Development of a positive psychology intervention for patients with acute cardiovascular disease

The management of depression and other negative psychological states in cardiac patients has been a focus of multiple treatment trials, though such trials have not led to substantial improvements in cardiac outcomes. In contrast, there has been minimal focus on interventions to increase positive psychological states in cardiac patients, despite the fact that optimism and other positive states have been associated with superior cardiovascular outcomes. Our objective was to develop an 8-week, phone-based positive psychology intervention for patients hospitalized with acute cardiac disease (acute coronary syndrome or decompensated heart failure). Such an intervention would consist of positive psychology exercises adapted for this specific population, and it would need to be feasible for practitioners and patients in real-world settings. By adapting exercises that were previously validated in healthy individuals, we were able to generate a positive psychology telemedicine intervention for cardiac patients that focused on optimism, kindness, and gratitude. In addition, we successfully created a companion treatment manual for subjects to enhance the educational aspects of the intervention and facilitate completion of exercises. Finally, we successfully performed a small pilot trial of this intervention, and found that the positive psychology intervention appeared to be feasible and well-accepted in a cohort of patients with acute cardiac illness. Future studies should further develop this promising intervention and examine its impact on psychological and medical outcomes in this vulnerable population of cardiac patients

Development of the State Optimism Measure

Background Optimism, or positive expectations about the future, is associated with better health. It is commonly assessed as a trait, but it may change over time and circumstance. Accordingly, we developed a measure of state optimism. Methods An initial 29-item pool was generated based on literature reviews and expert consultations. It was administered to three samples: sample 1 was a general healthy population (n = 136), sample 2 was people with cardiac disease (n = 96), and sample 3 was persons recovering from problematic substance use (n = 265). Exploratory factor analysis and item-level descriptive statistics were used to select items to form a unidimensional State Optimism Measure (SOM). Confirmatory factor analysis (CFA) was performed to test fit. Results The selected seven SOM items demonstrated acceptable to high factor loadings on a single dominant factor (loadings: 0.64–0.93). There was high internal reliability across samples (Cronbach\u27s alphas: 0.92–0.96), and strong convergent validity correlations in hypothesized directions. The SOM\u27s correlations with other optimism measures indicate preliminary construct validity. CFA statistics indicated acceptable fit of the SOM model. Conclusions We developed a psychometrically-sound measure of state optimism that can be used in various settings. Predictive and criterion validity will be tested in future studies

Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

Objectives:We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged-infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies.Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries.Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT(> MIC) (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving beta-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of >= 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025].Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

INTIMATE PARTNER VIOLENCE: analisi epidemiologica della conoscenza da parte delle studentesse in ostetricia della regione Lombardia

One in three women will experience of violence by intimate partner at some point in her life. Because this kind of experience is so predominant among women, and since midwives are the healthcare workers that take care of women, the first purpose of this study was to examine the knowledge of the problem of Intimate Partner Violence (IPV) among midwifery students from distinct universities in Lombardy (Italy). The second purpose was to examine educational and training experiences and what students think about the need of education about IPV for future midwives. A not probabilistic sample of 197 students was recruited online, and had to complete a validated questionnaire took from \u201cA Cross-Cultural Comparative Study of Undergraduate Health Care Professional Students\u2019 Knowledge, Definitions, Education, and Training Experience of Domestic Violence in Northern Ireland and Jordan\u201d (N.M. Al Ali, A. Lazenbatt). The results showed that a substantial percentage of all partecipants didn\u2019t receive any education or informations/material about IPV during lessons. The majority of partecipants had gone on training, but they had not a good knowledge about IPV. The students\u2019 opinion about the need of education on IPV for future midwives was strongly positive, with very little negative response. In accordance with the results and with literature, the third purpose of this study was the actionable proposition to educate future midwives to make an aware prevention based on knowledge of IPV, to recognize and manage women that are victims of IPV, by the creation of an Italian acronym: V.I.O.L.E.N.Z.A

A general and accurate measurement procedure for the detection of power losses variations in permanent magnet synchronous motor drives

The research of innovative solutions to improve the efficiency of electric drives is of considerable interest to challenges related to energy savings and sustainable development. In order to successfully validate the adoption of new and innovative software or hardware solutions in the field of electric drives, accurate measurement procedures for either efficiency or power losses are needed. Moreover, high accuracy and expensive measurement equipment are required to satisfy international standard prescriptions. In this scenario, this paper describes an accurate measurement procedure, which is independent of the accuracy of the adopted instrumentation, for the power losses variations involved in electrical drives, namely DDP, useful to detect the efficiency enhancement (or power losses reduction) due to the real-time modification of the related control algorithm. The goal is to define a valuable measurement procedure capable of comparing the impact of different control algorithms on electric drive performance. This procedure is carried out by experimentally verifying the action of different control algorithms by the use of a Field Oriented Control (FOC) with different values of the direct-axis current component (i.e., Id = 0 A and Id = =-1 A) applied for fixed working conditions in terms of speed and load torque. Two different measurement systems of power losses, each one characterized by different accuracy and cost, are taken into account for the validation of the proposed method. An investigation is, then, carried out, based on the comparison between the measurements acquired by both instrumentations, for different working conditions in terms of load and speed, highlighting that the uncertainty generated by systematic errors does not affect the DDP measurements. The results reported in this work demonstrate how the DDP parameter can be used as a valuable index for the characterization of the power drive system, which can also be evaluated even with low-accuracy instrumentation

Basi fisiologiche della resistenza alla clorosi ferrica nella vite

Iron chlorosis deficiency is a widwspread phenomenon particularly evident in calcareous and alkaline soils. Fe-efficiency/inefficiency is genetically determined and it is possible to find in the same species cv that are Fe-efficient and cultivars that are Fe- efficient. Currently, plants are divided into two strategies: strategy I (dicotyledons and monocotyledons except grasses) and strategy II (grasses) according to their capacity to take up iron. Grapevine is a strategy I plan