Purpose: Many people with breast cancer (PwBC) experience psychological distress, including fear of cancer recurrence (FCR). Clinical levels of FCR can negatively impact quality of life. While the FCR trajectory may vary according to age, stage at diagnosis, and imminent exams, FCR levels tend to remain relatively stable over time without intervention.
View Article and Find Full Text PDFThis retrospective, observational report describes an innovative quality improvement process, Phase-based Care (PBC), that eliminated wait times and achieved positive clinical outcomes in a community mental health center's (CMHC) mood disorder clinic without adding staff. PBC accomplishes this by eliminating the ingrained cultural practice of routinely scheduling stable patients at rote intervals of 1-3 months, regardless of clinical need or medical necessity. Based on four organizational transformations and using mathematical algorithms developed for this process, PBC re-allocates therapy and medical resources away from routinely scheduled appointments and front-loads those resources to patients in an acute phase of illness.
View Article and Find Full Text PDFBackground: Atrial fibrillation, the most common clinically important arrhythmia, is often treated by external cardioversion preceeded by transoesophageal echo (TOE) which are usually performed as separate procedures. We performed TOE and cardioversion as a combined procedure to evaluate its safety and feasibility.
Method: 173 patients were referred for a combined procedure; 154 underwent a combined TOE and cardioversion.
Aims: This study evaluates a simple echocardiographic rhythm independent expression of left atrial (LA) function, 'the left atrial function index' (LAFI).
Background: Quantitation of LA function is challenging and often established parameters including peak A are limited to sinus rhythm (SR). We hypothesized that atrial function could be characterized independent of rhythm by combining analogues of LA volume, reservoir function and LV stroke volume.
The utility of the Structured Interview of Reported Symptoms [SIRS; Rogers, R., Bagby, R. M.
View Article and Find Full Text PDFSeveral techniques for treatment of atrial fibrillation (AF) have been developed, including the direct placement of radiofrequency for lesions at open heart surgery. Detailed evaluation of left atrial (LA) function has not been performed after these procedures and has not been compared in patients with chronic AF. We compared the atrial function of patients with sustained sinus rhythm (SR) after linear ablation with a group who underwent direct-current cardioversion and a group of normal controls to investigate the measurable deleterious effects, if any, on atrial function after the surgical procedure.
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