Allied health professionals/Nursing/Health scientists最新文献

{"title":"75 Nurse-led sedation is safe and effective, shortening procedure times, and improving access for selected transcatheter aortic valve implantation (tavi) patients","authors":"Suzannah Browne, David Smith, Daniel Adams, Sumesh Thiruthalil, I. McGovern, S. Mattison, V. Panoulas, T. Kabir, S. Davies, Jo Shannon, E. Heng, H. Rahbi, N. Chandra, N. Patel, W. Banya, A. Tindale, Robert D. Smith, R. Lane, M. Dalby","doi":"10.1136/heartjnl-2022-bcs.75","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-bcs.75","url":null,"abstract":"","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129821906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"78 Cardiovascular manifestations of dengue","authors":"J. Malik, Danish Iltaf Satti","doi":"10.1136/heartjnl-2022-bcs.78","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-bcs.78","url":null,"abstract":"","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133497276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"79 Qualitative study on influences on anticoagulant prescribing for stroke prevention in atrial fibrillation","authors":"Rawand Jarrar","doi":"10.1136/heartjnl-2022-bcs.79","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-bcs.79","url":null,"abstract":"","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115012772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"76 Oxygen uptake efficiency slope - a valuable substitute for peak vo2?","authors":"A. Rudd, H. Khan, D. Gamble, P. Stephen, G. Horgan, A. Dawson, M. Frenneaux, D. Dawson","doi":"10.1136/heartjnl-2022-bcs.76","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-bcs.76","url":null,"abstract":"","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132266376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"77 Preventing stroke in patients with atrial fibrillation and intracerebral haemorrhage: a qualitative study of physicians’ decision-making","authors":"E. Ivany, Robyn R Lotto, G. Lip, D. Lane","doi":"10.1136/heartjnl-2022-bcs.77","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-bcs.77","url":null,"abstract":"","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116170318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"81 Meeting in the metaverse - a new paradigm for scientific mentorship","authors":"D. Radford, Samah Ahmed, Teddy Tai Loy Lee, J. Hui, Y. H. A. Lee, Danish Iltaf Satti, L. Roever, Tong Liu, A. Ciobanu, Elham Mahmoudi, J. Chan, G. Tse","doi":"10.1136/heartjnl-2022-bcs.81","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-bcs.81","url":null,"abstract":"81 Figure 1A photograph of our co-author, Mr. Teddy Tai Loy Lee, a pharmacy student using a virtual reality head-mounted display during the metaverse meeting. Informed consent was provided for the publication of identifiable information[Figure omitted. See PDF] 81 Figure 2A screenshot of the virtual experience during the mentorship sessions and research meetings taken using the selfie function. All participants consented to the publication of their avatars[Figure omitted. See PDF]ConclusionThe metaverse is an effective system for facilitating and enabling interactions amongst international colleagues, breaking down barriers between colleagues from different countries and across traditional hierarchies.Conflict of InterestN/A","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121089783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"80 Assessment of a novel integrated training programme in tranthoracic echocardiography for junior cardiac physiologists in a regional cardiac centre","authors":"Laurence O'Toole, Jane Mackay, Graham J. Fent, Oliver Watson","doi":"10.1136/HEARTJNL-2021-BCS.80","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2021-BCS.80","url":null,"abstract":"Introduction There is a national shortage of sonographers trained to British Society of Echo (BSE) transthoracic echocardiography (TTE) accreditation standard, which impacts directly on safe patient care. TTE training is arduous and impacts on departmental output, and 30% of echo departments in England had no cardiac physiologists training in TTE in 2018. In the face of a waiting list crisis due to loss of accredited staff, we introduced a novel, multifaceted and integrated TTE training programme for Agenda for Change (AfC) band 5 cardiac physiologists in January 2018. The aim was to train these much more junior staff, who were largely naïve to echo, to BSE accreditation standard at twice our previous rate. Methods The training programme included (i) a foundation course with selection for further training on the basis of competence, (ii) an introductory scanning module, (iii) pathologyspecific training lists, (iv) training lists booked at reduced capacity (4 not 6 patients per list), (v) a complementary lecture programme, (vi) four levels of supervision with directions for both trainees and trainers of goals each week and (vii) ongoing review of progress. The primary end-point was the number of trainees per year achieving BSE accreditation standard compared to a historical control group (January 2010 to January 2018) in our hospitals. Secondary end-points include the impact of the training programme on departmental capacity and the duration of training. Results In the control period, 7 sonographers were trained to BSE accreditation in a mean of 31 months (range 24 to 48 months), a training rate of 1.0 accredited sonographer/year. These staff were all AfC band 6, began training at an average age of 30 years, had a median of 4.7 years of prior postgraduate experience in cardiac physiology (range 0.75 to 5.25 years), and 4 had past echo training experience elsewhere. From January 2018 to Jan 2021, 11 physiologists entered the new training programme. These trainees were an average age of 25 years, median AfC Band of 5.0 and had a median of 1.5 years (range 0.25 to 11 yrs) of postgraduate experience in cardiac physiology. The training programme reduced departmental core echo capacity by 16% in the second year of implementation. Core capacity was recovered in the third year as trainees completed the programme. TTE out-patient waiting lists were maintained at less than 6 weeks by support from out-of-hours' work. Four trainees did not complete the programme. Five physiologists achieved full BSE accreditation by January 2021, in an average of 27 months of training (range 22 to 34 months) with some delays due to the 2020 Covid pandemic. This represents a training rate to independent scanning of 1.7 sonographers per year on the new programme. Conclusion A programme of intensive training of echo-naïve very junior cardiac physiologists achieved a 70% increase in the rate of attainment of BSE accreditation compared to historical performance with training compl","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116635456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"58 First-phase ejection fraction predicts repsonse to cardiac resynchronization therapy and adverse outcomes","authors":"H. Gu, B. Sidhu, L. Fang, J. Webb, Tom Jackson, S. Claridge, R. Razavi, P. Chowienczyk, A. Rinaldi","doi":"10.1136/HEARTJNL-2020-BCS.58","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BCS.58","url":null,"abstract":"Background Cardiac Resynchronization Therapy (CRT) is an important therapeutic treatment for chronic heart failure. However, even in carefully selected cases up to 40% of patient fail to respond. First-phase ejection fraction (EF1), the ejection fraction up to the time of maximal ventricular contraction, is a novel and more sensitive echocardiographic measure of early systolic function. We examined the value of EF1, to predict response to CRT and clinical outcomes after CRT. Methods Echocardiography was performed in 197 patients (table 1) who underwent CRT between 2009 and 2018 and were followed to determine clinical outcomes. LV volumes were measured by 2D Simpson’s method from apical views at end-diastole, time of peak aortic valve flow and end-systole to give end-diastolic volume (EDV), volume at TPAVF (V1) and ESV. 3D echocardiography was performed in a sub-sample of patients (n=73) allowing automated determination of EF1. EF1 was calculated as the percentage change between EDV and V1: EF 1= (EDV – V1) / EDV x 100 %. Results Volumetric response rate (reduction in end-systolic volume ≥ 15%) was 92.3% vs. 12.1%, for those with EF1 in the highest vs. lowest tertiles (p 85% sensitivity and specificity for prediction of response to CRT; on multivariate binary logistic regression analysis incorporating previously defined predictors (table 2) EF1 was the strongest predictor of response (odds ratio: 1.563, 95% confidence interval: 1.371-1.782, per 1% change in EF1, p Improvement in EF1 at 6 months (figure 1) after CRT implantation (6.5±5.8% vs 1.8±4.3% in responders vs. non-responders, p Conclusion EF1, a simple measure of early systolic function, is a promising predictor of response to CRT and may be useful in selecting patients for CRT and as a target for optimising CRT and other measures to improve outcomes in patients with HFrEF. Conflict of Interest None","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"19 9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126242669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"59 Can heart failure nurse specialists use the surprise question to improve patient access to palliative care services?","authors":"Melanie Mcginlay, S. Straw, A. Cowley, J. Gierula, M. Paton, Aaron Koshy, M. Drozd, R. Cubbon, M. Kearney, K. Witte","doi":"10.1136/HEARTJNL-2020-BCS.59","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BCS.59","url":null,"abstract":"Introduction Severe chronic heart failure (CHF) has a high symptom burden due to breathlessness, fatigue and fluid retention, comparable to many types of cancer but despite this, patients are often not referred to palliative care services. The ’Surprise Question’ - ‘would you be surprised if this patient were to die within the next year?’ has been proposed as a screening tool to prompt earlier recognition that patients are nearing the end of life. It forms part of the Gold Standards Framework and is included in the National Institute of Health and Clinical Excellence (NICE) guidance for end-of-life care. We have previously demonstrated the ability of this simple and intuitive question to predict mortality in hospitalised CHF patients and that it can be used by cardiologists and heart failure nurse (HFN) specialists with similar levels of accuracy. Aims We aimed to determine whether the Surprise Question could influence advanced care planning and referrals to palliative care in hospitalised CHF patients. Methods Retrospective analysis of 89 hospitalised CHF patients who received either a ‘surprised’ or ‘not surprised’ response from their HFN. We analysed the rate of referral to palliative care, completion of not-for-resuscitation status, readmission with decompensation and mortality after 2-years. Results Sixty patients (67%) received a ‘not surprised’ and 29 (33%) a ‘surprised’ response. In patients who received a ‘not surprised’ response, 25 (28%) were referred to palliative care within the study period, compared to 0 (0%) in the ‘surprised’ group. The median time from study enrolment to referral was 55 days, which was on average 19 days before death, but occurred within 30-days of enrolment for only 8 patients. Not-for-resuscitation status was completed for 11% and 3% of patients, respectively. The Surprise Question also predicted readmission with decompensation, occurring in 25 (42%) and 4 (14%), and continued to predict mortality beyond 1-year with 35 (58%) and 4 (14%) patients having died respectively. Discussion Our analysis highlights the potential of the Surprise Question to act as a prompt for earlier referral to palliative care services and advanced care planning. Decompensation of heart failure is a poor prognostic sign, but despite this there was a low rate of not-for-resuscitation decisions during the index admission, and referrals to palliative care were usually made shortly before death. In the future we aim to assess in a randomised controlled trial whether the introduction of the Surprise Question into routine clinical care can achieve these aims. HFNs are able to use the Surprise Question with similar levels of accuracy to cardiologists and are the point of contact for patients with whom they have regular interaction. HFN are therefore ideally placed to develop relationships conducive to palliative care planning and can lead in this area. Conflict of Interest None","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125915427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"56 Inter-atrial conduction delay is associated with la size in hypertrophic cardiomyopathy","authors":"A. Fletcher, L. Williams","doi":"10.1136/HEARTJNL-2020-BCS.56","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BCS.56","url":null,"abstract":"Introduction Hypertrophic cardiomyopathy (HCM) results in diastolic dysfunction and left atrial (LA) dilatation. Little is known about whether LA size or function relate to the presence of inter-atrial conduction delay (IACD). Hence, our purpose was to assess the relationship between IACD, ventricular filling and LA size & function in HCM. Methodology: Routine clinical transthoracic echocardiography (TTE) images from a specialist tertiary hospital were retrospectively analysed by a consultant imaging cardiologist and a British Society of Echocardiography accredited cardiac Clinical Scientist. Electromechanical delay (EMD) was measured from the onset of the electrocardiogram (ECG) P-wave to the onset of the A-wave on pulsed-wave Doppler waveforms from the mitral and tricuspid valves. IACD = mitral EMD – tricuspid EMD. Diastolic filling ratio = length of diastole on mitral PW Doppler / R-R interval. LA biplane ejection fraction = [(LA volume max – LA volume min) / LA volume max] x 100. Inclusion criteria; cardiologist confirmed diagnosis of HCM, adequate image quality, adequate ECG quality. Exclusion criteria; atrial fibrillation or ventricular pacing with no preceding atrial pacing or p-wave, >moderate valvular regurgitation/stenosis. Statistical analyses were performed using MedCalc. P-values Results Data from 66 HCM patients were analysed. Mean age=56±13years, 79% were male, mean body surface area=2.0±0.2m2, mean heart rate=60±8bpm. 41% of all patients (27/66) had truncated mitral A-waves. IACD (≥30ms) was present in 24/66 (36%) of patients. P-wave duration was prolonged and maximal LA volume significantly higher in patients with IACD (Table 1). However, IACD presence was not associated with a statistically significant difference in; LA ejection fraction, LA minimum volume, diastolic filling ratio, estimated filling pressure (E/e’ ratio), PR-interval nor proportion of mitral A-wave truncation (Table 1). Conclusions One third of patients with HCM have evidence of IACD, with an association to LA volume but not global LA function. The independent effect of electrical delay upon diastolic function warrants further investigation. Conflict of Interest None","PeriodicalId":193598,"journal":{"name":"Allied health professionals/Nursing/Health scientists","volume":"318 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116437000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}