Transcatheter aortic valve replacement in Bicuspid Aortic Valve Disease: An Insight

As per the current scenario, role of Transcatheter aortic valve replacement (TAVI) is controversial in bicuspid aortic valve stenosis. All the randomized clinical trials comparing outcomes of TAVI with surgery till date, have excluded patients with bicuspid aortic valve. Some of the observational studies have reported outcomes of TAVI in bicuspid aortic valve stenosis patients who are not surgical candidate. The recent advances in TAVI and its expansion into intermediate groups, which includes younger age groups sparks a debate on the efficacy and safety of TAVI in Bicsuspid aortic valve (BAV). The purpose of the present article is to review the available literature regarding the feasibility, safety and outcomes of TAVI in bicuspid aortic valve stenosis

SAFETY OF TRANSRADIAL CARDIAC CATHETERIZATION IN PATIENTS WITH END-STAGE LIVER DISEASE

The current study adopted McAdams’ multilayer framework as the basis to develop a psychological portrait of an elite athlete who was identified as being particularly “mentally tough.” The aim was to use this single case as an exemplar to demonstrate the utility of McAdams’ framework for understanding the complexity of sport performers across three domains of personality: dispositional traits, characteristic adaptations, and narrative identity. We operationalised these domains through the development of specific research questions and, subsequently, the collection and integration of the participant’s Big Five traits, personal strivings, coping strategies, and response to a life story interview. The results offered a comprehensive insight into the nature of one athlete’s personality that, in turn, informed conceptual perspectives of mental toughness in sport psychology literature and qualitatively supported emerging evidence of the validity of a three-layer framework in personality psychology. Specifically, the study’s design showed how a holistic approach to personality analysis can lead to a more complete psychological representation of competitors in sport, and people generally. It demonstrated how motivational, sociocultural, and meaning-making aspects of personality can complement a trait profile to achieving a satisfying assessment of the whole person

The Transradial Approach for Cardiac Catheterization and Percutaneous Coronary Intervention: A Review

Cardiac catheterization and percutaneous coronary intervention play an important role in the management of coronary artery disease. Although the transfemoral approach has been the traditionally dominant method, there has been an increased utilization of the transradial approach. Multiple observational studies and randomized clinical trials have shown fewer bleeding complications, reduced morbidity and mortality, improved quality of life, and better economic outcomes when the transradial approach is utilized when compared to the transfemoral approach. Despite its many benefits, utilization of this approach in certain countries including the United States has been less than optimal due to a lower adoption rates mostly driven by lack of training opportunities and decreased awareness of clinical benefits of the transradial approach. In this review, the history, observational trends, efficacy, and technical aspects of transradial cardiac catheterization and percutaneous coronary intervention are discussed

Frailty and Cardiovascular Disease

Cardiovascular disease (CVD) comprises a vast spectrum of disease states ranging from hypertension (HTN) to valvular heart disease (VHD). CVD is known to be the leading cause of morbidity, mortality, and health‐care expenditure throughout the world. According to the World Health Organization, coronary artery disease (CAD) and stroke, both subsets of CVD, are the world’s biggest killers, accounting for a combined 15 million deaths in 2015. These diseases have remained the leading causes of death globally in the last 15 years. In 2010, CAD alone was projected to cost the U.S. $108.9 billion including the cost of health‐care services, medications, and lost productivity. The presence of frailty significantly worsens outcomes for patients suffering from CAD. With just this one example of how frailty affects CVD, it is clear that understanding the impact of frailty upon patients afflicted with the spectrum of cardiovascular disease is integral for the care of this very significant patient population

Segmentation by Motivation in Ecotourism: Application to Protected Areas in Guayas, Ecuador

[EN] Among tourists, there is recently a growing interest in the environment and enjoying the natural world. This study analyzed the motivations and segmentation of the demand for ecotourism, using functional theory as a reference point. Empirical analysis was carried out in Santay National Recreation Area, Morro Mangrove Wildlife Refuge, and Samanes National Recreation Area. The sample included 382 surveys, obtained in situ using the simple random sampling method. Factorial analysis and non-hierarchical segmentation were performed to analyze the data. The results indicate that there are several motivational dimensions in ecotourism, including self-development, interpersonal relationships and ego-defensive function, building personal relationships, escape reward, and nature appreciation. We also identified three different segments of ecotourists based on their motivations¿nature, multiple motives, and reward and escape¿as well as the characteristics of the different segments. 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Developing the Travel Career Approach to Tourist Motivation. Journal of Travel Research, 43(3), 226-237. doi:10.1177/0047287504272020Lee, S., Lee, S., & Lee, G. (2013). Ecotourists’ Motivation and Revisit Intention: A Case Study of Restored Ecological Parks in South Korea. Asia Pacific Journal of Tourism Research, 19(11), 1327-1344. doi:10.1080/10941665.2013.852117Ma, A. T. H., Chow, A. S. Y., Cheung, L. T. O., & Liu, S. (2018). Self-determined travel motivation and environmentally responsible behaviour of Chinese visitors to national forest protected areas in South China. Global Ecology and Conservation, 16, e00480. doi:10.1016/j.gecco.2018.e00480Ma, A., Chow, A., Cheung, L., Lee, K., & Liu, S. (2018). Impacts of Tourists’ Sociodemographic Characteristics on the Travel Motivation and Satisfaction: The Case of Protected Areas in South China. Sustainability, 10(10), 3388. doi:10.3390/su10103388Chow, A. S. Y., Cheng, I. N. Y., & Cheung, L. T. O. (2017). 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CONDUÇÃO E DOENÇA DE ALZHEIMER: UMA BATERIA DE TRIAGEM NEUROPSICOLÓGICA PARA IDOSOS

As life expectancy increases, there is a marked increase in the elderly population eager to continue driving. A large proportion of these elderly drive safely, however, patients with mild dementia are high-risk drivers. Objective: to identify the cognitive tests that best predict driving ability in subjects with mild dementia. Methods: 28 drivers with mild dementia and 28 healthy elderly subjects underwent an extensive cognitive assessment (NACC Uniform Data Set Neuropsychological Battery), completed an adapted On Road Driving Test (ORDT) and a Driving Simulator assessment. Results: drivers with mild dementia made more mistakes on the ORDT and had slower responses in the simulator tasks. Cognitive tests correlated strongly with on road and simulator driving performance. Age, the Digit Symbol Modalities Test and Boston Naming Test scores were the variables that best predicted performance on the ORDT and were included in a logistic regression model. Conclusion: the strong correlation between driving performance and performance on specific cognitive tests supports the importance of cognitive assessment as a useful tool for deciding whether patients with mild dementia can drive safely. The algorithm including these three variables could be used as a screening tool for the detection of unsafe driving in elderly subjects with cognitive decline