2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death the Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC)

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Why some people do well and others don't. The role of sense of coherence in disease adaptation

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Requirements for quality-of-life reports

Original Publication: Philip Moons, Tiny Jaarsma and Tone M Norekval, Editorial Material: Requirements for quality-of-life reports in EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, (9), 3, 141-143, 2010. http://dx.doi.org/10.1016/j.ejcnurse.2010.05.008 Copyright: Elsevier</p

Negative concord and negative questions - understanding multiple negation in Greek

Η παρούσα Διπλωματική εργασία μελετά το φαινόμενο της πολλαπλής άρνησης στα Ελληνικά. Γενικά, οι γλώσσες διακρίνονται σε δύο μεγάλες κατηγορίες ανάλογα με το εάν η πολλαπλή άρνηση ερμηνεύεται ως απλή άρνηση ή κατάφαση. Οι πρώτες ονομάζονται Negative Concord γλώσσες, όπως είναι τα Ελληνικά και οι δεύτερες Double Negation γλώσσες, όπως είναι τα Αγγλικά. Στα Ελληνικά υπάρχουν δομές σύμφωνα με την Giannakidou (2000), στις οποίες οι αρνητικές λέξεις ερμηνεύονται ως υπαρκτικοί και όχι ως καθολικοί ποσοδείκτες. Αυτό συμβαίνει διότι οι αρνητικές λέξεις δεν είναι εγγένει αρνητικές. Έτσι, διακρίνει τις αρνητικές λέξεις σε εμφατικές και μη-εμφατικές. Οι πρώτες είναι εγγένει αρνητικές λέξεις και οι δεύτερες απλά υπαρκτικές. Βασιζόμενη στην παραπάνω θεώρηση, η εργασία αυτή αναζητεί συντακτικά περιβάλλοντα στα οποία η εξαγόμενη ερμηνεία των αρνητικών λέξεων να είναι καταφατική – υπαρκτική. Το περιβάλλον που εξετάζεται είναι οι αρνητικές ερωτήσεις. Στις αρνητικές ερωτήσεις η πολλαπλή εμφάνιση άρνησης δεν εξάγει αρνητική σημασία αλλά μάλλον υπαρκτική - καταφατική. Προτείνεται, λοιπόν, μια νέα θεώρηση των ελληνικών αρνητικών λέξεων, σύμφωνα με την οποία οι αρνητικές λέξεις είναι υπαρκτικοί ποσοδείκτες όταν τεθούν σε συγκεκριμένα συντακτικά περιβάλλοντα. Η θεώρηση αυτή συμφωνεί με την προσέγγιση της Giannakidou (2000), και με τον Weib (2002), ο οποίος θεωρεί πως όλες οι γλώσσες του κόσμου στην πραγματικότητα είναι γλώσσες διπλής άρνησης (Negative Concord languages). Έτσι, προτείνεται ότι στις αρνητικές ερωτήσεις νομιμοποιούνται μόνο τα μη-εμφατικά αδύναμα στοιχεία.This Master thesis studies the phenomenon of multiple Negation in Greek. In general, languages are divided into two broad categories depending on whether multiple denial is interpreted as a simple denial or affirmation. The first are called Negative Concord languages, such as Greek and the second Double Negation languages, such as English. In Greek there are structures according to Giannakidou (2000), in which negative words are interpreted as Existential and not as Universal Quantifiers. This is because N–words are not inherently negative. Thus, she distinguishes N–words into emphatic and non-emphatic. The former are inherently Negative words and the latter simply Existential. Based on the above view, this paper looks for syntactic environments in which the extracted interpretation of negative words is affirmative - existential. The environment under consideration is the Negative Questions. In negative questions the multiple appearance of denial does not exude a negative meaning but rather existential - affirmative. A new view of Greek negative words is therefore proposed, according to which negative words are existential quantifiers when placed in specific syntactic contexts. This view is in line with the approach of Giannakidou (2000), and Weib (2002), who considers that all the languages of the world are in fact Negative Concord languages. Thus, it is suggested that in negative questions only non-emphatic weak elements are legitimized

Sexual counseling of cardiovascular patients in Europe: Culture matters

BACKGROUND: Sexual problems are common amongst cardiac patients, and concerns may arise when resuming sexual activities after a cardiac event. Sexual counselling is therefore indispensible. Culture is an identified barrier to talking about sex, but research is lacking on whether and how culture influences nurses in providing sexual counselling. DESIGN: This cross-sectional descriptive study assessed four areas related to sexual counselling provided by cardiovascular nurses. We investigated the impact of culture on these areas by surveying cardiovascular nurses living in Denmark, Norway and two regions of Belgium - Flanders, Dutch-speaking region and Wallonia, French-speaking region. METHODS: Overall, 819 participants were recruited as they attended cardiovascular nursing congresses in Denmark, Norway and Belgium. Subjects completed the Undertaking Nursing Interventions Throughout Europe (UNITE) sexual counselling questionnaire, measuring practice, responsibility, confidence and perceived comfort of patients. Controlling for demographic, educational and professional covariates, we performed multiple linear regression analysis to determine the impact of culture on sexual counselling. RESULTS: All four subscale scores were independently associated with culture. Danish nurses counselled patients significantly more often, reported feeling more responsibility and confidence and estimated more comfort in patients than Norwegian, Flemish and Walloon nurses. CONCLUSIONS: This study showed that culture matters with respect to sexual counselling for cardiac patients. Interventions should be developed improving sexual counselling of cardiac patients. Educational courses and training of healthcare professionals on sexual counselling should be more sensitive to sociocultural differences. Cross-cultural perspectives may bias attitudes of professionals as they deal with concerns of cardiac patients about resuming sexual activity.status: publishe

Octogenarian patients sleep and delirium experiences in hospital and four years after aortic valve replacement: a qualitative interview study

Objectives Sleep disturbances and delirium are frequently observed complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve implantation (TAVI), especially in octogenarian patients. However, a knowledge gap exists on patient experiences of sleep and delirium. In particular, patients long-term sleep and delirium experiences are unknown. This article explores and describes how octogenarian patients suffering from delirium after aortic valve replacement experience their sleep and delirium situation. Design An explorative and descriptive design with a longitudinal qualitative approach was applied. Qualitative content analysis following the recommended steps of Graneheim and Lundman was performed. Setting Patients were included at a tertiary university hospital with 1400 beds. Delirium and insomnia screening was performed at baseline and five postoperative days after aortic valve treatment. For qualitative data, 10 patients were interviewed 6-12 months after treatment with focus on delirium. Five of these patients were reinterviewed 4 years after treatment, with focus on their sleep situation. Participants Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium after treatment. Results For the initial interview, we included five men and five women, four following TAVI and six following SAVR, mean age 83. One overarching theme revealed from the content analyses; Hours in bed represented emotional chaos. Whereas three subthemes described the patients experiences with sleep and delirium, a cascade of distressful experiences disturbing sleep, the struggle between sleep and activity and elements influencing sleep. Four years after the treatment, sleep disturbances persisted, and patients still remembered strongly the delirium incidences. Conclusions For octogenarian patients, sleep disturbances and delirium are long-term burdens and need a greater attention in order to improve patient care.Funding Agencies|Bergen Health Trust; Haukeland University Hospital; University of Bergen; Kavli Research Center for Aging and Dementia at Haraldsplass Deaconess Hospital; Western Norway University of Applied Sciences Bergen; Norwegian Nurses Association</p

Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement

Background: Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase. Aims: To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep-wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI. Methods: A prospective cohort design was used that included octogenarian patients undergoing SAVR or TAVI at a regional university hospital. Self-reports were used to document sleep and insomnia, and actigraphy was used to record sleep-wake patterns. Data were collected at baseline preoperatively, and then daily for the first five postoperative days. Results: SAVR patients experienced the most insomnia on postoperative nights later in recovery, while TAVI patients experienced the most insomnia on postoperative nights early in recovery. The median total sleep time, as measured by actigraphy, was 6.4 h, and the median sleep efficiency was 79% for the five postoperative nights, but no differences were found between SAVR and TAVI patients on this parameter. All patients slept more during daytime than at night, with SAVR patients having significantly more total sleep hours for all five days than TAVI patients (p &amp;lt; 0.01). Conclusion: Octogenarians with aortic stenosis had disturbed self-reported sleep, increased insomnia, and disturbed sleep-wake patterns postoperatively, resulting in more daytime sleep and inactivity. In patients undergoing SAVR or TAVI, sleep evolves differently during the in-hospital postoperative phase.Funding Agencies|Kavli Research Center for Aging and Dementia; University of Bergen; Bergen University College; Norwegian Nurses Association</p

Readmissions and mortality in delirious versus non-delirious octogenarian patients after aortic valve therapy : A prospective cohort study

Objectives: To determine whether postoperative delirium predicts first-time readmissions and mortality in octogenarian patients within 180 days after aortic valve therapy with surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI), and to determine the most common diagnoses at readmission. Design: Prospective cohort study of patients undergoing elective SAVR or TAVI. Setting: Tertiary university hospital that performs all SAVRs and TAVIs in Western Norway. Participants: Patients 80+ years scheduled for SAVR or TAVI and willing to participate in the study were eligible. Those unable to speak Norwegian were excluded. Overall, 143 patients were included, and data from 136 are presented. Primary and secondary outcome measures: The primary outcome was a composite variable of time from discharge to first all-cause readmission or death. Secondary outcomes were all-cause first readmission alone and mortality within 180 days after discharge, and the primary diagnosis at discharge from first-time readmission. Delirium was assessed with the confusion assessment method. First-time readmissions, diagnoses and mortality were identified in hospital information registries. Results: Delirium was identified in 56% of patients. The effect of delirium on readmissions and mortality was greatest during the first 2 months after discharge (adjusted HR 2.9 (95% CI 1.5 to 5.7)). Of 30 first-time readmissions occurring within 30 days, 24 (80%) were patients who experienced delirium. 1 patient (nondelirium group) died within 30 days after therapy. Delirious patients comprised 35 (64%) of 55 first-time readmissions occurring within 180 days. Circulatory system diseases and injuries were common causes of first-time readmissions within 180 days in delirious patients. 8 patients died 180 days after the procedure; 6 (75%) of them experienced delirium. Conclusions: Delirium in octogenarians after aortic valve therapy might be a serious risk factor for postoperative morbidity and mortality. Cardiovascular disorders and injuries were associated with first-time readmissions in these patients