180 research outputs found
Music resources in the public libraries of Melbourne with special reference to the Nunawading Public Library
No full textThis thesis was scanned from the print manuscript for digital preservation and is copyright the author.
Researchers can access this thesis by asking their local university, institution or public library to
make a request on their behalf. Monash staff and postgraduate students can use the link in the References field
Exercise training for chronic heart failure (ExTraMATCH II) : protocol for an individual participant data meta-analysis
No full textBackground
Patients with chronic heart failure (HF) experience a marked reduction in their exercise capacity, health-related quality of life, and life expectancy. Despite substantive evidence supporting exercise training in HF, uncertainties remain in the interpretation and understanding of this evidence base. Clinicians and healthcare providers seek definitive estimates of impact on mortality, hospitalisation and health-related quality of life, and which HF patient subgroups are likely to most benefit. The original Exercise Training Meta-Analysis for Chronic Heart Failure (ExTraMATCH) individual participant data (IPD) meta-analysis conducted in 2004 will be updated by the current collaboration (ExTraMATCH II), to investigate the effects of exercise training in HF.
Methods
Randomised controlled trials have been identified from the updated 2014 Cochrane systematic review and the original ExTraMATCH IPD meta-analysis with exercise training of 3 weeks' duration or more compared with a non-exercise control and a minimum follow-up of 6 months. Particular outcomes of interest are mortality, hospitalisation and health-related quality of life plus key baseline patient demographic and clinical data. Original IPD will be requested from the authors of all eligible trials; we will check original data and compile a master dataset. IPD meta-analyses will be conducted using a one-step approach where the IPD from all studies are modelled simultaneously whilst accounting for the clustering of participants with studies.
Discussion
The information from ExTraMATCH II will help inform future national and international clinical and policy decision-making on the use of exercise-based interventions in HF and improve the quality, design and reporting of future trials in this fiel
Is exercise training safe and effective for ALL heart failure patients: A retrospective service evaluation of a hospital based cardiac rehabilitation programme
No full textThe main purpose of this study was to investigate whether exercise training is safe and effective for all classifications of heart failure, female and elderly (70 years and above) heart failure patients and also those heart failure patients with significant co-morbidity. Much of the research into exercise training and heart failure has been carried out on middle aged men in NYHA II-III classification of heart failure who have no other significant co-existing conditions. This is not reflective of the population of heart failure patients in general. The cardiac rehabilitation records (n=1000) of heart failure patients who had attended an exercise programme at a hospital based NHS service over a period of ten years were retrospectively evaluated to investigate the safety and efficacy of exercise training. Analysis of baseline statistics and repeated outcome measures were used to investigate the significance of the service and to ascertain where similarities and differences lay with the research. 74% were male, the age range was 17-90 years and 52% of patients had one or more significant co-morbidity. The acute event incidence was recorded at four per 1000 patients. NYHA I patients, female, elderly heart failure patients and those with significant co-morbidity showed significant improvements in functional capacity and quality of life measures with exercise training (p< 0.05). However no conclusion on the effectiveness of exercise could be drawn for NYHA IV heart failure patients due to insufficient recorded data and reduced adherence to exercise sessions for this group. A hospital based exercise programme, therefore may not be the most appropriate setting for the NYHA IV patient. This study supports previous research of the benefit of exercise training in heart failure but broadens it further to show that exercise is safe for all heart failure patients and is also effective for all heart failure patients with the exception of NYHA IV patients where further investigation is needed
Turning a Clinical Dilemma into a Research Project: Clinical Research at Jefferson
No full textPresentation: 28:0
- …
