Barriers and facilitators to self-care in chronic heart failure: A meta-synthesis of qualitative studies

Chronic heart failure (CHF) is a costly condition that places large demands on self-care. Failure to adhere with self-care recommendations is common and associated with frequent hospitalization. Understanding the factors that enable or inhibit self-care is essential in developing effective health care interventions. This qualitative review was conducted to address the research question, "What are the barriers and facilitators to self-care among patients with CHF?" Electronic databases including Medline, EMBASE, CINAHL, Web of Science, Scopus and Google scholar were searched. Articles were included if they were peer reviewed (1995 to 2012), in English language and investigated at least one contextual or individual factor impacting on self-care in CHF patients > 18years. The criteria defined by Kuper et al. including clarity and appropriateness of sampling, data collection and data analysis were used to appraise the quality of articles. Twenty-three articles met the inclusion criteria. Factors impacting on self-care included: factors related to symptoms of CHF and the self-care process; factors related to personal characteristics; environmental and health care system factors. Important factors such as socioeconomic situation and education level have not been explored extensively and there is minimal data on the influence of age, gender, selfconfidence and duration of disease. Although there is an emerging literature, further research is required to address the barriers and facilitators of self-care in patients with CHF in order to provide an appropriate guide for intervention strategies to improve self-care in CHF. © 2013 Siabani et al

A randomized controlled trial to evaluate an educational strategy involving community health volunteers in improving self-care in patients with chronic heart failure: Rationale, design and methodology

© 2014, Siabani et al.; licensee Springer. Background: Chronic heart failure (CHF) is an increasingly important health problem worldwide. Effective self-care can improve the outcomes and quality of life in patients with CHF. Acknowledging the important role of educational interventions for improving self-care, we sought to assess a new educational strategy involving community health volunteers (CHVs) that could reduce the cost and, hypothetically, increase the effectiveness of self-care education in patients with CHF.Methods/Design: In this ongoing three-arm controlled trial, approved by two human research ethics committees in Australia and Iran, 231 patients with CHF registered at a referral cardiovascular hospital in Iran were randomly allocated into three groups -trained by community health volunteers at patients’ homes, rained by formal health professionals at hospital; and a control group with no formal educational exposure. Data obtained through interviewing participants and using the Persian self-care of CHF index (pSCHFI) before and two months after interventions will be analysed using SAS and SPSS.Discussion: The results of this study may help health service systems, especially in countries with limited resources, make use of community volunteers to teach patients with CHF to develop self-care behaviors and skills, reducing the cost of care and improving CHF outcomes. Also, this home-based educational strategy using face-to-face training, if successful, may provide psychosocial supports for patients suffering from chronic illnesses.Trial registration number: ACTRN12614000788673(Australian New Zealand Clinical Trials Registry)

Space biology initiative program definition review. Trade study 6: Space Station Freedom/spacelab modules compatibility

The differences in rack requirements for Spacelab, the Shuttle Orbiter, and the United States (U.S.) laboratory module, European Space Agency (ESA) Columbus module, and the Japanese Experiment Module (JEM) of Space Station Freedom are identified. The feasibility of designing standardized mechanical, structural, electrical, data, video, thermal, and fluid interfaces to allow space flight hardware designed for use in the U.S. laboratory module to be used in other locations is assessed

Space biology initiative program definition review. Trade study 3: Hardware miniaturization versus cost

The optimum hardware miniaturization level with the lowest cost impact for space biology hardware was determined. Space biology hardware and/or components/subassemblies/assemblies which are the most likely candidates for application of miniaturization are to be defined and relative cost impacts of such miniaturization are to be analyzed. A mathematical or statistical analysis method with the capability to support development of parametric cost analysis impacts for levels of production design miniaturization are provided

Space biology initiative program definition review. Trade study 4: Design modularity and commonality

The relative cost impacts (up or down) of developing Space Biology hardware using design modularity and commonality is studied. Recommendations for how the hardware development should be accomplished to meet optimum design modularity requirements for Life Science investigation hardware will be provided. In addition, the relative cost impacts of implementing commonality of hardware for all Space Biology hardware are defined. Cost analysis and supporting recommendations for levels of modularity and commonality are presented. A mathematical or statistical cost analysis method with the capability to support development of production design modularity and commonality impacts to parametric cost analysis is provided

Low Compute and Fully Parallel Computer Vision with HashMatch

Numerous computer vision problems such as stereo depth estimation, object-class segmentation and fore-ground/background segmentation can be formulated as per-pixel image labeling tasks. Given one or many images as input, the desired output of these methods is usually a spatially smooth assignment of labels. The large amount of such computer vision problems has lead to significant research efforts, with the state of art moving from CRF-based approaches to deep CNNs and more recently, hybrids of the two. Although these approaches have significantly advanced the state of the art, the vast majority has solely focused on improving quantitative results and are not designed for low-compute scenarios. In this paper, we present a new general framework for a variety of computer vision labeling tasks, called HashMatch. Our approach is designed to be both fully parallel, i.e. each pixel is independently processed, and low-compute, with a model complexity an order of magnitude less than existing CNN and CRF-based approaches. We evaluate HashMatch extensively on several problems such as disparity estimation, image retrieval, feature approximation and background subtraction, for which HashMatch achieves high computational efficiency while producing high quality results

Composite Leptoquarks at the LHC

If electroweak symmetry breaking arises via strongly-coupled physics, the observed suppression of flavour-changing processes suggests that fermion masses should arise via mixing of elementary fermions with composite fermions of the strong sector. The strong sector then carries colour charge, and may contain composite leptoquark states, arising either as TeV scale resonances, or even as light, pseudo-Nambu-Goldstone bosons. The latter, since they are coupled to colour, get a mass of the order of several hundred GeV, beyond the reach of current searches at the Tevatron. The same generic mechanism that suppresses flavour-changing processes suppresses leptoquark-mediated rare processes, making it conceivable that the many stringent constraints may be evaded. The leptoquarks couple predominantly to third-generation quarks and leptons, and the prospects for discovery at LHC appear to be good. As an illustration, a model based on the Pati-Salam symmetry is described, and its embedding in models with a larger symmetry incorporating unification of gauge couplings, which provide additional motivation for leptoquark states at or below the TeV scale, is discussed.Comment: 10 pp, version to appear in JHE

Paliperidone ER and oral risperidone in patients with schizophrenia: a comparative database analysis

<p>Abstract</p> <p>Background</p> <p>To compare the efficacy and tolerability of paliperidone extended-release (ER) with risperidone immediate-release using propensity score methodology.</p> <p>Methods</p> <p>Six double-blind, randomized, placebo-controlled, short-term clinical trials for acute schizophrenia with availability of individual patient-level data were identified (3 per compound). Propensity score pairwise matching was used to balance observed covariates between the paliperidone ER and risperidone patient populations. Scores were generated using logistic regression models, with age, body mass index, race, sex, baseline Positive and Negative Syndrome Scale (PANSS) total score and baseline Clinical Global Impressions–Severity (CGI-S) score as factors. The dosage range of paliperidone ER (6-12 mg/day) was compared with 2 risperidone dosage ranges: 2-4 and 4-6 mg/day. The primary efficacy measure was change in PANSS total score at week 6 end point. Tolerability end points included adverse event (AE) reports and weight. AEs with rates ≥5% and with a ≥2% difference between paliperidone ER and risperidone were identified.</p> <p>Results</p> <p>Completion rates for placebo-treated subjects in paliperidone ER trials (n = 95) and risperidone trials (n = 122) groups were 36.8% and 51.6%, respectively; end point changes on PANSS total scores were similar (p = 0.768). Completion rates for subjects receiving paliperidone ER 6-12 mg/day (n = 179), risperidone 2-4 mg/day (n = 113) or risperidone 4-6 mg/day (n = 129) were 64.8%, 54.0% and 66.7%, respectively (placebo-adjusted rates: paliperidone ER vs risperidone 2-4 mg/day, p = 0.005; paliperidone ER vs risperidone 4-6 mg/day, p = 0.159). PANSS total score improvement with paliperidone ER was greater than with risperidone 2-4 mg/day (difference in mean change score, -6.7; p < 0.05) and similar to risperidone 4-6 mg/day (0.2; p = 0.927). Placebo-adjusted AEs more common with paliperidone ER were insomnia, sinus tachycardia and tachycardia; more common with risperidone were somnolence, restlessness, nausea, anxiety, salivary hypersecretion, akathisia, dizziness and nasal congestion. Weight changes with paliperidone ER and risperidone were similar (paliperidone ER vs risperidone 2-4 mg/day, p = 0.489; paliperidone ER vs risperidone 4-6 mg/day, p = 0.236).</p> <p>Conclusions</p> <p>This indirect database analysis suggested that paliperidone ER 6-12 mg/day may be more efficacious than risperidone 2-4 mg/day and as efficacious as risperidone 4-6 mg/day. The AE-adjusted incidence rates suggest differences between treatments that may be relevant for individual patients. Additional randomized, direct, head-to-head clinical trials are needed to confirm these findings.</p

Formalization of Transform Methods using HOL Light

Transform methods, like Laplace and Fourier, are frequently used for analyzing the dynamical behaviour of engineering and physical systems, based on their transfer function, and frequency response or the solutions of their corresponding differential equations. In this paper, we present an ongoing project, which focuses on the higher-order logic formalization of transform methods using HOL Light theorem prover. In particular, we present the motivation of the formalization, which is followed by the related work. Next, we present the task completed so far while highlighting some of the challenges faced during the formalization. Finally, we present a roadmap to achieve our objectives, the current status and the future goals for this project.Comment: 15 Pages, CICM 201