PW376 A pilot study of a post-discharge nurse-led, educational intervention on cardiac self-efficacy and anxiety in post-PCI patients

Introduction Hospitalisation for percutaneous coronary intervention (PCI) is often short, with limited nurse-teaching time and poor information absorption. Currently, patients are discharged home only to wait up to 4-8 weeks to commence a secondary prevention program and visit their cardiologist. This wait is an anxious time for patients and confidence or self-efficacy (SE) to self-manage may be low. Objectives To determine the effects of a nurse-led, educational intervention on participant SE and anxiety in the early post-discharge period. Methods A pilot study was undertaken as a randomised controlled clinical trial. Thirty-three participants were recruited, with n=13 randomised to the intervention group. A face-to-face, nurse-led, educational intervention was undertaken within the first 5-7 days post-discharge. Intervention group participants received standard post-discharge education, physical assessment, with a strong focus on the emotional impact of cardiovascular events and PCI. Early reiteration of post-discharge education was offered, along with health professional support with the aim to increase patients’ SE and to effectively manage their post-discharge health and well being, as well as anxieties. Self-efficacy to return to normal activities was measured to gauge participants’ abilities to manage post-PCI after attending the intervention using the cardiac self-efficacy (CSE) scale. State and trait anxiety was also measured using the State-Trait Anxiety Inventory (STAI) to determine if an increase in SE would influence participant anxiety. Results There were some increases in mean CSE scores in the intervention group participants over time. Areas of increase included return to normal social activities and confidence to change diet. Although reductions were observed in mean state and trait anxiety scores in both groups, an overall larger reduction in intervention group participants was observed over time. Conclusion It is essential that patients are given the education, support, and skills to self-manage in the early post-discharge period so that they have greater SE and are less anxious. This study provides some initial evidence that nurse-led support and education during this period, particularly the first week following PCI, is beneficial and could be trialled using alternate modes of communication to support remote and rural PCI patients and extend to other cardiovascular patients.

Can nurses do more for patients to reduce vascular access and cardiac complications following PCI?

Percutaneous coronary interventions have increased 50% in Australia, yet vascular and cardiac complications remain ongoing outcome issues for patients. Managing complications is confounded by reduced length of patient stay, yet is an integral component of a cardiac nurses’ scope of practice. The aim of this study was to highlight in and out of hospital vascular and cardiac complications, for twelve months post patient discharge after PCI. Prospective data was collected from the hospital angioplasty database from 1089 consecutive patients who had PCI procedures from 1 January 2005 to 31 December 2006. In hospital vascular complications were reported by 391 (35%) of the 1089 patients, following PCI. Of these, 22.4% had haemorrhage only, 7.1% haematoma only. Cardiac complications in hospital were, one death (0.09%) following PCI, three deaths (0.27%) during the same admission and no incidence of myocardial infarction or bypass surgery. Patients who had PCI in 2005 (525) were telephone followed up after discharge at one and twelve months. Surprisingly, ongoing vascular outcomes were noted, with a 2.5% incidence at one month and 4% at 12 months. Cardiac complications were also identified, 51 (9.7%) patients requiring readmission for repeat angiogram, 19 (3.6%) a repeat PCI and 7 (1.3%) patients undergoing bypass surgery. This review highlights that vascular and cardiac problems are ongoing issues for PCI patients both in and out of hospital. The results suggest that cardiac nurses focus more on improving the monitoring and discharge care of patients and families for recovery after PCI.

A randomised controlled clinical trial of a post-discharge, nurse-led educational intervention to reduce anxiety and enhance self-efficacy in percutaneous coronary intervention (PCI) patients within the first week post-discharge: A pilot study

This research investigated the efficacy of a post-discharge nurse-led clinic, for patients who underwent a cardiovascular interventional procedure in Australia. A randomised controlled clinical trial measured the effects of the clinic on patient confidence to self-manage and minimise psychological distress given the strong link between anxiety, depression and coronary heart disease. Hospitalisation for the procedure is short and stressful, and patients may wait up to 7-64 days for post-discharge review. This study provides preliminary quantitative and qualitative evidence that nurse-led clinics undertaken within the first week post-percutaneous coronary intervention may fill a much-needed gap for patients during a potentially vulnerable period.

基于神经计算机的PCI接口系统设计

Submitted by zhangdi (zhangdi@red.semi.ac.cn) on 2009-04-13T11:45:31Z

基于WDM模型的PCI卡驱动程序设计

基于WDM模型的PCI卡驱动程序设计,是建立Windows操作系统下数据采集系统面临的关键问题。详细分析了WDM驱动程序的工作原理。以PCI9113A数据采集卡为例,提出了利用Microsoft公司的DDk实现Windows2000操作系统下驱动程序的有效开发方法。讨论了驱动程序的测试和封装。

基于PCI总线的计数卡电路

介绍了新近研制开发的一种实用计数卡,该计数卡基于PCI总线,采用单片机8051AH、计数器芯片LS7031等器件构建;最大计数范围为109-1,最大计数时间1×106s,最高的计数频率为20MHz。

玻璃海鞘多肽PCI的分离纯化及其抗血管生成活性研究

血管生成是肿瘤生长、发展的必经之路，并且与实体瘤的发生、转移有着密切的关系，抑制肿瘤新生血管生成具有特异性高、疗效好、不易产生耐药性以及毒副作用低等特点，因此抑制肿瘤血管形成可望成为治疗癌症的一个突破点，以抗血管生成为主的肿瘤生物治疗研究已成为近十年的研究热点。玻璃海鞘（Coina intestinalis）属于内性目、玻璃海鞘科，因其进化上的独特地位常作为研究神经发育、免疫系统进化的材料。在其它种属的海鞘中分离发现了多种具有抗肿瘤活性的多肽，但关于玻璃海鞘抗血管生成活性多肽的分离纯化和活性研究未见报道。本文利用多种分离纯化手段，采用活性追踪的方法首次从玻璃海鞘中分离得到具有抗新生血管生成作用的多肽，并对其抗血管生成活性做了初步研究。 本研究利用冷丙酮分级沉淀，超滤截留分子量小于5kDa的蛋白，再经SephadexG25、Superdex75柱层析，µRPC C2/C18反相柱层析等分离手段，采用活性追踪的方法，由玻璃海鞘（Coina intestinalis）中分离纯化出抗血管生成多肽PCI，据保留时间计算其分子量为1.8 kDa。MTT检测表明其对人脐静脉血管内皮细胞（HUVEC）具有强烈的抑制作用，IC50为7.5 μg/ml，并对多种肿瘤细胞有直接的抑制作用。斑马鱼胚胎体内实验进一步表明PCI在40 μg/ml的浓度下作用12h，斑马鱼胚胎新生血管生成受到显著抑制，肠下静脉血管长度为正常组的30%，斑马鱼胚胎血管生成率为正常组的45%。

Ronda de 2011 del Programa de Comparación Internacional (PCI) en América Latina y Caribe

Incluye Bibliografía

Resultados del Programa de Comparación Internacional (PCI) de 2011 para América Latina y el Caribe

El Programa de Comparación Internacional (PCI) es un proyecto estadístico mundial cuyo objetivo consiste en recolectar datos comparables sobre precios de una amplia canasta de productos y compilar valores detallados del producto interno bruto (PIB) relativos al gasto para calcular las paridades de poder adquisitivo (PPA). Al utilizarse las PPA en lugar de los tipos de cambio de mercado para convertir los agregados macroeconómicos, es posible comparar la producción de las economías y el bienestar de sus habitantes en términos reales, es decir, teniendo en consideración la capacidad de compra en cada uno de los países participantes.