Martina; Skorvanek, Matej; Rosenberger, Jaroslav; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.

    2014-01-01

    Purpose: To explore how social support is associated with anxiety and depression in Parkinson's disease (PD) patients controlling for gender, disease duration and disease severity. Methods: The sample consisted of 124 patients (52.4% male; mean age 68.1 +/- 8.4 years; mean disease duration 6.3 +/-

  2. Beyond stroke : Description and evaluation of an effective intervention to support family caregivers of stroke patients

    NARCIS (Netherlands)

    Schure, Lidwien M.; van den Heuvel, Elisabeth T. P.; Stewart, Roy E.; Sanderman, Robbert; de Witte, Luc P.; Meyboom-de Jong, Betty

    Objective: The objective of this study was to evaluate the strengths and weaknesses of a group support program and a home visiting program for family caregivers of stroke patients. It also examined the best fit between intervention variant and family caregiver and patient characteristics. van den

  3. Development of a Decision Support System to Predict Physicians' Rehabilitation Protocols for Patients with Knee Osteoarthritis

    Science.gov (United States)

    Hawamdeh, Ziad M.; Alshraideh, Mohammad A.; Al-Ajlouni, Jihad M.; Salah, Imad K.; Holm, Margo B.; Otom, Ali H.

    2012-01-01

    To design a medical decision support system (MDSS) that would accurately predict the rehabilitation protocols prescribed by the physicians for patients with knee osteoarthritis (OA) using only their demographic and clinical characteristics. The demographic and clinical variables for 170 patients receiving one of three treatment protocols for knee…

  4. WikiBuild: A New Application to Support Patient and Health Care Professional Involvement in the Development of Patient Support Tools

    Science.gov (United States)

    2011-01-01

    Active patient and public involvement as partners in their own health care and in the development of health services is key to achieving a health care system that is responsive to patients’ needs and values. It promotes better use of the health care system, and improves health outcomes, quality of life and patient satisfaction. By involving patients and health care professionals as partners in the creation and updating of patient health support tools, wikis—highly accessible, interactive vehicles of communication—have the potential to empower users to implement these support tools in daily life. Acknowledging the potential of wikis, and recognizing that they capitalize on the free and open access to information, scientists, opinion leaders and patient advocates have suggested that wikis could help decision-making constituencies improve the delivery of health care. They might also decrease its cost and improve access to knowledge within developing countries. However, little is known about the efficacy of wikis in helping to attain these goals. There is also a need to know more about the intention of patients and health care workers to use wikis, in what circumstances and what factors will influence their use of wikis. In this issue of the Journal of Medical Internet Research, Gupta et al describe how they developed and tested a new wiki-inspired application to improve asthma care. The researchers involved patients with asthma, primary care physicians, pulmonologists and certified asthma educators in the construction of an asthma action plan. Their paper—entitled “WikiBuild: a new online collaboration process for multistakeholder tool development and consensus building”—is the first description of a wiki-inspired technology built to involve patients and health care professionals in the development of a patient support tool. This innovative study has made important contributions toward how wikis could be generalized to involve multiple stakeholders in

  5. The ties that bind: perceived social support, stress, and IBS in severely affected patients.

    Science.gov (United States)

    Lackner, J M; Brasel, A M; Quigley, B M; Keefer, L; Krasner, S S; Powell, C; Katz, L A; Sitrin, M D

    2010-08-01

    This study assessed the association between social support and the severity of irritable bowel syndrome (IBS) symptoms in a sample of severely affected IBS patients recruited to an NIH-funded clinical trial. In addition, we examined if the effects of social support on IBS pain are mediated through the effects on stress. Subjects were 105 Rome II diagnosed IBS patients (F = 85%) who completed seven questionnaires which were collected as part of a pretreatment baseline assessment. Partial correlations were conducted to clarify the relationships between social support and clinically relevant variables with baseline levels of psychopathology, holding constant number of comorbid medical diseases, age, gender, marital status, ethnicity, and education. Analyses indicated that social support was inversely related to IBS symptom severity. Social support was positively related with less severe pain. A similar pattern of data was found for perceived stress but not quality of life impairment. Regression analyses examined if the effects of social support on pain are mediated by stress. The effects of social support on bodily pain were mediated by stress such that the greater the social support the less stress and the less pain. This effect did not hold for symptom severity, quality of life, or psychological distress. This study links the perceived adequacy of social support to the global severity of symptoms of IBS and its cardinal symptom (pain). It also suggests that the mechanism by which social support alleviates pain is through a reduction in stress levels.

  6. Nutritional support of the elderly cancer patient: the role of the nurse.

    Science.gov (United States)

    Hopkinson, Jane B

    2015-04-01

    Cancer in the geriatric population is a growing problem. Malnutrition is common in cancer. A number of factors increase the risk for malnutrition in older people with cancer, including chronic comorbid conditions and normal physiological changes of aging. Nurses have an important role in the nutritional support of older cancer patients. To contribute to the improvement of nutritional support of these patients, nurses need appropriate training to be able to identify risk for malnutrition and offer a range of interventions tailored to individual need. Factors to consider in tailoring interventions include disease status, cancer site, cancer treatment, comorbidity, physiological age, method of facilitating dietary change, and family support. This article identifies ways in which nurses can contribute to the nutritional support of older cancer patients and thus help mitigate the effects of malnutrition. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Basic vital cardiac support. Training to relatives of patients with acute miocardial infarction

    OpenAIRE

    Brandy Viera Valdés; Paula Aguila Solis; Francisco Valladares Carvajal; Marcos D. Iraola Ferrer; Pablo. A. Rodríguez

    2006-01-01

    Background: Title: Basic vital cardiac support. Training to relatives of patients with acute miocardial infarction. The cardiorespiratory reanimation is a proved procedure that can save a human life in case of a cardiorespiratory stop. For three years it is imparted in the University Hospital of Cienfuegos, a training for this procedure, to the family of patients with sharp myocardic infarction. Objective: To evaluate the knowledge acquired by the relatives of the patients during the training...

  8. Neuro-Oncology Branch patient emotional support services | Center for Cancer Research

    Science.gov (United States)

    Emotional Support Services The diagnosis of a brain tumor elicits many different and sometimes difficult emotions, not only for the patient, but also for their family members. Patients may encounter changes in cognitive functioning and language, a diminished ability to focus or make decisions, or short-term memory loss, all of which can greatly affect their personal and professional lives. We are dedicated to helping patients and their families deal with the physical and emotional facets of this disease.

  9. Zygoma Implant-Supported Prosthetic Rehabilitation of a Patient After Bilateral Maxillectomy.

    Science.gov (United States)

    Celakil, Tamer; Ayvalioglu, Demet Cagil; Sancakli, Erkan; Atalay, Belir; Doganay, Ozge; Kayhan, Kivanc Bektas

    2015-10-01

    Maxillectomy defects may vary from localized to extensive soft and hard tissue loss. In addition to physical and psychologic damages, functional and aesthetic aspects must be restored. This clinical report describes the rehabilitation of a patient with a zygoma implant-supported obturator prosthesis caused by a subtotal bilateral maxillectomy due to a squamous oral cell carcinoma. Prosthetic rehabilitation of this patient was performed after zygoma implant surgery. A maxillary obturator prosthesis supported by 2 osseointegrated zygoma implants was fabricated. Despite limited mouth opening and anatomic deficiencies, the patient's aesthetic and functional demands were fulfilled.

  10. Association between suicidal ideation and behavior, and depression, anxiety, and perceived social support in cancer patients.

    Science.gov (United States)

    Balcı Şengül, Melike Ceyhan; Kaya, Vildan; Şen, Cenk Ahmet; Kaya, Kemal

    2014-02-27

    The aim of this study was to determine the relationship between suicidal behavior and associated factors such as depression, anxiety, and perceived social support level in cancer patients. The study group included 102 patients who were under treatment in the oncology department and the control group included 100 individuals with similar sociodemographic features. A sociodemographic information form, Beck depression inventory, Beck anxiety inventory, suicidal behavior inventory, suicidal ideation inventory, and multidimensional inventory of perceived social support were used. The mean Beck depression inventory and Beck anxiety inventory scores in the study group were significantly higher compared to the control group. Thirteen patients in the study group attempted suicide, whereas 3 individuals attempted suicide in the control group. Similarly, the mean suicide behavior and ideation scores in the study group were significantly higher compared to the control group. The mean total multidimensional inventories of perceived social support score, as well as the mean family and friend sub-inventory scores in the control group were significantly higher compared to the study group. This study revealed that depression and anxiety occur frequently in cancer patients. Suicide attempts and ideation are higher in cancer patients compared to the control group. Social support perceived from family and friends is lower in cancer patients. Suicide attempts are correlated with depression, anxiety, low level of perceived social support, and advanced disease stage.

  11. Motivations for volunteers in food rescue nutrition.

    Science.gov (United States)

    Mousa, T Y; Freeland-Graves, J H

    2017-08-01

    A variety of organizations redistribute surplus food to low-income populations through food rescue nutrition. Why volunteers participate in these charitable organizations is unclear. The aim of this study is to document the participation and motivations of volunteers who are involved specifically in food rescue nutrition. A cross-sectional study was conducted in two phases. In phase 1, a new instrument, Motivations to Volunteer Scale, was developed and validated in 40 participants (aged ≥18 years). In phase 2, the new scale and a demographics questionnaire were administered to 300 participants who were volunteering in food pantries and churches. The pilot study showed that Motivations to Volunteer Scale exhibited an internal consistency of Cronbach's α of 0.73 (P  0.05). The scale was validated also by comparison to the Volunteer Function Inventory (r = 0.86, P social life, and altruism. The mean motivation score of the 300 volunteers was 9.15 ± 0.17. Greater motivations were observed among participants who were aged >45 years, women, Hispanics, college/university graduates, physically inactive, non-smokers, and had an income ≥ $48,000. The Motivations to Volunteer Scale is a valid tool to assess why individuals volunteer in food rescue nutrition. The extent of motivations of participants was relatively high, and the primary reason for volunteering was altruism. Health professionals should be encouraged to participate in food redistribution. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Effect of rescue breathing by lay rescuers for out-of-hospital cardiac arrest caused by respiratory disease: a nationwide, population-based, propensity score-matched study.

    Science.gov (United States)

    Fukuda, Tatsuma; Ohashi-Fukuda, Naoko; Kondo, Yutaka; Sera, Toshiki; Yahagi, Naoki

    2017-06-01

    The importance of respiratory care in cardiopulmonary resuscitation may vary depending on the cause of cardiac arrest. No previous study has investigated the effects of rescue breathing performed by a lay rescuer on the outcomes of patients with out-of-hospital cardiac arrest (OHCA) caused by intrinsic respiratory diseases. The aim of this study was to investigate whether rescue breathing performed by a lay rescuer is associated with outcomes after respiratory disease-related OHCA. In a nationwide, population-based, propensity score-matched study in Japan, among adult patients with OHCA caused by respiratory disease who received bystander cardiopulmonary resuscitation from January 1, 2005 to December 31, 2010, we compared patients with rescue breathing to those without rescue breathing. The primary outcome was neurologically favorable survival 1 month after OHCA. Of the eligible 14,781 patients, 4970 received rescue breathing from a lay rescuer and 9811 did not receive rescue breathing. In a propensity score-matched cohort (4897 vs. 4897 patients), the neurologically favorable survival rate was similar between patients with and without rescue breathing from a lay rescuer [0.9 vs. 0.7 %; OR 1.23 (95 % CI 0.79-1.93)]. Additionally, in subgroup analyses, rescue breathing was not associated with neurological outcome regardless of the type of rescuer [family member: adjusted OR 0.83 (95 % CI 0.39-1.70); or non-family member: adjusted OR 1.91 (95 % CI 0.79-5.35)]. Even among patients with OHCA caused by respiratory disease, rescue breathing performed by a lay rescuer was not associated with neurological outcomes, regardless of the type of lay rescuer.

  13. Withholding and withdrawing of life support from patients with severe head injury.

    Science.gov (United States)

    O'Callahan, J G; Fink, C; Pitts, L H; Luce, J M

    1995-09-01

    To characterize the withholding or withdrawing of life support from patients with severe head injury. San Francisco General Hospital, a city and county hospital with a Level I trauma center. A standardized questionnaire was used to collect data on demographics and functional outcome of severely head-injured (Glasgow Coma Score of family members. Forty-seven patients who were admitted to a medical-surgical intensive care unit over a 1-yr period. Twenty-four patients had life support withheld or withdrawn, and 23 patients did not. Physician and family separately assessed patient's probable functional outcome, degree of communication between them, reasons important in recommending or deciding on discontinuation of life support, and the result of action taken. Six months later, the families reviewed the process of their decision, how well physician(s) had communicated, and what might have improved communication. Of 24 patients with life support discontinued, 22 died; two were discharged from the hospital. Twenty-three of the 24 patients had a poor prognosis on admission. Of the 23 patients who were continued on life support for the duration of their hospitalization, ten had a poor (p Family's assessment of prognosis agreed with physician's assessment in 22 of the 24 patients from whom life support was discontinued (p families' assessments. Physicians' considerations in recommending limitation of care and families' considerations in making decisions were the same, primarily an inevitably poor prognosis. Neither physician nor families cited cost or availability of care as a deciding factor. Two families disagreed with the recommendation to limit care after initial agreement because the patients' prognosis improved from "likely death" to "vegetative." Care was therefore continued, and both patients remained vegetative 6 months after admission to the hospital and discharge to chronic care facilities. Life support is commonly withheld or withdrawn from patients with severe

  14. Drone configuration for seaside rescue missions

    OpenAIRE

    Garro Fernandez, Jose Miguel

    2017-01-01

    The project is based on creating a first aid tool to perform a coastline rescue with an unmanned. The System is formed by a ground segment, where the ground station will be placed and an air segment, where the unmanned vehicle, equipped with all the necessary extra devices to perform the mission will be found. For notices of possible drownings, the ground station will receive notifications that users will publish using a Mobile application. This app will allow users to capture images of the v...

  15. Comparison of electronic health record system functionalities to support the patient recruitment process in clinical trials.

    Science.gov (United States)

    Schreiweis, Björn; Trinczek, Benjamin; Köpcke, Felix; Leusch, Thomas; Majeed, Raphael W; Wenk, Joachim; Bergh, Björn; Ohmann, Christian; Röhrig, Rainer; Dugas, Martin; Prokosch, Hans-Ulrich

    2014-11-01

    Reusing data from electronic health records for clinical and translational research and especially for patient recruitment has been tackled in a broader manner since about a decade. Most projects found in the literature however focus on standalone systems and proprietary implementations at one particular institution often for only one singular trial and no generic evaluation of EHR systems for their applicability to support the patient recruitment process does yet exist. Thus we sought to assess whether the current generation of EHR systems in Germany provides modules/tools, which can readily be applied for IT-supported patient recruitment scenarios. We first analysed the EHR portfolio implemented at German University Hospitals and then selected 5 sites with five different EHR implementations covering all major commercial systems applied in German University Hospitals. Further, major functionalities required for patient recruitment support have been defined and the five sample EHRs and their standard tools have been compared to the major functionalities. In our analysis of the site's hospital information system environments (with four commercial EHR systems and one self-developed system) we found that - even though no dedicated module for patient recruitment has been provided - most EHR products comprise generic tools such as workflow engines, querying capabilities, report generators and direct SQL-based database access which can be applied as query modules, screening lists and notification components for patient recruitment support. A major limitation of all current EHR products however is that they provide no dedicated data structures and functionalities for implementing and maintaining a local trial registry. At the five sites with standard EHR tools the typical functionalities of the patient recruitment process could be mostly implemented. However, no EHR component is yet directly dedicated to support research requirements such as patient recruitment. We

  16. Exploring the Interplay between Rescue Drugs, Data Imputation, and Study Outcomes: Conceptual Review and Qualitative Analysis of an Acute Pain Data Set.

    Science.gov (United States)

    Singla, Neil K; Meske, Diana S; Desjardins, Paul J

    2017-12-01

    In placebo-controlled acute surgical pain studies, provisions must be made for study subjects to receive adequate analgesic therapy. As such, most protocols allow study subjects to receive a pre-specified regimen of open-label analgesic drugs (rescue drugs) as needed. The selection of an appropriate rescue regimen is a critical experimental design choice. We hypothesized that a rescue regimen that is too liberal could lead to all study arms receiving similar levels of pain relief (thereby confounding experimental results), while a regimen that is too stringent could lead to a high subject dropout rate (giving rise to a preponderance of missing data). Despite the importance of rescue regimen as a study design feature, there exist no published review articles or meta-analysis focusing on the impact of rescue therapy on experimental outcomes. Therefore, when selecting a rescue regimen, researchers must rely on clinical factors (what analgesics do patients usually receive in similar surgical scenarios) and/or anecdotal evidence. In the following article, we attempt to bridge this gap by reviewing and discussing the experimental impacts of rescue therapy on a common acute surgical pain population: first metatarsal bunionectomy. The function of this analysis is to (1) create a framework for discussion and future exploration of rescue as a methodological study design feature, (2) discuss the interplay between data imputation techniques and rescue drugs, and (3) inform the readership regarding the impact of data imputation techniques on the validity of study conclusions. Our findings indicate that liberal rescue may degrade assay sensitivity, while stringent rescue may lead to unacceptably high dropout rates.

  17. Rescuing mutant CFTR: a multi-task approach to a better outcome in treating cystic fibrosis.

    Science.gov (United States)

    Amaral, Margarida D; Farinha, Carlos M

    2013-01-01

    Correcting multiple defects of mutant CFTR with small molecule compounds has been the goal of an increasing number of recent Cystic Fibrosis (CF) drug discovery programmes. However, the mechanism of action (MoA) by which these molecules restore mutant CFTR is still poorly understood, in particular of CFTR correctors, i.e., compounds rescuing to the cells surface the most prevalent mutant in CF patients--F508del-CFTR. However, there is increasing evidence that to fully restore the multiple defects associated with F508del-CFTR, different small molecules with distinct corrective properties may be required. Towards this goal, a better insight into MoA of correctors is needed and several constraints should be addressed. The methodological approaches to achieve this include: 1) testing the combined effect of compounds with that of other (non-pharmacological) rescuing strategies (e.g., revertants or low temperature); 2) assessing effects in multiple cellular models (non-epithelial vs epithelial, non-human vs human, immortalized vs primary cultures, polarized vs non polarized, cells vs tissues); 3) assessing compound effects on isolated CFTR domains (e.g., compound binding by surface plasmon resonance, assessing effects on domain folding and aggregation); and finally 4) assessing compounds specificity in rescuing different CFTR mutants and other mutant proteins. These topics are reviewed and discussed here so as to provide a state-of-the art review on how to combine multiple ways of rescuing mutant CFTR to the ultimate benefit of CF patients.

  18. The impact of a patient support program for multiple sclerosis on patient satisfaction and subjective health status.

    Science.gov (United States)

    Kohlmann, Thomas; Wang, Cheng; Lipinski, Jens; Hadker, Nandini; Caffrey, Elizabeth; Epstein, Michael; Sadasivan, Ravi; Gondek, Kathleen

    2013-06-01

    Leading multiple sclerosis (MS) therapies have patient support programs (PSPs) aimed at improving patients' lives. There is limited knowledge about what drives patient satisfaction with PSPs and little evidence about its impact on patient-reported health status or health-related quality of life. The aims of this study were to evaluate patient needs and the PSP's role in meeting those needs; understand the drivers of PSP satisfaction and loyalty; and assess whether a MS PSP provides quantifiable, incremental benefit to patients, as measured by patient-reported health status, health state utility, and/or health-related quality of life. An Internet survey was conducted among 1,123 adult German MS patients currently enrolled in Bayer's German BETAPLUS PSP. Health status, health state utility, and health-related quality of life were measured using the EQ-5D Visual Analog Scale, the EQ-5D Index, and Short Form-12 Health Survey, respectively. MS patient needs vary by disease severity, duration of disease, and gender. Patients with greater self-reported needs and lower health status, health state utility, and health-related quality of life value and use the PSP more than other patients. Drivers of PSP satisfaction include use of patient hotline, nurse telephone calls, and mail education. Patients estimate that their health status would be 15 points lower if the PSP ceased to exist (translating to 0.15 on the time trade-off utility scale). This impact is significant, as it is nearly two times the minimally important difference. MS patients place inherent value on PSPs. From a patient's viewpoint, PSPs provide real incremental benefit in patient-reported health status at all stages of MS.

  19. Study Protocol: Nutritional Support in a Cross-sector Model for the Rehabilitation of Geriatric Patients

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Rask, Kø; Leedo, Eva

    2014-01-01

    Background: Hospital stays are generally getting shorter which leaves limited time to improve a poor nutritional status for geriatric patients. Therefore, it seems necessary to integrate nutritional support also in the period after discharge. Furthermore, improving cross-sector cooperation...... support to geriatric patients. This may ultimately lead to reduced health care costs, and improvement in mobility, independence and quality of life for geriatric patients at nutritional risk. Trial registration: Clinical Trials.gov NCT01776762....... in the transition of geriatric patients between hospital and home-care institutions is essential to ensure follow-up and completion of hospital (nutritional) treatment and rehabilitation of patients. In spite of many issues, i.e. the multi-morbidity, the reduced level of functioning and the excessive use...

  20. Exploring the breast cancer patient journey: do breast cancer survivors need menopause management support?

    Science.gov (United States)

    Tanna, Nuttan; Buijs, Helene; Pitkin, Joan

    2011-12-01

    Breast cancer survivors can be expected to suffer from menopause symptoms with estrogen deprivation due to cancer treatments, in addition to natural menopause-related estrogen loss. To gain an understanding of what support breast cancer patients have when they suffer from menopausal symptoms, and utilize findings to further inform National Health Service (NHS) care provision for breast cancer survivors. Qualitative study with focus group sessions targeting Caucasian and Asian women with breast cancer. Patient stories, with women describing their breast cancer journey and speaking about support received for any menopausal symptoms. Thematic data analysis of transcription. Breast cancer patients were not sure if they had menopausal symptoms or whether this was due to their breast cancer condition or treatment. Patients had an attitude of acceptance of menopausal symptoms and reported trying to cope with these by themselves. This research identifies a need for more information that is culturally sensitive on managing menopause symptoms, both as side-effects of breast cancer treatments as well as for affect on quality of life during the survivorship phase. Our work also gives insight into cultural remedies used for hot flushes by Asian patients, which they consider as 'cooling' foods. Breast cancer patients want to know whether side-effects of cancer treatment persist long term and how these can be managed. There is a need for improved patient support within any new NHS service models that are developed along breast cancer patient pathways, and inclusion of personalized advice for menopause symptoms.

  1. Telemedicine support to patients with chronic diseases for better long-term control at home

    Directory of Open Access Journals (Sweden)

    Drago Rudel

    2017-02-01

    Full Text Available Authors in many scientific publications suggest that the telemonitoring of health parameters is a useful tool for supporting patients with long-term conditions staying at home and their self-management of the disease. Those patients are likely to benefit from timely and adequate response to deteriorated conditions detected by the telemedicine system. Almost all of the studies state that telemedicine provided as telemonitoring can be an effective add-on tool in the hands of patients and medical experts for the self-management of patients with, for example, heart failure or diabetes. In this paper the principles of patient telemonitoring are presented as applied within a telemedicine service provided by the Centre for Telehealth (CEZAR at the General Hospital Slovenj Gradec (Slovenia. The centre supports patients with diabetes mellitus type 2 and/or with chronic congestive heart failure. The service was set-up in 2014 as part of a European project called UNITED4HEALTH. Since then over 550 patients from the Carinthia and Saleška regions (Slovenia have been receiving telemedicine support for more than two years. The clinical outcomes of the telemedicine service published elsewhere prove that the selected telemedicine service model is adequate and the implemented technological solution is acceptable for all service users: the patients and the clinicians.

  2. Palateless custom bar supported overdenture: a treatment modality to treat patient with severe gag reflex.

    Science.gov (United States)

    Singh, Kunwarjeet; Gupta, Nidhi

    2012-01-01

    To suggest a custom bar supported overdenture treatment modality for prosthodontic management of patients with severe gag reflex. Some patients have a severe gag reflex and cannot tolerate conventional maxillary complete dentures with maximum palatal coverage and extensions of all borders. The condition further gets complicated in patients suffering from respiratory problems along with severe gag reflex. Severe gagging acts as a barrier to treat such patients with accepted clinical procedures and prevent patients from wearing the prosthesis. By saving some of the remaining natural teeth and fabricating, a horse shoe shape palateless simple tooth or bar supported overdenture can be successfully used for treating such patients. The remaining maxillary right and left canines were prepared with the tapered round end diamond bur to receive copings of custom bar after intentional root canal treatment of same teeth. Impression was made with light body and putty of the polyvinyl siloxane elastomer with double step putty wash technique. Impression was poured with die stone. Wax pattern of copings with bar was fabricated with inlay wax which was invested and casted. After retrieving the bar, it was finished and its fit was evaluated. The coping-bar assembly was finally cemented with the glass ionomer cement. Palateless overdenture was fabricated by conventional technique used for the fabrication of complete denture. Palateless custom bar supported overdenture procedure can be successfully used for the management of patients with severe gag reflex with improved denture retention, stability, chewing efficiency and comfort of the patient.

  3. Impact of family support on psychiatric disorders and seizure control in patients with juvenile myoclonic epilepsy.

    Science.gov (United States)

    Jayalakshmi, Sita; Padmaja, Gaddamanugu; Vooturi, Sudhindra; Bogaraju, Anand; Surath, Mohandas

    2014-08-01

    Psychiatric disorders (PDs) are frequently observed in patients with juvenile myoclonic epilepsy (JME). In this study, we aimed to assess factors associated with PDs in patients with JME. Retrospective analysis of data of 90 consecutive patients with JME was performed. Assessment of DSM-IV Axis I clinical disorders was done using Structured Clinical Interview for Axis I. Diagnosis of PDs is made when the score exceeds the threshold provided by the DSM-IV. We also applied the Global Assessment of Functioning (GAF) scale which is part of the multiaxial evaluation of the DSM-IV (Axis-V). Using seizure frequency score at presentation, we classified subjects into controlled and uncontrolled groups. In the current cohort, 29 (32.2%) patients were diagnosed with PDs. Fewer patients with PDs had family support (48.3% vs. 83.6%; p=0.001). Lifetime prevalence of PDs was higher among patients with current PDs (96.6% vs. 18.0%; pseizure control (7.8% vs. 73.1%; pseizure control. Patients with lack of family support had poor seizure control (0% vs. 36.9%; pseizure control and higher incidence of PDs in patients with JME. Lack of family support increases neither the odds of PDs nor seizure control. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. [Proposal of a conceptual method of supportive care for co-active patients].

    Science.gov (United States)

    Abidli, Yamine; Piette, Danielle; Casini, Annalisa

    2015-01-01

    There is a broad consensus on the importance for health professionals to support co-active patients. However, in practice, very few "patient care partnership" approaches have been developed. We hypothesized that the lack of investment in supporting patient care partnerships is due to the lack of interest in the skills needed by caregivers to provide such support. This paper intends to address thisgap. The patient care partnership method is studied, adapted and developed from existing models. It complements, harmonizes and integrates various schools of thought arising from the need to place the patient at the center of care and life in general. The patient care partnership method includes 7 stages during which the professional accompanies the patient through the process of care. The methodological approach for training professionals is designed to ensure that professionals experience the change as well as its difficulties of the change they expect from the patient in the care relationship. This method now needs to be validated by the experience of other professionals in order define the limits of application and to allow further development.

  5. Application of spiral nasointestinal tube in enteral nutrition support for patients with extensive burn

    Directory of Open Access Journals (Sweden)

    Lai-Ping Wang

    2016-09-01

    Full Text Available Objective: To observe the effect of spiral nasointestinal tube on enteral nutrition support in patients with extensive burn. Methods: A total of 60 patients with extensive burn who were admitted in our hospital from January, 2014 to June, 2015 were included in the study and divided into the observation group and the control group with 30 cases in each group according to different catheter indwelling methods. The patients in the observation group were given spiral nasointestinal tube for enteral nutrition support, while the patients in the control group were given routine gastric tube for enteral nutrition support. The nutrition status and the occurrence rate of complications before catheter indwelling, 3, 6, and 10 d after catheter indwelling in the two groups were recorded. Results: The levels of ALB, HB, PA, and Scr 6, 10 d after catheter indwelling in the observation group were significantly higher than those in the control group (P<0.05. The occurrence rate of complications during the treatment period in the observation group was significantly lower than that in the control group (P<0.05. Conclusions: The spiral nasointestinal tube can provide the patients with extensive burn a better effective enteral nutrition support and improve the nutrition support, with a lower occurrence rate of complications, which is beneficial for the patients’ rehabilitation.

  6. [Perception of social support in the aspect of a cognitive style of patients with affective disorders].

    Science.gov (United States)

    Poradowska-Trzos, Magdalena; Dudek, Dominika; Rogoz, Monika; Zieba, Andrzej

    2008-01-01

    According to Aaron Beck, dysfunctional thinking patterns appear also in euthymic patients, after withdrawal of acute diseases symptoms. Patients have a disordered, negative image of themselves, of their future and the surrounding world. It has been shown that a way a man perceives possessed social support has a basic meaning for him. The purpose of the research was to analyze the relationship between perceived social support and the patient's cognitive style. The study group consisted of euthymic outpatients diagnosed with recurrent depressive disorder (UID) or bipolar affective disorder (BID). Assessment of a cognitive style was made according to the Rosenberg Scale, Hopelessness Scale HS-20 and Automatique Thoughts Questionnaire ATQ 30, assessment of the amount of received support - according to Cohen's ISEL. The presented study revealed that, in both groups of patients, a thinking style is disturbed and that there is a link between a cognitive style and the perception of the level of received support. The link was stronger in the group of patients with unipolar affective disorder. In both groups, correlations concerning emotional support were the highest.

  7. Nutrition support team management of enterally fed patients in a community hospital is cost-beneficial.

    Science.gov (United States)

    Hassell, J T; Games, A D; Shaffer, B; Harkins, L E

    1994-09-01

    To determine whether nutrition support team (NST) management of enterally fed patients is cost-beneficial and to compare primary outcomes of care between team and nonteam management. A quasi-experimental study was conducted over a 7-month period. A 400-bed community hospital. A convenience sample of 136 subjects who had received enteral nutrition support for at least 24 hours. Forty-two patients died; only their mortality data were used. Ninety-six patients completed the study. Outcomes, including cost, for enterally fed patients in two treatment groups--those managed by the nutrition support team and those managed by nonteam staff--were compared. Severity of illness level was determined for patients managed by the nutrition support team and those managed by nonteam staff. For each group, the following measures were adjusted to reflect a significant difference in average severity of illness and then compared: length of hospital stay, readmission rates, and mortality rates. Complication rates between the groups were also compared. The cost benefit was determined based on savings from the reduction in adjusted length of hospital stay. Parametric and nonparametric statistics were used to evaluate outcomes between the two groups. Differences were statistically significant for both severity of illness, which was at a higher level in the nutrition support team group (P group (P team-managed group, there was a 23% reduction in adjusted mortality rate, an 11.6% reduction in the adjusted length of hospital stay, and a 43% reduction in adjusted readmission rate. Cost-benefit analysis revealed that for every $1 invested in nutrition support team management, a benefit of $4.20 was realized. Financial and humanitarian benefits are associated with nutrition support team management of enterally fed hospitalized patients.

  8. Home noninvasive ventilatory support for patients with chronic obstructive pulmonary disease : patient selection and perspectives

    NARCIS (Netherlands)

    Storre, Jan Hendrik; Callegari, Jens; Magnet, Friederike Sophie; Schwarz, Sarah Bettina; Duiverman, Marieke Leontine; Wijkstra, Peter Jan; Windisch, Wolfram

    2018-01-01

    Long-term or home mechanical noninvasive ventilation (Home-NIV) has become a well-established form of therapy over the last few decades for chronic hypercapnic COPD patients in European countries. However, meta-analyses and clinical guidelines do not recommend Home-NIV for COPD patients on a routine

  9. Economic Evaluation of Implant-Supported Overdentures in Edentulous Patients: A Systematic Review.

    Science.gov (United States)

    Zhang, Qi; Jin, Xin; Yu, Mengliu; Ou, Guoming; Matsui, Hiroyuki; Liang, Xing; Sasaki, Keiichi

    Edentulous patients benefit significantly from implant-supported overdenture prostheses. The purpose of this systematic review was to evaluate the cost-effectiveness of implant-supported overdentures (IODs) for edentulous patients. The search was limited to studies written in English and included an electronic and manual search through MEDLINE (Ovid, 1946 to November 2015), Embase (Ovid, 1966 to November 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (to November 2015), and PubMed (to November 2015). Two investigators extracted the data and assessed the studies independently. No meta-analysis was conducted due to the high heterogeneity within the literature. Of the initial 583 selected articles, 10 studies involving 802 participants were included. Of these, 6 studies had a high risk of bias and the rest had an unclear risk of bias. Implant-supported prostheses were more cost-effective when compared to conventional dentures and fixed implant-supported prostheses. Overdentures supported by two implants and magnet attachment were reported as cost-effective. Implant-supported overdentures are a cost-effective treatment for edentulous patients. More clinical studies with appropriate scientific vigor are required to further assess the cost-effectiveness of implant-supported overdentures.

  10. Evaluation of the quality of patient information to support informed shared decision-making.

    Science.gov (United States)

    Godolphin, W; Towle, A; McKendry, R

    2001-12-01

    (a) To find out how much patient information material on display in family physicians' offices refers to management choices, and hence may be useful to support informed and shared decision-making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians. All print information available for patients and exchanged between physicians and patients was collected in a single complete day of the office practices of 21 family physicians. A published and validated instrument (DISCERN) was used to assess quality. Community office practices in the greater Vancouver area, British Columbia, Canada. The physicians were purposefully recruited by their association with the medical school Department of Family Practice, their interest in providing patients with print information and their representation of a range of practice types and location. The source of the pamphlets and these categories: available in the physicians' offices; exchanged between physician and patient; and produced with the explicit or apparent intent to support evidence-based patient choice. The quality of the print information to support ISDM, as measured by DISCERN and the ease of use and reliability of the DISCERN tool. Fewer than 50% of pamphlets available in these offices fulfilled our minimum criteria for ISDM (mentioned more than one management option). Offices varied widely in the proportion of pamphlets on display that supported ISDM and how particular the physician was in selecting materials. The DISCERN tool is quick, valid and reliable for the evaluation of patient information. The quality of patient information materials used in the consultation and available in these offices was below midpoint on the DISCERN score. Major deficiencies were with respect to the mention of choices, risks, effect of no treatment or uncertainty and reliability (source, evidence-base). Good quality

  11. Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support.

    Science.gov (United States)

    Saadatmand, Vahid; Rejeh, Nahid; Heravi-Karimooi, Majideh; Tadrisi, Sayed Davood; Vaismoradi, Mojtaba; Jordan, Sue

    2015-08-01

    Nonpharmacologic pain management in patients receiving mechanical ventilation support in critical care units is under investigated. Natural sounds may help reduce the potentially harmful effects of anxiety and pain in hospitalized patients. The aim of this study was to examine the effect of pleasant, natural sounds on self-reported pain in patients receiving mechanical ventilation support, using a pragmatic parallel-arm, randomized controlled trial. The study was conducted in a general adult intensive care unit of a high-turnover teaching hospital, in Tehran, Iran. Between October 2011 and June 2012, we recruited 60 patients receiving mechanical ventilation support to the intervention (n = 30) and control arms (n = 30) of a pragmatic parallel-group, randomized controlled trial. Participants in both arms wore headphones for 90 minutes. Those in the intervention arm heard pleasant, natural sounds, whereas those in the control arm heard nothing. Outcome measures included the self-reported visual analog scale for pain at baseline; 30, 60, and 90 minutes into the intervention; and 30 minutes post-intervention. All patients approached agreed to participate. The trial arms were similar at baseline. Pain scores in the intervention arm fell and were significantly lower than in the control arm at each time point (p natural sounds via headphones is a simple, safe, nonpharmacologic nursing intervention that may be used to allay pain for up to 120 minutes in patients receiving mechanical ventilation support. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  12. Internalized Stigma and Perceived Family Support in Acute Psychiatric In-Patient Units.

    Science.gov (United States)

    Korkmaz, Gülçin; Küçük, Leyla

    2016-02-01

    This descriptive study aims to identify the relationship between internalized stigma and perceived family support in patients hospitalized in an acute psychiatric unit. The sample is composed of 224 patients treated in an acute inpatient psychiatric ward in İstanbul, Turkey. The data were collected using information obtained from the Internalized Stigma of Mental Illness Scale and Social Support from Family Scale. The mean age of the patients was 37±11.56years, and the mean duration of treatment was 6.27±5.81years. Most patients had been hospitalized three or more times. Of the total number of patients, 66.1% had been taken to the hospital by family members. We noted a statistically significant negative correlation between the total scores obtained from the perceived Social Support from Family Scale and the Internalized Stigma of Mental Illness Scale. The patients were observed to stigmatize themselves more when the perceived social support from their family had decreased. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Do improved patient recall and the provision of memory support enhance treatment adherence?

    Science.gov (United States)

    Dong, Lu; Lee, Jason Y; Harvey, Allison G

    2017-03-01

    Patient adherence to psychosocial treatment is an important but understudied topic. The aim of this study was to examine whether better patient recall of treatment contents and therapist use of memory support (MS) were associated with better treatment adherence. Data were drawn from a pilot randomized controlled trial. Participants were 48 individuals (mean age = 44.27 years, 29 females) with Major Depressive Disorder randomized to receive either Cognitive Therapy (CT) with an adjunctive Memory Support Intervention (CT + Memory Support) or CT-as-usual. Therapist and patient ratings of treatment adherence were collected during each treatment session. Patient recall was assessed at mid-treatment. Therapist use of MS was manually coded for a random selection of sessions. Patient recall was significantly associated with better therapist and patient ratings of adherence. Therapist use of Application, a specific MS strategy, predicted higher therapist ratings of adherence. Attention Recruitment, another specific MS strategy, appeared to attenuate the positive impact of session number on patient ratings of adherence. Treatment groups, MS summary scores and other specific MS strategies were not significantly associated with adherence. The measure for treatment adherence is in the process of being formally validated. Results were based on small sample. These results support the importance of patient recall in treatment adherence. Although collectively the effects of MS on treatment adherence were not significant, the results support the use of certain specific MS strategy (i.e., application) as a potential pathway to improve treatment adherence. Larger-scale studies are needed to further examine these constructs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Loneliness, depression, and social support of patients with cancer and their caregivers.

    Science.gov (United States)

    Şahin, Zümrüt Akgün; Tan, Mehtap

    2012-04-01

    Loneliness is a significant psychosocial concern for patients with cancer, and depression may be an antecedent to loneliness. To date, no studies have directly addressed the relationship of loneliness, depression, and social support among Turkish patients with cancer and their caregivers. The emotional responses that result from a cancer diagnosis vary and may include anxiety, anger, frustration, or depression. Because of the unexpected demands and emotions thrust on them, the caregivers of patients with cancer may be just as likely to experience loneliness or depression following a cancer diagnosis. As a result, this study sought to examine that relationship among a sample of 60 patients with cancer and 60 caregivers.

  15. Modeling posttraumatic growth among cancer patients: The roles of social support, appraisals, and adaptive coping.

    Science.gov (United States)

    Cao, Weidan; Qi, Xiaona; Cai, Deborah A; Han, Xuanye

    2018-01-01

    The purpose of the study was to build a model to explain the relationships between social support, uncontrollability appraisal, adaptive coping, and posttraumatic growth (PTG) among cancer patients in China. The participants who were cancer patients in a cancer hospital in China filled out a survey. The final sample size was 201. Structural equation modeling was used to build a model explaining PTG. Structural equation modeling results indicated that higher levels of social support predicted higher levels of adaptive coping, higher levels of uncontrollability appraisal predicted lower levels of adaptive coping, and higher levels of adaptive coping predicted higher levels of PTG. Moreover, adaptive coping was a mediator between social support and growth, as well as a mediator between uncontrollability and growth. The direct effects of social support and uncontrollability on PTG were insignificant. The model demonstrated the relationships between social support, uncontrollability appraisal, adaptive coping, and PTG. It could be concluded that uncontrollability appraisal was a required but not sufficient condition for PTG. Neither social support nor uncontrollability appraisal had direct influence on PTG. However, social support and uncontrollability might indirectly influence PTG, through adaptive coping. It implies that both internal factors (eg, cognitive appraisal and coping) and external factors (eg, social support) are required in order for growth to happen. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Ways of coping with stress and perceived social support in gynecologic cancer patients.

    Science.gov (United States)

    Yilmaz, Sema Dereli; Bal, Meltem Demirgöz; Beji, Nezihe Kzlkaya; Arvas, Macit

    2015-01-01

    Stress is commonly encountered among cancer patients and may be a challenge affecting immune system resistance. Social support may contribute positively to the health of cancer patients, playing a role in coping with stress. The aim of this study was to determine whether ways of coping are related to social support given to women with gynecologic cancer. The study was performed as a cross-sectional design in a university hospital in Istanbul, Turkey, with 221 women with gynecologic cancer; the data were collected via 3 questionnaires, the first with sociodemographic and clinical features, the second with multidimensional scale of perceived social support, and the third with the scale of ways of coping with stress. Women with gynecologic cancer who were employed and declared their incomes as balanced and reported more years of education were more likely to perceive higher social support and to use the ineffective coping ways with stress at a lower rate (P perceived social support from family, friends, significant other, and total increases (P support from family members is the mainstay of coping with stress by women with gynecologic cancer. Nurses are indispensable in increasing social support required by women with gynecologic cancer. Well-trained clinical nurses via in-service programs should be experienced and aware of women diagnosed with gynecologic cancer in need of social support during hospital visits and provide necessary guidance.

  17. Gender Differences in Perceived Social Support and Stressful Life Events in Depressed Patients.

    Science.gov (United States)

    Soman, S; Bhat, S M; Latha, K S; Praharaj, S K

    2016-03-01

    To study the gender differences in perceived social support and life events in patients with depression. A total of 118 patients aged 18 to 60 years, with depressive disorder according to the DSM-IV-TR, were evaluated using the Multidimensional Scale of Perceived Social Support and Presumptive Stressful Life Events Scale. The perceived social support score was significantly higher in males than females (p friends than females (p life events as well as specific type of life events in males that became apparent after controlling for education (p life event in both males and females. Work-related problems were more commonly reported by males, whereas family and marital conflict were more frequently reported by females. Perceived social support and stressful life events were higher in males with depression than females.

  18. Initiation of nutritional support is delayed in critically ill obese patients: a multicenter cohort study.

    Science.gov (United States)

    Borel, Anne-Laure; Schwebel, Carole; Planquette, Benjamin; Vésin, Aurélien; Garrouste-Orgeas, Maité; Adrie, Christophe; Clec'h, Christophe; Azoulay, Elie; Souweine, Bertrand; Allaouchiche, Bernard; Goldgran-Toledano, Dany; Jamali, Samir; Darmon, Michael; Timsit, Jean-François

    2014-09-01

    A high catabolic rate characterizes the acute phase of critical illness. Guidelines recommend an early nutritional support, regardless of the previous nutritional status. We aimed to assess whether the nutritional status of patients, which was defined by the body mass index (BMI) at admission in an intensive care unit (ICU), affected the time of nutritional support initiation. We conducted a cohort study that reported a retrospective analysis of a multicenter ICU database (OUTCOMEREA) by using data prospectively entered from January 1997 to October 2012. Patients who needed orotracheal intubation within the first 72 h and >3 d were included. Data from 3257 ICU stays were analyzed. The delay before feeding was different according to BMI groups (P = 0.035). The delay was longer in obese patients [BMI (in kg/m²) ≥30; n = 663] than in other patients with either low weight (BMI nutritional status and a delay in nutrition initiation was independent of potential confounding factors such as age, sex, and diabetes or other chronic diseases. In comparison with normal weight, the adjusted RR (95% CI) associated with a delayed nutrition initiation was 0.92 (0.86, 0.98) for patients with low weight, 1.00 (0.94, 1.05) for overweight patients, and 1.06 (1.00, 1.12) for obese patients (P = 0.004). The initiation of nutritional support was delayed in obese ICU patients. Randomized controlled trials that address consequences of early compared with delayed beginnings of nutritional support in critically ill obese patients are needed. © 2014 American Society for Nutrition.

  19. Patient compliance and supportive periodontal therapy: Study among young adults of Namakkal district

    Directory of Open Access Journals (Sweden)

    Subramanium Gokulanathan

    2014-01-01

    Full Text Available Aims: The aim of this study is to assess the patient compliance to supportive and maintenance periodontal therapy and to determine the reason for noncompliance among young adult patients of Namakkal district, India. Materials and Methods: This was a cross-sectional study conducted on 400 patients who underwent periodontal therapy and subsequently recalled for supportive and maintenance periodontal treatment in the Department of Periodontics, Vivekanandha Dental College for Women, Namakkal. Patients age group 25-35 years and of both gender were equally selected and grouped by occupation and socioeconomic status. According to their compliance with appointments, they are categorized as complete compliance, partially compliance and insufficient or noncompliance. Noncompliance and partially compliance patients were contacted and asked to rate their experience and reason for noncompliance. Results: In this study, 80% of patients showed complete compliance and were regular for supportive periodontal therapy appointments. Women were more regular in maintaining recall appointments than men. Salaried employers showed 84.3% complete compliance, while self-employed personals showed 77% complete compliance and 75% of nonworking personals were regular to the appointment schedule. Noncompliance person has quoted lack of time and forgetting the appointment date as a major reason for missed appointments. Conclusions: This study recommends the need for improvement in communication skills of practitioners and weekend appointment for patient undergoing periodontal maintenance therapy.

  20. Nursing Support of Home Hospice Caregivers on the Day of Patient Death.

    Science.gov (United States)

    Clayton, Margaret F; Hulett, Jennifer; Kaur, Kirandeep; Reblin, Maija; Wilson, Andrew; Ellington, Lee

    2017-07-01

    To describe nurse-caregiver communication on the day of patient death.
. A descriptive secondary analysis of 44 audio-recorded home hospice nursing visits on day of death.
. Nine hospices in Utah, Oregon, and Massachusetts.
. 42 caregiver-patient dyads, 27 hospice nurses.
. Transcripts of audio recordings were coded for supportive nursing communication and relative time spent in physical, psychosocial, and spiritual discussion.
. Tangible, emotional, informational, esteem, and networking supportive communication; nurses' self-reported communication effectiveness; caregiver religious affiliation.
. Nurses reported that their communication skills were less effective when discussing difficult topics as compared to their overall communication effectiveness. Eleven patients died before the nursing visit, 3 died during the visit, and 30 died post-visit. Nurses primarily engaged in discussions facilitating caregiver emotional, tangible, and informational support. More informational support was observed when patient death occurred during the nursing visit. Time spent in general conversation showed that physical care conversations predominated (80% of the average overall amount of conversation time), compared to lifestyle/psychosocial discussions (14%) and spiritual discussions (6%). Spiritual discussions were observed in only 7 of 44 hospice visits. Spiritual discussions, although short and infrequent, were significantly longer, on average, for caregivers without a religious affiliation.
. Nurses support caregivers on the day of patient death using multiple supportive communication strategies. Spiritual discussions are minimal.
. Communication skills programs can potentially increase self-reported communication effectiveness. Emerging acute spiritual concerns, particularly for caregivers without a previous religious affiliation, should be anticipated. Spiritual support is included in the hospice model of holistic care.

  1. Electromyographic evaluation of implant-supported prostheses in hemimandibulectomy-reconstructed patients.

    Science.gov (United States)

    Dellavia, Claudia; Romeo, Eugenio; Ghisolfi, Marco; Chiapasco, Matteo; Sforza, Chiarella; Ferrario, Virgilio F

    2007-06-01

    To assess the clinical conditions, patient's satisfaction and functional outcomes in oral neoplasia patients with hemimandibulectomy, bone reconstruction and implant-supported prosthesis. Twelve patients after mandibular resection (with and without condyle), reconstruction and successful fixed implant-supported prosthesis rehabilitation were examined. Patients underwent clinical evaluation and filled in a questionnaire about their satisfaction toward oral functions. Surface electromyography (EMG) of the masticatory muscles was performed during a 15-s unilateral gum chewing test. EMG potentials were standardized as percentage of a maximum clench on cotton rolls and compared with reference data obtained from 20 healthy subjects. Excellent clinical and radiological parameters were found. Patients stated a decreased post-rehabilitation satisfaction toward mastication and phonetics, but an increased attention to oral care. Only patients with condylar resection reported augmented esthetic scores. In both the resected and the remaining sides, chewing frequency was higher in the patients than in the reference group (Wilcoxon's rank-sum test, Pchewing were more variable in the reconstructed patients than in control subjects; the difference was significant only in the non-operated side (P<0.01). Post-rehabilitation median scores of the questionnaire indicated a positive judgment of the treatment. EMG analysis showed that functional recovery in hemimandibulectomy patients was satisfactory, although some alterations were observed in the non-operated side of mastication.

  2. Randomized Trial of Interleukin-2 (IL-2) as Early Consolidation Following Marrow Ablative Therapy With Stem Cell Rescue for Metastatic Breast Cancer

    National Research Council Canada - National Science Library

    Samlowski, Wolfram

    2002-01-01

    Marrow ablative doses of chemotherapy followed by stem cell rescue (MAT/SR) produces a high frequency of objective responses in patients with metastatic breast cancer, with up to 40-50% complete responses...

  3. Randomized Trial of Interleukin-2 (IL-2) as Early Consolidation Following Marrow Ablative Therapy with Stem Cell Rescue for Metastatic Breast Cancer

    National Research Council Canada - National Science Library

    Samlowski, Wolfram

    2000-01-01

    Marrow ablative doses of chemotherapy followed by stem cell rescue (MAT/SR) produce a high frequency of objective responses in patients with metastatic breast cancer, with up to 40-50 % complete responses...

  4. Randomized Trial of Interleukin-2 (IL-2) as Early Consolidation Following Marrow Ablative Therapy with Stem Cell Rescue for Metastatic Breast Cancer

    National Research Council Canada - National Science Library

    Samlowski, Wolfram

    2001-01-01

    Marrow ablative doses of chemotherapy followed by stem cell rescue (MAT/SR) produce a high frequency of objective responses in patients with metastatic breast cancer, with up to 40-50% complete responses...

  5. Optimal support systems for patients with stomas – an opinion piece

    Directory of Open Access Journals (Sweden)

    Burch J

    2014-06-01

    Full Text Available Jennie BurchSt Marks Hospital, Surgery, London, UKAbstract: Coping with a stoma is physically and emotionally difficult. This adaptation process can be hindered by various factors, including complications associated with the stoma, such as appliance leakage, and comorbidities, such as arthritis. There are many ways of learning to live successfully with a stoma, which may be influenced by family, health care professionals, and spiritual support. There is some evidence that a good social support network can result in a positive coping mechanism for people with a newly formed stoma. Difficulty in accepting the stoma has been shown to slow down the adaptation process. This article explores the basic issues related to stomas and the general preoperative and postoperative support that is supplied by health care professionals. There was no optimal support system protocol discovered in the review of the literature. However, some of the published data related to stoma care were extrapolated to enable the reader to understand the important role that support systems can play in the acceptance of the stoma. Health care professionals provide support in a variety of ways, including the provision of telephone advice, clinics, and “open days”, to assist the patient to come to terms with their newly formed stoma. Care includes training on the practical aspects of the stoma, supporting empowerment and self-efficacy of people with a stoma (ostomates, and providing assistance when problems arise. Other support systems that are available are support groups, which may be local or national. It can be seen that the adaptation process takes many months or longer, but by utilizing various means of support, people with a stoma can have a good quality of life. The optimal support systems for patients with a stoma are discussed in relation to the literature and the personal experience of the author.Keywords: colostomy, ileostomy, urostomy

  6. Relationship between social support and the nutritional status of patients receiving radiation therapy for cancer

    International Nuclear Information System (INIS)

    Pulliam, L.W.

    1985-01-01

    The purpose of this descriptive, correlational study was to ascertain if there is a relationship between social support and the nutritional status of patients receiving radiation therapy for cancer. The data collection instruments used included the Norbeck Social Support Questionnaire (NSSQ), the Personal Characteristics Form, the abbreviated Health History, the Flow Sheet for Nutritional Data, and the Interview Schedule. For the analysis of data descriptive statistics were utilized to provide a profile of subjects, and correlational statistics were used to ascertain if there were relationships among the indicators of nutritional status and the social support variables. A convenience sample was comprised of 50 cancer patients deemed curable by radiation therapy. Findings included significant decreases in anthropometric measurements and biochemical tests during therapy. Serial assessments of nutritional status, therefore, are recommended for all cancer patients during therapy in order to plan and implement strategies for meeting the self-care requisites for food and water. No statistically significant relationships were found between the social support variables as measured by the NSSQ and the indicators of nutritional status. This suggests that nurses can assist patients by fostering support from actual and potential nutritional confidants

  7. Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: neurocritical patient.

    Science.gov (United States)

    Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

    2011-11-01

    Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calorie intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL.

  8. 30 CFR 49.17 - Physical requirements for mine rescue team.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Physical requirements for mine rescue team. 49... EDUCATION AND TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.17 Physical requirements for mine rescue team. (a) Each member of a mine rescue team shall be examined annually by a...

  9. Percutaneous cardiopulmonary support for catheter ablation of unstable ventricular arrhythmias in high-risk patients.

    Science.gov (United States)

    Carbucicchio, Corrado; Della Bella, Paolo; Fassini, Gaetano; Trevisi, Nicola; Riva, Stefania; Giraldi, Francesco; Baratto, Francesca; Marenzi, Giancarlo; Sisillo, Erminio; Bartorelli, Antonio; Alamanni, Francesco

    2009-11-01

    In patients with severe cardiomyopathy, recurrent episodes of nontolerated ventricular tachycardia (VT) or electrical storm (ES) frequently cause acute heart failure and cardiac death; the suppression of the arrhythmia is therefore lifesaving, but feasibility of catheter ablation (CA) is precluded by the adverse hemodynamic conditions together with the characteristics of the arrhythmia that interdicts efficacious mapping. The use of the percutaneous cardiopulmonary support (CPS) for circulatory assistance may allow patient's stabilization and enhance efficacy and safety of CA in this emergency setting. 19 patients (19 males; mean age 61 +/- 6 years; chronic ischemic cardiomyopathy, eleven patients; primary dilated cardiomyopathy, six patients; arrhythmogenic right ventricular dysplasia/ cardiomyopathy, two patients) with recurrent nontolerated VT episodes undergoing CPS-assisted CA were retrospectively evaluated. Twelve patients had acute hemodynamic failure refractory to inotropic agents and ventilatory assistance, seven patients had undergone a failing nonconventional CA procedure. 14 patients presented with ES, and in twelve the procedure was undertaken under emergency conditions within 24 h from admission. Patients were ventilated under general anesthesia and assisted by a multidisciplinary team. The CPS system consisted in a Medtronic Bio-Medicus centrifugal pump and in a Maxima Plus oxygenator, a 15-F arterial cannula, and a 17-F venous cannula. Flows between 2 and 3 l/min were activated after induction of 56/62 forms of nontolerated VT, achieving hemodynamic stabilization in all patients. CA was mainly guided by conventional activation mapping and was effective in abolishing 45/56 supported VTs; in 10/19 patients all clinical VTs were suppressed by CA. Mean procedural time was 4 h and 20 min. Complete stabilization was achieved in 13 patients (68%) without VT recurrence during a 7-day in-hospital monitoring. A significant clinical improvement was observed in

  10. Social reintegration of TBI patients: a solution to provide long-term support.

    Science.gov (United States)

    Bulinski, Leszek

    2010-01-01

    This article evaluates the effectiveness of a workable long-term program to provide social support for TBI patients, based on the "Academy of Life" concept. Disability after TBI causes numerous disruptions of normal life, which affect the patient, the family, and society. The patient needs the particular kind of support the program was designed to provide. The study involved 200 married couples with a TBI spouse previously enrolled in the "Academy of Life." The methods included documentation analysis, clinical interviews, the Family Bonds Scale, the Social Isolation Scale, and the Social Functions subscale from a battery used to evaluate QOL after TBI. The subjects were examined before and after completing the program. In the first examination all types of family bonds were found to be severely weakened; there was deep social isolation, loneliness, sadness, a feeling of being surrounded by hostility, and no purposeful social activity. The most common form of support from significant others was pity and unwanted interference, accompanied by lack of understanding and social ostracism. In the second examination there was selective improvement of all parameters, significantly greater in patients without PTSD symptoms. The best effects were achieved in the reduction of social dysfunctions, the growth of purposeful social activity, and improvement in the type of support received, and a reduction of selected parameters of social isolation. The program here described is selectively effective for the social reintegration of TBI-patients, especially those without PTSD symptoms.

  11. Banding together: an investigation of post-surgery support groups for laparoscopic adjustable gastric banding patients

    Directory of Open Access Journals (Sweden)

    Melissa Opolski

    2014-09-01

    Full Text Available Though advocated as useful for patients, there is little in the literature regarding the use and effectiveness of bariatric support groups. This study investigated characteristics and experiences of bariatric patients who did and did not attend offered groups. Seventy-eight postoperative laparoscopic adjustable gastric banding patients from a private bariatric clinic completed mailed self-report questionnaires. Almost 60% reported having attended the clinic groups, with most wanting to meet other patients and obtain information rather than access psychological assistance. Participants reported generally positive experiences of attending. Nonattendance was often attributed to practical barriers. Satisfaction with support from others was not related to past or predicted future attendance, but higher psychological distress was related to and predictive of greater intention to attend future groups. Likely future attenders also held more positive beliefs about the groups than those who were unlikely to attend. Further research is required into potential positive and negative consequences of attendance, and characteristics of those who are likely to benefit or be harmed by attending. Interventions addressing stereotypes about support groups may help patients make informed decisions about whether to attend a bariatric support group.

  12. Translational Research in Enteral and Parenteral Nutrition Support for Patients with Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Fa-liang LIN

    2015-12-01

    Full Text Available Abstract Objective: To explore the key points of the translational research in enteral and pareenteral nutrition support for patients with severe head injury (SHI, and to analyze the influence of different nutritional support routes on the prognosis of SHI patients. Methods: Totally 141 patients with severe craniocerebral injury were selected as study subjects, 47 cases for each group, and were given early enteral nutrition (EEN, delayed enteral nutrition (DEN, and parenteral nutrition (PN, respectively. The effect of different nutritional support routes on SHI patients was observed. Results: After 14 d of treatment, Glasgow coma scale (GCS scores of 3 groups were higher than treatment before (P<0.01, and with statistical differences among groups (P<0.05, or P<0.01. The levels of serum albumin, total serum protein and hemoglobin were higher in EEN group than the other groups (P<0.01. The level of serum albumin was lower in PN group than in DEN group (P<0.05. There were statistical differences in the incidence of complications among three groups (χ2=9.2487, P=0.0098. Conclusion: EEN support is more conductive to the improvement of the nutrition status, reduction of the incidence of complications, and promotion of the prognosis of SHI patients than DEN and PN.

  13. Hope and social support in elderly patients with cancer and their partners: an actor-partner interdependence model.

    Science.gov (United States)

    Goldzweig, Gil; Baider, Lea; Andritsch, Elisabeth; Rottenberg, Yakir

    2016-12-01

    Assess relationships between oldest-old (minimum 86 years) patients' perceived social support to their own and their spousal caregivers' hope through application of the actor-partner interdependence model (APIM). 58 dyads of patients and their spousal caregivers completed standardized self-report measures of depression, distress, hope and social support. Patients presented high distress levels. Among patients and spouses, perceived social support was positively correlated to their own level of hope (β = 0.44, p hope (β = -0.25, p hope among dyads of oldest-old patients and their spousal caregivers. Patients and caregiver seem to utilize social support to enhance hope.

  14. Osseointegrated Supported Prosthesis and Interdisciplinary Approach for Prosthodontic Rehabilitation of a Young Patient with Ectodermal Dysplasia

    Directory of Open Access Journals (Sweden)

    Karthik M. Sadashiva

    2013-01-01

    Full Text Available Anhidrotic ectodermal dysplasia is a triad of hypodontia or anodontia, hypotrichosis, and hypohydrosis, associated with other problems that result from the defective development of structures of ectodermal origin (Freire-Maia, Pinheiro (1988. Early and extensive dental treatment is needed keeping in mind the effect on the craniofacial growth. Due to rapid growth of the jaws, the patients are rehabilitated using removable prostheses (Tarjan et al. (2005. Hence for a young patient in this case report, the placement of endosseous osseointegrated implants was delayed till adulthood. Finally a definitive fixed tooth-supported and osseointegrated implant supported fixed partial denture therapy was used to rehabilitate the patient satisfactorily after she had completed her growth (Sweeney et al. (2005. A review of the current literature relevant to several aspects of syndromic hypodontia, patient selection, and implant planning is discussed.

  15. A Decision Support Tool for Appropriate Glucose-Lowering Therapy in Patients with Type 2 Diabetes

    DEFF Research Database (Denmark)

    Ampudia-Blasco, F Javier; Benhamou, Pierre Yves; Charpentier, Guillaume

    2014-01-01

    Abstract Background: Optimal glucose-lowering therapy in type 2 diabetes mellitus requires a patient-specific approach. Although a good framework, current guidelines are insufficiently detailed to address the different phenotypes and individual needs of patients seen in daily practice. We developed...... a patient-specific decision support tool based on a systematic analysis of expert opinion. Materials and Methods: Based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) 2012 position statement, a panel of 12 European experts rated the appropriateness (RAND....... The panel recommendations were embedded in an online decision support tool (DiaScope(®); Novo Nordisk Health Care AG, Zürich, Switzerland). Results: Treatment appropriateness was associated with (combinations of) the patient variables mentioned above. As second-line agents, dipeptidyl peptidase-4 inhibitors...

  16. Exercise physiology, testing, and training in patients supported by a left ventricular assist device.

    Science.gov (United States)

    Loyaga-Rendon, Renzo Y; Plaisance, Eric P; Arena, Ross; Shah, Keyur

    2015-08-01

    The left ventricular assist device (LVAD) is an accepted treatment alternative for the management of end-stage heart failure. As we move toward implantation of LVADs in less severe cases of HF, scrutiny of functional capacity and quality of life becomes more important. Patients demonstrate improvements in exercise capacity after LVAD implantation, but the effect is less than predicted. Exercise training produces multiple beneficial effects in heart failure patients, which would be expected to improve quality of life. In this review, we describe factors that are thought to participate in the persistent exercise impairment in LVAD-supported patients, summarize current knowledge about the effect of exercise training in LVAD-supported patients, and suggest areas for future research. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  17. A Standardized "Rescue" Exercise Program for Symptomatic Flare-up of Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Bartholdy, Cecilie; Klokker, Louise; Bandak, Elisabeth

    2016-01-01

    the implementation of standardized rescue exercises for patients with pain exacerbations and to assess whether performing these benefit or further worsen symptoms in patients with exacerbated symptoms of knee OA. Methods The data from 2 randomized controlled studies of exercise in patients with knee OA were used......Study Design Secondary analysis of clinical trial data. Background Knee osteoarthritis (OA) management has changed significantly over recent decades toward nonpharmacological treatments, particularly exercise. However, the optimal exercise program remains to be established. Objective To describe....... A supervised, standard exercise program that included standardized "rescue" exercises to be performed in the event of symptomatic exacerbation, defined as knee pain of greater than 5 on a 0-to-10 numeric pain-rating scale, was conducted for 12 weeks at 3 sessions per week. Pain ratings were obtained before...

  18. Implementation of telehealth support for patients with type 2 diabetes using insulin treatment: an exploratory study.

    Science.gov (United States)

    Turner, Jane; Larsen, Mark; Tarassenko, Lionel; Neil, Andrew; Farmer, Andrew

    2009-01-01

    Initiating and adjusting insulin treatment for people with type 2 diabetes (T2D) requires frequent clinician contacts both face-to-face and by telephone. We explored the use of a telehealth system to offer additional support to these patients. Twenty-three patients with uncontrolled T2D were recruited from nine general practices to assess the feasibility and acceptability of telehealth monitoring and support for insulin initiation and adjustment. The intervention included a standard algorithm for self-titration of insulin dose, a Bluetooth enabled glucose meter linked to a mobile phone, an integrated diary to record insulin dose, feedback of charted blood glucose data and telehealth nurse review with telephone follow-up. Additional contact with patients was initiated when no readings were transmitted for >3 days or when persistent hyper- or hypoglycaemia was identified. Reponses of patients and clinicians to the system were assessed informally. The mean (SD) patient age was 58 years (12) with 78% male. The mean (SD) diabetes duration was 6.4 years (4.5), HbA1c at baseline was 9.5% (2.2), and the decrease in HbA1c at three months was 0.52% (0.91) with an insulin dose increase of 9 units (26). A mean (SD) of 160 (93) blood glucose readings was transmitted per patient in these three months. Practice nurses and general practitioners (GPs) viewed the technology as having the potential to improve patient care. Most patients were able to use the equipment with training and welcomed review of their blood glucose readings by a telehealth nurse. Although the concept of telehealth monitoring is unfamiliar to most patients and practice nurses, the technology improved the support available for T2D patients commencing insulin treatment.

  19. Disease specific stress of tumor patients at the beginning of radiotherapy. Effect on psychosocial support requirement

    International Nuclear Information System (INIS)

    Sehlen, S.; Hollenhorst, H.; Schymura, B.; Firsching, M.; Duehmke, E.; Herschbach, P.

    2001-01-01

    Purpose: Radiotherapy brings a tumor patient into a special life situation in which different variables play a role of often unknown importance. The goal of this study was to investigate disease specific stress of tumor patients at the beginning of radiotherapy with established psychodiagnostic questionnaires and to evaluate the effect on psychosocial support requirement in order to reduce stress and to improve quality of life and compliance during radiotherapeutical treatment. Patients and Methods: 732 patients were screened, of whom 446 (60.9%) fulfilled the criteria for inclusion (refusals 21.0%, low Karnofsky performance status 6.6%, management problems 3.4%, language barriers 3.0%, cognitive restrictions 2.6%, death 2.5%). Disease specific aspects of stress in the questionnaire (Fragebogen zur Belastung von Krebspatienten, FBK), life situation (LS) and self-defined care requirements (BB) were self-rated by patients with different tumor types before radiotherapy. Medical and sociodemographic data were also documented. We investigated 446 patients (262 male, 184 female; median age 60.0 years) with different diagnoses. Results: Stress was observed mainly due to reduction of efficiency, anxiety and pain on the subscales. Women had a significant higher stress on subscales of pain (p=0.016) and anxiety (p=0.009), patients younger than 45 years in the subscale information (p=0.002) and patients older than 45 and younger than 60 years in the subscale anxiety (p=0.002) and the total score (p=0.003). Patients with mamma carcinoma had the highest stress. The maximum percentages of patients under high stress were found for the subscales of efficiency (43%) and anxiety (40%). The support requirement was characterized by the need of more medical information and dialogue with the doctor. We saw a significant correlation of high stress and high care requirement. Conclusions: Psychosocial support should be founded on psychosocial stress diagnostic and self-defined care

  20. Association between suicidal ideation and behavior, and depression, anxiety, and perceived social support in cancer patients

    OpenAIRE

    Şengül, Melike Ceyhan Balcı; Kaya, Vildan; Şen, Cenk Ahmet; Kaya, Kemal

    2014-01-01

    Background The aim of this study was to determine the relationship between suicidal behavior and associated factors such as depression, anxiety, and perceived social support level in cancer patients. Material/Methods The study group included 102 patients who were under treatment in the oncology department and the control group included 100 individuals with similar sociodemographic features. A sociodemographic information form, Beck depression inventory, Beck anxiety inventory, suicidal behavi...

  1. Advanced Clinical Decision Support for Transport of the Critically Ill Patient

    Science.gov (United States)

    2013-12-01

    in the sections to follow. Accomplishments according to proposed tasks: Our "team" has included all CHRCO based physician and nurse investigators...ahead of print). Winsor, G., et al., Inadequate hemodynamic management in patients undergoing interfacility transfer for suspected aortic dissection...Fields, and C.d. Forca-Tarefa, Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock. J Pediatr, 2002

  2. Social support, self-care, and quality of life in cancer patients receiving radiotherapy in Thailand

    International Nuclear Information System (INIS)

    Hanucharurnkul, S.

    1988-01-01

    The purpose of the study was two-fold: (1) to examine the relationships among self-care, social support, and quality of life in adult cancer patients receiving radiotherapy while the selected basic conditioning factors of age, marital and socio-economic status, living arrangement, stage and site of cancer were statistically controlled; and (2) to test a theoretical model which postulated that (a) quality of life was predicted jointly by the selected basic conditioning factors, social support and self-care, and (b) self-care was predicted jointly by the selected basic conditioning factors and social support. A convenience sample of 112 adult cervical and head/neck cancer patients receiving radiotherapy was obtained from radiotherapy outpatient clinic in three hospitals located in Bangkok, Thailand. Results of the study indicated positive relationships among self-care, social support, and quality of life. Socio-economic status, site of cancer, and self-care were significant predictors for reported quality of life. Social support appeared to be a significant predictor of quality of life indirectly through self-care. Socio-economic status and social support were also significant predictors of self-care, whereas, stage and site of cancer seemed to predict self-care indirectly through social support

  3. Breast cancer patients receiving postoperative radiotherapy: Distress, depressive symptoms and unmet needs of psychosocial support

    International Nuclear Information System (INIS)

    Luutonen, Sinikka; Vahlberg, Tero; Eloranta, Sini; Hyvaeri, Heidi; Salminen, Eeva

    2011-01-01

    Background and purpose: The diagnosis and treatment of breast cancer can cause considerable psychological consequences, which may remain unrecognized and untreated. In this study, the prevalence of depressive symptoms and distress, and unmet needs for psychosocial support were assessed among breast cancer patients receiving postoperative radiotherapy. Material and methods: Out of 389 consecutive patients, 276 responded and comprised the final study group. Depressive symptoms were assessed with the Beck Depression Inventory. Distress was measured with the Distress Thermometer. Hospital records of the patients were examined for additional information. Results: Nearly one third of patients (32.1%) displayed depressive symptoms, and more than a quarter of patients (28.4%) experienced distress. Younger age (p = 0.001) and negative hormone receptor status (p = 0.008) were independent factors associated with distress. One quarter of the patients expressed an unmet need for psychosocial support, which was independently associated with depressive symptoms and/or distress (p = 0.001) and younger age (p = 0.006). Conclusions: During radiotherapy for breast cancer, the staff should have awareness of the higher risk of depression and distress in their patients and should consider screening tools to recognise distress and depressive symptoms. Special attention should be paid to younger patients.

  4. The Airtraq as a rescue airway device following failed direct laryngoscopy: a case series.

    LENUS (Irish Health Repository)

    Maharaj, C H

    2007-06-01

    We report the successful use of the Airtraq as a rescue device following failed direct laryngoscopy, in patients deemed at increased risk for difficult tracheal intubation. In a series of seven patients, repeated attempts at direct laryngoscopy with the Macintosh blade, and the use of manoeuvres to aid intubation, such as the gum elastic bougie placement, were unsuccessful. In contrast, with the Airtraq device, each patient\\'s trachea was successfully intubated on the first attempt. This report underlines the utility of the Airtraq device in these patients.

  5. Supporting the Sexual Intimacy Needs of Patients in a Longer Stay Inpatient Forensic Setting.

    Science.gov (United States)

    Quinn, Chris; Happell, Brenda

    2016-10-01

    To explore perceptions of nurses and patients regarding sexual intimacy in a long-term mental health unit. Qualitative exploratory design including in-depth semi-structured individual interviews with 12 registered nurses and 10 long-term patients of a forensic mental health hospital. The theme of supporting sexual intimacy was identified and described in this paper and included the following subthemes for nurses: It depends on the setting, need for guidelines and consent, and for patients-it depends on the setting; and need for support. The findings suggest that current guidelines regarding sexual intimacy in acute inpatient settings may not be appropriate in long-term facilities, with a need for guidelines to specifically address this setting. Furthermore, support for sexual intimacy needs of patients was identified as a strong need for patients and they believed not currently met. Nurses have an important role to play as part of their holistic approach to care and barriers to providing this aspect of care must be overcome to ensure patients' rights are respected. © 2015 Wiley Periodicals, Inc.

  6. Role of resilience and social support in alleviating depression in patients receiving maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    Liu YM

    2018-03-01

    Full Text Available Yueh-Min Liu,1 Hong-Jer Chang,2 Ru-Hwa Wang,3 Li-King Yang,4 Kuo-Cheng Lu,4 Yi-Chou Hou4 1Department of Nursing, Ching Kuo Institute of Management and Health, Taiwan; 2Graduate Institute of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan; 3Department of Nursing, Fu-Jen Catholic University, New Taipei City, Taiwan; 4Division of Nephrology, Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan Background: Patients who undergo hemodialysis encounter challenges including role changes, physical degeneration, and difficulty in performing activities of daily living (ADLs and self-care. These challenges deteriorate their physiological and psychosocial conditions, resulting in depression. High resilience (RES and social support can alleviate stress and depression. This study evaluated the importance of RES and social support in managing depression in elderly patients undergoing maintenance hemodialysis (HD. Patients and methods: In this descriptive, correlational study, 194 older patients undergoing HD were enrolled from the HD centers of three hospitals in northern Taiwan. The Barthel ADL Index, RES scale, Inventory of Socially Supportive Behavior, and Beck Depression Inventory-II were used. Hierarchical regression analysis was applied to evaluate the interaction of RES and social support with illness severity, demographics, and ADLs. Results: Of the total participants, 45.9% experienced depressive symptoms. Demographic analysis showed that men and those with high educational level and income and financial independence had less depression (p<0.01. Patients with a higher Barthel Index (n=103, RES scale (n=33, and social support (n=113 showed less depressive symptoms (p<0.01. We found a significant negative correlation between depressive symptoms and social support (r=-0.506, p<0.01 and RES (r=-0.743, p<0.01. Hierarchical regression analysis showed

  7. Association of Social Support and Family Environment with Cognitive Function in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Wang, Qin; Yang, Zhi-Kai; Sun, Xiu-Mei; Du, Yun; Song, Yi-Fan; Ren, Ye-Ping; Dong, Jie

    ♦ BACKGROUND: Cognitive impairment (CI) is a common phenomenon and predictive of high mortality in peritoneal dialysis (PD) patients. This study aimed to analyze the association of social support and family environment with cognitive function in PD patients. ♦ METHODS: This is a cross-sectional study of PD patients from Peking University First Hospital and the Second Affiliated Hospital of Harbin Medical University. Global cognitive function was measured using the Modified Mini-Mental State Examination (3MS), executive function was measured by the A and B trail-making tests, and other cognitive functions were measured by the Repeatable Battery for the Assessment of Neuropsychological Status. Social support was measured with the Social Support Scale developed by Xiaoshuiyuan and family environment was measured with the Chinese Version of the Family Environment Scale (FES-CV). ♦ RESULTS: The prevalence of CI and executive dysfunction among the 173 patients in the study was, respectively, 16.8% and 26.3%. Logistic regression found that higher global social support (odds ratio [OR] = 1.09, 1.01 - 1.17, p = 0.027) and subjective social support predicted higher prevalence of CI (OR = 1.13, 1.02 - 1.25, p = 0.022), adjusting for covariates. Analyses of the FES-CV dimensions found that greater independence was significantly associated with better immediate memory and delayed memory. Moreover, higher scores on achievement orientation were significantly associated with poorer language skills. ♦ CONCLUSIONS: Our findings indicate that social support is negatively associated with the cognitive function of PD patients and that some dimensions of the family environment are significantly associated with several domains of cognitive function. Copyright © 2017 International Society for Peritoneal Dialysis.

  8. Peer counselors' role in supporting patients' adherence to ART in Ethiopia and Uganda.

    Science.gov (United States)

    Gusdal, Annelie K; Obua, Celestino; Andualem, Tenaw; Wahlstrom, Rolf; Chalker, John; Fochsen, Grethe

    2011-06-01

    Our aim was to explore peer counselors' work and their role in supporting patients' adherence to antiretroviral treatment (ART) in resource-limited settings in Ethiopia and Uganda. Qualitative semi-structured interviews were conducted with 79 patients, 17 peer counselors, and 22 providers in ART facilities in urban and rural areas of Ethiopia and Uganda. Two main categories with related subcategories emerged from the analysis. The first main category, peer counselors as facilitators of adherence, describes how peer counselors played an important role by acting as role models, raising awareness, and being visible in the community. They were also recognized for being close to the patients while acting as a bridge to the health system. They provided patients with an opportunity to individually talk to someone who was also living with HIV, who had a positive and life-affirming attitude about their situation, and were willing to share personal stories of hope when educating and counseling their patients. The second main category, benefits and challenges of peer counseling, deals with how peer counselors found reward in helping others while at the same time acknowledging their limitations and need of support and remuneration. Their role and function were not clearly defined within the health system and they received negligible financial and organizational support. While peer counseling is acknowledged as an essential vehicle for treatment success in ART support in sub-Saharan Africa, a formal recognition and regulation of their role should be defined. The issue of strategies for disclosure to support adherence, while avoiding or reducing stigma, also requires specific attention. We argue that the development and implementation of support to peer counselors are crucial in existing and future ART programs, but more research is needed to further explore factors that are important to sustain and strengthen the work of peer counselors.

  9. Study of the Psychological Profile in Diabetic Patient and its Relationship with their Social Support

    Directory of Open Access Journals (Sweden)

    Akbar Atadokht

    2013-06-01

    Full Text Available Background & objectives: Diabetes mellitus is a common metabolic disorder that has negative effect on physical function, psychological condition, interpersonal, family and social relationship and in general, on psychological well being. The aim of this study was to investigate of psychological profile in diabetic patients and it's relatioship with social support.   Methods: In this descriptive-correlational study, 120 diabetic patients have been selected among of those that systematically refered to Diabetes Clinic of Emam Khomeini Hospital in order to follow their therapeutic process in Ardabil . Data gathering was accomplished by two tests: SCL-90-R and Social Support Scale. Finally data were analyzed by Pearson correlation coefficient and T-test on SPSS-17 software and p-value less than 0.05 considered as significant.   Results: Results showed that 70% of diabetic patients had problems in somatic complaint and obsession, 62.5% in sensitivity, 72.5% in depression, 62.5% in anxiety, 55% in hostility, 67.5% in paranoid thoughts, 27.5% in phobia and 37.5% in psychosis. Correlations between social support with somatic complaint, obsession, sensitivity, depression, anxiety, hostility and paranoid thoughts were negatively significant. Family support associated significantly with all of the psychological variables but friend Support had no significant correlation with them.   Conclusion: The range of psychological problems experienced by diabetic patients is more extensive and these problems have significant relationship with social support. Thus, attention to different dimensions of psychological health is necessary and social support-based interventions can be more effective.

  10. Self-reported differences in empowerment between lurkers and posters in online patient support groups.

    Science.gov (United States)

    van Uden-Kraan, Cornelia F; Drossaert, Constance H C; Taal, Erik; Seydel, Erwin R; van de Laar, Mart A F J

    2008-06-30

    Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants' feelings of "being empowered." However, most studies of online patient support groups have focused on the members of these groups who actively contribute by sending postings (posters). Thus far, little is known about the impact for "lurkers" (ie, those who do not actively participate by sending postings). In the present study, we explored if lurkers in online patient support groups profit to the same extent as posters do. We searched the Internet with the search engine Google to identify all Dutch online support groups for patients with breast cancer, fibromyalgia, and arthritis. Invitations to complete an online survey were sent out by the owners of 19 groups. In the online questionnaire, we asked questions about demographic and health characteristics, use of and satisfaction with the online support group, empowering processes, and empowering outcomes. The online questionnaire was completed by 528 individuals, of which 109 (21%) identified themselves as lurkers. Lurkers (mean age 47 years) were slightly older than active participants (mean age 43 years, P = .002), had a shorter disease history (time since diagnosis 3.7 years vs 5.4 years, P = .001), and reported lower mental well-being (SF 12 subscore 37.7 vs 40.5, P = .004). No significant differences were found in other demographic variables. Posters indicated visiting the online support groups significantly more often for social reasons, such as curiosity about how other members were doing, to enjoy themselves, as a part of their daily routine (all P posters did not differ in their information-related reasons for visiting the online support group. Lurkers were significantly less satisfied with the online support group compared to posters (P posters. However, lurkers did not differ significantly from posters with regard to

  11. Embryo rescue of crosses between diploid and tetraploid grape ...

    African Journals Online (AJOL)

    ajl yemi

    2011-12-19

    Dec 19, 2011 ... embryo rescue from interspecific hybridization between diploid and tetraploid grape species. Wakana et al. (2003) and Motosugi et al. (2003) studied the formation and developments of hybrid seeds from cross between diploid and tetraploid, and then obtained triploid progenies through embryo rescue.

  12. 29 CFR 553.215 - Ambulance and rescue service employees.

    Science.gov (United States)

    2010-07-01

    ... activities, the applicable standard is the one which applies to the activity in which the employee spends the majority of work time during the work period. (b) Ambulance and rescue service employees of public agencies... 29 Labor 3 2010-07-01 2010-07-01 false Ambulance and rescue service employees. 553.215 Section 553...

  13. Emotional Reactions of Rescue Workers Following a Tornado.

    Science.gov (United States)

    McCammon, Susan L.; And Others

    Rescue and medical workers may be at risk for negative emotional experience following intervention efforts in disaster situations. To examine this possibility, 120 rescue and hospital personnel responded to a survey of their emotional reactions and coping behaviors 3 months after a devastating tornado. Twenty-eight subjects had been involved in…

  14. Review and expectations of terror attack emergency rescue

    Directory of Open Access Journals (Sweden)

    De-wen WANG

    2012-03-01

    Full Text Available Ten years of anti-terror struggle since the 9/11 event has indicated adequately that terrorism is a global problem and international danger. Likewise, anti-terror emergency rescue is also an important task which will influence the safety and benefit of every country all over the world. This paper reviews the main progress and result of international anti-terror struggle in the last ten years, and also introduces the new characteristic of the international anti-terror activity. Besides that, this paper also brings forward the further consideration about the anti-terror emergency medical rescue and the researches remaining to be carried out. The latter includes: (1 to further perfect the high-efficient medical rescue command organization; (2 to further perfect the emergency medical rescue prearranged scheme; (3 to further perfect the construction of rescue system and rescue base after various types of terror attack; (4 to further promote the anti-terror consciousness in the public, and pay more attention to the prevention and investigation of the psychological disaster; (5 to further carry out the basic investigation on emergency medical rescue after various terror attack injuries (for example the types and characteristics of new injuries, pathophysiology and prevention and treatment of stress-psychological effect induced by terror attack, new high-efficient medical rescue measure and equipments, and so on.

  15. 78 FR 79010 - Criteria to Certify Coal Mine Rescue Teams

    Science.gov (United States)

    2013-12-27

    ... coal requires more heat to combust; (3) anthracite dust does not propagate an explosion; and (4) there... to Certify Coal Mine Rescue Teams AGENCY: Mine Safety and Health Administration, Labor. ACTION... updated the coal mine rescue team certification criteria. The Mine Improvement and New Emergency Response...

  16. Medical rescue for nuclear or radiologic emergencies

    International Nuclear Information System (INIS)

    Chen Xiaohua; Nie Suifeng

    2011-01-01

    Nuclear or radiologic emergencies are defined as incidents that are caused by radioactive substance or by other sources of radiation and can pose a serious hazard to public health. In case of nuclear or radiologic emergencies, radioactive rays will damage the human body and bring about psychological and mental stress, resulting in a series of social psychological effects. The key to medical rescue for nuclear or radiologic emergencies is to take effective measures which can minimize the body harm resulting from nuclear or radiologic emergencies and maintain social stability. This article reviews the personnel protection, on-the-spot salvage, treatments of various harm, and prevention of public psychological effect following nuclear or radiologic emergencies. (authors)

  17. Rescue from replication stress during mitosis.

    Science.gov (United States)

    Fragkos, Michalis; Naim, Valeria

    2017-04-03

    Genomic instability is a hallmark of cancer and a common feature of human disorders, characterized by growth defects, neurodegeneration, cancer predisposition, and aging. Recent evidence has shown that DNA replication stress is a major driver of genomic instability and tumorigenesis. Cells can undergo mitosis with under-replicated DNA or unresolved DNA structures, and specific pathways are dedicated to resolving these structures during mitosis, suggesting that mitotic rescue from replication stress (MRRS) is a key process influencing genome stability and cellular homeostasis. Deregulation of MRRS following oncogene activation or loss-of-function of caretaker genes may be the cause of chromosomal aberrations that promote cancer initiation and progression. In this review, we discuss the causes and consequences of replication stress, focusing on its persistence in mitosis as well as the mechanisms and factors involved in its resolution, and the potential impact of incomplete replication or aberrant MRRS on tumorigenesis, aging and disease.

  18. Teleautonomous Control on Rescue Robot Prototype

    Directory of Open Access Journals (Sweden)

    Son Kuswadi

    2012-12-01

    Full Text Available Robot application in disaster area can help responder team to save victims. In order to finish task, robot must have flexible movement mechanism so it can pass through uncluttered area. Passive linkage can be used on robot chassis so it can give robot flexibility. On physical experiments, robot is succeeded to move through gravels and 5 cm obstacle. Rescue robot also has specialized control needs. Robot must able to be controlled remotely. It also must have ability to move autonomously. Teleautonomous control method is combination between those methods. It can be concluded from experiments that on teleoperation mode, operator must get used to see environment through robot’s camera. While on autonomous mode, robot is succeeded to avoid obstacle and search target based on sensor reading and controller program. On teleautonomous mode, robot can change control mode by using bluetooth communication for data transfer, so robot control will be more flexible.

  19. FACTORS AFFECTING QUALITY OF LIFE AND LEVEL OF SOCIAL SUPPORT IN CANCER PATIENTS

    Directory of Open Access Journals (Sweden)

    Ayse Berivan Bakan

    2017-04-01

    Full Text Available Background: When people face health problems, their life satisfaction levels and social relations could be ruined. When it comes to an eerie, deadly and chronic disease like cancer, the individual is much more likely to be affected by it. Objective: This descriptive study aims to identify quality of life and level of social support and the affecting factors in cancer patients. Methods: The sample included 170 patients who applied to Internal Diseases, Radiation Oncology, Thorax diseases clinics and Chemotherapy polyclinic in a university hospital in Turkey between March and August, 2005, who met the research criteria, and who volunteered to participate in the study. The sample represented 20 % of the target population. Data were collected through SF-36 Quality of Life Scale and Multidimensional Scale of Perceived Social Support. Results: The patients’ Global Quality of Life mean score was found 38.67 ± 13.64, and mean score for the Perceived Social Support was found 59.19 ± 17.5. Global Quality of Life score was higher in those who underwent an operation and who received ambulatory health care. Although Global Quality of Life was not influenced by the gender variable, male patients’ level of well-being was found to be higher. Perceived Social Support total score was found to be higher in those who knew about their disease. Family support was found to be higher in those who were married and who lived in town; it was found to be low in those who had low socio-economic level and who received inpatient treatment. Friend support was found to be high in those who knew about their disease. Conclusion: There was a linear relationship between Perceived Social Support and Quality of Life. It is recommended that more studies with wider groups of participants would shed more light to the issue of identifying quality of life, social support level and the relationships between them in cancer patients.

  20. Quality of life and social support in patients with multiple sclerosis.

    Science.gov (United States)

    Rosiak, Katarzyna; Zagożdżon, Paweł

    2017-10-29

    Quality of life and needforsocial support in persons diagnosed with multiple sclerosis (MS) are to a large extent determined by the degree of their disability. The aim of the study was to analyze an association between specific forms of MS, subjectively perceived quality of life and social support. The study included subjects with established diagnosis of MS, treated at rehabilitation centers, hospitals and in a home setting, as well as the members of patient organizations. After being informed about objectives of the study, type of included tasks and way to complete them, each participant was handed out a set of questionnaires: Berlin Social Support Scales (Łuszczyńska, Kowalska, Schwarzer, Schulz), Quality of Life Questionnaire (WHOQOLBREF), as well as a survey developed specifically for the purposes of this project. The results were subjected to statistical analysis with STATA 12 package. The study included a total of 110 persons (67 women and 43 men). Quality of life overall, as well in physical, psychological, social relationships and environmental health domains, turned out to be particularly important in patients with primary-progressive MS. Irrespective of MS type, social support overall did not play a significant role on univariate analysis. However, subgroup analysis according to sex demonstrated that men with MS received social support four times less often than women. Quality of life in individuals with primary-progressive MS is significantly lower than in patients presenting with other types of this disease. Men with MS are more likely to present with worse scores for social support overall. They are less likely both to acknowledge the need for support and to realize the availability of support they actually need.

  1. The relationship between type D personality and perceived social support in myocardial infarction patients

    Directory of Open Access Journals (Sweden)

    Reza Bagherian Sararoudi

    2011-01-01

    Full Text Available Background: Type D personality is based on two global and stable personality traits, including negative affectivity (NA and social inhibition (SI. The aim of this study was to examine the relationship between type D personality and perceived social support in post myocardial infarction (MI patients. Methods: One hundred seventy six consecutive patients following MI admitted to the cardiac care unit (CCU of nine hospitals in Isfahan, Iran from April to September 2006 were selected based on the inclusive and exclusive criteria. The patients completed the Persian version of type D personality scale and the Persian version of multidimensional scale of perceived social support (MSPSS. Also, demographic and medical questionnaire was completed for each patient. Chi-squared test, t-test and MANOVA were used to analyze the data. Results: The findings indicated that 35.8% patients (35.8 % were classified as type D. The results of MANOVA showed that type D patients were significantly different from non-type D patients (F = 8.72, p = 0.0001 on MSPSS scores and on all dimensions including family subscale (F = 11.52, p = 0.001, friends subscale (F= 16.16, p = 0.0001 and significant others subscale (F = 5.04, p = 0.026. Conclusions: Type D personality substantially affects the way MI patients perceive availability of social support from different sources including family, friends, and significant others. One implication of this finding may be to develop tailor-made interventions for MI patients with type D.

  2. Supporting cancer patients in illness management: usability evaluation of a mobile app.

    Science.gov (United States)

    Mirkovic, Jelena; Kaufman, David R; Ruland, Cornelia M

    2014-08-13

    Mobile phones and tablets currently represent a significant presence in people's everyday lives. They enable access to different information and services independent of current place and time. Such widespread connectivity offers significant potential in different app areas including health care. Our goal was to evaluate the usability of the Connect Mobile app. The mobile app enables mobile access to the Connect system, an online system that supports cancer patients in managing health-related issues. Along with symptom management, the system promotes better patient-provider communication, collaboration, and shared decision making. The Connect Mobile app enables access to the Connect system over both mobile phones and tablets. The study consisted of usability tests of a high fidelity prototype with 7 cancer patients where the objectives were to identify existing design and functionality issues and to provide patients with a real look-and-feel of the mobile system. In addition, we conducted semistructured interviews to obtain participants' feedback about app usefulness, identify the need for new system features and design requirements, and measure the acceptance of the mobile app and its features within everyday health management. The study revealed a total of 27 design issues (13 for mobile apps and 14 for tablet apps), which were mapped to source events (ie, errors, requests for help, participants' concurrent feedback, and moderator observation). We also applied usability heuristics to identify violations of usability principles. The majority of violations were related to enabling ease of input, screen readability, and glanceability (15 issues), as well as supporting an appropriate match between systems and the real world (7 issues) and consistent mapping of system functions and interactions (4 issues). Feedback from participants also showed the cancer patients' requirements for support systems and how these needs are influenced by different context-related factors

  3. Stakeholder engagement in diabetes self-management: patient preference for peer support and other insights.

    Science.gov (United States)

    Kwan, Bethany M; Jortberg, Bonnie; Warman, Meredith K; Kane, Ilima; Wearner, Robyn; Koren, Romona; Carrigan, Thomas; Martinez, Vincent; Nease, Donald E

    2017-06-01

    Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices. To use the Boot Camp Translation (BCT) method to engage patient, practice, community resource and research stakeholders in translation of evidence about SMS and diabetes distress into mutually acceptable care models and to inform patient-centred outcomes research (PCOR). Twenty-seven diabetes care stakeholders, including patients and providers from a local network of federally qualified health centres participated. Stakeholders met in-person and by conference call over the course of 8 months. Subject matter experts provided education on the diabetes SMS evidence. Facilitators engaged the group in discussions about barriers to self-management and opportunities for improving delivery of SMS. BCT participants identified lack of social support, personal resources, trust, knowledge and confidence as barriers to diabetes self-management. Intervention opportunities emphasized peer support, use of multidisciplinary care teams and centralized systems for sharing information about community and practice resources. BCT informed new services and a PCOR study proposal. Patients and family engaged in diabetes care research value peer support, group visits, and multidisciplinary care teams as key features of SMS models. SMS should be tailored to an individual patient's health literacy. BCT can be used to engage multiple stakeholders in translation of evidence into practice and to inform PCOR. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Posture manipulation for rescue activity via small traction robots

    International Nuclear Information System (INIS)

    Iwano, Yuki; Osuka, Koichi; Amano, Hisanori

    2006-01-01

    We discuss a conceptual design of rescue robots against nuclear-power plant accidents. We claim that the rescue robots in nuclear-power plants should have the following properties. (1) The size is small. (2) The structure is simple. (3) The number of the robots is large. This paper studies the rescue robots to rescue people in an area polluted with radioactive leakage in nuclear power institutions. In particular, we propose a rescue system which consists of a group of small mobile robots. First, small traction robots set the posture of the fainted victims to carry easily, and carry them to the safety space with the mobile robots for the stretcher composition. In this paper, we describe the produced small traction robots. And, we confirm that the robots can manipulate a 40 kg dummy doll's posture. We also examine the optimal number of robots from a perspective of working efficiency in the assumption spot. (author)

  5. There's an App for That!: New Directions Using Social Media in Patient Education and Support.

    Science.gov (United States)

    Wellde, Paula T; Miller, Lisa A

    2016-01-01

    Social media has opened the door of information to patients and fundamentally changed communication in ways never imagined 30 years ago. Apps and Web sites from professional organizations as well as private individuals and commercial businesses abound. Opportunities for both research and unique forms of social and emotional support are part of the trend. While there are obvious advantages to having so much information available, social media has disadvantages as well. Today's clinicians need to understand how to access and evaluate social media for patient education and provide guidance for patients seeking health information from the cloud.

  6. Heart Transplant and Mechanical Circulatory Support in Patients With Advanced Heart Failure.

    Science.gov (United States)

    Sánchez-Enrique, Cristina; Jorde, Ulrich P; González-Costello, José

    2017-05-01

    Patients with advanced heart failure have a poor prognosis and heart transplant is still the best treatment option. However, the scarcity of donors, long waiting times, and an increasing number of unstable patients have favored the development of mechanical circulatory support. This review summarizes the indications for heart transplant, candidate evaluation, current immunosuppression strategies, the evaluation and treatment of rejection, infectious prophylaxis, and short and long-term outcomes. Regarding mechanical circulatory support, we distinguish between short- and long-term support and the distinct strategies that can be used: bridge to decision, recovery, candidacy, transplant, and destination therapy. We then discuss indications, risk assessment, management of complications, especially with long-term support, and outcomes. Finally, we discuss future challenges and how the widespread use of long-term support for patients with advanced heart failure will only be viable if their complications and costs are reduced. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Rescue, rehabilitation, and release of marine mammals: An analysis of current views and practices.

    OpenAIRE

    St. Aubin, David J.; Geraci, Joseph R.; Lounsbury, Valerie J.

    1996-01-01

    Stranded marine mammals have long attracted public attention. Those that wash up dead are, for all their value to science, seldom seen by the public as more than curiosities. Animals that are sick, injured, orphaned or abandoned ignite a different response. Generally, public sentiment supports any effort to rescue, treat and return them to sea. Institutions displaying marine mammals showed an early interest in live-stranded animals as a source of specimens -- in 1948, Marine Studios in...

  8. Impact of emotional support on serum cortisol in breast cancer patients

    Directory of Open Access Journals (Sweden)

    Sampoornam Webster

    2016-01-01

    Methods: The study was designed to compare the effectiveness of emotional support focused nurse directed intervention in terms of verbal, written and telephone basis on serum cortisol among breast cancer patients in Cancer Centre at Erode. Participants were randomly allocated by using Sequentially Numbered Opaque Sealed Envelope (SNOSE method. 2 ml of blood samples were collected from 30 breast cancer patients who were selected randomly by adopting random number table, 10 in each experimental arm during evening at 18 hour; radioimmunoassay method was used to measure the level of serum cortisol before and after intervention. The intervention was given twice in a week for the duration of 30-45 minutes, in which early 20-30 minutes spares to express thoughts and feelings of the participants and subsequent 10-15 minutes for rendering informational support and later follow up session for the period of 1 month. Results: Emotional support was effective in reducing serum cortisol level among breast cancer patients. There was no statistically significant difference between arms on serum cortisol levels. Conclusions: Marginal differences were noted between posttest mean scores of serum cortisol among verbal, written and telephone arms. Further emotional support can be rendered according to the preference of the breast cancer patients.

  9. Treatment Outcome and Patient Satisfaction with Two Adjacent Implant-Supported Restorations in the Esthetic Zone

    NARCIS (Netherlands)

    Tymstra, Nynke; Meijer, Henny J. A.; Stellingsma, Kees; Raghoebar, Gerry M.; Vissink, Arjan

    2010-01-01

    The purpose of this study was to evaluate the clinical and radiographic parameters as well as the esthetic outcome of two adjacent implant-supported restorations and the surrounding peri-implant mucosa in the maxillary esthetic zone. Ten patients were treated with two adjacent implants in the

  10. An online self-care education program to support patients after total laryngectomy : feasibility and satisfaction

    NARCIS (Netherlands)

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I; Lacko, Martin; Hardillo, José A; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Verdonck-de Leeuw, Irma M

    PURPOSE: The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. METHODS: Health care professionals (HCPs) were invited to participate

  11. An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction

    NARCIS (Netherlands)

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F.; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I.; Lacko, Martin; Hardillo, José A U; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Leeuw, Irma M Verdonck de

    2015-01-01

    PURPOSE: The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. METHODS: Health care professionals (HCPs) were invited to participate

  12. Early home-supported discharge for patients with stroke in Portugal

    DEFF Research Database (Denmark)

    Santana, Silvina; Rente, José; Neves, Conceição

    2017-01-01

    Measure at six months after stroke. Results: We randomised 190 patients of whom 34 were lost to follow-up. There were no significant differences (p > 0.5) in the average scores of Functional Independence Measure between the early home-supported discharge (69 ±22; mean ±SD) and the control groups (71 ±17...

  13. Survival benefit of cardiopulmonary bypass support in bilateral lung transplantation for emphysema patients

    NARCIS (Netherlands)

    Hepkema, BG; Loef, BG; van der Bij, W; Verschuuren, EAM; Lems, SPM; Ebels, T

    2002-01-01

    Background. This study is designed to examine a possible association of cardiopulmonary bypass (CPB) support and outcome of lung transplantation in a well-balanced group of emphysema patients. Methods. We performed a retrospective analysis of 62 consecutive primary bilateral lung transplantations

  14. Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Holst, Mette; Rasmussen, Henrik Højgaard

    2013-01-01

    To estimate the effectiveness of oral nutritional support compared to placebo or usual care in improving clinical outcome in older (65 years+) medical and surgical patients after discharge from hospital. Outcome goals were: re-admissions, survival, nutritional and functional status, quality of life...

  15. A quality-of-data aware mobile decision support system for patients with chronic illnesses

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; van Schooten, B.W.; Shalom, Erez; Fung, L.S.N.; van Sinderen, Marten J.; Hermens, Hermanus J.; Jones, Valerie M.; Riano, David; Lenz, Richard; Miksch, Silvia; Peleg, Mor; Reichert, M.U.; ten Teije, Annette

    2015-01-01

    We present a mobile decision support system (mDSS) which runs on a patient Body Area Network consisting of a smartphone and a set of biosensors. Quality-of-Data (QoD) awareness in decision making is achieved by means of a component known as the Quality-of-Data Broker, which also runs on the

  16. Design of a consumer health record for supporting the patient-centered management of chronic diseases.

    NARCIS (Netherlands)

    de Clerq, P.A.; Hasman, A.; Wolffenbuttel, B.H.R.

    2001-01-01

    : Medinfo 2001;10(Pt 2):1445-9 Related Articles, Books, LinkOut Design of a consumer health record for supporting the patient-centered management of chronic diseases. de Clercq PA, Hasman A, Wolffenbuttel BH. Department of Medical Informatics, University of Maastricht, Maastricht, The Netherlands.

  17. Social Support, a Mediator in Collaborative Depression Care for Cancer Patients

    Science.gov (United States)

    Oh, Hyunsung; Ell, Kathleen

    2015-01-01

    Objective: This study assessed whether perceived social support (PSS) is a factor in improving physical and functional well-being observed among cancer patients receiving collaborative depression care. Methods: A secondary analysis was conducted of data collected in a randomized clinical trial testing the effectiveness of collaborative depression…

  18. Development of a tailored work-related support intervention for gastrointestinal cancer patients

    NARCIS (Netherlands)

    Zaman, Anne-Claire G. N. M.; Tytgat, Kristien M. A. J.; Van Hezel, Sanne; Klinkenbijl, Jean H. G.; de Boer, Angela G. E. M.; Frings-Dresen, Monique H. W.

    2017-01-01

    Aim is the development of a work-related support intervention, tailored to the severity of work-related problems of patients diagnosed with gastrointestinal (GI) cancer treated with curative intent. Two methods were used: (1) Work-related problems were identified from the literature and submitted to

  19. The design of patient decision support interventions: addressing the theory-practice gap

    NARCIS (Netherlands)

    Elwyn, G.; Stiel, M.; Durand, M.A.; Boivin, J.

    2011-01-01

    BACKGROUND: Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a

  20. An online self-care education program to support patients after total laryngectomy : feasibility and satisfaction

    NARCIS (Netherlands)

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I; Lacko, Martin; Hardillo, José A; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Leeuw, Irma M Verdonck-de

    The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. Health care professionals (HCPs) were invited to participate and to recruit

  1. Selection of an entecavir-resistant mutant despite prolonged hepatitis B virus DNA suppression, in a chronic hepatitis B patient with preexistent lamivudine resistance : successful rescue therapy with tenofovir

    NARCIS (Netherlands)

    Leemans, Wilhelmus F; Niesters, Hubert G; van der Eijk, Annemiek A; Janssen, Harry L; Schalm, Solko W; de Man, Robert A

    BACKGROUND AND OBJECTIVE: Entecavir has potent activity against hepatitis B virus. Drug resistance has not been reported in nucleoside-naïve patients and is low in lamivudine-refractory patients. METHODS AND RESULTS: A 43-year-old man was treated with lamivudine for hepatitis B e antigen-positive

  2. Effect of intensive nutritional counseling and support on clinical outcomes of hemodialysis patients.

    Science.gov (United States)

    Molfino, Alessio; Chiappini, Maria Grazia; Laviano, Alessandro; Ammann, Thomas; Bollea, Maria Rosa; Alegiani, Filippo; Rossi Fanelli, Filippo; Muscaritoli, Maurizio

    2012-10-01

    Protein-energy wasting is frequently found in patients on hemodialysis (HD). Anorexia and hypophagia contribute to malnutrition and increased morbidity and mortality, but the clinical impact of correcting hypophagia remains uncertain. We evaluated whether the correction of hypophagia influences morbidity and mortality in anorexic patients on HD. Thirty-four patients on HD were enrolled in a 2-y follow-up program including regular nutritional assessments. Patients not meeting the nutritional requirements during the follow-up received nutritional counseling, consisting of advice, individually tailored diets, and, for a failed dietary intervention, artificial nutrition. Biochemical, anthropometric, and body composition parameters, morbidity, and mortality were recorded in all patients at 12 and 24 mo. At baseline, 14 patients (41%) were anorexic, and 20 patients (59%) were non-anorexic. Anorexic patients were hypophagic and presented with a decreased fat-free mass. After 12 and 24 mo, cholesterol, albumin, lymphocyte count, and body mass index did not differ between the groups, whereas fat-free mass (percentage) in supplemented anorexic patients significantly improved in no longer differing from non-anorexic patients (65.8 ± 4.4 versus 65.4 ± 8.9, respectively, P = NS; 65.8 ± 4.4 versus 66.7 ± 10.78, respectively, P = NS). Morbidity and mortality were not different between the two groups. In patients on HD, nutritional counseling and nutritional support positively affect the nutritional status in hypophagic patients and make the risk of morbidity and mortality in anorexic patients comparable to those of non-anorexic patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. [Nutritional support and parenteral nutrition in the oncological patient: an expert group consensus report].

    Science.gov (United States)

    Camblor-Álvarez, Miguel; Ocón-Bretón, María Julia; Luengo-Pérez, Luis Miguel; Viruzuela, Juan Antonio; Sendrós-Maroño, María José; Cervera-Peris, Mercedes; Grande, Enrique; Álvarez-Hernández, Julia; Jiménez-Fonseca, Paula

    2018-01-10

    Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life. To analyze and respond to different issues related to the nutritional management of cancer patients in the clinical setting. A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition developed a list of topics related to the nutritional status of cancer patients, which were grouped into three blocks: Nutritional support; Parenteral nutrition (PN); and Home PN (HPN) in cancer patients. A literature search, which included articles published in Spanish, English, and French until February 2017, was carried out. The document was organized as a questionnaire with those questions that, according to the panel's criteria, could generate greater controversy or doubt. Of the 18 questions addressed, 9 focused on nutritional support: 5 were related to PN and 4 about HPN. Among the different recommendations, the panel emphasized that in the cancer patient, PN is indicated mainly when it is not possible to use the digestive tract and/or oral feeding and/or enteral nutrition is not sufficient or possible. Additionally, the objective of the HPN is to improve or maintain the nutritional status of a patient at home. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for the nutritional management of cancer Patients.

  4. Rescue of Long-Tail Data from the Ocean Bottom to the Moon

    Science.gov (United States)

    Hsu, L.; Lehnert, K. A.; Carbotte, S. M.; Ferrini, V.; Delano, J. W.; Gill, J. B.; Tivey, M.

    2013-12-01

    IEDA (Integrated Earth Data Applications, www.iedadata.org), the NSF facility that operates EarthChem, the Marine Geoscience Data System, and the System for Earth Sample Registration, launched a Data Rescue Initiative in 2013 to advance preservation and re-use of valuable legacy datasets that are in danger of being lost. As part of this initiative, IEDA established a competition for Data Rescue Mini-Awards that provide modest funds to investigators to properly compile, document, and transfer legacy data sets to IEDA. Applications from late-career and near-retirement investigators were specifically encouraged. Awardees were given approximately six months to complete their data rescue activities. Three projects were awarded in 2013: (1) Geochemistry of Lunar Glasses: assembly of major element, trace element, volatile element, and isotope ratio data for lunar volcanic glasses and lunar impact glasses, (2) Geochemical and Geochronological data from Fiji, Izu-Bonin-Marianas, and Endeavor segment: assembly of published and unpublished data and metadata from large rock sample collections, and (3) Near-bottom Magnetic Data: curation and archival of 35 years of high-resolution, near-bottom magnetic field data from deeptowed platforms, submersibles, and ROVs. IEDA is working closely with the awardees to guide and support the data rescue effort and to assist with specific challenges related to outdated storage media or technology, diversity of platforms over decades of research, and the lack of established standards for data documentation. In this contribution we describe procedures and tools used for each project, summarize lessons learned and best practices, and present the final output of each data rescue project. Depending on the experiences of this first year and the availability of funds, we plan to continue the competition in future years.

  5. Health of women: associations among life events, social support, and personality for selected patient groups.

    Science.gov (United States)

    Norlander, T; Dahlin, A; Archer, T

    2000-02-01

    This study examined the effects of life events, social support, personality traits, and siblings' birth-order on the health of women. 199 middle-class participants were included. 95 women, randomly assigned from four different patient groups, were compared with a control group of 96 randomly selected women without any special health problems. They completed a questionnaire which included questions regarding family background, health, different life events, social support, and signs of disease and a projective test, the Sivik Psychosomatism Test. Analysis indicated that report of negative life events was associated with more physical symptoms than positive life events and that the patient groups reported more negative life events and less social support than the control group.

  6. Providing nutritional support to patients with thoracic cancer: findings of a dedicated rehabilitation service.

    Science.gov (United States)

    Percival, Cheryl; Hussain, Asmah; Zadora-Chrzastowska, Sonja; White, Gillian; Maddocks, Matthew; Wilcock, Andrew

    2013-05-01

    National guidelines recommend screening patients with thoracic cancer to identify those requiring nutritional support. To help quantify this area of need, the associated workload and explore its impact, we report findings from a dedicated rehabilitation service. Patients were screened soon after diagnosis to determine the prevalence of malnutrition, and various aspects compared between malnourished and not malnourished groups. A nutritional care plan was instigated and all contacts recorded, together with follow-up body weight. Of 243 patients seen, 35% were malnourished which was associated with a palliative treatment intent (P group received oral nutritional supplements, but also experienced problems tolerating them. Over one month, neither the pattern nor magnitude of the change in weight differed between malnourished and not malnourished groups. Overall, weight was stable, increased or decreased in 52 (27%), 80 (42%) and 59 (31%) respectively, with no difference in overall survival (P = 0.16). Our data provides a pragmatic insight into the implications of following national guidance on nutritional screening and support in this patient group. Nutritional support failed to prevent weight loss in some patients, and did not appear to impact on survival; new assessments and treatments for cachexia are required. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Interventions for supporting informal caregivers of patients in the terminal phase of a disease.

    Science.gov (United States)

    Candy, Bridget; Jones, Louise; Drake, Robyn; Leurent, Baptiste; King, Michael

    2011-06-15

    Patients in the terminal phase of a disease may have complex needs. It is often family and friends who play a central role in providing support, despite health professional input and regardless of whether the patient is at home or elsewhere. Such informal caring may involve considerable physical, psychological, and economic stresses. A range of supportive programmes for caregivers is being developed including psychological support and practical assistance. To assess the effects of supportive interventions that aim to improve the psychological and physical health of informal caregivers of patients in the terminal phase of their illness. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2 2010); MEDLINE (1950 to May 2010); EMBASE (1980 to May 2010); PsycINFO (1872 to May 2010); CINAHL (1937 to May 2010); National Health Service Research Register (2000 to November 2008) and Dissertation Abstracts (1716 to May 2010). We searched the reference lists of relevant studies; contacted experts; and handsearched journals. Randomised controlled trials (RCTs) of interventions to support adults who were caring for a friend or relative with a disease in the terminal phase. Interventions could include practical and emotional support and/or the facilitation of coping skills. Interventions could support caregivers indirectly via patient care. Two authors independently screened citations against the selection criteria. Data were extracted by one author and checked by another. This included extraction of any adverse effects. Risk of bias assessment was undertaken by two authors. We contacted trial authors to obtain missing information. Trial data were combined, where appropriate, on the review's primary outcomes. We included eleven RCTs involving 1836 caregiver participants. Nine interventions were delivered directly to the caregiver. Seven of these provided support in the caring role, another involved a family life review, and one

  8. PCI in Patients Supported With CF-LVADs: Indications, Safety, and Outcomes.

    Science.gov (United States)

    Anyanwu, Emeka C; Ota, Takeyoshi; Sayer, Gabriel; Nathan, Sandeep; Jeevanandam, Valluvan; Shah, Atman; Uriel, Nir

    2016-06-01

    Patients with heart failure supported with left ventricular assist devices (LVADs) may require coronary intervention during their support. This case series seeks to explore the indications, safety, and outcomes of percutaneous coronary intervention (PCI) in this population. Electronic medical records of patients with LVADs undergoing PCI at a large academic medical center were reviewed. Demographics, reason for PCI, procedural success, complications, and outcomes were collected. From 2010-2014, a total of 6 patients underwent PCI post LVAD implantation. Three patients had PCI in the early postimplantation period (1-3 days post LVAD implantation) while the other three received it later in the LVAD support period. Three indications for PCI were found in the reviewed cases: right ventricular failure (right coronary artery stenting), bridge to left ventricular recovery, and ventricular tachycardia (VT) storm. All patients were maintained on triple blood thinning therapy (aspirin, clopidogrel, and warfarin). There were no acute complications during the interventions; however, 2 patients died in the early intervention period and 2 died much later. The 2 deaths in the early intervention period were related to fatal gastrointestinal bleeding while on dual-antiplatelet therapy and warfarin, and intractable VT that PCI did not correct. The 2 deaths in the late postintervention period occurred due to unknown causes nearly 1 and 2 years post intervention, respectively. PCI was performed in patients with continuous-flow LVAD with several possible indications and without acute complications. The utility of PCI in this patient population, however, is likely limited by the risk of bleeding related to combined antiplatelet and anticoagulation therapies as well as lack of immediate apparent benefit. Further studies are necessary to better characterize this risk as well as quantify any potential long-term benefits.

  9. Strategies for self-management support by patients with stroke: integrative review

    Directory of Open Access Journals (Sweden)

    Huana Carolina Cândido Morais

    2015-02-01

    Full Text Available OBJECTIVE To analyze strategies for self-management support by patients with stroke in the light of the methodology of the five A's (ask, advice, assess, assist and arrange. METHODS Integrative review conducted at the following databases CINAHL, SCOPUS, PubMed, Cochrane and LILACS. RESULTS A total of 43 studies published between 2000 and 2013 comprised the study sample. All proposed actions in the five A's methodology and others were included. We highlight the Assist and Arrange, in which we added actions, especially with regard to the use of technological resources and joint monitoring between patients, families and professionals. No study included all five A's, which suggests that the actions of supported self-management are developed in a fragmented way. CONCLUSION The use of five A's strategy provides guidelines for better management of patients with stroke with lower cost and higher effectiveness.

  10. MAXILLOFACIAL TRAUMA MANAGEMENT IN POLYTRAUMATIZED PATIENTS – THE USE OF ADVANCED TRAUMA LIFE SUPPORT (ATLS PRINCIPLES.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-03-01

    Full Text Available Management of the multiply injured patient requires a co-ordinated multi-disciplinary approach in order to optimise patients’ outcome. A working knowledge of the sort of problems these patients encounter is therefore vital to ensure that life-threatening injuries are recognised and treated in a timely pattern and that more minor associated injuries are not omitted. This article outlines the management of polytraumatized patients using the Advanced Trauma Life Support (ATLS principles and highlights the areas of specific involvement of the engaged medical team. Advanced Trauma Life Support is generally regarded as the gold standard and is founded on a number of well known principles, but strict adherence to protocols may have its drawbacks when facial trauma co-exists. These can arise in the presence of either major or minor facial injuries, and oral and maxillofacial surgeons need to be aware of the potential problems.

  11. An IHE-conform telecooperation platform supporting the treatment of dementia patients

    Directory of Open Access Journals (Sweden)

    Saleh K.

    2015-09-01

    Full Text Available Ensuring medical support of patients of advanced age in rural areas is a major challenge. Moreover, the number of registered doctors—medical specialists in particular—will decrease in such areas over the next years. These unmet medical needs in combination with communication deficiencies among different types of health-care professionals pose threats to the quality of patient treatment. This work presents a novel solution combining telemedicine, telecooperation, and IHE profiles to tackle these challenges. We present a telecooperation platform that supports longitudinal electronic patient records and allows for intersectoral cooperation based on shared electronic medication charts and other documents. Furthermore, the conceived platform allows for an integration into the planned German telematics infrastructure.

  12. Satisfaction with support versus size of network: differential effects of social support on psychological distress in parents of pediatric cancer patients.

    Science.gov (United States)

    Harper, Felicity W K; Peterson, Amy M; Albrecht, Terrance L; Taub, Jeffrey W; Phipps, Sean; Penner, Louis A

    2016-05-01

    This study examined the direct and buffering effects of social support on longer-term global psychological distress among parents coping with pediatric cancer. In both sets of analyses, we examined whether these effects depended on the dimension of social support provided (i.e., satisfaction with support versus size of support network). Participants were 102 parents of pediatric cancer patients. At study entry, parents reported their trait anxiety, depression, and two dimensions of their social support network (satisfaction with support and size of support network). Parents subsequently reported their psychological distress in 3- and 9-month follow-up assessments. Parents' satisfaction with support had a direct effect on longer-term psychological distress; satisfaction was negatively associated with distress at both follow-ups. In contrast, size of support network buffered (moderated) the impact of trait anxiety and depression on later distress. Parents with smaller support networks and higher levels of trait anxiety and depression at baseline had higher levels of psychological distress at both follow-ups; for parents with larger support networks, there was no relationship. Social support can attenuate psychological distress in parents coping with pediatric cancer; however, the nature of the effect depends on the dimension of support. Whereas interventions that focus on increasing satisfaction with social support may benefit all parents, at-risk parents will likely benefit from interventions that ensure they have an adequate number of support resources. Copyright © 2015 John Wiley & Sons, Ltd.

  13. Identifying How Patient Portals May Be Effectively Used Among Mental Health Populations to Support Digital Inclusion: A Study Protocol.

    Science.gov (United States)

    Strudwick, Gillian; Booth, Richard; Strauss, John

    2018-01-01

    Patient portals are secure online websites that allow patients access to their medical information from a particular healthcare organization. Currently, it is unknown how this technology can best be used to support patients with mental illness, and what types of indicators of portal adoption are meaningful to these patients. This study addresses this gap in our knowledge by obtaining the perspectives on this topic from patients, family members and Peer Support Workers.

  14. Conveying hope in consultations with patients with life-threatening diseases: the balance between supporting and challenging the patient.

    Science.gov (United States)

    Werner, Anne; Steihaug, Sissel

    2017-06-01

    There is limited knowledge about the communication of hope and denial in consultations with patients with life-threatening diseases on a practical level. In this study, we explored a real-life medical consultation between a doctor and a patient with incurable cancer, focusing on conveying hope. We found one consultation especially suited for illustrating how a physician can convey and reinforce hope without attaching it to curative treatment. The consultation was analysed using a method for discourse analysis, where we took as a point of departure that discourse means language in use. The doctor communicated in a recognising manner, expressing respect for the patient as a subject and an authority of his own experiences. The doctor and patient succeeded in creating a good working alliance characterised by warmth and trust. Within this context, there was room for the doctor to challenge the patient's views and communicate disagreement. The doctor succeeds in conveying and maintaining hope. Within a good working alliance with the patient the doctor can convey hope by balancing between supporting and challenging him. Exploring and grasping the patient's real concerns is essential for being able to relieve and comfort him and convey hope.

  15. Failed common bile duct cannulation during pregnancy: Rescue with endoscopic ultrasound guided rendezvous procedure.

    Science.gov (United States)

    Singla, Vikas; Arora, Anil; Tyagi, Pankaj; Sharma, Praveen; Bansal, Naresh; Kumar, Ashish

    2016-01-01

    Common bile duct (CBD) stones can lead to serious complications and require intervention with either endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic techniques for urgent relief. On an average 10%-20% of the patients with gall bladder stones can have associated CBD stones. CBD stones during pregnancy can be associated with hazardous complications for both the mother and the fetus. Failed cannulation while performing ERCP during pregnancy is a technically demanding situation, which requires immediate rescue with special techniques. Conventional rescue techniques may not be feasible and can be associated with hazardous consequences. Endoscopic ultrasound (EUS) guided rendezvous technique has now emerged as a safe alternative, and in one of our patients, this technique was successfully attempted. To the best of our knowledge, this is the first case report in the literature on EUS-guided rendezvous procedure during pregnancy.

  16. Rescue endoscopic bleeding control for nonvariceal upper gastrointestinal hemorrhage using clipping and detachable snaring.

    Science.gov (United States)

    Lee, J H; Kim, B K; Seol, D C; Byun, S J; Park, K H; Sung, I K; Park, H S; Shim, C S

    2013-06-01

    Nonvariceal upper gastrointestinal (UGI) bleeding recurs after appropriate endoscopic therapy in 10 % - 15 % of cases. The mortality rate can be as high as 25 % when bleeding recurs, but there is no consensus about the best modality for endoscopic re-treatment. The aim of this study was to evaluate clipping and detachable snaring (CDS) for rescue endoscopic control of nonvariceal UGI hemorrhage. We report a case series of seven patients from a Korean tertiary center who underwent endoscopic hemostasis using the combined method of detachable snares with hemoclips. The success rate of endoscopic hemostasis with CDS was 86 %: six of the seven patients who had experienced primary endoscopic treatment failure or recurrent bleeding after endoscopic hemostasis were treated successfully. In conclusion, rescue endoscopic bleeding control by means of CDS is an option for controlling nonvariceal UGI bleeding when no other method of endoscopic treatment for recurrent bleeding and primary hemostatic failure is possible. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Intervention to improve social and family support for caregivers of dependent patients: ICIAS study protocol.

    Science.gov (United States)

    Rosell-Murphy, Magdalena; Bonet-Simó, Josep M; Baena, Esther; Prieto, Gemma; Bellerino, Eva; Solé, Francesc; Rubio, Montserrat; Krier, Ilona; Torres, Pascuala; Mimoso, Sonia

    2014-03-25

    Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver.Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life. CONTROLled, multicentre, community intervention trial, with patients and their caregivers randomized to the intervention or control group according to their assigned Primary Health Care Team (PHCT). Primary Health Care network (9 PHCTs). Primary informal caregivers of patients receiving home health care from participating PHCTs. Required sample size is 282 caregivers (141 from PHCTs randomized to the intervention group and 141 from PHCTs randomized to the control group. a) PHCT professionals: standardized training to implement caregivers intervention. b) Caregivers: 1 individualized counselling session, 1 family session, and 4 educational group sessions conducted by participating PHCT professionals; in addition to usual home health care visits, periodic telephone follow-up contact and unlimited telephone support. Caregivers and dependent patients: usual home health care, consisting of bimonthly scheduled visits, follow-up as needed, and additional attention upon request.Data analysisDependent variables: Caregiver burden (short-form Zarit test), caregivers' social support (Medical Outcomes Study), and caregivers' reported quality of life (SF-12)INDEPENDENT VARIABLES: a) Caregiver: sociodemographic data

  18. Social support for patients undergoing liver transplantation in a Public University Hospital.

    Science.gov (United States)

    Garcia, Clerison Stelvio; Lima, Agnaldo Soares; La-Rotta, Ehideé Isabel Gómez; Boin, Ilka de Fátima Santana Ferreira

    2018-02-17

    Several diseases may lead to the need for liver transplantation due to progressive organ damage until the onset of cirrhosis, resulting in changes in interpersonal relationships. Social Support for transplant candidates is an important variable, providing them with psychological and social well-being. This study aims to assess social support in chronic hepatic patients, waiting for liver transplantation. A cross-sectional study was conducted with 119 patients, for convenience sampling, from the liver transplant waiting list at a Brazilian University Hospital Outpatients. The information was collected through semistructured questionnaires, in four stages: 1) socioeconomic and demographic information 2) clinical aspects 3) feelings 4) Social Support Network Inventory (SSNI), to Brazilian Portuguese. The statistical analysis was conducted using ANOVA and multivariate linear regression analysis to evaluate the relationship between the scales of social support and the collected co-variables. Average age was 50.2 ± 11.6, and 87 (73.1%) were men. Patients with alcohol and virus liver disease etiology had the same frequency of 28%. The MELD, without extrapoints, was 16.7 ± 4.9. Global social support family score was 3.72 ± 0.39, and Cronbach's alpha = 0.79. The multivariate analysis presented the following associations, age = [- 0.010 (95% CI = - 0.010 - -0.010); P = 0.001], etiology of hepatic disease = [- 0.212 (95% CI = - 0.37 - -0.05); P = 0.009], happiness = [- 0.214(95% CI = - 0.33 - -0.09) P = 0.001) and aggressiveness = [0.172 (95% CI = 0.040-0.030); P = 0.010). The social support was greater when the patients were younger (18 to 30 years). Patients with alcoholic cirrhosis, regardless of whether or not they were associated with virus, had less social support. As for feelings, the absence of happiness and the presence of aggressiveness showed a negative effect on social support.

  19. Evaluation of the quality of patient information to support informed shared decision‐making

    Science.gov (United States)

    Godolphin, William; Towle, Angela; McKendry, Rachael

    2008-01-01

    Objectives (a) To find out how much patient information material on display in family physicians’ offices refers to management choices, and hence may be useful to support informed and shared decision‐making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians. Design All print information available for patients and exchanged between physicians and patients was collected in a single complete day of the office practices of 21 family physicians. A published and validated instrument (DISCERN) was used to assess quality. Setting and participants Community office practices in the greater Vancouver area, British Columbia, Canada. The physicians were purposefully recruited by their association with the medical school Department of Family Practice, their interest in providing patients with print information and their representation of a range of practice types and location. Main variables studied The source of the pamphlets and these categories: available in the physicians’ offices; exchanged between physician and patient; and produced with the explicit or apparent intent to support evidence‐based patient choice. Main outcome measures The quality of the print information to support ISDM, as measured by DISCERN and the ease of use and reliability of the DISCERN tool. Results and conclusions Fewer than 50% of pamphlets available in these offices fulfilled our minimum criteria for ISDM (mentioned more than one management option). Offices varied widely in the proportion of pamphlets on display that supported ISDM and how particular the physician was in selecting materials. The DISCERN tool is quick, valid and reliable for the evaluation of patient information. The quality of patient information materials used in the consultation and available in these offices was below midpoint on the DISCERN score. Major deficiencies were with

  20. Health Professionals' Expanding eHealth Competences for Supporting Patients' Self-Management.

    Science.gov (United States)

    Kujala, Sari; Rajalahti, Elina; Heponiemi, Tarja; Hilama, Pirjo

    2018-01-01

    An increasing number of new eHealth services that support patients' self-management has changed health professionals' work and has created a need for a new eHealth competence. In this study, we evaluated the health professionals' eHealth competences and training needs in a public health organization in Finland. The target organization's goal was to increase the number of eHealth services provided to patients, and health professionals and their competences were seen as critical for the adoption of services. Data was collected through an online survey of 701 health professionals working in the target organization. Professionals perceived their basic computer skills as good and they were mostly willing to use eHealth services in patient work. However, health professionals need guidance, especially in their patient work in the new eHealth-enabled environment. They were less confident about their competence to motivate and advise patients to use eHealth services and how to communicate with patients using eHealth solutions. The results also imply that eHealth competence is not merely about an individual's skills but that organizations need to develop new working processes, work practices and distribution of work. We suggest that the training and support needs identified be considered in curricula and lifelong learning.

  1. Ventilatory support and pharmacological treatment of patients with central apnoea or hypoventilation during sleep

    Directory of Open Access Journals (Sweden)

    D. Pevernagie

    2007-12-01

    Full Text Available The concept of central sleep apnoea or hypoventilation encompasses hypercapnic central hypoventilation, such as obesity hypoventilation syndrome and eucapnic or hypocapnic central sleep apnoea. Among subjects with eucapnic or hypocapnic central sleep apnoea, several therapeutic options are available for those with Cheyne–Stokes respiration (CSR. CSR is frequent in patients with New York Heart Association stage III and IV chronic heart failure, and in various neurological disorders. In these patients, treatment modalities include optimising cardiac condition and drugs, such as theophylline, acetazolamide and/or oxygen. Ventilatory support, such as nasal continuous positive airway pressure (CPAP, bi-level pressure support, or adaptive servo-ventilation (ASV, has been shown to improve CSR in patients with cardiac failure; however, convincing evidence that nasal CPAP improves life expectancy in these patients is lacking. Nevertheless, the treatment of associated obstructive sleep-disordered breathing is indicated per se, as it may improve cardiac function. There is currently no proof that bi-level ventilation is superior to nasal CPAP. The few available studies that have focused on ASV have shown satisfactory control of CSR in cardiac failure patients. While ASV is not a first-line treatment choice, it appears to be superior to oxygen, CPAP and bi-level pressure ventilation in controlling the apnoea/hypopnea index and probably sleep fragmentation. As yet there are no data on mortality and, as such, firm conclusions cannot be drawn as to the role of ASV in the management of cardiac failure patients suffering from CSR. Obesity-related hypoventilation has increased dramatically over recent decades due to the epidemic increase in obesity in the developed countries. Obesity hypoventilation syndrome predisposes to the development of pulmonary hypertension and cor pulmonale. Noninvasive home ventilation is increasingly applied in obese patients with

  2. Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk [Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Jeon, Ung Bae; Kang, Dae Hwan [Pusan National University School of Medicine, Yangsan Pusan National University Hospital, Yangsan (Korea, Republic of)

    2013-11-15

    Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

  3. Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

    International Nuclear Information System (INIS)

    Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk; Jeon, Ung Bae; Kang, Dae Hwan

    2013-01-01

    Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

  4. Analysis of emergency helpline support for home ventilator dependent patients: risk management and workload

    Directory of Open Access Journals (Sweden)

    M. Chatwin

    2008-04-01

    Full Text Available From a total of 1211 adult & paediatric patients receiving home ventilation (HV supervised by Royal Brompton Hospital between 1/1/06 and 30/6/06 the respiratory support team received an average of 528 daytime calls/month and 14/month out of hours calls to a telephone helpline. Diagnoses included: neuromuscular disease, chest wall disease, COPD, obesity hypoventilation and non-COPD lung disease. 99% received non-invasive ventilation, 1% tracheostomy ventilation. 149 required 2 ventilators for near 24 hour ventilator dependency, the remainder were classified as 1 (17% 2 (33% & 3 (50% night dependency as were able to breathe spontaneously for this period. 50% used bilevel positive pressure ventilators, 48% inspiratory pressure ventilators and 2% volume ventilators. In 188 calls a home visit was carried out because of ventilator or associated equipment-related problems. Despite regular equipment servicing programme, in 188 patients there was a technical problem with the equipment which was solved in the patient's home in 64% or required replacement / parts in 22%. Of the 25 calls in which no fault was found, 13 patients were unwell at home or required hospital admission, 2 patients died within 1 month of identification of no fault. No patient was admitted as a result of technical failure of equipment. Conclusion: There is a significant workload associated with supporting HV patients. Patients / carers all received standard competency training before discharge but other calls may be reduced by a more flexible problem-solving approach. Importantly, reports in which no technical fault is found may indicate deteriorating health in the patient and require close follow-up.

  5. Combined enteral feeding and total parenteral nutritional support improves outcome in surgical intensive care unit patients.

    Science.gov (United States)

    Hsu, Min-Hui; Yu, Ying E; Tsai, Yueh-Miao; Lee, Hui-Chen; Huang, Ying-Che; Hsu, Han-Shui

    2012-09-01

    For intensive care unit (ICU) patients with gastrointestinal dysfunction and in need of total parenteral nutrition (TPN) support, the benefit of additional enteral feeding is not clear. This study aimed to investigate whether combined TPN with enteral feeding is associated with better outcomes in surgical intensive care unit (SICU) patients. Clinical data of 88 patients in SICU were retrospectively collected. Variables used for analysis included route and percentage of nutritional support, total caloric intake, age, gender, body weight, body mass index, admission diagnosis, surgical procedure, Acute Physiology and Chronic Health Evaluation (APACHE) II score, comorbidities, length of hospital stay, postoperative complications, blood glucose values and hospital mortality. Wound dehiscence and central catheter infection were observed more frequently in the group of patients receiving TPN calories less than 90% of total calorie intake (p = 0.004 and 0.043, respectively). APACHE II scores were higher in nonsurvivors than in survivors (p = 0.001). More nonsurvivors received TPN calories exceeding 90% of total calorie intake and were in need of dialysis during ICU admission (p = 0.005 and 0.013, respectively). Multivariate analysis revealed that the percentage of TPN calories over total calories and APACHE II scores were independent predictors of ICU mortality in patients receiving supplementary TPN after surgery. In SICU patients receiving TPN, patients who could be fed enterally more than 10% of total calories had better clinical outcomes than patients receiving less than 10% of total calorie intake from enteral feeding. Enteral feeding should be given whenever possible in severely ill patients. 2012 Published by Elsevier B.V

  6. Health Social Networks as Online Life Support Groups for Patients With Cardiovascular Diseases

    International Nuclear Information System (INIS)

    Medina, Edhelmira Lima; Loques, Orlando Filho; Mesquita, Cláudio Tinoco

    2013-01-01

    The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences

  7. Health Social Networks as Online Life Support Groups for Patients With Cardiovascular Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Medina, Edhelmira Lima, E-mail: edhyly@ic.uff.br; Loques, Orlando Filho [Instituto de Computação - Universidade Federal Fluminense, Niterói, RJ (Brazil); Mesquita, Cláudio Tinoco [Hospital Universitário Antônio Pedro - Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2013-08-15

    The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences.

  8. Interaction of social support and psychological stress on anxiety and depressive symptoms in breast cancer patients.

    Science.gov (United States)

    Liu, Dong-Gen; Wang, Shu-Sen; Peng, Rou-Jun; Qin, Tao; Shi, Yan-Xia; Teng, Xiao-Yu; Wang, Xi; Chen, Wei-Qing; Yuan, Zhong-Yu

    2011-01-01

    The aim of the present study was to assess the association of psychological stress and social support with anxiety and depressive symptoms in Chinese newly diagnosed breast cancer patients. Four hundred and one patients with breast cancer were recruited. Their demographic characteristics, psychological stress and social support were determined with a structured questionnaire, and their anxiety and depressive symptoms were assessed with the Hospital Anxiety and Depression Scale. Psychological stressors caused by breast cancer diagnosed originated from five major sources, as determined by factor analysis. These included "Worrying about health being harmed, " "Fear of decline of physical function, " "Fear of work being harmed, " "Worry about daily life and social relationship being restricted, " and "Fear of family being harmed. " Hierarchical linear regression analysis indicated that, after adjusting for gender, age, marital status, educational level, and duration of illness, solid social support can alleviate such symptoms. The results of this study suggest that there are strong associations between patients' needs and psychological distress with newly diagnosed breast cancer. Social support might affect these associations in Chinese women with breast cancer.

  9. Elements of implant-supported rehabilitation planning in patients with bruxism.

    Science.gov (United States)

    Sarmento, Hugo Ramalho; Dantas, Raquel Venâncio Fernandes; Pereira-Cenci, Tatiana; Faot, Fernanda

    2012-11-01

    The rehabilitation of partial or completely edentulous patients with implant-supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to revise the literature and identify risk factors in implant-supported rehabilitation planning in subjects with bruxism. Available literature was searched through Medline, with no time limit, including only studies in English. Topics discussed were etiology of bruxism and its implications on dental implants, biomechanical considerations regarding the overload on dental implants, and methods to prevent the occurrence of overloads in implant-supported prostheses. The rehabilitation of bruxers using implant-supported prostheses, using implants with adequate length and diameter, as well as proper positioning seems to be a reliable treatment, with reduced risks of failure. Bruxism control through the use of a nightguard by rigid occlusal stabilization appliance relieved in the region of implants is highly indicated. Although it is clear that implant-supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

  10. Rescue mastectomy in 192 breast cancer patients with T2 tumors larger than 3 cm or T3 tumors first treated by breast conservation protocols and followed-up for at least ten years

    International Nuclear Information System (INIS)

    Khayat, D.; Baillet, F.; Simon, J.M.; Sahraoui, S.; Voican, D.; Housset, M.

    1997-01-01

    Breast conservation therapy was used in 192 breast cancer patients treated between 1980 and 1986 for T2 tumors larger than 3 cm or T3 tumors. Primary chemotherapy was followed by external beam radiation therapy then by boost brachytherapy and adjuvant chemotherapy. Locoregional recurrences were treated whenever possible by tumor-ectomy and/or axillary node clearance. Median follow-up was 13 years. Of the three patients with local therapeutic failures at completion of the locoregional treatment, two were treated by tumor-ectomy and one by mastectomy. Subsequently, 21 mastectomies were performed, for oncological reasons in 20 cases. Overall survival was 55 % after five years, 60 % after ten years, and 56 % after 15 years. Local control rates were 82 %, 77 %, and 75 % after five, ten, and 15 years, respectively. After exclusion of the patients who required mastectomy, cosmetic results were satisfactory in 68 % of patients overall, 67 % of five-year survivors, and 73 % of ten-year survivors. These results show that the conventional approach involving routine initial mastectomy is no longer appropriate in patients with T3 or large T2 breast cancers. (authors)

  11. Course of social support and relationships between social support and life satisfaction in spouses of patients with stroke in the chronic phase

    NARCIS (Netherlands)

    Adriaansen, Jacinthe J. E.; van Leeuwen, Christel M. C.; Visser-Meily, Johanna M. A.; van den Bos, Geertrudis A. M.; Post, Marcel W. M.

    2011-01-01

    Objective: To describe the course of social support in spouses of patients with stroke, and to examine direct and indirect relationships between social support and life satisfaction over time. Methods: Prospective cohort study (N = 180) with measurements at 2 months after discharge from inpatient

  12. The moderating role of social support on depression and anxiety for gastric cancer patients and their family caregivers.

    Science.gov (United States)

    Jeong, Ansuk; An, Ji Yeong

    2017-01-01

    There is a consensus that cancer care should go beyond physical care as cancer patients and their family caregivers experience psychological burden, financial difficulty, as well as social relation issues. The current study aimed to investigate the moderating impact of social support on depression and anxiety of cancer patients and their family caregivers. Gastric cancer patients and their family caregivers who visited a university medical center in Seoul were approached for participation in the study. Fifty-two pairs of adult patients and caregivers participated in the study. Along with demographic information and the physical condition of the patients, such as pre-operation cancer stage and the type of gastrectomy, social support, depression, and anxiety were measured for patients and caregivers, respectively. In the first round of analysis, patients' depression was associated with age, while patients' anxiety was related to income. On the other hand, caregivers' depression was not associated with patients' health and living arrangement. In the second round of analysis to examine the moderating effect of social support, patients' income and social support were related to depression and anxiety, but the interaction of income and social support was only observed for anxiety. For caregivers, no interaction effects were found. Social support decreased the negative effects of low income status on the patients. While the income of the families with cancer cannot be adjusted in the short-term, their experience of social support can be managed by a proper support system. Diverse implications in medical settings are discussed.

  13. Developing an eHealth Tool to Support Patient Empowerment at Home.

    Science.gov (United States)

    Schildmeijer, Kristina; Wannheden, Carolina; Nilsson, Lina; Frykholm, Oscar; Hellström, Amanda; Flink, Maria; Ekstedt, Mirjam

    2018-01-01

    In previous research we have learned that patients with chronic or complex diseases often experience difficulties when transitioning from hospital care to self-care in their home. We address these difficulties by developing an eHealth tool for patients - ePATH (electronic Patient Activation in Treatment at Home) - intended to empower each patient to manage their individual situation. We have employed a user-centered design process involving both patients and healthcare personnel to specify the content and functionality of ePATH. The system is deployed as a web application with secure login for patients. In this article, we describe the main content and functionality of the system that makes it possible for a patient to manage symptoms development in relation to treatment progression Interactive functionality, e.g., reminders and social support, is included to make the ePATH a useful and informative bridge between patients, next-of-kin and different caregivers. One lesson learned is that it is necessary to incorporate motivational components in the development of an eHealth tool to successfully overcome the "intention-behavior" gap. The self-determination theory of motivation can be used to ensure that important aspects are not missed.

  14. Supporting Active Patient and Health Care Collaboration: A Prototype for Future Health Care Information Systems.

    Science.gov (United States)

    Åhlfeldt, Rose-Mharie; Persson, Anne; Rexhepi, Hanife; Wåhlander, Kalle

    2016-12-01

    This article presents and illustrates the main features of a proposed process-oriented approach for patient information distribution in future health care information systems, by using a prototype of a process support system. The development of the prototype was based on the Visuera method, which includes five defined steps. The results indicate that a visualized prototype is a suitable tool for illustrating both the opportunities and constraints of future ideas and solutions in e-Health. The main challenges for developing and implementing a fully functional process support system concern both technical and organizational/management aspects. © The Author(s) 2015.

  15. Nutritional Support of the Critically Ill Pediatric Patient: Foundations and Controversies

    Directory of Open Access Journals (Sweden)

    Iván José Ardila Gómez

    2017-04-01

    Full Text Available Critically ill children require nutritional support that will give them nutritional and non-nutritional support to successfully deal with their disease. In the past few years, we have been able to better understand the pathophysiology of critical illness, which has made possible the establishment of nutritional strategies resulting in an improved nutritional status, thus optimizing the pediatric intensive care unit (PICU stay and decreasing morbidity and mortality. Critical illness is associated with significant metabolic stress. It is crucial to understand the physiological response to stress to create nutritional recommendations for critically ill pediatric patients in the PICU.

  16. Nutritional support and parenteral nutrition in cancer patients: An expert consensus report.

    Science.gov (United States)

    Ocón Bretón, María Julia; Luengo Pérez, Luis Miguel; Virizuela, Juan Antonio; Álvarez Hernández, Julia; Jiménez Fonseca, Paula; Cervera Peris, Mercedes; Sendrós Madroño, María José; Grande, Enrique; Camblor Álvarez, Miguel

    2018-03-01

    Malnutrition is a common medical problem in cancer patients with a negative impact on quality of life. The aim of this study was to address different issues related to nutritional management of cancer patients in clinical practice. A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Endocrinology and Nutrition prepared a list of topics related to the nutritional status of cancer patients and grouped them into three blocks: nutritional support, parenteral nutrition (PN), and home PN (HPN). A literature review was made of articles published in Spanish, English and French until April 2017. This consensus emphasizes several key elements that help physicians standardize management of the nutritional status of cancer patients in clinical practice, and establishes common guidelines for indication, monitoring, nutritional requirements, and access routes to PN. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Acceptability Study of "Ascenso": An Online Program for Monitoring and Supporting Patients with Depression in Chile.

    Science.gov (United States)

    Espinosa, H Daniel; Carrasco, Álvaro; Moessner, Markus; Cáceres, Cristian; Gloger, Sergio; Rojas, Graciela; Perez, J Carola; Vanegas, Jorge; Bauer, Stephanie; Krause, Mariane

    2016-07-01

    Major depression is a highly prevalent and severe mental disease. Despite the effective treatment options available, the risk of relapse is high. Interventions based on information and communication technologies generate innovative opportunities to provide support to patients after they completed treatment for depression. This acceptability study evaluated the Internet-based program Apoyo, Seguimiento y Cuidado de Enfermedades a partir de Sistemas Operativos (ASCENSO) in terms of its feasibility and acceptability in a sample of 35 patients in Chile. The study reveals high rates of acceptance and satisfaction among patients who actively used the program. As obstacles, patients mentioned technical problems, a lack of contact with other participants, and an insufficient connection between the program and the health service professionals. ASCENSO appears to be a promising complement to regular care for depression. Following improvements of the program based on participants' feedback, future research should evaluate its efficacy and cost-effectiveness.

  18. Physical capacity of rescue personnel in the mining industry

    Directory of Open Access Journals (Sweden)

    Hunt Andrew P

    2008-10-01

    Full Text Available Abstract Background The mining industry has one of the highest occupational rates of serious injury and fatality. Mine staff involved with rescue operations are often required to respond to physically challenging situations. This paper describes the physical attributes of mining rescue personnel. Methods 91 rescue personnel (34 ± 8.6 yrs, 1.79 ± 0.07 m, 90 ± 15.0 kg participating in the Queensland Mines Rescue Challenge completed a series of health-related and rescue-related fitness tasks. Health-related tasks comprised measurements of aerobic capacity (VO2max, abdominal endurance, abdominal strength, flexibility, lower back strength, leg strength, elbow flexion strength, shoulder strength, lower back endurance, and leg endurance. Rescue-related tasks comprised an incremental carry (IC, coal shovel (CS, and a hose drag (HD, completed in this order. Results Cardiovascular (VO2max and muscular endurance was average or below average compared with the general population. Isometric strength did not decline with age. The rescue-related tasks were all extremely demanding with heart rate responses averaging greater than 88% of age predicted maximal heart rates. Heart rate recovery responses were more discriminating than heart rates recorded during the tasks, indicating the hose drag as the most physically demanding of the tasks. Conclusion Relying on actual rescues or mining related work to provide adequate training is generally insufficient to maintain, let alone increase, physical fitness. It is therefore recommended that standards of required physical fitness be developed and mines rescue personnel undergo regularly training (and assessment in order to maintain these standards.

  19. The SHERPA project: Smart collaboration between humans and ground-aerial robots for improving rescuing activities in alpine environments

    NARCIS (Netherlands)

    Marconi, L.; Melchiorri, C.; Beetz, M.; Pangercic, D.; Siegwart, R.; Leutenegger, S.; Carloni, Raffaella; Stramigioli, Stefano; Bruyninckx, H.; Doherty, P.; Kleiner, A.; Lippiello, V.; Finzi, A.; Siciliano, B.; Sala, A.; Tomatis, N.

    2012-01-01

    The goal of the paper is to present the foreseen research activity of the European project “SHERPA‿ whose activities will start officially on February 1th 2013. The goal of SHERPA is to develop a mixed ground and aerial robotic platform to support search and rescue activities in a real-world hostile

  20. The effect of music therapy on physiological signs of anxiety in patients receiving mechanical ventilatory support.

    Science.gov (United States)

    Korhan, Esra Akin; Khorshid, Leyla; Uyar, Mehmet

    2011-04-01

    The aim of this study was to investigate if relaxing music is an effective method of reducing the physiological signs of anxiety in patients receiving mechanical ventilatory support. Few studies have focused on the effect of music on physiological signs of anxiety in patients receiving mechanical ventilatory support. A study-case-control, experimental repeated measures design was used. Sixty patients aged 18-70 years, receiving mechanical ventilatory support and hospitalised in the intensive care unit, were taken as a convenience sample. Participants were randomised to a control group or intervention group, who received 60 minutes of music therapy. Classical music was played to patients using media player (MP3) and headphones. Subjects had physiological signs taken immediately before the intervention and at the 30th, 60th and 90th minutes of the intervention. Physiological signs of anxiety assessed in this study were mean systolic and diastolic blood pressure, pulse rate, respiratory rate and oxygen saturation in blood measured by pulse oxymetry. Data were collected over eight months in 2006-2007. The music group had significantly lower respiratory rates, and systolic and diastolic blood pressure, than the control group. This decrease improved progressively in the 30th, 60th and 90th minutes of the intervention, indicating a cumulative dose effect. Music can provide an effective method of reducing potentially harmful physiological responses arising from anxiety. As indicated by the results of this study, music therapy can be supplied to allay anxiety in patients receiving mechanical ventilation. Nurses may include music therapy in the routine care of patients receiving mechanical ventilation. © 2011 Blackwell Publishing Ltd.

  1. Development of stretcher component robots for rescue against nuclear disaster

    International Nuclear Information System (INIS)

    Iwano, Yuki; Osuka, Koichi; Amano, Hisanori

    2006-01-01

    This paper studies the rescue robots to rescue people in an area polluted with radioactive leakage in nuclear power institutions. In particular, we propose the rescue system which consists of a group of small mobile robots. First, small traction robots set the posture of the fainted victims to carry easily, and carry them to the safety space with the mobile robots for the stretcher composition. In this paper, we confirm that the stretcher component robots could transport and convey a 40 [kg] dummy doll. And, we also show an application usage of stretcher robot. (author)

  2. Medical rescue of naval combat: challenges and future.

    Science.gov (United States)

    Jin, Hai; Hou, Li-Jun; Fu, Xiao-Bing

    2015-01-01

    There has been no large-scale naval combat in the last 30 years. With the rapid development of battleships, weapons manufacturing and electronic technology, naval combat will present some new characteristics. Additionally, naval combat is facing unprecedented challenges. In this paper, we discuss the topic of medical rescue at sea: what challenges we face and what we could do. The contents discussed in this paper contain battlefield self-aid buddy care, clinical skills, organized health services, medical training and future medical research programs. We also discuss the characteristics of modern naval combat, medical rescue challenges, medical treatment highlights and future developments of medical rescue at sea.

  3. Twitter Social Media is an Effective Tool for Breast Cancer Patient Education and Support: Patient-Reported Outcomes by Survey.

    Science.gov (United States)

    Attai, Deanna J; Cowher, Michael S; Al-Hamadani, Mohammed; Schoger, Jody M; Staley, Alicia C; Landercasper, Jeffrey

    2015-07-30

    Despite reported benefits, many women do not attend breast cancer support groups. Abundant online resources for support exist, but information regarding the effectiveness of participation is lacking. We report the results of a Twitter breast cancer support community participant survey. The aim was to determine the effectiveness of social media as a tool for breast cancer patient education and decreasing anxiety. The Breast Cancer Social Media Twitter support community (#BCSM) began in July 2011. Institutional review board approval with a waiver of informed consent was obtained for a deidentified survey that was posted for 2 weeks on Twitter and on the #BCSM blog and Facebook page. There were 206 respondents to the survey. In all, 92.7% (191/206) were female. Respondents reported increased knowledge about breast cancer in the following domains: overall knowledge (80.9%, 153/189), survivorship (85.7%, 162/189), metastatic breast cancer (79.4%, 150/189), cancer types and biology (70.9%, 134/189), clinical trials and research (66.1%, 125/189), treatment options (55.6%, 105/189), breast imaging (56.6%, 107/189), genetic testing and risk assessment (53.9%, 102/189), and radiotherapy (43.4%, 82/189). Participation led 31.2% (59/189) to seek a second opinion or bring additional information to the attention of their treatment team and 71.9% (136/189) reported plans to increase their outreach and advocacy efforts as a result of participation. Levels of reported anxiety before and after participation were analyzed: 29 of 43 (67%) patients who initially reported "high or extreme" anxiety reported "low or no" anxiety after participation (Psocial media support group.

  4. Αpproach techniques and psychological support in pediatric patients: literature review

    Directory of Open Access Journals (Sweden)

    Anthoula Patsiala

    2017-10-01

    Full Text Available Effective approaches and psychological support of pediatric patients provided by health professionals are complex processes. The negative reactions and fear that pediatric patients develop during their hospitalization hamper cooperation with health professionals. The pediatric nursing staff is called upon to apply appropriate techniques for managing these situations.The purpose of this paper was to investigate, through contemporary literature review, methods of technical and psychological support of pediatric patients, applied by nurses in everyday clinical practice. The management of negative reactions and fear of pediatric patients requires individualized approach, given the uniqueness of each one of them. However, there are some general measures which may bring the ultimate results. According to literature some of them are: creation of a sincere relationship through targeted discussion, application of documented interactive educational programs to familiarize with nursing and medical procedures, distraction during painful acts, such as venipuncture or bladder catheterization, and finally high perception to identify nonverbal reactions.Awareness and familiarization of health professionals with appropriate methods will improve the relationship between pediatric patients and healthcare providers.

  5. Patient Segmentation Analysis Offers Significant Benefits For Integrated Care And Support.

    Science.gov (United States)

    Vuik, Sabine I; Mayer, Erik K; Darzi, Ara

    2016-05-01

    Integrated care aims to organize care around the patient instead of the provider. It is therefore crucial to understand differences across patients and their needs. Segmentation analysis that uses big data can help divide a patient population into distinct groups, which can then be targeted with care models and intervention programs tailored to their needs. In this article we explore the potential applications of patient segmentation in integrated care. We propose a framework for population strategies in integrated care-whole populations, subpopulations, and high-risk populations-and show how patient segmentation can support these strategies. Through international case examples, we illustrate practical considerations such as choosing a segmentation logic, accessing data, and tailoring care models. Important issues for policy makers to consider are trade-offs between simplicity and precision, trade-offs between customized and off-the-shelf solutions, and the availability of linked data sets. We conclude that segmentation can provide many benefits to integrated care, and we encourage policy makers to support its use. Project HOPE—The People-to-People Health Foundation, Inc.

  6. An evidence-based approach to perioperative nutrition support in the elective surgery patient.

    Science.gov (United States)

    Miller, Keith R; Wischmeyer, Paul E; Taylor, Beth; McClave, Stephen A

    2013-09-01

    In surgical practice, great attention is given to the perioperative management of the elective surgical patient with regard to surgical planning, stratification of cardiopulmonary risk, and postoperative assessment for complication. However, growing evidence supports the beneficial role for implementation of a consistent and literature-based approach to perioperative nutrition therapy. Determining nutrition risk should be a routine component of the preoperative evaluation. As with the above issues, this concept begins with the clinician's first visit with the patient as risk is assessed and the severity of the surgical insult considered. If the patient is an appropriate candidate for benefit from preoperative support, a plan for initiation and reassessment should be implemented. Once appropriate nutrition end points have been achieved, special consideration should be given to beneficial practices the immediate day preceding surgery that may better prepare the patient for the intervention from a metabolic standpoint. In the operating room, consideration should be given to the potential placement of enteral access during the index operation as well as judicious and targeted intraoperative resuscitation. Immediately following the intervention, adequate resuscitation and glycemic control are key concepts, as is an evidence-based approach to the early advancement of an enteral/oral diet in the postoperative patient. Through the implementation of perioperative nutrition therapy plans in the elective surgery setting, outcomes can be improved.

  7. Assessing the perceived level of institutional support for the second victim after a patient safety event.

    Science.gov (United States)

    Joesten, Leroy; Cipparrone, Nancy; Okuno-Jones, Susan; DuBose, Edwin R

    2015-06-01

    The objective of this study was to establish a baseline of perceived availability of institutional support services or interventions and experiences following an adverse patient safety event (PSE) in a 650-bed children and adult community teaching hospital. Investigators queried associates about their experiences after a PSE, what institutional support services or interventions they perceived to be available, and how helpful used services were. The investigators used an online modified version of a PSE survey developed by several health related organizations in Boston. One hundred twenty evaluable surveys were analyzed. Sixty-eight percent of respondents were nurses, 99% of whom were female. Only 10% to 30% of respondents reported that various support services or interventions were actively offered, and 30% to 60% indicated that they were not available. Respondents reported having experienced several distressing symptoms after a PSE, most notably, troubling memories (56%) and worry about lawsuits (37%). Less than 32% "agreed" or "strongly agreed" that they could report concerns without fear of retribution or punitive action. More respondents experienced support from clinical colleagues (64%) than from their manager or department chair (38%). These results validate a need by associates for emotional support after a PSE and that associates' perception of available formal institutional support services or interventions is low.

  8. Integrated system of occupational safety and health and fire protection of the fire rescue brigades members.

    Science.gov (United States)

    Božović, Marijola; Živković, Snežana; Mihajlović, Emina

    2018-06-01

    The objective of the conducted research is the identification and determination of requirements of members of fire rescue brigades during operations in the conditions of high risk in order to minimize the possibilities for injury incidence during the intervention. The research is focused on examination, determination and identification of factors affecting the increasing number of occupational injuries of members of fire rescue brigades during interventions. Hypothetical framework of the research problem consists of general hypothesis and six special hypotheses. Results suggest that almost all respondents believe that their skills and abilities are applicable in the intervention phase, but less than a half believe that their skills are applicable in prevention phase. Two-thirds of respondents stated that in their organization they have support for further education and upgrading while a half of respondents stated that they need education concerning identification, assessment and management of risks that can lead to emergency situations.

  9. Computer Security: DNS to the rescue!

    CERN Multimedia

    Stefan Lueders, Computer Security Team

    2016-01-01

    Why you should be grateful to the Domain Name System at CERN.   Incidents involving so-called “drive-by” infections and “ransomware” are on the rise. Whilst an up-to-date and fully patched operating system is essential; whilst running anti-virus software with current virus signature files is a must; whilst “stop --- think --- don’t click” surely helps, we can still go one step further in better protecting your computers: DNS to the rescue. The DNS, short for Domain Name System, translates the web address you want to visit (like “http://cern.ch”) to a machine-readable format (the IP address, here: “188.184.9.234”). For years, we have automatically monitored the DNS translation requests made by your favourite web browser (actually by your operating system, but that doesn’t matter here), and we have automatically informed you if your computer tried to access a website known to hos...

  10. [The development of a portable life support device for transporting pre-hospital critically ill patients].

    Science.gov (United States)

    Song, Zhen-xing; Wu, Tai-hu; Meng, Xing-ju; Lu, Heng-zhi; Zheng, Jie-wen; Wang, Hai-tao

    2012-06-01

    To describe a portable life support device for transportation of pre-hospital patients with critical illness. The characteristics and requirements for urgent management during transportation of critically ill patients to a hospital were analyzed. With adoption of the original equipment, with the aid of staple of the art soft ware, the overall structure, its installation, fixation, freedom from interference, operational function were studied, and the whole system of life support and resuscitation was designed. The system was composed by different modules, including mechanical ventilation, transfusion, aspiration, critical care, oxygen supply and power supply parts. The system could be fastened quickly to a stretcher to form portable intensive care unit (ICU), and it could be carried by different size vehicles to provide nonstop treatment by using power supply of the vehicle, thus raising the efficiency of urgent care. With characteristics of its small size, lightweight and portable, the device is particularly suitable for narrow space and extreme environment.

  11. Defining effective community support for long-term psychiatric patients according to behavioural principles.

    Science.gov (United States)

    Evans, I M; Moltzen, N L

    2000-08-01

    The purpose of this article is to define the characteristics of effective support in community mental health settings for patients with serious and persistent mental illness. A broad literature providing empirical evidence on competent caregiver behaviours and styles is selectively reviewed. Relevant findings from family caregiver research and studies of social environments that enhance skill development in people with intellectual disabilities are incorporated, within a cognitive-behavioural framework. Six important domains are identified which represent positive caregiver styles: acceptance, creating a positive atmosphere, expectations of change, responsiveness, normalisation and educativeness. The characteristics hypothesised to be critical for caregivers and support workers are defined in a general way that can allow for individualisation according to the goals of the programs and the cultural priorities of staff and patients. Further empirical validation of these characteristics would enable community mental health services to provide more specialised clinical treatments.

  12. New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition.

    Science.gov (United States)

    Akbulut, Gamze

    2011-07-01

    Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer.

  13. A well-being support program for patients with severe mental illness: a service evaluation

    Directory of Open Access Journals (Sweden)

    Dawber Nicky

    2011-03-01

    Full Text Available Abstract Background The risk of cardiovascular disease is increased in patients with severe mental illness (SMI dramatically reducing life expectancy. Method A real world pragmatic service evaluation of a Well-Being Support Program (WSP was conducted. This was a four-session package delivered over a one-year period by mental health practitioners that had received additional training in providing physical health assessment and intervention. Patients' physical health was screened and appropriate one-to-one and group intervention was offered. Results 212 mental health practitioners were trained in the WSP and 782 patients were enrolled on the program. The majority of our sample was overweight or obese; 66% had a Body Mass Index (BMI >25. Lifestyle risk factors for cardiovascular disease (CVD were common and the patients had low self esteem. The average number of formally recorded well-being sessions attended was 2.10. Just under a quarter of those patients enrolled in the program completed. The only cardiovascular risk factor that significantly altered in patients that completed the program was BMI. The qualitative feedback about the program was largely positive. Conclusions The need to intervene to enhance the physical health of people with SMI is beyond doubt. Maintaining patient engagement in a physical health improvement program is challenging. Regular comprehensive physical health monitoring is necessary to establish the benefit of intervention and increase life expectancy and well-being in this population.

  14. [Effect of nutritional support on survival in patients with amyotrophic lateral sclerosis].

    Science.gov (United States)

    López Gómez, J J; Ballesteros Pomar, Ma D; Vázquez Sánchez, F; Vidal Casariego, A; Calleja Fernández, A; Cano Rodríguez, I

    2011-01-01

    Malnutrition affects morbidity and mortality of patients with ALS. The nutrition unit should evaluate these patients early and regularly providing the necessary steps in the evolution of the disease. A retrospective cohort study in which we analyzed 46 patients diagnosed with ALS, 21 of them received nutritional therapy. We studied age, mode of onset, date of entry into a nutritional protocol, placement of PEG and survival. We performed a test of Breslow comparing patients who were at nutritional protocol with those not receiving nutritional support, and those who received early nutritional therapy with those with delayed nutrition. There was an increase in median survival for patients in nutritional therapy in bulbar ALS (452 vs 55 days) and in spinal ALS (1,798 vs 357 days) (p = 0.002). The median delay in the initiation of nutritional therapy in spinal ALS was 557 days while in bulbar ALS was 230 days. The survival in the spinal ALS of those who entered into nutritional protocol before the median survival was 325 days to 181 days (p = 0.09) while in bulbar ALS those who entered before had a median survival of 435 days to 177 days (p = 0.38). The entry of patients with ALS in a nutritional protocol increases survival. There is an advantage in the evolution of patients with early nutritional treatment.

  15. New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

    Science.gov (United States)

    AKBULUT, GAMZE

    2011-01-01

    Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer. PMID:22977559

  16. Comparison of patient's satisfaction with implant-supported mandibular overdentures and complete dentures

    Directory of Open Access Journals (Sweden)

    Yu-Hwa Pan

    2014-06-01

    Full Text Available Background: The purpose of this study was to compare patients' subjective experiences with respect to long-term satisfaction with mandibular implant-retained overdentures versus conventional complete dentures. Methods: Among 85 completely edentulous patients, 60 were treated with four one-stage titanium implants and overdentures retained by a cast bar with extracoronal attachments. These patients constituted the experimental group, and were subsequently evaluated clinically over a period of up to 6 years. The other 25 patients constituted the control group and were treated with conventional complete dentures without implant retained. All the patients (n = 60 in the experimental group responded to questions on their experiences before and after treatment with the implant-retained overdentures. Sixty percent (n = 15 of the 25 patients in the control group responded to the questionnaire. Results: No implants or restorations failed during the observation period. The experimental group, however, showed significant differences with the control group in terms of their responses to the questionnaire. Conclusion: The use of implants to retain and support the overdenture improved comfort and gave the experimental patients greater self-confidence in social interactions, in addition to more effective oral rehabilitation. The results demonstrate that the effects of rehabilitation of the mandibular arch with an implant-retained overdenture are predictable.

  17. Toward patient-centered, personalized and personal decision support and knowledge management: a survey.

    Science.gov (United States)

    Leong, T-Y

    2012-01-01

    This paper summarizes the recent trends and highlights the challenges and opportunities in decision support and knowledge management for patient-centered, personalized, and personal health care. The discussions are based on a broad survey of related references, focusing on the most recent publications. Major advances are examined in the areas of i) shared decision making paradigms, ii) continuity of care infrastructures and architectures, iii) human factors and system design approaches, iv) knowledge management innovations, and v) practical deployment and change considerations. Many important initiatives, projects, and plans with promising results have been identified. The common themes focus on supporting the individual patients who are playing an increasing central role in their own care decision processes. New collaborative decision making paradigms and information infrastructures are required to ensure effective continuity of care. Human factors and usability are crucial for the successful development and deployment of the relevant systems, tools, and aids. Advances in personalized medicine can be achieved through integrating genomic, phenotypic and other biological, individual, and population level information, and gaining useful insights from building and analyzing biological and other models at multiple levels of abstraction. Therefore, new Information and Communication Technologies and evaluation approaches are needed to effectively manage the scale and complexity of biomedical and health information, and adapt to the changing nature of clinical decision support. Recent research in decision support and knowledge management combines heterogeneous information and personal data to provide cost-effective, calibrated, personalized support in shared decision making at the point of care. Current and emerging efforts concentrate on developing or extending conventional paradigms, techniques, systems, and architectures for the new predictive, preemptive, and

  18. Emotions, Ideas and Experiences of Caregivers of Patients With Schizophrenia About "Family to Family Support Program".

    Science.gov (United States)

    Bademli, Kerime; Duman, Zekiye Çetinkaya

    2016-06-01

    "Family to Family Support Program" is a significant intervention program to assist families by informing them about treatment procedures and coping strategies, increasing their functionality, helping them to overcome the challenges of the disease. This study was particularly designed to investigate the emotions, thoughts, and experiences of caregivers of schizophrenia patients who participated in "Family to Family Support Program." The study was conducted with one of the qualitative research methods, phenomenological method. The study sample included caregivers who care for schizophrenia patients and participated in the "Family to Family Support Program". Twenty caregivers were included in the sample. The study was carried out in İzmir Schizophrenia Support Association. The study data were collected with four open ended questions. The average age of the participants was 56,77 ± 72,89, 10 male caregivers and 10 female caregivers, 9 caregivers were fathers, 6 caregivers were mothers, and 5 of them were siblings. The thematic analysis indicated that the emotions, thoughts and experiences of caregivers can be categorized in four groups: "I learned to deal with my problems", "I am conscious in my interaction with the patient and I know and I am not alone", "I feel much better", and "Schizophrenia is not the end of the road, knowledge sorts things out." Caregivers who participated in "Family to Family Support Program" expressed their satisfaction that they were benefited from the program, their coping skills were improved, they experienced less challenges when providing care, they understood the disease better, and it felt comfortable. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Supporting smoking cessation in older patients: a continuing challenge for community nurses

    OpenAIRE

    Phillips, A.

    2016-01-01

    Tobacco smoking continues to pose negative health consequences for smokers and their families, and is the single greatest cause of health inequalities in the UK. Older people are particularly vulnerable to the negative health impacts of smoking and therefore, supporting older smokers to quit remains an important public health goal. Community nurses are required to help patients to lead healthier lifestyles and have ideal opportunities to encourage smoking cessation in older people who are aff...

  20. STIGMA, SOCIAL SUPPORT, AND TREATMENT ADHERENCE AMONG HIV-POSITIVE PATIENTS IN CHIANG MAI, THAILAND

    OpenAIRE

    Li, Michael Jonathan; Murray, Jordan Keith; Suwanteerangkul, Jiraporn; Wiwatanadate, Phongtape

    2014-01-01

    Our study assessed the influence of HIV-related stigma on treatment adherence among people living with HIV in Chiang Mai, Thailand, and whether social support had a moderating effect on this relationship. We recruited 128 patients living with HIV from Sansai Hospital, a community hospital in Chiang Mai, Thailand, and collected data through structured interviews. All forms of HIV-related stigma considered in this study (personalized experience, disclosure, negative self-image, and public attit...

  1. "Sometimes you just have to walk alone"--meanings of emotional support among Danish-born and migrant cancer patients

    DEFF Research Database (Denmark)

    Kristiansen, Maria; Tjørnhøj-Thomsen, Tine; Krasnik, Allan

    2010-01-01

    The study explores differences and similarities in needs for and experiences with emotional support among Danish-born and migrant cancer patients. Qualitative narrative interviews with 18 adult cancer patients were conducted. Analysis was inspired by phenomenological methods. Migrant patients...... experienced more dispersed social networks compared to Danish-born patients. However, common difficulties in asking for and receiving emotional support were related to cancer being perceived as a fatal disease among the social network, and this lead to fear among patients that articulating needs for support...

  2. In the Aftermath: Attitudes of Anesthesiologists to Supportive Strategies After an Unexpected Intraoperative Patient Death.

    Science.gov (United States)

    Heard, Gaylene C; Thomas, Rowan D; Sanderson, Penelope M

    2016-05-01

    Although most anesthesiologists will have 1 catastrophic perioperative event or more during their careers, there has been little research on their attitudes to assistive strategies after the event. There are wide-ranging emotional consequences for anesthesiologists involved in an unexpected intraoperative patient death, particularly if the anesthesiologist made an error. We used a between-groups survey study design to ask whether there are different attitudes to assistive strategies when a hypothetical patient death is caused by a drug error versus not caused by an error. First, we explored attitudes to generalized supportive strategies. Second, we examined our hypothesis that the presence of an error causing the hypothetical patient death would increase the perceived social stigma and self-stigma of help-seeking. Finally, we examined the strategies to assist help-seeking. An anonymous, mailed, self-administered survey was conducted with 1600 consultant anesthesiologists in Australia on the mailing list of the Australian and New Zealand College of Anaesthetists. The participants were randomized into "error" versus "no-error" groups for the hypothetical scenario of patient death due to anaphylaxis. Nonparametric, descriptive, parametric, and inferential tests were used for data analysis. P' is used where P values were corrected for multiple comparisons. There was a usable response rate of 48.9%. When an error had caused the hypothetical patient death, participants were more likely to agree with 4 of the 5 statements about support, including need for time off (P' = 0.003), counseling (P' self-stigma (P = 0.98) or social stigma (P = 0.15) of seeking counseling, whether or not an error had caused the hypothetical patient death. Finally, when an error had caused the patient death, participants were more likely to agree with 2 of the 5 statements about help-seeking, including the need for a formal, hospital-based process that provides information on where to obtain

  3. Narratives of empowerment and compliance: studies of communication in online patient support groups.

    Science.gov (United States)

    Wentzer, Helle S; Bygholm, Ann

    2013-12-01

    New technologies enable new forms of patient participation in health care. The article discusses whether communication in online patient support groups is a source of individual as well as collective empowerment or to be understood within the tradition of compliance. The discussion is based on a qualitative analysis of patient communication in two online groups on the Danish portal sundhed.dk, one for lung patients and one for women with fertility problems. The object of study is the total sum of postings during a specific period of time - a total of 4301 posts are included. The textmaterial was analyzed according to the textual paradigm of Paul Ricoeur, and the three steps of critical interpretation. Thus, the analysis moves from describing communicative characteristics of the site to a thorough semantic analysis of its narrative structure of construing meaning, interaction and collective identity, and finally as a source of collective action. The meta-narratives of the two groups confirm online patient support groups for individual empowerment, for collective group identity, but not for collective empowerment. The collective identities of patienthood on the two sites are created by the users (patients) through specific styles of communication and interaction, referred to as 'multi-logical narratives'. In spite of the potential of online communities of opening up health care to the critical voice of the public, the analysis points to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. On a collective level, the site is empowering the individual users to comply with 'doctor's recommendations' as a group. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Lack of support structures in prioritization decision making concerning patients and resources. Interviews with Swedish physicians.

    Science.gov (United States)

    Werntoft, Elisabet; Edberg, Anna-Karin

    2011-08-01

    To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: prioritisation, easier in theory than in practice, and increasing costs threaten the Swedish welfare model. The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.

  5. Quality of online information to support patient decision-making in breast cancer surgery.

    Science.gov (United States)

    Bruce, Jordan G; Tucholka, Jennifer L; Steffens, Nicole M; Neuman, Heather B

    2015-11-01

    Breast cancer patients commonly use the internet as an information resource. Our objective was to evaluate the quality of online information available to support patients facing a decision for breast surgery. Breast cancer surgery-related queries were performed (Google and Bing), and reviewed for content pertinent to breast cancer surgery. The DISCERN instrument was used to evaluate websites' structural components that influence publication reliability and ability of information to support treatment decision-making. Scores of 4/5 were considered "good." 45 unique websites were identified. Websites satisfied a median 5/9 content questions. Commonly omitted topics included: having a choice between breast conservation and mastectomy (67%) and potential for 2nd surgery to obtain negative margins after breast conservation (60%). Websites had a median DISCERN score of 2.9 (range 2.0-4.5). Websites achieved higher scores on structural criteria (median 3.6 [2.1-4.7]), with 24% rated as "good." Scores on supporting decision-making questions were lower (2.6 [1.3-4.4]), with only 7% scoring "good." Although numerous breast cancer-related websites exist, most do a poor job providing women with essential information necessary to actively participate in decision-making for breast cancer surgery. Providing easily- accessible, high-quality online information has the potential to significantly improve patients' experiences with decision-making. © 2015 Wiley Periodicals, Inc.

  6. Factors Influencing Support for National Health Insurance among Patients Attending Specialist Clinics in Malaysia

    Science.gov (United States)

    Almualm, Yasmin; Alkaff, Sharifa Ezat; Aljunid, Syed; Alsagoff, Syed Sagoff

    2013-01-01

    This study was carried out to determine the level of support towards the proposed National Health Insurance scheme among Malaysian patients attending specialist clinics at the National University of Malaysia Medical centre and its influencing factors. The cross sectional study was carried out from July-October 2012. 260 patients were selected using multistage sampling method. 71.2% of respondents supported the proposed National Health insurance scheme. 61.4% of respondents are willing to pay up to RM240 per year to join the National Health Insurance and 76.6% of respondents are of the view that enrolment in NHI should be made compulsory. Knowledge had a positive influence on respondent's support towards National Health Insurance. National Health Insurance when implemented in Malaysia can be used to raise funds for health care financing, increase access to health services and achieve the desired health status. More efforts should be taken to promote the scheme and educate the public in order to achieve higher support towards the proposed National Health Insurance. The cost to enroll in NHI as well as services to be included under the scheme should be duly considered. PMID:23985101

  7. Sensorimotor plasticity after music-supported therapy in chronic stroke patients revealed by transcranial magnetic stimulation.

    Directory of Open Access Journals (Sweden)

    Julià L Amengual

    Full Text Available BACKGROUND: Several recently developed therapies targeting motor disabilities in stroke sufferers have shown to be more effective than standard neurorehabilitation approaches. In this context, several basic studies demonstrated that music training produces rapid neuroplastic changes in motor-related brain areas. Music-supported therapy has been recently developed as a new motor rehabilitation intervention. METHODS AND RESULTS: In order to explore the plasticity effects of music-supported therapy, this therapeutic intervention was applied to twenty chronic stroke patients. Before and after the music-supported therapy, transcranial magnetic stimulation was applied for the assessment of excitability changes in the motor cortex and a 3D movement analyzer was used for the assessment of motor performance parameters such as velocity, acceleration and smoothness in a set of diadochokinetic movement tasks. Our results suggest that the music-supported therapy produces changes in cortical plasticity leading the improvement of the subjects' motor performance. CONCLUSION: Our findings represent the first evidence of the neurophysiological changes induced by this therapy in chronic stroke patients, and their link with the amelioration of motor performance. Further studies are needed to confirm our observations.

  8. Sensorimotor plasticity after music-supported therapy in chronic stroke patients revealed by transcranial magnetic stimulation.

    Science.gov (United States)

    Amengual, Julià L; Rojo, Nuria; Veciana de Las Heras, Misericordia; Marco-Pallarés, Josep; Grau-Sánchez, Jennifer; Schneider, Sabine; Vaquero, Lucía; Juncadella, Montserrat; Montero, Jordi; Mohammadi, Bahram; Rubio, Francisco; Rueda, Nohora; Duarte, Esther; Grau, Carles; Altenmüller, Eckart; Münte, Thomas F; Rodríguez-Fornells, Antoni

    2013-01-01

    Several recently developed therapies targeting motor disabilities in stroke sufferers have shown to be more effective than standard neurorehabilitation approaches. In this context, several basic studies demonstrated that music training produces rapid neuroplastic changes in motor-related brain areas. Music-supported therapy has been recently developed as a new motor rehabilitation intervention. In order to explore the plasticity effects of music-supported therapy, this therapeutic intervention was applied to twenty chronic stroke patients. Before and after the music-supported therapy, transcranial magnetic stimulation was applied for the assessment of excitability changes in the motor cortex and a 3D movement analyzer was used for the assessment of motor performance parameters such as velocity, acceleration and smoothness in a set of diadochokinetic movement tasks. Our results suggest that the music-supported therapy produces changes in cortical plasticity leading the improvement of the subjects' motor performance. Our findings represent the first evidence of the neurophysiological changes induced by this therapy in chronic stroke patients, and their link with the amelioration of motor performance. Further studies are needed to confirm our observations.

  9. Sensorimotor Plasticity after Music-Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation

    Science.gov (United States)

    Amengual, Julià L.; Rojo, Nuria; Veciana de las Heras, Misericordia; Marco-Pallarés, Josep; Grau-Sánchez, Jennifer; Schneider, Sabine; Vaquero, Lucía; Juncadella, Montserrat; Montero, Jordi; Mohammadi, Bahram; Rubio, Francisco; Rueda, Nohora; Duarte, Esther; Grau, Carles; Altenmüller, Eckart; Münte, Thomas F.; Rodríguez-Fornells, Antoni

    2013-01-01

    Background Several recently developed therapies targeting motor disabilities in stroke sufferers have shown to be more effective than standard neurorehabilitation approaches. In this context, several basic studies demonstrated that music training produces rapid neuroplastic changes in motor-related brain areas. Music-supported therapy has been recently developed as a new motor rehabilitation intervention. Methods and Results In order to explore the plasticity effects of music-supported therapy, this therapeutic intervention was applied to twenty chronic stroke patients. Before and after the music-supported therapy, transcranial magnetic stimulation was applied for the assessment of excitability changes in the motor cortex and a 3D movement analyzer was used for the assessment of motor performance parameters such as velocity, acceleration and smoothness in a set of diadochokinetic movement tasks. Our results suggest that the music-supported therapy produces changes in cortical plasticity leading the improvement of the subjects' motor performance. Conclusion Our findings represent the first evidence of the neurophysiological changes induced by this therapy in chronic stroke patients, and their link with the amelioration of motor performance. Further studies are needed to confirm our observations. PMID:23613966

  10. Psychological aspects of caregivers associated with family support in the therapeutic adherence of diabetic patients

    Directory of Open Access Journals (Sweden)

    Miriam Teresa Domínguez - Guedea

    2010-03-01

    Full Text Available Objective: To analyze the relationship of psychological aspects of family caregivers with the support that they offer to the diabetic patient’s adherence to treatment. The psychological aspects were: subjective well-being, attachment styles, coping strategies to problems and perceived social support. Methods: Joined in the study 29 family caregivers in a noneprobabilistic sample. Participants were contacted from three Mutual Aid Groups for diabetic and hypertensive patients in the city of Hermosillo, México. Questionnaires designed for the purposes of research were applied, as well as psychometric instruments previously validated in the cultural reference group. Results: The data showed that the psychological aspects that are statistically significant and negatively related to adherence therapy are avoidant attachment and negative affection, both associated to each other in a positive way, indicating that they occur in parallel. Avoidant attachment was positively associated with avoidant coping strategies and emotional disturbance, but negatively with secure attachment and material satisfaction. Negative affection were positively associated with emotional coping, but negatively with secure attachment and material satisfaction. Negative affect were positively associated with emotional confrontation, but negatively with positive affection, material satisfaction, emotional support and guidance support. Conclusions: More applied research in needed on the influence of family factors in achieving adherence to treatment, because so far, most work focuses more on the individual patient, disregarding the family factor.

  11. Preparation and Support of Patients through the Transplant Process: Understanding the Recipients' Perspectives

    Directory of Open Access Journals (Sweden)

    Oliver Mauthner

    2012-01-01

    Full Text Available Preparation for heart transplant commonly includes booklets, instructional videos, personalized teaching sessions, and mentorship. This paper explores heart transplant recipients’ thoughts on their preparation and support through the transplant process. Twenty-five interviews were audio-/videotaped capturing voice and body language and transcribed verbatim. Coding addressed language, bodily gesture, volume, and tone in keeping with our visual methodology. Recipients reported that only someone who had a transplant truly understands the experience. As participants face illness and life-altering experiences, maintaining a positive attitude and hope is essential to coping well. Healthcare professionals provide ongoing care and reassurance about recipients’ medical status. Mentors, family members, and close friends play vital roles in supporting recipients. Participants reported that only heart transplant recipients understood the experience, the hope, and ultimately the suffering associated with living with another persons’ heart. Attention needs to be focused not solely on the use of teaching modalities, but also on the development of innovative support networks. This will promote patient and caregiver engagement in self-management. Enhancing clinicians’ knowledge of the existential aspects of transplantation will provide them with a nuanced understanding of the patients’ experience, which will ultimately enhance their ability to better prepare and support patients and their caregivers.

  12. Home Enteral Nutrition therapy: Difficulties, satisfactions and support needs of caregivers assisting older patients.

    Science.gov (United States)

    Jukic P, Nikolina; Gagliardi, Cristina; Fagnani, Donata; Venturini, Claudia; Orlandoni, Paolo

    2017-08-01

    The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's "Home Enteral Nutrition Caregiver Task Checklist" was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's "Home Enteral Nutrition Caregiver Task Checklist". This qualitative study underlined the challenges and adaptations of

  13. A decision support tool for appropriate glucose-lowering therapy in patients with type 2 diabetes.

    Science.gov (United States)

    Ampudia-Blasco, F Javier; Benhamou, Pierre Yves; Charpentier, Guillaume; Consoli, Agostino; Diamant, Michaela; Gallwitz, Baptist; Khunti, Kamlesh; Mathieu, Chantal; Ridderstråle, Martin; Seufert, Jochen; Tack, Cees; Vilsbøll, Tina; Phan, Tra-Mi; Stoevelaar, Herman

    2015-03-01

    Optimal glucose-lowering therapy in type 2 diabetes mellitus requires a patient-specific approach. Although a good framework, current guidelines are insufficiently detailed to address the different phenotypes and individual needs of patients seen in daily practice. We developed a patient-specific decision support tool based on a systematic analysis of expert opinion. Based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) 2012 position statement, a panel of 12 European experts rated the appropriateness (RAND/UCLA Appropriateness Method) of treatment strategies for 930 clinical scenarios, which were permutations of clinical variables considered relevant to treatment choice. These included current treatment, hemoglobin A1c difference from individualized target, risk of hypoglycemia, body mass index, life expectancy, and comorbidities. Treatment options included addition of a second or third agent, drug switches, and replacement by monotherapies if the patient was metformin-intolerant. Treatment costs were not considered. Appropriateness (appropriate, inappropriate, uncertain) was based on the median score and expert agreement. The panel recommendations were embedded in an online decision support tool (DiaScope(®); Novo Nordisk Health Care AG, Zürich, Switzerland). Treatment appropriateness was associated with (combinations of) the patient variables mentioned above. As second-line agents, dipeptidyl peptidase-4 inhibitors were considered appropriate in all scenarios, followed by glucagon-like peptide-1 receptor agonists (50%), insulins (33%), and sulfonylureas (25%), but not pioglitazone (0%). Ratings of third-line combinations followed a similar pattern. Disagreement was highest for regimens including pioglitazone, sulfonylureas, or insulins and was partly due to differences in panelists' opinions and in drug availability and reimbursement across European countries (although costs were disregarded in the rating process

  14. Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year.

    Science.gov (United States)

    Gargari, M; Prete, V; Pujia, M; Ceruso, F M

    2012-10-01

    Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. Forty-three patients were selected from the out patient clinic, Department of Dentistry "Fra G.B. Orsenigo Ospedale San Pietro F.B.F.", Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. DISCUSSION AND RESULT: The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn't difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven't difficulty in removal and insertion of the denture and in oral hygiene. They haven't in both groups problems related to fractures.

  15. Modulation of NF-KB in rescued irradiated cells

    International Nuclear Information System (INIS)

    Lam, R.K.K.; Fung, Y.K.; Han, W.; Li, L.; Chiu, S.K.; Cheng, S.H.; Yu, K.N.

    2015-01-01

    Studies by different groups on the rescue effect, where unirradiated bystander cells mitigated the damages in the irradiated cells, since its discovery by the authors' group in 2011 were first reviewed. The properties of the rescue effect were then examined using a novel experimental set-up to physically separate the rescue signals from the bystander signals. The authors' results showed that the rescue effect was mediated through activation of the nuclear factor-KB (NF-KB) response pathway in the irradiated cells, and that the NF-KB activation inhibitor BAy -1 1-7082 did not affect the activation of this response pathway in the irradiated cells induced by direct irradiation. (authors)

  16. Expectations of a business rescue plan: international directives for ...

    African Journals Online (AJOL)

    Kirstam

    2014-09-01

    Sep 1, 2014 ... 10Key words: business rescue, South African Companies Act, business ... countries such as Germany, Australia, the United Kingdom (UK) and ...... operating statistics and detailed cash flow projections is needed for sound risk.

  17. Achievements in emergency medical rescue service, North-West ...

    African Journals Online (AJOL)

    2006-08-28

    Aug 28, 2006 ... In North-West province this process of provincialisation took place in ... Emergency Medical Rescue Service, Department of Health, North-West. Victor R .... recovery after CPR treatment should be started as soon as possible ...

  18. The Cognitive Dissonance between Child Rescue and Child Protection

    NARCIS (Netherlands)

    K.E. Cheney (Kristen)

    2015-01-01

    textabstract‘Saving orphans’ has become an industry that irrevocably harms children and undermines the development of child welfare systems. We must replace the drive to rescue with the desire to protect.

  19. That Others May Live: USAF Air Rescue in Korea

    National Research Council Canada - National Science Library

    Marion, Forrest L

    2004-01-01

    When the Korean War began in June 1950, the United States Air Force's Air Rescue Service was a fledgling organization possessing a variety of aircraft types, most having seen service during World War II...

  20. Outcomes of pediatric patients supported with continuous-flow ventricular assist devices: A report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS).

    Science.gov (United States)

    Rossano, Joseph W; Lorts, Angela; VanderPluym, Christina J; Jeewa, Aamir; Guleserian, Kristine J; Bleiweis, Mark S; Reinhartz, Olaf; Blume, Elizabeth D; Rosenthal, David N; Naftel, David C; Cantor, Ryan S; Kirklin, James K

    2016-05-01

    Continuous-flow (CF) ventricular assist devices (VADs) have largely replaced pulsatile-flow VADs in adult patients. However, there are few data on CF VADs among pediatric patients. In this study we aimed to describe the overall use, patients' characteristics and outcomes of CF VADs in this population. The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a national registry for U.S. Food and Drug Adminstration (FDA)-approved VADs in patients <19 years of age. Patients undergoing placement of durable CF VADs between September 2012 and June 2015 were included and outcomes were compared with those of adults from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). CF VADs were implanted in 109 patients at 35 hospitals. The median age at implantation was 15 years (2.8 to 18.9 years) and median weight was 62 kg (range 16 to 141 kg). The underlying disease was cardiomyopathy in 89 (82%) patients. The INTERMACS level at time of implant was Level 1 in 20 (19%), Level 2 in 64 (61%) and Levels 3 to 7 in 21 (20%) patients. Most were implanted as LVADs (n = 102, 94%). Median duration of support was 2.3 months (range <1 day to 28 months). Serious adverse event rates were low, including neurologic dysfunction (early event rate 4.1 per 100 patient-months with 2 late events). Competing outcomes analysis at 6 months post-implant indicated 61% transplanted, 31% alive with device in place and 8% death before transplant. These outcomes compared favorably with the 3,894 adults supported with CF VADs as a bridge to transplant. CF VADs are commonly utilized in older children and adolescents, with excellent survival rates. Further study is needed to understand impact of patient and device characteristics on outcomes in pediatric patients. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  1. Influence of Neighborhood-level Factors on Social Support in Early-stage Breast Cancer Patients and Controls

    Science.gov (United States)

    Thompson, Tess; Rodebaugh, Thomas L.; Pérez, Maria; Struthers, Jim; Sefko, Julianne A.; Lian, Min; Schootman, Mario; Jeffe, Donna B.

    2016-01-01

    Rationale Low social support has been linked to negative health outcomes in breast cancer patients. Objective We examined associations between perceived social support, neighborhood socioeconomic deprivation, and neighborhood-level social support in early-stage breast cancer patients and controls. Methods This two-year longitudinal study in the United States included information collected from telephone interviews and clinical records of 541 early-stage patients and 542 controls recruited from 2003 to 2007. Social support was assessed using the Medical Outcomes Study Social Support Survey (MOS-SS). Residential addresses were geocoded and used to develop measures including neighborhood social support (based on MOS-SS scores from nearby controls) and neighborhood socioeconomic deprivation (a composite index of census tract characteristics). Latent trajectory models were used to determine effects of neighborhood conditions on the stable (intercept) and changing (slope) aspects of social support. Results In a model with only neighborhood variables, greater socioeconomic deprivation was associated with patients’ lower stable social support (standardized estimate = −0.12, p = .027); neighborhood-level social support was associated with social support change (standardized estimate = 0.17, p = .046). After adding individual-level covariates, there were no direct neighborhood effects on social support. In patients, neighborhood socioeconomic deprivation was associated with support indirectly through marriage, insurance status, negative affect, and general health. In controls, neighborhood socioeconomic deprivation was associated with support indirectly through marriage (p social support differed in patients and controls. Psychosocial and neighborhood interventions may help patients with low social support, particularly patients without partnered relationships in deprived areas. PMID:27017091

  2. The relationship between body esteem, exercise motivations, depression, and social support among female free clinic patients.

    Science.gov (United States)

    Kamimura, Akiko; Christensen, Nancy; Al-Obaydi, Sarah; Solis, Silvia Patricia; Ashby, Jeanie; Greenwood, Jessica L J; Reel, Justine J

    2014-01-01

    Obesity is a significant public health problem in women's health. This study examined relationship between body esteem, exercise motivations, depression, and social support among female free clinic patients. Low-income women who are at risk for obesity and other health concerns would benefit from health education efforts. We compared 299 female and 164 male free clinic patients 18 years or older using assessments for body esteem, motivation to exercise, depression, and social support. Although female participants reported lower levels of body esteem and higher levels of depression compared with male participants (p exercise for weight-related reasons than male participants (p exercise motivations compared with non-U.S.-born female participants (p exercise motivation among female free clinic patients (p health educators to engage a myriad of physical activity motives to increase the likelihood that clients will experience enjoyment and sustained adoption of exercise into their lifestyle. Future practice and research should warrant the implementation of body image and physical activity programs and the potential impact of using exercise to reducing depression among female patients at free clinics. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  3. Barriers to counselling support for HIV/AIDS patients in south-western Cameroon.

    Science.gov (United States)

    Fonchingong, Charles C; Mbuagbo, Timothy O; Abong, Jennifer T

    2004-11-01

    The potential synergy between counselling and HIV/AIDS prevention is gaining recognition in Cameroon as counselling sessions are more often organised at health centres. In order to evaluate the actual achievements of these efforts, a qualitative ethnographic survey (based on interviews and focus group discussions) was conducted in two public and two private hospitals in the South-West Province. Churches and public health officials in Cameroon are struggling with the psycho-social, philosophical, psychological, theological, social, moral, ethical and cultural dimensions of HIV/AIDS, as they seek out viable prevention strategies. Health centres are also struggling to embrace the full meaning of counselling and to make psychological and spiritual support to AIDS patients available through the centres. Patients using these health centres may receive HIV testing against a backdrop of cultural standards that allow unsafe sex and bar open discussion on sex and sexuality. We propose that reversing the trend of the epidemic requires the intervention of the State, organisations in civil society and the family. Equally crucial is the role played by the churches - especially in confronting issues of stigmatisation and abandonment that often accompany patient disclosure, and in providing spiritual, emotional and psychological support to patients undergoing treatment.

  4. Storytelling as part of cancer rehabilitation to support cancer patients and their relatives.

    Science.gov (United States)

    la Cour, Karen; Ledderer, Loni; Hansen, Helle Ploug

    2016-01-01

    Previous research on psychosocial support for cancer-related concerns has primarily focused on either patients or their relatives, although limited research is available on how patients and their relatives can be supported together. The aim of this article is to explore the use of storytelling as a part of a residential cancer rehabilitation intervention for patients together with their relatives, with a specific focus on their management of cancer-related concerns. Ten pairs participated in the intervention and data were generated through ethnographic fieldwork, including participant observations, informal conversations and follow-up interviews conducted one month after completing the intervention. Analysis was performed drawing on narrative theory combined with social practice theory. The results demonstrate that the use of storytelling and metaphors intertwined with other course activities, such as dancing and arts & crafts, provided the patients and their relatives with strategies to manage cancer-related concerns, which they were later able to apply in their everyday lives. The study results may be useful to other professionals in clinical practice for rehabilitation purposes for addressing issues of fear and worry.

  5. Hydrometry data rescue, a stake for the future

    Directory of Open Access Journals (Sweden)

    Pons Frédéric

    2016-01-01

    Full Text Available The knowledge of past events and long-term series is a base to understand phenomena, analyze climate change and forecast future events. To increase long term series and their accuracy, NUNIEAU software, sort of “Digitizing Table”, was developed and distributed freely since 2006 by Cerema. It is an international reference in tide gauge record, but has been improved to widespread its used for river and rainfall record. The SCHAPI (the French national service for hydrometeorology and support to flood forecasting launched a tender to rescue the old data on rainfall and rivers available. Many improvements have been done to manage different types of rainfall charts. NUNIEAU was developed in French and is also available in English and Spanish version with collaboration of foreign institutes. Main challenge is not only to digitize old data but also assess the quality of digitized data. Protocol has been done to control the digitizing process and after to allows assessing the final quality of data.

  6. The work of the South Manchester Accident Rescue Team (SMART).

    Science.gov (United States)

    Redmond, A D

    1990-01-01

    Skills acquired in the hospital do not necessarily translate to the scene of an accident. However, training in certain hospital specialties, particularly accident and emergency medicine, will expose doctors to dealing with very ill patients in a less rigidly structured environment. The operating theatre is a disciplined and controlled environment. Skill in anaesthesia, monitoring and operating, if tested only in these circumstances may be found to be gravely inadequate when exposed to the fluctuant and hostile environment at the site. Doctors who wish to do this sort of work or are designated to do it, must undergo regular and frequent training, especially if they are not trained in accident and emergency departments. This has long been recognised by the British Association for Immediate Care. In combination with the Royal College of Surgeons of Edinburgh they have now established a diploma in Immediate Medical Care. In urban areas the need for a doctor to attend at the scene of an accident is usually limited to entrapment. These occasions are likely to be infrequent and this can result in a lack of preparedness for such events. Interhospital transfer, primarily from peripheral hospitals to the specialist services of a teaching hospital, often involves critically ill and injured patients. The management of these cases by the mobile team provides regular, frequent exposure to working in a 'hostile' environment. Relationships with the rescue services are developed and staff become familiar with equipment and call-out procedures. The care of transported patients is improved. None of our patients have died in transit or within 6 h of arrival at base.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Coaching patients in the use of decision and communication aids: RE-AIM evaluation of a patient support program.

    Science.gov (United States)

    Belkora, Jeff; Volz, Shelley; Loth, Meredith; Teng, Alexandra; Zarin-Pass, Margot; Moore, Dan; Esserman, Laura

    2015-05-28

    Decision aids educate patients about treatment options and outcomes. Communication aids include question lists, consultation summaries, and audio-recordings. In efficacy studies, decision aids increased patient knowledge, while communication aids increased patient question-asking and information recall. Starting in 2004, we trained successive cohorts of post-baccalaureate, pre-medical interns to coach patients in the use of decision and communication aids at our university-based breast cancer clinic. From July 2005 through June 2012, we used the RE-AIM framework to measure Reach, Effectiveness, Adoption, Implementation and Maintenance of our interventions. 1. Reach: Over the study period, our program sent a total of 5,153 decision aids and directly administered 2,004 communication aids. In the most recent program year (2012), out of 1,524 eligible patient appointments, we successfully contacted 1,212 (80%); coached 1,110 (73%) in the self-administered use of decision and communication aids; sent 958 (63%) decision aids; and directly administered communication aids for 419 (27%) patients. In a 2010 survey, coached patients reported self-administering one or more communication aids in 81% of visits 2. Effectiveness: In our pre-post comparisons, decision aids were associated with increased patient knowledge and decreased decisional conflict. Communication aids were associated with increased self-efficacy and number of questions; and with high ratings of patient preparedness and satisfaction 3. Adoption: Among visitors sent decision aids, 82% of survey respondents review