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Unraveling the complexity of cardiac distress: a study of prevalence and severity
Get PDFIntroduction: While much research attention has been paid to anxiety and depression in people who have had a recent cardiac event, relatively little has focused on the broader concept of cardiac distress. Cardiac distress is a multidimensional construct that incorporates but extends beyond common mood disorders such as anxiety and depression. In the present study we assessed the prevalence, severity and predictors of a broad range of physical, affective, cognitive, behavioral and social symptoms of cardiac distress. This is the first study to investigate cardiac distress in this comprehensive way.
Method: A sample of 194 patients was recruited from two hospitals in Australia. Eligible participants were those who had recently been hospitalized for an acute cardiac event. Data were collected at patients' outpatient clinic appointment ~8 weeks after their hospital discharge. Using a questionnaire developed through a protocol-driven 3-step process, participants reported on whether they had experienced each of 74 issues and concerns in the past 4 weeks, and the associated level of distress. They also provided sociodemographic and medical information. Regression analyses were used to identify risk factors for elevated distress.
Results: Across the 74 issues and concerns, prevalence ratings ranged from a high of 66% to a low of 6%. The most commonly endorsed items were within the domains of dealing with symptoms, fear of the future, negative affect, and social isolation. Common experiences were “being physically restricted” (66%), “lacking energy” (60%), “being short of breath” (60%), “thinking I will never be the same again” (57%), and “not sleeping well” (51%). While less prevalent, “not having access to the health care I need,” “being concerned about my capacity for sexual activity,” and “being unsupported by family and friends” were reported as highly distressing (74, 64, and 62%) for those experiencing these issues. Having a mental health history and current financial strain were key risk factors for elevated distress.
Conclusion and Implications: Specific experiences of distress appear to be highly prevalent in people who have had a recent cardiac event. Understanding these specific fears, worries and stressors has important implications for the identification and management of post-event mental health and, in turn, for supporting patients in their post-event cardiac recovery
Longshore drift
No full textCo-authored with Jane Watt, a moving image essay on coastal erosion commissioned by British Art Network’s (BAN) Landscape Research Group supported by Tate and Paul Mellon Centre for Studies in British Art, as well as Orford Ness National Nature Reserve (National Trust
Early versus late Tracheostomy promotes weaning in intensive care unit patients
Get PDFBackground and aim of the study: The time interval between the patients’ intubation and the performance of a tracheostomy has been considered as critical for the disease prognosis and outcome. The aim of the present study was to compare and contrast the outcomes of early vs late tracheostomy with regard to intensive care unit (ICU) patients’ weaning from respiratory support.
Methods: This retrospective observational study, involved patients who were hospitalized in two general and one Covid-19 ICUs of two tertiary hospitals in Athens and were subjected to tracheostomy. Data were collected from the patients’ medical records in order to estimate the duration of patient weaning and the number of days from the patients’ intubation until the time of tracheostomy. In the present study the term early tracheostomy denotes tracheostomy performed within 14 days from patient intubation and late tracheostomy defines the tracheostomy carried out after 14 days. For Covid-19 patients, guidelines suggested that tracheostomies should be performed 21 days following intubation, due to the high risk of virus transmission.
Results: One hundred and thirty-one patients who underwent tracheostomy participated in the study. Most tracheostomies were performed using the percutaneous technique. The group of patients tracheostomized within 14 days after their admission in ICU weaned faster from respiratory support compared to ones who were tracheostomized after 14 days.
Conclusions: The most common distinction between early and late tracheostomy is 14 days, with early tracheostomy being more beneficial in terms of patients’ outcomes, and specifically ICU patients’ weaning
Benchmarking for biomedical natural language processing tasks with a domain specific ALBERT
Get PDFAbstract: Background: The abundance of biomedical text data coupled with advances in natural language processing (NLP) is resulting in novel biomedical NLP (BioNLP) applications. These NLP applications, or tasks, are reliant on the availability of domain-specific language models (LMs) that are trained on a massive amount of data. Most of the existing domain-specific LMs adopted bidirectional encoder representations from transformers (BERT) architecture which has limitations, and their generalizability is unproven as there is an absence of baseline results among common BioNLP tasks. Results: We present 8 variants of BioALBERT, a domain-specific adaptation of a lite bidirectional encoder representations from transformers (ALBERT), trained on biomedical (PubMed and PubMed Central) and clinical (MIMIC-III) corpora and fine-tuned for 6 different tasks across 20 benchmark datasets. Experiments show that a large variant of BioALBERT trained on PubMed outperforms the state-of-the-art on named-entity recognition (+ 11.09% BLURB score improvement), relation extraction (+ 0.80% BLURB score), sentence similarity (+ 1.05% BLURB score), document classification (+ 0.62% F1-score), and question answering (+ 2.83% BLURB score). It represents a new state-of-the-art in 5 out of 6 benchmark BioNLP tasks. Conclusions: The large variant of BioALBERT trained on PubMed achieved a higher BLURB score than previous state-of-the-art models on 5 of the 6 benchmark BioNLP tasks. Depending on the task, 5 different variants of BioALBERT outperformed previous state-of-the-art models on 17 of the 20 benchmark datasets, showing that our model is robust and generalizable in the common BioNLP tasks. We have made BioALBERT freely available which will help the BioNLP community avoid computational cost of training and establish a new set of baselines for future efforts across a broad range of BioNLP tasks
Seam or swing? Identifying the most effective type of bowling variation for fast bowlers in men’s international 50-over cricket
Get PDFIn this study, 13,176 balls bowled by international level fast bowlers were analysed in order to investigate the relationship between the types of delivery and their effectiveness. The results of Chi-Squared analyses revealed significant associations between the type of delivery and runs conceded (p < 0.001) as well as wickets taken (p < 0.001). Seam movement was revealed to be more effective than swing bowling at both producing dot balls and taking wickets. Specifically, balls that ‘seam-away” were revealed to be the most effective for bowling dots and “seam-in” for taking wickets. The “away-swinger” resulted in significantly greater than expected dot balls as did the “in-swinger” but only the in-swinger resulted in significantly greater than expected wickets. Both the “off-cutter” and “slower-balls” were revealed to result in significantly fewer than expected dot balls but significantly greater than expected wickets, implying bowlers must assess for themselves the risk versus reward of these two types of variation. Balls with no-movement were revealed to have no significant relationship with runs conceded, but did result in significantly fewer than expected wickets. Evidence suggests that lateral movement is crucial to bowling success with seam movement revealed to be more effective than swing
Protocol for a systematic review of interventions targeting mental health, cognition or psychological well-being among individuals with long COVID.
Get PDFFor some people, COVID-19 infection leads to negative health impacts that can last into the medium or long term. The long-term sequelae of COVID-19 infection, or 'long COVID', negatively affects not only physical health, but also mental health, cognition or psychological well-being. Complex, integrated interventions are recommended for long COVID, including psychological components; however, the effectiveness of such interventions has yet to be critically evaluated. This protocol describes a systematic review to be conducted of scientific literature reporting on clinical trials of interventions to promote mental health, cognition or psychological well-being among individuals with long COVID. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be followed. A health sciences librarian will identify the relevant literature through comprehensive systematic searches of Medline, Embase, APA PsycINFO, Cumulative Index to Nursing and Allied Health Literature, medRxiv, PsyArXiv, China National Knowledge Internet and WANFANG Data databases, as well as The Cochrane Central Register of Controlled Trials, clinicaltrials.gov and the WHO International Clinical Trials Registry Platform. Studies will be selected through a title and abstract review, followed by a full-text review using inclusion and exclusion criteria. Data extracted will include intervention descriptions and efficacy metrics. Data will be narratively synthesised; if the data allow, a meta-analysis will be conducted. Risk of bias assessment will be conducted using the Cochrane Risk of Bias 2.0 tool. Ethical approval for systematic reviews is not required. As researchers and clinicians respond to the new clinical entity that long COVID represents, this review will synthesise a rapidly emerging evidence base describing and testing interventions to promote mental health, cognition or psychological well-being. Results will therefore be disseminated through an open-access peer-reviewed publication and conference presentations to inform research and clinical practice. CRD42022318678. [Abstract copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Evaluating experiences of a degree-level nursing apprenticeship
Get PDFThe introduction of the degree-level nursing apprenticeship provides an alternative route to professional registration. The aims of this study were: a) obtain a greater understanding of the experiences of nursing apprentices midway through their four-year programme; b) explore with ward managers and practice education facilitators the challenges and benefits of the programme; c) identify examples of good practice. 19 participants (7 apprentice student nurses, 8 ward managers, and 4 practice education facilitators) completed semi-structured interviews. Results suggested apprentices felt well supported, and respected as members of an organisation, receiving financial remuneration was important, and their confidence grew over their course
Nursing students’ attitudes on caring for people living with HIV/AIDS. A European Multicentre Study
No full textBackground and aim: Caring for people with HIV/AIDS is a challenging issue for nursing students, involving sometimes misconceptions due to different cultural, political and religious views. !e aim of this project was to investigate nursing students’ attitudes on caring for people with HIV/AIDS. Methods: A convenient sample of undergraduate nursing students enrolled in four European universities was recruited. Data were collected by administering the AIDS Attitude Scale (AAS). Statistical analysis included the ANOVA test, the t–test for independent variables, and the Kruskal-Wallis test with a confidence level P <0.05. Results: !e sample consisted of 594 students of which 162 (27.3%) were English, 246 (41.4%) Italian and 186 (31.3%) Greek. Study findings demonstrated that students’ attitudes toward HIV/AIDS patients were relatively positive, although the majority of them indicated fear of contracting HIV through clinical practice. Nursing students’ positive feelings for HIV/ AIDS patients were also correlated with their strong willingness to take care of them. Conclusions: Despite being ex- posed to different teaching and learning experiences, a significant part of the participants believe that HIV/AIDS make nursing a high-risk profession. Furthermore, students’ misconceptions are not limited to clinical practice areas as they expressed concerns in sending their children in a class along with a child affected by AIDS and/or in dining in a restaurant where a chef affected by AIDS works. Students are in general well-disposed towards this patients’ population but there is still stigma associated with this condition. A new teaching and learning approach may help redefining students’ attitudes and in limiting the negative impact of misconceptions on the quality of nursing care. Further investigation in this area would help in shading light on the reasons why students are still biased in approaching AIDS/HIV patients. !e use of a qualitative approach based on semi-structured interviews and/or focus group would be recommended
