Objective: To evaluate adherence and adherence consistency to the handheld ECG device-based screening protocol and their association with adverse cerebral and cardiovascular outcomes in two systematic atrial fibrillation (AF) screening programmes.
Methods: In 2012 (Systematic ECG Screening for Atrial Fibrillation Among 75-Year Old Subjects in the Region of Stockholm and Halland, Sweden (STROKESTOP) study) and 2016 (Stepwise mass screening for atrial fibrillation using N-terminal pro b-type natriuretic peptide (STROKESTOP II) study), half of all 75- and 76-year-old inhabitants of up to two Swedish regions were invited to participate in a systematic AF screening programme. Participants were instructed to perform 30-second measurements twice daily in STROKESTOP and four times daily in STROKESTOP II for 2 weeks. Adherence was defined as the number of measurements performed divided by the number of measurements asked, whereas adherence consistency was defined as the number of days with complete registrations.
Results: In total, 6436 participants (55.7% female) from STROKESTOP and 3712 (59.8% female) from STROKESTOP II were included. Median adherence and adherence consistency were 100 (92-100)% and 12 (11-13) days in STROKESTOP and 90 (75-98)% and 8 (3-11) days in STROKESTOP II. Female sex and lower education were factors associated with both optimal adherence and adherence consistency in both studies. In STROKESTOP, low adherence and adherence consistency were associated with higher risk of adverse cerebral and cardiovascular outcomes (HR for composite primary endpoint 1.30 (1.11 to 1.51), p=0.001), including stroke (HR 1.68 (1.22 to 2.32), p=0.001) and dementia (1.67 (1.27 to 2.19), p<0.001).
Conclusions: Adherence to twice daily handheld ECG measurements in STROKESTOP was higher than to four times daily measurements in STROKESTOP II. Female sex and lower educational attainment were associated with ≥100% adherence and adherence consistency. Low adherence and adherence consistency were associated with a higher risk of adverse outcomes.
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http://dx.doi.org/10.1136/heartjnl-2023-323522 | DOI Listing |
BMC Infect Dis
December 2024
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Background: Mucocutaneous leishmaniasis (MCL) is a severe form of leishmaniasis causing chronic and destructive lesions. Accurate diagnosis is crucial for effective treatment. Traditional methods, such as the Montenegro skin test is delayed hypersensitivity test.
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December 2024
Department of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. box 400, Woldia, Ethiopia; Research Center for Tuberculosis and Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Prinshof, 0084 Pretoria, South Africa.
Background: Diabetes mellitus (DM) is a metabolic abnormality affecting 537 million people worldwide. Poor glycemic control, longer duration, and poor medication adherence increased the risk of DM complications. Comprehensive evidence on the pooled prevalence of microvascular complications in DM patients in Ethiopia is not available.
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December 2024
Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
Background: Medical advances in intensive care units (ICUs) have resulted in the emergence of a new patient population-those who survive the initial acute phase of critical illness, but require prolonged ICU stays and develop chronic critical symptoms. This condition, often termed Persistent Critical Illness (PerCI) or Chronic Critical Illness (CCI), remains poorly understood and inconsistently reported across studies, resulting in a lack of clinical practice use. This scoping review aims to systematically review and synthesize the existing literature on PerCI/CCI, with a focus on definitions, epidemiology, and outcomes for its translation to clinical practice.
View Article and Find Full Text PDFJ Geriatr Oncol
December 2024
Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia; School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia; Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia.
Introduction: Older patients with cancer (65 years and older) are a growing population with unique nutrition-and treatment-related issues that accelerate aging. Nutrition interventions attenuate nutritional decline, muscle loss, and risk of malnutrition and sarcopenia in patients with cancer, however the evidence for older patients with cancer is limited. The aim of this systematic review was to evaluate the efficacy of nutrition interventions on nutritional status, body weight/composition and clinical outcomes in older patients with cancer and to identify future research priority areas.
View Article and Find Full Text PDFClin Psychol Rev
December 2024
Arizona State University, Department of Psychology, The REACH Institute, 900 S. McAllister Avenue, Suite 205, Tempe, AZ, USA.
As developers and practitioners translate parenting interventions from research to practice, significant heterogeneity in provider fidelity and parent engagement with the program has contributed to observed declines in intervention effectiveness. Despite this, empirical investigations of the relationship between provider fidelity, parent engagement, and intervention outcomes are scarce and those that exist show discrepant outcomes. This is, in part, due to the variability in the way fidelity is defined, operationalized, and measured.
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