Development of a positive psychology intervention for patients with acute cardiovascular disease

The management of depression and other negative psychological states in cardiac patients has been a focus of multiple treatment trials, though such trials have not led to substantial improvements in cardiac outcomes. In contrast, there has been minimal focus on interventions to increase positive psychological states in cardiac patients, despite the fact that optimism and other positive states have been associated with superior cardiovascular outcomes. Our objective was to develop an 8-week, phone-based positive psychology intervention for patients hospitalized with acute cardiac disease (acute coronary syndrome or decompensated heart failure). Such an intervention would consist of positive psychology exercises adapted for this specific population, and it would need to be feasible for practitioners and patients in real-world settings. By adapting exercises that were previously validated in healthy individuals, we were able to generate a positive psychology telemedicine intervention for cardiac patients that focused on optimism, kindness, and gratitude. In addition, we successfully created a companion treatment manual for subjects to enhance the educational aspects of the intervention and facilitate completion of exercises. Finally, we successfully performed a small pilot trial of this intervention, and found that the positive psychology intervention appeared to be feasible and well-accepted in a cohort of patients with acute cardiac illness. Future studies should further develop this promising intervention and examine its impact on psychological and medical outcomes in this vulnerable population of cardiac patients

Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

Objectives:We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged-infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies.Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries.Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT(> MIC) (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving beta-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of >= 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025].Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

INTIMATE PARTNER VIOLENCE: analisi epidemiologica della conoscenza da parte delle studentesse in ostetricia della regione Lombardia

One in three women will experience of violence by intimate partner at some point in her life. Because this kind of experience is so predominant among women, and since midwives are the healthcare workers that take care of women, the first purpose of this study was to examine the knowledge of the problem of Intimate Partner Violence (IPV) among midwifery students from distinct universities in Lombardy (Italy). The second purpose was to examine educational and training experiences and what students think about the need of education about IPV for future midwives. A not probabilistic sample of 197 students was recruited online, and had to complete a validated questionnaire took from \u201cA Cross-Cultural Comparative Study of Undergraduate Health Care Professional Students\u2019 Knowledge, Definitions, Education, and Training Experience of Domestic Violence in Northern Ireland and Jordan\u201d (N.M. Al Ali, A. Lazenbatt). The results showed that a substantial percentage of all partecipants didn\u2019t receive any education or informations/material about IPV during lessons. The majority of partecipants had gone on training, but they had not a good knowledge about IPV. The students\u2019 opinion about the need of education on IPV for future midwives was strongly positive, with very little negative response. In accordance with the results and with literature, the third purpose of this study was the actionable proposition to educate future midwives to make an aware prevention based on knowledge of IPV, to recognize and manage women that are victims of IPV, by the creation of an Italian acronym: V.I.O.L.E.N.Z.A

Modified Field Oriented Control for Fail-Operational Multi-Phase Induction Motor Drives

Recently, multiphase machines have gained worldwide attention from the research community and industry for their applications in the electric ship propulsion, electric transports, more-electric aircrafts and for those particular loads that require continuous operation of the machine after one or more phases become open-circuited. A fault can be due to the loss of one of the leg transistors in the voltage source inverter, or be internal to the machine, affecting one of the phase windings. Multiphase machines can continue to operate even in the case where more than one phase is open-circuited, while for a three-phase machine, post-fault operation is possible only if one phase is opened and the star point of the machine is connected to the dc mid-point of the inverter.In this papers the modeling and control of a five-phase induction machine with the field oriented control technique are presented; then, an algorithm for the post fault operation when one stator phase is open-circuited has been proposed and the results of the simulations, carried out with different load torques and reference speeds, have been reported and discussed

Basi fisiologiche della resistenza alla clorosi ferrica nella vite

Iron chlorosis deficiency is a widwspread phenomenon particularly evident in calcareous and alkaline soils. Fe-efficiency/inefficiency is genetically determined and it is possible to find in the same species cv that are Fe-efficient and cultivars that are Fe- efficient. Currently, plants are divided into two strategies: strategy I (dicotyledons and monocotyledons except grasses) and strategy II (grasses) according to their capacity to take up iron. Grapevine is a strategy I plan