Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic Review.

Background: The known and established benefits of exercise in patients with heart failure (HF) are often hampered by low exercise adherence. Mobile health (mHealth) technology provides opportunities to overcome barriers to exercise adherence in this population.

Objective: This systematic review builds on prior research to (1) describe study characteristics of mHealth interventions for exercise adherence in HF including details of sample demographics, sample sizes, exercise programs, and theoretical frameworks; (2) summarize types of mHealth technology used to improve exercise adherence in patients with HF; (3) highlight how the term "adherence" was defined and how it was measured across mHealth studies and adherence achieved; and (4) highlight the effect of age, sex, race, New York Heart Association (NYHA) functional classification, and HF etiology (systolic vs diastolic) on exercise adherence.

Examining the Influence of Optimal Guideline-Directed Medical Therapy on Patient-Reported Outcomes in Adults With Heart Failure.

Background: Multidrug, guideline-directed medical therapy (GDMT) improves mortality and hospitalizations for heart failure (HF), but little is known about how optimization of multidrug GDMT influences patient-reported outcomes. Trials of single GDMT medications demonstrate improvements in patient-reported outcomes; however, the effect of the multidrug GDMT regimen on patient-reported outcomes is unclear.

Objective: The objective of this study is to determine how multidrug optimization during a multidisciplinary, advanced practice provider HF clinic impacted patient-reported symptoms and quality of life in adults with HF.

Examining Long-Term Influences of Frailty on Outcomes for Adults Undergoing Left Ventricular Assist Device Therapy.

Background: Frailty is common in adults with end-stage heart failure receiving a left ventricular assist device (LVAD). Short-term studies show frailty reversal post-LVAD. Little is known about long-term frailty and how frailty relates to key LVAD outcomes, including depression, quality of life (QoL), and cognition beyond 6 months.

'Working me to life': longitudinal perceptions from adults with heart failure with preserved ejection fraction enrolled in an exercise training clinical trial.

Aims: Adults with heart failure with preserved ejection fraction (HFpEF) responded more favourably to an exercise intervention compared with those with reduced ejection fraction. This study explores factors that contributed to this response, focusing on the qualitative perceptions of adults with HFpEF enrolled in an exercise intervention.

Methods And Results: This qualitative descriptive study is a secondary analysis of longitudinal interviews collected at 3, 6, 12, and 18 months from participants with HFpEF enrolled in a randomized controlled trial testing an intervention to promote adherence to exercise.

Sex Disparities in Longitudinal Use and Intensification of Guideline-Directed Medical Therapy Among Patients With Newly Diagnosed Heart Failure With Reduced Ejection Fraction.

Background: Guideline-directed medical therapies (GDMTs) are the mainstay of treatment for heart failure with reduced ejection fraction (HFrEF), but they are underused. Whether sex differences exist in the initiation and intensification of GDMT for newly diagnosed HFrEF is not well established.

Methods: Patients with incident HFrEF were identified from the 2016 to 2020 Optum deidentified Clinformatics Data Mart Database, which is derived from a database of administrative health claims for members of large commercial and Medicare Advantage health plans.

Sex differences in long-term outcomes following acute heart failure hospitalization: Findings from the Get With The Guidelines-Heart Failure registry.

Aims: Sex differences in long-term outcomes following hospitalization for heart failure (HF) across ejection fraction (EF) subtypes are not well described. In this study, we evaluated the risk of mortality and rehospitalization among males and females across the spectrum of EF over 5 years of follow-up following an index HF hospitalization event.

Methods And Results: Patients hospitalized with HF between 1 January 2006 and 31 December 2014 from the American Heart Association's Get With The Guidelines-Heart Failure registry with available 5-year follow-up using Medicare Part A claims data were included.

Comorbidities are associated with state hopelessness in adults with ischemic heart disease.

Background: In adults with ischemic heart disease (IHD), comorbidities and hopelessness are independently associated with increased risk of mortality.

Objectives: To determine if comorbidities were associated with state and trait hopelessness and explore the influence of specific conditions and hopelessness in individuals hospitalized for IHD.

Methods: Participants completed the State-Trait Hopelessness Scale.

Exercise Interventions During Hospitalization for Stem Cell Transplantation: An Integrative Review.

Exercise interventions may influence adverse effects experienced during hospitalization for hematopoietic stem cell transplantation (HSCT). Adherence to exercise interventions is challenging. This review aimed to synthesize the literature to identify exercise interventions implemented during hospitalization for HSCT, including intervention characteristics, adherence, barriers and facilitators, and behavior change techniques using the behavior change technique taxonomy.

The role of a multidisciplinary heart failure clinic in optimization of guideline-directed medical therapy: HF-optimize.

Background: Guideline-directed medical therapy (GDMT) reduces mortality and hospitalizations in adults with heart failure with reduced ejection fraction (HFrEF); however, few are receiving GDMT. National registries show as few as 1% of patients are receiving appropriate GDMT. Development of heart failure clinics achieving optimal GDMT are crucial to improve outcomes for HFrEF patients.

Productivity of mother pigs is lower, and mortality greater, in countries that still confine them in gestation crates.

: For decades, pig farmers have used gestation crates to confine pregnant sows. Gestation crates physically restrain sows for most of their life, preventing them from walking or turning around. Growing concern about animal welfare has been pressuring the industry for change, with recent legislation in several countries restricting the use of crates.

Pre-left Ventricular Assist Device Cognition: A Comparison of Rural and Urban Implant Recipients.

Mild cognitive impairment (MCI) is common in patients before left ventricular assist device (LVAD) placement. The consequences of these deficits may differentially impact groups of patients with limited access to postimplantation resources, such as those in rural areas. However, to date, no studies have examined preimplantation cognition in rural and urban patients.

The HEART Camp Exercise Intervention Improves Exercise Adherence, Physical Function, and Patient-Reported Outcomes in Adults With Preserved Ejection Fraction Heart Failure.

Background: Despite exercise being one of few strategies to improve outcomes for individuals with heart failure with preserved ejection fraction (HFpEF), exercise clinical trials in HFpEF are plagued by poor interventional adherence. Over the last 2 decades, our research team has developed, tested, and refined Heart failure Exercise And Resistance Training (HEART) Camp, a multicomponent behavioral intervention to promote adherence to exercise in HF. We evaluated the effects of this intervention designed to promote adherence to exercise in HF focusing on subgroups of participants with HFpEF and heart failure with reduced ejection fraction (HFrEF).

Frailty Assessment in Heart Failure and Ventricular Assist Device Populations: A Review from the United States.

Importance: Post-operative risk is increased with frail individuals undergoing cardiac surgery. Yet, there is no consensus for frailty assessment prior to durable left ventricular assist device (dLVAD) evaluation.

Objective: The objectives of this integrative review were to describe frailty measures, examine psychometrics of measures used, and identify variables related to frailty in heart failure with reduced ejection fraction (HFrEF) and dLVAD populations.

Long-term neurologically intact survival after extracorporeal cardiopulmonary resuscitation for in-hospital or out-of-hospital cardiac arrest: A systematic review and meta-analysis.

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been used as extracorporeal cardiopulmonary resuscitation (ECPR) to support further resuscitation efforts in patients with cardiac arrest, yet its clinical effectiveness remains uncertain.

Objectives: This study reviews the role of ECPR in contemporary resuscitation care compared to no ECPR and/or standard care, e.g.

Pain-Track: a time-series approach for the description and analysis of the burden of pain.

Objective: To present the Pain-Track, a novel framework for the description and analysis of the pain experience based on its temporal evolution, around which intensity and other attributes of pain (texture, anatomy), interventions and clinical symptoms can be registered. This time-series approach can provide valuable insight on the expected evolution of the pain typically associated with different medical conditions and on time-varying (risk) factors associated with the temporal dynamics of pain.

Results: We illustrate the use of the framework to explore hypotheses on the temporal profile of the pain associated with an acute injury (bone fracture), and the magnitude of the pain burden it represents.

Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: a scoping review.

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging concept in cardiac arrest and cardiopulmonary resuscitation. Recent research has documented a significant improvement in favorable outcomes, notable survival to discharge, and neurologically intact survival.

Objectives: The present study undertakes a scoping review to summarize the available evidence by assessing the use of ECPR, compared with no ECPR or the standard of care, for adult patients who sustain cardiac arrest in any setting, in studies which record survival and neurologic outcomes.

Laying hen mortality in different indoor housing systems: a meta-analysis of data from commercial farms in 16 countries.

Societal concern with the welfare of egg laying hens housed in conventional cages is fostering a transition towards cage-free systems in many countries. However, although cage-free facilities enable hens to move freely and express natural behaviours, concerns have also been raised over the possibility that cage-free flocks experience higher mortality, potentially compromising some aspects of their welfare. To investigate this possibility, we conducted a large meta-analysis of laying hen mortality in conventional cages, furnished cages and cage-free aviaries using data from 6040 commercial flocks and 176 million hens from 16 countries.