Do heart failure status and psychosocial variables moderate the relationship between leisure time physical activity and mortality risk among patients with a history of myocardial infarction?

Background: Leisure time physical activity (LTPA) is inversely related to mortality risk among patients with a history of myocardial infarction (MI). The aims were to explore if heart failure (HF) status and psychosocial variables moderate the association.Methods: Participants (n = 1169) were from a multi-center prospective cohort study. Information on LTPA (none, irregular,1–150, 151–300 and >300 weekly minutes), depression, social support and other prognostic indicators were collected 10–13 years after index MI. Cox regressions were conducted, adjusting for potential confounders. In case of significant moderation by HF-status or psychosocial variables, stratified analyses were performed.Results: During follow-up (M = 8.4 years), 25.6 % of the sample had died. LTPA was inversely associated with mortality (p for trend < 0.01 in all models). HF did not, but psychosocial variables did, moderate the association. In the LTPA category 1–150 weekly minutes, patients with a high level of depression had a lower mortality risk in comparison to those with a low level (hazard ratios (95 % confidence intervals) were 0.43 (0.25, 0.75) versus 0.69 (0.36, 1.32)), and patients with a low level of social support had a lower mortality risk in comparison to those with a high level (0.40 (0.21, 0.77) versus 0.71 (0.39, 1.27)). In the category >300 min, patients with a high level of social support had a lower mortality risk than those with a low level (0.38 (0.19, 0.79) versus 0.51 (0.30, 0.87)).Conclusions: LTPA was inversely related to mortality risk of post-MI patients. HF did not moderate the relationship; depression and social support partially did

Assistive Technology to Promote Communication and Social Interaction for People With Deafblindness:A Systematic Review

Background: People with deafblindness experience stigmatization, exclusion, and isolation. Due to complex communication challenges, feelings of isolation and exclusion can increase. However, assistive technology can change these negative outcomes. The aim of this systematic review is to synthesize and analyze the research published in journal articles focused on the use of assistive technology to improve communication and social interaction for people with deafblindness. Methods: A qualitative review study, examining journal articles focusing on the use of assistive technology to support social interaction of people with deafblindness as found in the following databases: IEEE Xplore, ProQuest, Cochrane, Embase, CINANHL, PsychINFO, Web of Science, PubMed, and ProQuest, was conducted. An in-depth analysis of the selected articles was performed. Results: Nine articles were included in this systematic review. The Technology Readiness Levels indicated that the communication assistive technologies reported in the included journal articles span across readiness levels, but mostly remained in the prototype phase. The identified themes are: (1) the objective of the assistive technology, with as sub-themes two-way communication, and access to information; (2) design and development, with as sub-themes new communication assistive technology design, and development, usability and co-creators; (3) acquisition and implementation; and (4) the impact of the assistive technology, with as sub-themes social integration and expansion, autonomy and confidence, and well-being. Conclusions: This systematic review provides a roadmap for the way forward in the use of assistive technology in communication and social interaction for people with deafblindness. Co-creation should start during the design and development stages and continue into testing, evaluating and implementation. A greater understanding of the unique communication needs and challenges may contribute to the development of more advanced technologies which can be used in daily situations and contribute to support two-way communication and social inclusion of people with deafblindness. Furthermore, a challenge remains to focus on the development of assistive technology supporting declarative communication, which includes giving comments, declarations, predictions, and reflections during a conversation. More research conducted over the long-term is needed to bring the communication assistive technologies into more advanced stages of readiness

An interactive-technology health behavior promotion program for heart failure patients: A pilot study of experiences and needs of patients and nurses in the hospital setting

Background: Heart failure (HF) is a chronic condition, prevalent especially among older people, characterized by acute episodes leading to hospitalization. To promote HF patients' engagement in physical activity (PA) and adherence to medication, we developed Motivate4Change: A new interactive, information and communication technology (ICT)-based health promotion program for delivery in the hospital. The development of this program was guided by the Intervention Mapping protocol for the planning of health promotion programs. The users of Motivate4Change were defined as hospitalized HF patients and hospital nurses involved in HF patient education. Objective: Two aims were addressed. First, to explore the use of interactive technology in the hospital setting and second, to evaluate user needs in order to incorporate them in Motivate4Change. Methods: Participant observations at a hospital in the United Kingdom and semistructured interviews were conducted with hospitalized HF patients and HF nurses following their completion of Motivate4Change. Interviews were recorded, transcribed, and analyzed according to a thematic coding approach. Results: Seven patients and 3 nurses completed Motivate4Change and were interviewed. Results demonstrated that patient needs included empathic and contextual content, interactive learning, and support from others, including nurses and family members. The nurse needs included integration in current educational practices and finding opportunities for provision of the program. Conclusions: The current work provides insight into user needs regarding an interactive-technology health promotion program for implementation in the hospital setting, such as Motivate4Change

Additional file 2: Table S2. of Do heart failure status and psychosocial variables moderate the relationship between leisure time physical activity and mortality risk among patients with a history of myocardial infarction?

Baseline characteristics of the HF subsample. Baseline characteristics of the subsample of post-MI patients who developed HF categorized according to amount of LTPA performed. (DOC 58 kb

Additional file 1: Table S1. of Do heart failure status and psychosocial variables moderate the relationship between leisure time physical activity and mortality risk among patients with a history of myocardial infarction?

Baseline characteristics of the post-MI patient sample. Baseline characteristics of the post-MI sample categorized according to amount of LTPA performed. (DOC 61 kb