• BP measurement
• hypertension
• prediction
• risk factors
• white-coat effect

• Humans
• Male
• Middle Aged
• Europe/epidemiology
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/mortality
• Cardiovascular Diseases/physiopathology
• Cardiovascular Diseases/diagnosis
• Cardiovascular Diseases/etiology
• Follow-Up Studies
• White Coat Hypertension/diagnosis
• White Coat Hypertension/epidemiology
• White Coat Hypertension/physiopathology
• Blood Pressure/physiology
• Risk Factors
• Risk Assessment/methods
• Cause of Death/trends
• Time Factors
• Adult
• Blood Pressure Determination/methods

• TAVI
• aortic valve stenosis
• biomarkers
• major cardiovascular events
• triglycerides-glucose index

• COVID-19 drug-related problems healthcare costs non-adherence polypharmacy

• Humans
• Polypharmacy
• COVID-19/epidemiology
• SARS-CoV-2
• Inappropriate Prescribing/prevention & control
• COVID-19 Drug Treatment
• Pandemics

• Chronic Disease
• Cross-Sectional Studies
• Health Equity
• Patient Reported Outcome Measures
• Primary Healthcare

• Humans
• Cross-Sectional Studies
• England/epidemiology
• Male
• Middle Aged
• Female
• Chronic Disease/epidemiology
• Aged
• Adult
• General Practice/statistics & numerical data
• General Practice/standards
• Age Factors
• Adolescent
• Young Adult
• Health Status Disparities
• Socioeconomic Factors
• Income
• Sex Factors

• EuroQol Research Foundation

• China
• QUALITATIVE RESEARCH
• Stroke

• Humans
• Male
• Female
• China
• Qualitative Research
• Middle Aged
• Stroke/psychology
• Stroke/therapy
• Aged
• Adult
• Self Care/psychology
• Stroke Rehabilitation/psychology
• Health Knowledge, Attitudes, Practice

• National Natural Science Foundation of China

• Adolescents
• Denmark
• Poor metabolic control
• Quality improvement
• Type 1 diabetes

• Humans
• Diabetes Mellitus, Type 1/psychology
• Diabetes Mellitus, Type 1/therapy
• Adolescent
• Qualitative Research
• Female
• Male
• Denmark
• Interviews as Topic
• Parents/psychology
• Social Support
• Family/psychology

• blended collaborative care
• care manager
• patient’s needs
• psychological distress
• psychosomatic distress
• quality of life
• somatization

• Allied health profession act
• Allied health professions
• Criteria for profession of allied Health
• Document review analysis
• Focus group discussion
• Malaysia

• Humans
• Malaysia
• Delivery of Health Care
• Health Occupations
• Qualitative Research
• Focus Groups
• Allied Health Personnel

• Inflammatory bowel disease
• care manager
• clinical-therapeutic pathways
• multidisciplinary approach
• nurse

• CVD
• EPPM
• communication
• prevention
• public health

• Humans
• Male
• Cardiovascular Diseases/prevention & control
• Poland

• BDS
• Cognitive impairment
• HRQoL
• MCS
• PCS
• SDMT
• SF-6D

• Humans
• Aged
• Aged, 80 and over
• Quality of Life/psychology
• Australia/epidemiology
• Aging
• Surveys and Questionnaires
• Cognitive Dysfunction/epidemiology

• The University of Queensland

• Chronic liver disease
• Cirrhosis
• Nutrition
• Nutritional education strategies

• Humans
• Quality of Life
• Nutrition Therapy/methods
• Malnutrition/prevention & control
• Nutritional Status
• Health Education

• Coronary artery disease
• Health education
• Mobile health
• Public health
• WeChat

• Humans
• Coronary Artery Disease
• Health Education
• Risk Factors
• Cholesterol, LDL
• Outcome Assessment, Health Care

• Cost-benefit
• Economic evaluation
• Rehabilitation
• Stroke

• intermittent claudication
• lower extremity artery disease
• peripheral artery disease
• questionnaire
• treadmill test
• walking distance assessment

• barriers
• childhood obesity
• facilitators
• policies
• policies barriers
• prevention

• Tabriz University of Medical Sciences

• chronic obstructive pulmonary disease (COPD)
• depression/mood disorder
• managed care
• multidisciplinary care
• obesity
• patient adherence

• behavioural health
• goals
• interviews
• patient care management
• patient participation
• primary care

Cardiovascular disease (CVD) remains the leading cause of premature death globally and a major contributor to decreasing quality of life. In the present study, we investigated the contribution of social, behavioral, and physiological determinants of CVD and their different patterns among middle-aged and older adults.

We used harmonized data from 6 nationally representative individual-level longitudinal studies across 25 countries. We restricted the age to ≥50 years and defined cases as a self-reported history of CVD. The exposure variables were the demographic status (age and sex), socioeconomic position (education level, employment, and household income level), social connections (marital status and family size), behavioral factors (smoking, alcohol drinking, and frequency of moderate to vigorous physical activity), and physiological risk factors (obesity, presence of hypertension, and presence of diabetes). Mixed logistic regression models were fitted to investigate the associations, and dominance analysis was conducted to examine the relative contributions.

In total, 413,203 observations were included in the final analysis, with the CVD prevalence ranging from 10.4% in Mexico to 28.8% in the United States. Physiological risk factors were the main driver of CVD prevalence with the highest dominance proportion, which was higher in developing countries (China, 57.5%; Mexico, 72.8%) than in developed regions (United States, England, 10 European countries, and South Korea). Socioeconomic position and behavioral factors also highly contributed but were less significant in developing countries than in developed regions. The relative contribution of socioeconomic position ranged from 9.4% in Mexico to 23.4% in the United States, and that of behavioral factors ranged from 5.7% in Mexico to 26.1% in England.

The present study demonstrated the different patterns of determinant contributions to CVD prevalence across developing and developed countries. With the challenges produced by different risk factors, the implementation of tailored prevention and control strategies will likely narrow disparities in the CVD prevalence by promoting health management and enhancing the capacity of health systems across different countries.

• cardiovascular disease(s)
• country-level disparity
• dominance analysis
• prevalence
• risk factors

• attitudes
• awareness
• dental students
• older adults

Cardiovascular disease (CVD) continues to be the leading cause of mortality globally. Cardiac rehabilitation (CR) programs act by modifying the evolution of CVD and mortality; however, CR programs are under-used. The aim was to determine the profile of patients that received rehabilitation after cardiac surgery.

A retrospective observational study was conducted from January 2017 to December 2017 at a single center. The study sample was chosen among patients admitted to the Intensive Care Unit of the Hospital Gregorio Marañón/Gregorio Marañón General University Hospital. Socio-demographic and clinical variables were collected.

In the present study, 336 patients underwent cardiac surgery of which 63.8% were men and 87.1% had ≥1 cardiovascular risk factors. Of the total cohort, 24.7% were operated for ischemic heart disease, 47.9% valvulopathy, 11% underwent combined surgery, 3.6% cardiac transplantation, 6.5% aneurysms, and 3.9% congenital disease. In-hospital respiratory rehabilitation was prescribed to all patients. Only 4.8% of the patients received motor rehabilitation and 13.8% were referred to CR. We found higher referral rates among patients with more cardiovascular risk factors, <65 years of age, and those undergoing coronary surgery and heart transplantation. Age, ischemic heart disease, and overweight were independent predictors of CR referral.

The benefit of CR programs after cardiac surgery is widely described; however, the referral rate to CR remains low. It is crucial to optimize referral protocols for these patients.

• chronic disease
• community
• general practice
• nursing
• organisational model
• pharmacist
• physician
• physiotherapist
• primary health care

• Adult
• Child
• Chronic Disease
• Humans
• Models, Organizational
• Multimorbidity
• Pharmacists
• Primary Health Care

The COVID-19 pandemic has caused major disruption to healthcare services globally. We present the findings of a national survey of home mechanical ventilation (HMV) services in England and Wales. 30 HMV services (60%) responded. There was a significant reduction in outpatient services with 93% of services not offering routine face-to-face appointments, although most centres were able to offer emergency appointments for ventilation review and set-up. HMV inpatient capacity was reassigned, and HMV service staff re-deployed in the majority of centres (97%). The initial wave of the COVID-19 pandemic left a service backlog of a median of 87 outpatient appointments [range 0–1500] and a median of 4 patients (range 0–100) awaiting NIV set-up.

• Cardiovascular mortality
• County-level determinants of health
• Opioid use mortality
• Social Determinants of Health (SDoH)
• Socio-economic context

• Anxiety
• COVID-19
• Depression
• Eating pathology
• SARS-CoV-2

• Anxiety/epidemiology
• COVID-19
• Depression/epidemiology
• Female
• Humans
• Male
• Pandemics
• Prevalence
• SARS-CoV-2

• Heart failure
• modified shock index
• mortality
• prognosis
• shock
• shock index

• Cross-sectional studies
• Implantable cardioverter defibrillators
• Patient preference
• Shared decision-making

• Acute coronary syndrome
• The RAND 36-Item health survey
• coronary artery diseases
• depression
• hamilton depression rating scale.
• myocardial infarction quality of life

• F117.1/201516/MANF2015-17-KER--68754 University Grants Commission, Government of India

Due to restrictions imposed by the severe acute respiratory syndrome coronavirus 2 pandemic much attention has been given to virtual education in cardiac rehabilitation (CR). Despite growing evidence that virtual education is effective in teaching patients how to better self-manage their conditions, there is very limited evidence on barriers and facilitators of CR patients in the virtual world.

To identify barriers and facilitators to virtual education participation and learning in CR.

A systematic review of peer-reviewed literature was conducted. Medline, Embase, Emcare, CINAHL, PubMed, and APA PsycInfo were searched from inception through April 2021. Following the PRISMA checklist, only qualitative studies were considered. Theoretical domains framework (TDF) was used to guide thematic analysis. The Critical Appraisal Skills Program was used to assess the quality of the studies.

Out of 6662 initial citations, 12 qualitative studies were included (58% ‘high’ quality). A total of five major barriers and facilitators were identified under the determinants of TDF. The most common facilitator was accessibility, followed by empowerment, technology, and social support. Format of the delivered material was the most common barrier. Technology and social support also emerged as barriers.

This is the first systematic review, to our knowledge, to provide a synthesis of qualitative studies that identify barriers and facilitators to virtual education in CR. Cardiac rehabilitation patients face multiple barriers to virtual education participation and learning. While 12 qualitative studies were found, future research should aim to identify these aspects in low-income countries, as well as during the pandemic, and methods of overcoming the barriers described.

• Cardiac rehabilitation
• Cardiovascular disease
• Patient education as a topic
• Systematic review
• Telerehabilitation
• Virtual education

One of the strategies for overcoming diuretic resistance among heart failure (HF) patients is adding thiazide-type diuretics. The main aim of this article is to compare the adverse clinical outcomes, including death and re-hospitalization, among individuals suffering from severe acute decompensated HF (ADHF) that consumed furosemide or furosemide plus metolazone.

This retrospective cohort study was done in the context of the Persian registry of cardiovascular disease (PROVE) from September 2017 to September 2018. One thousand and four hundred thirty-eight individuals (furosemide: 972 and furosemide plus metolazone: 466) with the final diagnosis of severe ADHF (left ventricular ejection fraction < 30%) were selected and followed for 10.3 ± 7.8 months. The association between two groups, as mentioned above, with the incidence of death and re-admission, was evaluated with different models.

The mean age of the study population was 68.19 ± 12.98 years. There was no significant relation in terms of death or re-hospitalization between patients with different diuretic regimens. After adjustment of potential confounders, we found that adding metolazone as an adjuvant HF therapy was not independently associated with death or re-hospitalization (hazard ratio (HR): 0.78,95% confidence interval (CI) = 0.59–1.03, P = 0.085, and odds ratio (OR): 0.80, 95% CI: 0.60–1.07, P = 0.135, respectively).

Our findings revealed that adding metolazone in patients with furosemide resistance is not associated with higher morbidity and mortality. Therefore, usage of these two therapeutic agents could be a helpful strategy for severe HF patients.

• Cardiovascular diseases
• Family history of MI
• General health
• Prevention
• Risk perception

• CCTA
• Computed tomography
• Non-coronary chest pain
• Reassurance
• Treatment satisfaction

Deep vein thrombosis (DVT) is common among patients with stroke. However, the incidence of DVT in acute ischemic stroke patients treated with thrombolytic therapy and the risk factors associated with this condition are unknown.

This study aimed to investigate the incidence and risk factors of DVT after thrombolysis in patients with acute ischemic stroke.

We retrospectively reviewed the medical records of all patients with acute ischemic stroke who underwent ultrasonic examination after intravenous thrombolysis between April 2017 and December 2019 at the stroke center of the First Hospital of Jilin University, China. Color duplex ultrasound was used to diagnosis DVT in all patients within 72 h after intravenous thrombolysis. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for DVT.

Overall, 474 patients were included in the study. Of these, 75 (15.8%) developed DVT (95% confidence interval 12.5–19.1). Older age was the risk factor that most significantly affected the development of DVT (p = 0.001). Compared to patients younger than 60 years old, those aged 60–69 years and ≥70 years had a higher risk of DVT, at rates of 2.201 (95% CI: 1.033–4.689; p < 0.05) and 4.241 (95% CI: 2.016–8.922; p < 0.001) times higher, respectively. Patients with higher triglyceride levels (odds ratio 0.545, 95% CI: 0.372–0.799, p = 0.002) and longer activated partial thromboplastin time (OR 0.927, 95% CI: 0.862–0.996, p = 0.040) were less likely to have DVT.

DVT is a common complication among patients undergoing intravenous thrombolysis after acute ischemic stroke. Advanced age may increase the occurrence of DVT to some extent. For these patients, safe antiplatelet therapy should be explored and implemented as soon as possible.

• acute ischemic stroke
• deep vein thrombosis
• incidence
• risk factors
• thrombolytic therapy

• cognitive complaints
• depressive symptoms
• health-related quality of life
• mediator
• path analysis

• Adult
• Cognition
• Depression/epidemiology
• Female
• Health Status
• Humans
• Japan/epidemiology
• Male
• Quality of Life
• Surveys and Questionnaires
• Volunteers

• Amyotrophic lateral sclerosis
• Assisted coughing
• Bulbar dysfunction
• Dextromethorphan/quinidine
• Noninvasive ventilation
• Pseudobulbar affect

Objectives: The study aims to understand the acceptability of Prolanis, a program that shifts the diabetes mellitus type 2 (T2DM) patient management from secondary to primary care, among Indonesian primary health care providers. Method: We completed face-to-face semistructured interviews with 14 health professionals from 3 urban and 4 rural government-owned primary health care clinics (Puskesmas) in 4 districts. We performed content analysis using the theoretical framework of acceptability (TFA) to understand which factors could facilitate or reduce acceptability. Results: Our study identifies that lack of health care providers’ acceptability to Prolanis was attributable to the negative affective attitude, low perceived effectiveness, poor self-efficacy, and work burden. The use of Prolanis output as one of the pay-for-performance indicators was deemed unsuitable because it could demotivate health providers to capture more undetected T2DM cases. This, compounded by lacking perceived benefit for the health care providers, leading to negative attitudes. Participants believed that the program improved patients’ adherence to visiting clinics routinely; however, the absence of a formal evaluation of reductions of key T2DM indicators—blood glucose level and HbA1c—causing the health providers to doubt the program effectiveness. Availability of or access to adequate blood glucose testing equipment is also of paramount importance to improve acceptability. Although the significant increase in patient load only occurred to Puskesmas with lacking doctors, an increased workload burden due to clerical works was experienced by the nonmedical workforce. The program appears to be more acceptable for health care providers in urban Puskesmas compared with their rural counterparts, attributable to better geographical accessibility and care-seeking behavior among people living in urban locations. Conclusions: This study highlights critical issues that should be addressed to improve the acceptability of Prolanis among health care professionals. Government or stakeholders play a critical role in improving program acceptability. More study is needed to capture wider variety of health care facilities’ characteristics.

• Indonesia
• acceptability
• attitude of health personnel
• delivery of health care
• diabetes mellitus
• primary health care
• rural health services

Interprofessional collaboration (IPC) is becoming more widespread in primary care due to the increasing complex needs of patients. However, its implementation can be challenging. We aimed to identify barriers and facilitators of IPC in primary care settings.

An overview of reviews was carried out. Nine databases were searched, and two independent reviewers took part in review selection, data extraction and quality assessment. A thematic synthesis was carried out to highlight the main barriers and facilitators, according to the type of IPC and their level of intervention (system, organizational, inter-individual and individual).

Twenty-nine reviews were included, classified according to six types of IPC: IPC in primary care (large scope) (n = 11), primary care physician (PCP)-nurse in primary care (n = 2), PCP-specialty care provider (n = 3), PCP-pharmacist (n = 2), PCP-mental health care provider (n = 6), and intersectoral collaboration (n = 5). Most barriers and facilitators were reported at the organizational and inter-individual levels. Main barriers referred to lack of time and training, lack of clear roles, fears relating to professional identity and poor communication. Principal facilitators included tools to improve communication, co-location and recognition of other professionals’ skills and contribution.

The range of barriers and facilitators highlighted in this overview goes beyond specific local contexts and can prove useful for the development of tools or guidelines for successful implementation of IPC in primary care.

• barriers
• collaboration
• facilitators
• interprofessional
• overview
• primary care
• review

Background and objectives: In this study, we aimed to evaluate whether the systemic immune-inflammation index (SII) has a prognostic value for major adverse cardiac events (MACEs), including stroke, re-hospitalization, and short-term all-cause mortality at 6 months, in aortic stenosis (AS) patients who underwent transcatheter aortic valve implantation (TAVI). Materials and Methods: A total of 120 patients who underwent TAVI due to severe AS were retrospectively included in our study. The main outcome of the study was MACEs and short-term all-cause mortality at 6 months. Results: The SII was found to be higher in TAVI patients who developed MACEs than in those who did not develop them. Multivariate Cox regression analysis revealed that the SII (HR: 1.002, 95%CI: 1.001–1.003, p < 0.01) was an independent predictor of MACEs in AS patients after TAVI. The optimal value of the SII for MACEs in AS patients following TAVI was >1.056 with 94% sensitivity and 96% specificity (AUC (the area under the curve): 0.960, p < 0.01). We noted that the AUC value of SII in predicting MACEs was significantly higher than the AUC value of the C-reactive protein (AUC: 0.960 vs. AUC: 0.714, respectively). Conclusions: This is the first study to show that high pre-procedural SII may have a predictive value for MACEs and short-term mortality in AS patients undergoing TAVI.

• SII
• TAVI
• inflammation
• major adverse cardiac events
• mortality

• Aortic Valve/surgery
• Aortic Valve Stenosis/surgery
• Humans
• Inflammation
• Prognosis
• Retrospective Studies
• Risk Factors
• Severity of Illness Index
• Transcatheter Aortic Valve Replacement/adverse effects
• Treatment Outcome

• Cerebral palsy
• Diaphragm
• Manual diaphragmatic stretching technique
• Respiratory function
• Ultrasonography

• Hemoglobin A1c
• diabetes
• poor glycemic control
• rural residents

• Chronic disease
• Chronic kidney disease
• Dietary change
• Narrative synthesis
• Self-management
• Systematic review

• Caregivers
• Child
• Chronic Disease
• Humans
• Narration
• Parents
• Self-Management

• Department of Health

Breast cancer is the most frequent cause of tumors and net survival is increasing. Achieving a higher survival probability reinforces the importance of studying health-related quality of life (HR-QoL). The main aim of this work is to test the relationship between different sociodemographic, clinical and tumor-intrinsic characteristics, and treatment received with HR-QoL measured using SF-12 and the FACT/NCCN (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy) Breast Symptom Index (FBSI). Women with breast cancer recruited between 2008 and 2013 and followed-up until 2017–2018 in a prospective cohort answered two HR-QoL surveys: the SF-12 and FBSI. The scores obtained were related to woman and tumor characteristics using linear regression models. The telephone survey was answered by 1078 women out of 1685 with medical record follow-up (64%). Increases in all three HR-QoL scores were associated with higher educational level. The score differences between women with university qualifications and women with no schooling were 5.43 for PCS-12, 6.13 for MCS-12 and 4.29 for FBSI. Histological grade at diagnosis and recurrence in the follow-up displayed a significant association with mental and physical HR-QoL, respectively. First-line treatment received was not associated with HR-QoL scores. On the other hand, most tumor characteristics were not associated with HR-QoL. As breast cancer survival is improving, further studies are needed to ascertain if these differences still hold in the long run.

• FBSI
• SF-12
• breast cancer
• educational level
• quality of life

It is still not clear whether to screen women with primary premature ovarian insufficiency for autoimmunity. Moreover, a possible association of autoimmunity with decreased bone mass density in premature ovarian insufficiency patients has not been evaluated. Thus, the objectives of this study were to review our experience with the use of an autoimmune screening panel in premature ovarian insufficiency women and to focus on bone mass density.

In a retrospective cohort study, 76 chromosomally normal women with primary premature ovarian insufficiency were included. The main outcome parameters were the results of an autoimmune screening panel and of dual-energy X-ray absorptiometry.

Median age was 33 years. Sixty percent of premature ovarian insufficiency patients revealed abnormal dual-energy X-ray absorptiometry results (minimal T-score < −1.0). Any signs of autoimmunity were found in 21 women (36.2%). The most frequent abnormal results were increased thyroperoxidase antibodies (24.1%) and thyroglobulin antibodies (20.7%). A longer duration of amenorrhea (β = −0.015; p = 0.007), any abnormality during autoimmune screening (β = −0.940; p = 0.010), and a lower body mass index (β = −0.057; p = 0.036) were associated with a lower minimal T-score.

In chromosomally normal women with primary premature ovarian insufficiency, the prevalence of autoimmunity and decreased bone mass density seem high. Our data highlight the association between autoimmune abnormalities and decreased dual-energy X-ray absorptiometry results.

• Autoimmunity
• Bone mass density
• Premature ovarian insufficiency

• Infertile women
• Instrument
• Psychometric
• Sexual health

• Adult
• Cross-Sectional Studies
• Educational Status
• Female
• Humans
• Infertility, Female
• Middle Aged
• Psychometrics/methods
• Reproducibility of Results
• Sexual Health
• Surveys and Questionnaires/standards
• Women's Health

Cardiovascular disease is one of the leading causes of death globally, and cardiovascular risk factors (CRFs) are major behavioral risk factors. Therefore, community-based programs are being designed based on the prescription of physical exercise from primary care centers to improve people’s health through changes in lifestyle. The objective was to compare the effects of two types of community exercise on adherence, lipid profile, body composition and blood pressure. A prospective observational cohort study was designed with two cohorts of study depending on the duration and type of physical exercise program performed. Fifty-one participants (82.4% women) with CRF completed the observation period in which they carried out a short-term, non-individualized exercise program (3 months), and 42 participants (71.4% women) with CRF completed the observation period in which they conducted a long-term, individualized exercise program (6 months). The results suggest that participants who carried out the longer program with an individualized progression produced greater adherence to physical exercise and a decrease in diastolic blood pressure. In addition, LDL and insulin levels decreased in both groups. Therefore, our results suggest that a longer duration and individualized evolution of the loads of a community exercise program lead to higher levels of physical activity (PA) and improvements diastolic blood pressure.

• METs
• chronic disease
• exercise
• physical activity
• primary care