Stability and change of lifestyle profiles in cardiovascular patients after their first acute coronary event

Background: Acute coronary syndrome (ACS) is a major cause of morbidity and mortality. Lifestyle and health behavior changes play an important role in the primary and secondary prevention of ACS recurrence. Changes in unhealthy lifestyles after an acute coronary event have been analyzed by considering separate behaviors individually, even though research on the healthy population has demonstrated that unhealthy behaviors tend to co-occur. Purpose: The aim of this study was to identify lifestyle profiles of ACS patients and to explore their pathways of change for one year after their first coronary event by adopting a typological approach. Methods: Two hundred and twenty-three patients (84% male; mean age = 57.14) completed self-report measures of health-related behaviors at the beginning of cardiac rehabilitation, and six months and twelve months after. At each wave depression, anxiety and heart rate were also evaluated. Cluster analysis was performed to identify lifestyle profiles and to analyze their change over time. Differences in psychological factors and heart rate among clusters were assessed. Results: Patients’ diet, physical activity, and smoking behavior greatly improved six months after their first coronary event. No further improvements were detected after one year. At each wave specific lifestyle profiles were identified, ranging from more maladaptive to healthier clusters. Patients with multiple unhealthy behaviors experience greater difficulties in maintaining a healthier lifestyle over time. Moreover, the results demonstrated the association between lifestyle profiles at twelve months after the acute coronary event and depression measured six months earlier. Finally, the most maladaptive lifestyle profile had many members with elevated heart rate at twelve months after the cardiac rehabilitation. Conclusions: Current findings may have a strong practical impact in the development and implementation of personalized secondary prevention programs targeting lifestyles of ACS patients

A longitudinal study on the information needs and preferences of patients after an acute coronary syndrome

Background: Research has shown that the provision of pertinent health information to patients with cardiovascular disease is associated with better adherence to medical prescriptions, behavioral changes, and enhanced perception of control over the disease. Yet there is no clear knowledge on how to improve information pertinence. Identifying and meeting the information needs of patients and their preferences for sources of information is pivotal to developing patient-led services. This prospective, observational study was aimed at exploring the information needs and perceived relevance of different information sources for patients during the twenty-four months following an acute coronary syndrome. Methods: Two hundred and seventeen newly diagnosed patients with acute coronary syndrome were enrolled in the study. The patients were primarily men (83.41 %) with a mean age of 57.28 years (range 35-75; SD = 7.98). Patients' needs for information and the perceived relevance of information sources were evaluated between 2 and 8 weeks after hospitalization (baseline) and during three follow-ups at 6, 12 and 24 months after baseline. Repeated measures ANOVA, Bonferroni post hoc tests and Cochran's Q Test were performed to test differences in variables of interest over time. Results: Results showed a reduction in information needs, but this decrease was significant only for topics related to daily activities, behavioral habits, risk and complication. At baseline, the primary sources of information were specialists and general practitioners, followed by family members and information leaflets given by physicians. Relevance of other sources changed differently over time. Conclusion: The present longitudinal study is an original contribution to the investigation of changes in information needs and preferences for sources of information among patients who are diagnosed with acute coronary syndrome. One of the main results of this study is that information on self-disease management is perceived as a minor theme for patients even two years after the event. Knowledge on how patients' information needs and perceived relevance of information sources change over time could enhance the quality of chronic disease management, leading health-care systems to move toward more patient-tailored care

A type A and type D combined personality typology in essential hypertension and acute coronary syndrome patients: Associations with demographic, psychological, clinical, and lifestyle indicators

Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs), but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men). Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed

第964回千葉医学会例会・第31回麻酔科例会

Background: Research has shown that the provision of pertinent health information to patients with cardiovascular disease is associated with better adherence to medical prescriptions, behavioral changes, and enhanced perception of control over the disease. Yet there is no clear knowledge on how to improve information pertinence. Identifying and meeting the information needs of patients and their preferences for sources of information is pivotal to developing patient-led services. This prospective, observational study was aimed at exploring the information needs and perceived relevance of different information sources for patients during the twenty-four months following an acute coronary syndrome. Methods: Two hundred and seventeen newly diagnosed patients with acute coronary syndrome were enrolled in the study. The patients were primarily men (83.41 %) with a mean age of 57.28 years (range 35-75; SD = 7.98). Patients' needs for information and the perceived relevance of information sources were evaluated between 2 and 8 weeks after hospitalization (baseline) and during three follow-ups at 6, 12 and 24 months after baseline. Repeated measures ANOVA, Bonferroni post hoc tests and Cochran's Q Test were performed to test differences in variables of interest over time. Results: Results showed a reduction in information needs, but this decrease was significant only for topics related to daily activities, behavioral habits, risk and complication. At baseline, the primary sources of information were specialists and general practitioners, followed by family members and information leaflets given by physicians. Relevance of other sources changed differently over time. Conclusion: The present longitudinal study is an original contribution to the investigation of changes in information needs and preferences for sources of information among patients who are diagnosed with acute coronary syndrome. One of the main results of this study is that information on self-disease management is perceived as a minor theme for patients even two years after the event. Knowledge on how patients' information needs and perceived relevance of information sources change over time could enhance the quality of chronic disease management, leading health-care systems to move toward more patient-tailored care

Proteoglycan-4 Regulates Fibroblast to Myofibroblast Transition and Expression of Fibrotic Genes in the Synovium

Background: Synovial tissue fibrosis is common in advanced OA with features including the presence of stress fiber-positive myofibroblasts and deposition of cross-linked collagen type-I. Proteoglycan-4 (PRG4) is a mucinous glycoprotein secreted by synovial fibroblasts and is a major component of synovial fluid. PRG4 is a ligand of the CD44 receptor. Our objective was to examine the role of PRG4-CD44 interaction in regulating synovial tissue fibrosis in vitro and in vivo. Methods: OA synoviocytes were treated with TGF-β ± PRG4 for 24h and α-SMA content was determined using immunofluorescence. Rhodamine-labeled rhPRG4 was incubated with OA synoviocytes ± anti-CD44 or isotype control antibodies and cellular uptake of rhPRG4 was determined following a 30-min incubation and α-SMA expression following a 24-h incubation. HEK-TGF-β cells were treated with TGF-β ± rhPRG4 and Smad3 phosphorylation was determined using immunofluorescence and TGF-β/Smad pathway activation was determined colorimetrically. We probed for stress fibers and focal adhesions (FAs) in TGF-β-treated murine fibroblasts and fibroblast migration was quantified ± rhPRG4. Synovial expression of fibrotic markers: α-SMA, collagen type-I, and PLOD2 in Prg4 gene-trap (Prg4GT) and recombined Prg4GTR animals were studied at 2 and 9 months of age. Synovial expression of α-SMA and PLOD2 was determined in 2-month-old Prg4GT/GT&Cd44−/− and Prg4GTR/GTR&Cd44−/− animals. Results: PRG4 reduced α-SMA content in OA synoviocytes (p \u3c 0.001). rhPRG4 was internalized by OA synoviocytes via CD44 and CD44 neutralization attenuated rhPRG4’s antifibrotic effect (p \u3c 0.05). rhPRG4 reduced pSmad3 signal in HEKTGF- β cells (p \u3c 0.001) and TGF-β/Smad pathway activation (p \u3c 0.001). rhPRG4 reduced the number of stress fiberpositive myofibroblasts, FAs mean size, and cell migration in TGF-β-treated NIH3T3 fibroblasts (p \u3c 0.05). rhPRG4 inhibited fibroblast migration in a macrophage and fibroblast co-culture model without altering active or total TGF-β levels. Synovial tissues of 9-month-old Prg4GT/GT animals had higher α-SMA, collagen type-I, and PLOD2 (p \u3c 0.001) content and Prg4 re-expression reduced these markers (p \u3c 0.01). Prg4 re-expression also reduced α-SMA and PLOD2 staining in CD44-deficient mice. Conclusion: PRG4 is an endogenous antifibrotic modulator in the joint and its effect on myofibroblast formation is partially mediated by CD44, but CD44 is not required to demonstrate an antifibrotic effect in vivo

Hubungan antara Gaya Belajar dan Prestasi Belajar Siswa Kelas XI pada Mata Pelajaran PAI di SMAN 9 Manado

This study aims to determine the Relationship between Student Learning Stlye and Student Achievement  in Class XI in subject of Islamic Education at SMAN 9 Manado.In collecting data, the author uses a quantitative approach with 2 variables, variable X (Learning Stlye) and variable Y (Learning Achievement). This research uses nonparametric statistical data. Non-parametric methods are assessed based on rank, level, or ordinal preparation of the data obtained. The populastion in this study were students of class XI who were Muslim whose sample number was 60 people, 30 had been tested and 30 others were research samples. After testing the normality of the data using the chi square test. It was found that the variables X X2count = 346,41 and variable Y X2count= 123,8. Whereas for value X 2tables with dk=k-1= 7-1=6 obtained X 2tables 12,592 and dk= k-1= 6-1=5  obtained X 2tables 11.070 with error level  5% turns out  X2 count ≥ X2 tables. So it can be conculed that the variable X data is not normally distributer and the Y variable is not normally sidtributed. After the prerequisite test was found, the data was not normally distributed. So the researchers used the correlation test rho. Based on the result of the manual rho correlation test, the calculated value rscount= 0.991. Where the result of the calculated value is greater than the rtables atau 0,991 ≥ 0.364 then Ha is  accepted so that there is a significant relationship between learning stlye and learnong achievement.Based on the result of theabove research, the researchers suggest the foloowing: in this study, student learning achievement is only vewed from the factors of student learning stlye without reviewing from other factors. Therefore, for other researchers who want to do research on learning achievement can tracce from other factor

Building a User Model for Museum Exploration and Information-Providing Adaptive System

Hyperaudio is a system able to organize the presentation of a museum contents taking into account the visitor's needs and the layout of the physical space. The system is able to integrate a physical space with a virtual space in order to build a more general notion of augmented space: not only can the system provide the visitor with information tailored on his own interests and interaction history, but it can also support the visitor in his own exploration of the physical space, helping him to find what he is looking for and suggesting new interesting physical locations. In this paper we describe the developing of the User Model components for this type of system: we found helpful to separate distinct functionalities about user modelling. These components are useful in planning the content presentations to the visitors. A presentation could take into account what the user already knows (to avoid boring repetitions, to make new things easier to understand by making comparisons, etc...), what the user is interested to (to propose new concepts and/or location to go etc...) and the interaction way the user seems to prefer. Some observations from psychologists and emerging from questionnaires, workshops and observations about users help identifying parameters and features that influence how the User Model evolve and could be organize

MANAJEMEN PEMBELAJARAN EKONOMI DIMASA PANDEMI COVID-19 PADA GURU EKONOMI KOTA SINTANG

abstractThis research is entitled Management of Economic Learning during the Covid-19Pandemic for Economic Teachers in Sintang City. This study aims to determinehow planning, organizing, actuating, and evaluating on economic learning inSMA Sintang City? This research approach uses a qualitative approach, theresearch form is descriptive, and the informants in this study are 5economicteachers, 65 students, 2 principals of SMA Negeri Sintang City. 1 head ofcurriculum. The techniques used in this research data collection are interview,observation, and documentation. The results of this study indicate that what theschool is currently doing is using Virtual Learning such as whatsapp Group,Google Form, quizizz, audio Visual, power point,and classroom to facilitate thelearning process of the implementatiton function is to carry out thepredetermined plan. Economics teachers also evaluate students. Properevaluation is an effort to form decisions about the level of student learningoutcomes in accordance with learning objectives.Keywords: Management, Economics Learning, Pandemic period, Economics Teacher