Effects of an outpatient service holistic rehabilitation program in a case of pulmonary atresia.

A 42-year-old woman affected by pulmonary atresia came to our attention complaining of dyspnea and fatigue for minimal efforts with important desaturation. After assessing her basal functional capacity with a cardiopulmonary exercise test, the patient was enrolled in an extremely individualized rehabilitation program, which entailed a discreet improvement in the quality of life indices, in the absence of side effects. This paper shows that even patients with extremely severe forms of congenital heart disease, when clinical stable, can undergone a tailored cardiorespiratory rehabilitation program. This must be carried out in a monitored environment and under the supervision of expert personnel

Information about secondary prevention in coronary patients: a comparison between Italian and Brazilian Application of MICRO-Q Questionnaire

Background: The MICRO-Q (MaugerI CaRdiac preventiOn Questionnaire) is a self-administered questionnaire addressed to the evaluation of information regarding secondary prevention in patients with coronary heart disease (CHD). The aim of this study was to compare the results from Italian and Brazilian application of MICRO-Q. Methods: the instrument was administered to 500 coronary patients (250 Italian and 250 Brazilian), 117 female and 383 male, aged on average 61.16 years (SD=9.74; range: 33-86), participants of cardiac rehabilitation programs. The Italian MICRO-Q has 26 items, 18 true statements and 8 false, with responses true, false and ‘don’t know’, with three separate scores: correct, uncorrect and uncertain. The Brazilian MICRO-Q has 25 items, 18 true statements and 7 false, with the same responses and scores. To verify and compare results we used Independent-Sample T Test, ANOVA and Bonferroni Post-hoc. Results: The analysis of mean total scores of Italian and Brazilian applications showed statistically significant differences for correct answers (p<0.001) and for ‘don’t know’ answers (p<0.001). 18 statements had significant (p<0.005) differences between applications in the two countries. Conclusion: Despite differences between Italy and Brazil, the analysis of MICRO-Q applications showed a similar mean score percent of correct answers, indicating enough knowledge about secondary prevention of CHD

Autoregressive Point-Processes as Latent State-Space Models: a Moment-Closure Approach to Fluctuations and Autocorrelations

Modeling and interpreting spike train data is a task of central importance in computational neuroscience, with significant translational implications. Two popular classes of data-driven models for this task are autoregressive Point Process Generalized Linear models (PPGLM) and latent State-Space models (SSM) with point-process observations. In this letter, we derive a mathematical connection between these two classes of models. By introducing an auxiliary history process, we represent exactly a PPGLM in terms of a latent, infinite dimensional dynamical system, which can then be mapped onto an SSM by basis function projections and moment closure. This representation provides a new perspective on widely used methods for modeling spike data, and also suggests novel algorithmic approaches to fitting such models. We illustrate our results on a phasic bursting neuron model, showing that our proposed approach provides an accurate and efficient way to capture neural dynamics

organization of psychological activities in italian cardiac rehabilitation and prevention survey on the implementation of guidelines for psychological activities in cardiac rehabilitation and prevention

The present study was developed as part of a comprehensive evaluation of the state of the art of knowledge and implementation of the Italian Guidelines for psychological activities in Cardiac Rehabilitation, published in 2003 by the Working Group of Psychology of the Italian Society of Cardiac Rehabilitation (GICR). Methods. A questionnaire was designed to collect detailed information on facilities, organization, staffing level, professional background and activities carried out by psychologists working in Italian Cardiac Rehabilitation Units (CRU). Out of 144 Italian CRU (inventory 2004), 107 reported structured psychological programmes. The questionnaires were sent by conventional mail to the referring psychologist of these 107 CRU; they were invited to participate in the survey on a purely voluntary basis. Results. Responses were received from 70 (65.4%) of 107 CRU. 55 CRU (79.8%) report a good knowledge of the published GL; 10.1% declare that the psychologists did not know the current GL. 84.5% consider the GL to be fully applicable, while 15.5% believe that they are only partly applicable. Psychological assessment is performed through clinical interview (94.3%) and psychometric tests (81.4%). 92.8% of the CRU use screening instruments in order to evaluate psychosocial risk factors, in particular anxiety and depression (64.3%). Quality of life (22.8%) and cognitive impairment (17.1%) are not routinely assessed. Educational interventions are planned in 87.1% of the CR programme and are extended to the family members (51%) as well as counselling (57%). Psychological programme includes smoking (56%) and eating behaviour (55%) group interventions. Stress management is routinely planned in 69% of the CRU. Psychological intervention tailored to individual needs of the patients is performed in 62.9% CRU. Written final reports are available in 88.6% cases. The follow-up is carried out by 48.6% of the CRU, 15.7% in a structured way. Conclusions. The survey shows wide discrepancies in the provision of psychological activities in Italian CRU. Nevertheless psychological assessment and interventions seem acceptably coherent with current national GL on CR

ISYDE-Ψ* First step of the implementation of guidelines for psychology activities in cardiac rehabilitation and prevention *Italian SurveY on CarDiac REhabilitation – Psychology

The Italian SurveY on CarDiac REhabilitation – Psychology (ISYDE-Ψ) was developed, in line with the indications of the Italian National Guidelines Program, as part of a project to implement and apply the guidelines for psychology interventions in cardiac rehabilitation and prevention published in 2003. The Task Force on Psychological Interventions in Cardiac Rehabilitation conducted this pilot survey of the existing situation of Psychology in order to prepare the ground for implementation of the guidelines through interactive training. As part of the evaluation of training requirements a questionnaire was elaborated to gather information on the models of organization of and activities carried out by psychologists working in the surveyed cardiac rehabilitation facilities. Data collection for ISYDE-Ψ terminated at the end of March 2005, with replies from 68/107 (63.6%) structures. In the light of this response, the Task Force has developed a training project for psychologists working in cardiac rehabilitation, sponsored by the Italian Council of Psychologists, that will be implemented in different regions of the country with the aim of disseminating the guidelines and promoting their correct application despite the existing regional disparities in organization

Nursing role in cardiac prevention

The lack of a multidisciplinary approach is certainly among the causes of the ineffectiveness of intervention in the field of cardiovascular secondary prevention. By multidisciplinary approach is meant involving cardiologists, nurses, rehabilitation therapists, dieticians as well as psychologists in the framing of interventions tailor made to patients needs. In particular, people working in the nursing area can play a very important role which can be summed up into three different levels: a technical level, aiming at the cooperation with cardiologists to carry out diagnostic examinations and give a portrait of patients in terms of risks; a second level consists in giving information, and helping to face the disease, as well as stepping in during its evolution, almost a health counsellor for the patients; finally the nurse can act as a psychological support both to the patient and his/her family during acute illnesses and reassure him/her that he/she is being treated properly and that successively will resume a good quality of life. Hospital represent an ideal place for secondary prevention, at least in the first phases of the intervention. The results collected during hospitalization would be rapidly lost if they were not followed and sustained in the medium- long term by structured follow-up programmes. The development of ambulatories might represent a link between hospitals and the territory, i.e. the specialist and one's personal physician. The staff of ambulatories should comprise a cardiologist and a trained professional nurse, this being specialized, specifically, in cardiology and cardiovascular prevention. Staff of the type described could work independently, co-ordinating ambulatories on the territory within the framework of standardized recognized protocols and relating information concerning patients, general practitioners and other surgeries. In this way, an essential link of the continuity in medical care would be guaranteed

Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: [email protected] Delphi consensus by 28 experts from the European Association of Preventive Cardiology (EAPC) provides initial recommendations on how cardiovascular rehabilitation (CR) facilities should modulate their activities in view of the ongoing coronavirus disease 2019 (COVID-19) pandemic. A total number of 150 statements were selected and graded by Likert scale [from -5 (strongly disagree) to +5 (strongly agree)], starting from six open-ended questions on (i) referral criteria, (ii) optimal timing and setting, (iii) core components, (iv) structure-based metrics, (v) process-based metrics, and (vi) quality indicators. Consensus was reached on 58 (39%) statements, 48 'for' and 10 'against' respectively, mainly in the field of referral, core components, and structure of CR activities, in a comprehensive way suitable for managing cardiac COVID-19 patients. Panelists oriented consensus towards maintaining usual activities on traditional patient groups referred to CR, without significant downgrading of intervention in case of COVID-19 as a comorbidity. Moreover, it has been suggested to consider COVID-19 patients as a referral group to CR per se when the viral disease is complicated by acute cardiovascular (CV) events; in these patients, the potential development of COVID-related CV sequelae, as well as of pulmonary arterial hypertension, needs to be focused. This framework might be used to orient organization and operational of CR programmes during the COVID-19 crisis.info:eu-repo/semantics/publishedVersio

Self-perceived provision of patient centered care by healthcare professionals: The role of emotional intelligence and general self-efficacy

none4noAvailable online 11 December 2016Objective: This study aimed to investigate whether healthcare professionals' emotional intelligence (EI) is associated with self-perceived provision of patient-centered care (PCC), taking into account the potential mediating effect of general self-efficacy (GSE). Methods: A sample of 318 healthcare professionals, recruited in 2015 among four hospitals in Italy, completed the Provider-Patient Relationship Questionnaire, the Emotional Intelligence Scale, and the General Self-Efficacy scale. A structural equation model was tested with GSE mediating the relationship between EI and self-perceived provision of PCC. Groups of participants based on gender, profession, and work setting were also compared on the study variables. Results: EI had direct effects on the self-perceived provision of PCC dimensions. GSE partially mediated only the relationship between EI and involving the patient in care. Healthcare professionals in rehabilitation units showed higher self-perceived provision of PCC than those in acute care or ambulatory services. Conclusion: Self-perceived provision of PCC seems to have the potential to be improved by EI and to be distinguishable from GSE. Practice implications: Since EI can be developed, findings of this study have potential implications for improving PCC through continuing education interventions for healthcare professionals.openSommaruga, Marinella; Casu, Giulia; Giaquinto, Francesco; Gremigni, PaolaSommaruga, Marinella; Casu, Giulia; Giaquinto, Francesco; Gremigni, Paol