Management of congestive heart failure: a gender gap may still exist. Observations from a contemporary cohort

BACKGROUND: Unlike other cardiovascular diseases the incidence and prevalence of congestive heart failure (CHF) continues to increase. While gender differences in coronary artery disease have been well described, to date, there has been a relative paucity of similar data in patients with CHF. We conducted a pilot study to evaluate the profile and management of patients with CHF at a tertiary care centre to determine if a gender difference exists. METHODS: A chart review was performed at a tertiary care centre on consecutive patients admitted with a primary diagnosis of CHF between June 1997 and 1998. Co-morbidity, diagnostic investigations, and management of CHF were recorded. Comparisons between male and female patients were conducted. RESULTS: One hundred and forty five patients were reviewed. There were 80 male (M) and 65 female (F) patients of similar age [71.6 vs. 71.3 (M vs. F), p = NS]. Male patients were more likely to have had a previous myocardial infarction (66% vs. 35%, p < 0.01) and revascularization (41% vs. 20%, p < 0.05), and had worse left ventricular ejection fraction (LVEF) than women, [median LVEF 3 vs. 2 (M vs. F), p < 0.01]. Male patients were more likely to have a non-invasive assessment of left ventricular (LV) function [85% vs. 69%, (M vs. F), p < 0.05]. A logistic regression analysis suggests that amongst those without coronary disease, males were more likely to receive non-invasive testing. There were no differences in the use of prescribed medications, in this cohort. CONCLUSIONS: This pilot study demonstrated that there seem to be important gender differences in the profile and management of patients with CHF. Importantly women were less likely to have an evaluation of LV function. As assessment of LV function has significant implications on patient management, this data justifies the need for larger studies to assess gender differences in CHF profile and treatment

Risk-taking attitudes and their association with process and outcomes of cardiac care: a cohort study

<p>Abstract</p> <p>Background</p> <p>Prior research reveals that processes and outcomes of cardiac care differ across sociodemographic strata. One potential contributing factor to such differences is the personality traits of individuals within these strata. We examined the association between risk-taking attitudes and cardiac patients' clinical and demographic characteristics, the likelihood of undergoing invasive cardiac procedures and survival.</p> <p>Methods</p> <p>We studied a large inception cohort of patients who underwent cardiac catheterization between July 1998 and December 2001. Detailed clinical and demographic data were collected at time of cardiac catheterization and through a mailed survey one year post-catheterization. The survey included three general risk attitude items from the Jackson Personality Inventory. Patients' (n = 6294) attitudes toward risk were categorized as risk-prone versus non-risk-prone and were assessed for associations with baseline clinical and demographic characteristics, treatment received (i.e., medical therapy, coronary artery bypass graft (CABG) surgery, percutaneous coronary intervention (PCI)), and survival (to December 2005).</p> <p>Results</p> <p>2827 patients (45%) were categorized as risk-prone. Having risk-prone attitudes was associated with younger age (p < .001), male sex (p < .001), current smoking (p < .001) and higher household income (p < .001). Risk-prone patients were more likely to have CABG surgery in unadjusted (Odds Ratio [OR] = 1.21; 95% CI 1.08–1.36) and adjusted (OR = 1.18; 95% CI 1.02–1.36) models, but were no more likely to have PCI or any revascularization. Having risk-prone attitudes was associated with better survival in an unadjusted survival analysis (Hazard Ratio [HR] = 0.78 (95% CI 0.66–0.93), but not in a risk-adjusted analysis (HR = 0.92, 95% CI 0.77–1.10).</p> <p>Conclusion</p> <p>These exploratory findings suggest that patient attitudes toward risk taking may <b>contribute to </b>some of the documented differences in use of invasive cardiac procedures. An awareness of these associations could help healthcare providers as they counsel patients regarding cardiac care decisions.</p

ALLEVAMENTO DI BESTIAME BOVINO IN ITALIA

The research reported in this paper was partly funded by project grants PSI2011-29016-C02-01, PSI2014-51890-C2-1-P (Ministerio de Economía y Competitividad, Spain) http://www.mineco.gob.es/ and UCM-BSCH GR3/14-940813 (Universidad Complutense de Madrid y Banco Santander Central Hispano) to F. C. A post-doctoral scholarship from Fondo Nacional de Desarrollo Científico y Tecnológico / FONDECYT Nº 3140580 awarded to J.ZA. funded his salary. http://www.conicyt.cl/fondecyt. European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013) / ERC grant SOMICS agreement n° 609819. Dr. Josep Call.Cetaceans are remarkable for exhibiting group-specific behavioral traditions or cultures in several behavioral domains (e.g., calls, behavioral tactics), and the question of whether they can be acquired socially, for example through imitative processes, remains open. Here we used a “Do as other does” paradigm to experimentally study the ability of a beluga to imitate familiar intransitive (body-oriented) actions demonstrated by a conspecific. The participant was first trained to copy three familiar behaviors on command (training phase) and then was tested for her ability to generalize the learned “Do as the other does” command to a different set of three familiar behaviors (testing phase). We found that the beluga (1) was capable of learning the copy command signal “Do what-the-other-does”; (2) exhibited high matching accuracy for trained behaviors (mean = 84% of correct performance) after making the first successful copy on command; (3) copied successfully the new set of three familiar generalization behaviors that were untrained to the copy command (range of first copy = 12 to 35 trials); and (4) deployed a high level of matching accuracy (mean = 83%) after making the first copy of an untrained behavior on command. This is the first evidence of contextual imitation of intransitive (body-oriented) movements in the beluga and adds to the reported findings on production imitation of sounds in this species and production imitation of sounds and motor actions in several cetaceans, especially dolphins and killer whales. Collectively these findings highlight the notion that cetaceans have a natural propensity at skillfully and proficiently matching the sounds and body movements demonstrated by conspecifics, a fitness-enhancing propensity in the context of cooperative hunting and anti-predatory defense tactics, and of alliance formation strategies that have been documented in these species’ natural habitats. Future work should determine if the beluga can also imitate novel motor actions.Publisher PDFPeer reviewe