The aim of this study was to investigate the relationships between depression and occurrence of chemotherapy induced prospective memory impairment in patients with breast cancer (BC).The 63 BC patients before and after chemotherapy were administered with the self-rating depression scale (SDS) and a battery of cognitive neuropsychological tests including event-based and time-based prospective memory (EBPM and TBPM, respectively) tasks. The changes in their prospective memory and cognitive neuropsychological characteristics before and after chemotherapy were compared. Compared with the scores before chemotherapy, the EBPM score exhibited a statistically significant difference after chemotherapy (t = 6.069, P < 0.01), while the TBPM score showed no significant difference (t = 1.087, P > 0.05). Further, compared with the patients without depression, the patients with depression exhibited a statistically significant difference in the EBPM score (t = -4.348, P < 0.01), while the TBPM scores did not show a statistically significant difference between the two groups (t = -1.260, P > 0.05). Post-chemotherapy, EBPM and overall cognitive functions in BC patients merged with depression were found to decline, while TBPM did not show a significant change, suggesting that the combination of chemotherapy and depression might be related with the occurrence of post-chemotherapy EBPM impairment.
Abstract—In the case of neurological disorders, patient autonomy is a fundamental principle which must be taken into consideration. In the case of this pathology, fluctuating mental deterioration is encountered most frequently in the case of mild forms of dementia. In the case of severe forms of dementia, the patient loses any autonomy and requires permanent medical care, as well as a permanent legal representative.
Aim of this study was to know autonomy of the patients with certain neurological disorders about ability of making decisions for their medical care.
Material and method: It is a quantitative retrospective observational study and data for which is gathered from the observation charts of 323 patients attended in either emergency or outpatient, between April to December 2006, in “Prof. Dr. Nicolae Oblu” Clinical Hospital of Emergency, Iasi, Romania. Study subjects were split into 2 groups: Group 1 (with a number of 215 cases) – a group of patients with the diagnostics of acute cerebrovascular accident, aphasia and dementia. Group 2 (with a number of 108 cases) – patients known or recently diagnosed with amyotrophic lateral sclerosis, multiple sclerosis and myasthenia gravis. Consent informed given by patient in the observation charts of above two groups was observed and number of patients who has given consent was compared in both the groups.
Results: On the cases under study, only for 13.6% of the patients of the first group there is consent informed in the observation chart, while for the patients in the second group this percentage was slightly smaller (9.3%).
Conclusions: As very few patients have given written informed consent and more sever the neurological disorder less the chances to have written informed consent by patients. So it can be concluded that medical performance brings indisputable benefits, however it should be done by a careful selection of the subjects and by following ethical principles.
Palliative care could help improve the quality of life for Parkinson’s diseas...Δρ. Γιώργος K. Κασάπης
A small study of individuals with Parkinson’s disease finds that adding palliative care to standard care may help raise their quality of life. Half the patients in a 210-person trial were assigned to visit physicians as usual, while the others also received palliative care — a team of a social worker, nurse, palliative medicine specialist, and chaplain visited the patient at home or via telemedicine to discuss symptoms and difficult emotions and offer support to caregivers. Patients in the combination care group had more improvement in their quality of life score (as measured by a survey that assesses physical and mental health).
These patients also scored higher on quality of life measures when their caregivers were surveyed in their stead.
Abstract—In the case of neurological disorders, patient autonomy is a fundamental principle which must be taken into consideration. In the case of this pathology, fluctuating mental deterioration is encountered most frequently in the case of mild forms of dementia. In the case of severe forms of dementia, the patient loses any autonomy and requires permanent medical care, as well as a permanent legal representative.
Aim of this study was to know autonomy of the patients with certain neurological disorders about ability of making decisions for their medical care.
Material and method: It is a quantitative retrospective observational study and data for which is gathered from the observation charts of 323 patients attended in either emergency or outpatient, between April to December 2006, in “Prof. Dr. Nicolae Oblu” Clinical Hospital of Emergency, Iasi, Romania. Study subjects were split into 2 groups: Group 1 (with a number of 215 cases) – a group of patients with the diagnostics of acute cerebrovascular accident, aphasia and dementia. Group 2 (with a number of 108 cases) – patients known or recently diagnosed with amyotrophic lateral sclerosis, multiple sclerosis and myasthenia gravis. Consent informed given by patient in the observation charts of above two groups was observed and number of patients who has given consent was compared in both the groups.
Results: On the cases under study, only for 13.6% of the patients of the first group there is consent informed in the observation chart, while for the patients in the second group this percentage was slightly smaller (9.3%).
Conclusions: As very few patients have given written informed consent and more sever the neurological disorder less the chances to have written informed consent by patients. So it can be concluded that medical performance brings indisputable benefits, however it should be done by a careful selection of the subjects and by following ethical principles.
Palliative care could help improve the quality of life for Parkinson’s diseas...Δρ. Γιώργος K. Κασάπης
A small study of individuals with Parkinson’s disease finds that adding palliative care to standard care may help raise their quality of life. Half the patients in a 210-person trial were assigned to visit physicians as usual, while the others also received palliative care — a team of a social worker, nurse, palliative medicine specialist, and chaplain visited the patient at home or via telemedicine to discuss symptoms and difficult emotions and offer support to caregivers. Patients in the combination care group had more improvement in their quality of life score (as measured by a survey that assesses physical and mental health).
These patients also scored higher on quality of life measures when their caregivers were surveyed in their stead.
EBM is the practice of integrating individual clinical expertise with the best available clinical evidence from systematic research to maximize the quality and quantity of life for individual patients.
Fibromyalgia Over-Diagnosed 97% of the timeNelson Hendler
97% of patients told they have fibromyalgia do not meet the diagnostic criteria for this diagnosis, and have treatable disorders, such as nerve entrapments, thoracic outlet syndrome, discs which do not show on MRI, facet syndromes, etc.
Percutaneous image-guided cryoablation of spinal metastases: A systematic reviewAhmad Ozair
Percutaneous cryoablation (PCA) is a minimally invasive technique that has been recently used to treat spinal metastases with a paucity of data currently available in the literature. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective or retrospective studies concerning metastatic spinal neoplasms treated with current generation PCA systems and with available data on safety and clinical outcomes were included. In the 8 included studies (7 retrospective, 1 prospective), a total of 148 patients (females = 63%) underwent spinal PCA. Tumors were located in the cervical (3/109 [2.8%], thoracic (74/109 [68.8%], lumbar (37/109 [33.9%], and sacrococcygeal (17/109 [15.6%] regions. Overall, 187 metastatic spinal lesions were treated. Thermo-protective measures (e.g., carbo-/hydro-dissection, thermocouples) were used in 115/187 [61.5%] procedures. For metastatic spinal tumors, the pooled mean difference (MD) in pain scores from baseline on the 0–10 numeric rating scale was 5.03 (95% confidence interval [CI]: 4.24 to 5.82) at a 1-month follow-up and 4.61 (95% CI: 3.27 to 5.95) at the last reported follow-up (range 24–40 weeks in 3/4 studies). Local tumor control rates ranged widely from 60% to 100% at varying follow-ups. Grade I-II complications were reported in 9/148 [6.1%] patients and grade III-V complications were reported in 3/148 [2.0%]) patients. PCA, as a stand-alone or adjunct modality, may be a viable therapy in appropriately selected patients with painful spinal metastases who were traditionally managed with open surgery and/or radiation therapy.
Objective: To describe cognitive disorders in patients with epilepsy attending neurology consultations in the city of Ouagadougou. Methodology: This was a prospective cross-sectional multicenter study carried on patients with epilepsy during the period from 1erJanuary 2018 to 30 April 2019. All the patients were screened using mini-mental state examination (MMSE). Results: The study included 102 patients with a mean age of 33.28 ± 15.55 years. The sample was consisted of 54 (52.9%) men and 48 (47.1%) women. The majority of patients had secondary level (55.7 %). Generalized seizures were more common (74.5%). The most common causes of epilepsy was head trauma (24.5%). A great number of patients were treated by phenobarbital (49%). The overall mean MMSE score was 25.65 ± 5.07. The frequency of cognitive disorders was 61.8%, including cognitive impairment (25.5%), mild dementia (25.5%), moderate dementia (7.8%) and severe dementia (3%). The domains most affected were calculation and attention
deficit (48%) followed by memory disorders (27.5%) and copying (12.8%). Head trauma and phenobarbital were signifi cantly associated to cognitive. Cognitive disorders were less frequent in young adult aged of 26-35 years.
CHD Secondary Prevention Clinics in Primary Care; a critical assessmentJosep Vidal-Alaball
There is a need for CHD secondary prevention in primary care. This need has been addressed providing specialized clinics run by nurses or GPs. Whether with this clinics we are meeting this need is a question to be answered.
Abstract—Prevalence of degenerative dementias and dementias associated with cerebrovascular disease is increasing with the time. Dementia is one of the most significant public health problems. Demographic data, medical history, general biochemical data and serum total homocysteine (tHcy) levels was used in this study to examine the differences between dementia and normal control groups. A cross-sectional study was conducted on 236 individuals who were above the age of 65 years. These participants went through the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), demographic characteristics, biochemical data and tHcy level. Each of the above mentioned factors was assessed. There were significant differences in the history of hypertension, diabetes mellitus, marital status, alcohol consumption (AC), BMI value, and triglyceride (TG) and serum tHcy levels. The logistic regression analysis showed significant differences in marital status, AC and tHcy. So it can be concluded that elevated serum tHcy, no AC and no partner are associated with the risk of dementia in elders of Southern Taiwan. It needs further researches to identify and reduce the risk of dementia.
Risk of pulmonary aspiration with the outpatient electroconvulsive therapy: C...Ahmed Elaghoury
A case study presented at the 2nd International Brain Stimulation in Barcelona.
Cite as: Gad, M., & Elaghoury, A. (2017). Risk of pulmonary aspiration with the outpatient electroconvulsive therapy: Case report. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 10(2), 419.
http://dx.doi.org/10.1016/j.brs.2017.01.244
EBM is the practice of integrating individual clinical expertise with the best available clinical evidence from systematic research to maximize the quality and quantity of life for individual patients.
Fibromyalgia Over-Diagnosed 97% of the timeNelson Hendler
97% of patients told they have fibromyalgia do not meet the diagnostic criteria for this diagnosis, and have treatable disorders, such as nerve entrapments, thoracic outlet syndrome, discs which do not show on MRI, facet syndromes, etc.
Percutaneous image-guided cryoablation of spinal metastases: A systematic reviewAhmad Ozair
Percutaneous cryoablation (PCA) is a minimally invasive technique that has been recently used to treat spinal metastases with a paucity of data currently available in the literature. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective or retrospective studies concerning metastatic spinal neoplasms treated with current generation PCA systems and with available data on safety and clinical outcomes were included. In the 8 included studies (7 retrospective, 1 prospective), a total of 148 patients (females = 63%) underwent spinal PCA. Tumors were located in the cervical (3/109 [2.8%], thoracic (74/109 [68.8%], lumbar (37/109 [33.9%], and sacrococcygeal (17/109 [15.6%] regions. Overall, 187 metastatic spinal lesions were treated. Thermo-protective measures (e.g., carbo-/hydro-dissection, thermocouples) were used in 115/187 [61.5%] procedures. For metastatic spinal tumors, the pooled mean difference (MD) in pain scores from baseline on the 0–10 numeric rating scale was 5.03 (95% confidence interval [CI]: 4.24 to 5.82) at a 1-month follow-up and 4.61 (95% CI: 3.27 to 5.95) at the last reported follow-up (range 24–40 weeks in 3/4 studies). Local tumor control rates ranged widely from 60% to 100% at varying follow-ups. Grade I-II complications were reported in 9/148 [6.1%] patients and grade III-V complications were reported in 3/148 [2.0%]) patients. PCA, as a stand-alone or adjunct modality, may be a viable therapy in appropriately selected patients with painful spinal metastases who were traditionally managed with open surgery and/or radiation therapy.
Objective: To describe cognitive disorders in patients with epilepsy attending neurology consultations in the city of Ouagadougou. Methodology: This was a prospective cross-sectional multicenter study carried on patients with epilepsy during the period from 1erJanuary 2018 to 30 April 2019. All the patients were screened using mini-mental state examination (MMSE). Results: The study included 102 patients with a mean age of 33.28 ± 15.55 years. The sample was consisted of 54 (52.9%) men and 48 (47.1%) women. The majority of patients had secondary level (55.7 %). Generalized seizures were more common (74.5%). The most common causes of epilepsy was head trauma (24.5%). A great number of patients were treated by phenobarbital (49%). The overall mean MMSE score was 25.65 ± 5.07. The frequency of cognitive disorders was 61.8%, including cognitive impairment (25.5%), mild dementia (25.5%), moderate dementia (7.8%) and severe dementia (3%). The domains most affected were calculation and attention
deficit (48%) followed by memory disorders (27.5%) and copying (12.8%). Head trauma and phenobarbital were signifi cantly associated to cognitive. Cognitive disorders were less frequent in young adult aged of 26-35 years.
CHD Secondary Prevention Clinics in Primary Care; a critical assessmentJosep Vidal-Alaball
There is a need for CHD secondary prevention in primary care. This need has been addressed providing specialized clinics run by nurses or GPs. Whether with this clinics we are meeting this need is a question to be answered.
Abstract—Prevalence of degenerative dementias and dementias associated with cerebrovascular disease is increasing with the time. Dementia is one of the most significant public health problems. Demographic data, medical history, general biochemical data and serum total homocysteine (tHcy) levels was used in this study to examine the differences between dementia and normal control groups. A cross-sectional study was conducted on 236 individuals who were above the age of 65 years. These participants went through the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), demographic characteristics, biochemical data and tHcy level. Each of the above mentioned factors was assessed. There were significant differences in the history of hypertension, diabetes mellitus, marital status, alcohol consumption (AC), BMI value, and triglyceride (TG) and serum tHcy levels. The logistic regression analysis showed significant differences in marital status, AC and tHcy. So it can be concluded that elevated serum tHcy, no AC and no partner are associated with the risk of dementia in elders of Southern Taiwan. It needs further researches to identify and reduce the risk of dementia.
Risk of pulmonary aspiration with the outpatient electroconvulsive therapy: C...Ahmed Elaghoury
A case study presented at the 2nd International Brain Stimulation in Barcelona.
Cite as: Gad, M., & Elaghoury, A. (2017). Risk of pulmonary aspiration with the outpatient electroconvulsive therapy: Case report. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 10(2), 419.
http://dx.doi.org/10.1016/j.brs.2017.01.244
This presentation focusses on the importance of diagnostic biomarkers for Alzheimer's disease. MRI, amyloid PET and CSF biomarkers are discussed in detail.
QUALITY OF LIFE AS A PREDICTOR OF POST OPERATIVE OUTCOME FOLLOWING REVASCULAR...Shantonu Kumar Ghosh
World Health Organization (WHO) defines quality of life as an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.8
QOL encompasses the concept of health-related quality of life (HRQOL) and other domains such as environment, family and work. HRQOL is the extent to which one’s usual or expected physical, emotional and social well-being is affected by a medical condition or its treatment.9
For patients suffering from peripheral arterial disease (PAD), quality of life (QoL) has become as important as medical outcome end points, such as mortality and morbidity, to evaluate the effect of disease and treatment.10
Evidence-Based Practices & Nursing
Introduction
Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Summary of Case Study
The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Research Question
In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?
PICOT Format
1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.
2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.
3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.
4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded i ...
Patient-Reported Outcomes: Does Stigma Affect the Quality of Life of Patients...semualkaira
The degree to which stigma affects the
health-related quality of life (HRQoL) of patients with chronic
hepatitis B (CHB)-related diseases is not known. We evaluated the
HRQoL of patients with CHB-related disease and identified stigma
associated with HRQoL
Running head The Critique of Ethical Consideration of Patients wi.docxtodd521
Running head: The Critique of Ethical Consideration of Patients with Dementia 1
The critique of ethical consideration of patients with dementia
8
The Critique of Ethical Consideration of Patients with Dementia
Yeni Hernandez
GCU NRS-433V
August 19, 2018
The critique of ethical consideration of patients with dementia
Introduction
Based on Pan et al. (2013) study, the severities of the behavioural and psychological symptoms that are evident for vascular dementia are clearly presented. The research focuses on the application of quantitative measures to understand the severity of the symptoms using a sample of 51 patients with vascular dementia (Pan et al., 2013). The analysis considered the fluctuation of the behavioural symptoms based on diurnal, evening, and nocturnal activities. The ageing population has been outlined as being a risk factor for the continued prevalence and rise in the cases of dementia for decades. This paper will critique the PICOT statement on the grounds of those living with dementia in their daily lives.
PICOT statement for patients with dementia
P- (problem/patient/population): the research will focus on patients living with dementia (PWD)
I- Intervention will come in the form of integrating regular exercises to dementia patients to help improve memory loss and maintain a healthy fit.
C- Comparison: if a patient cannot engage in productive and useful forms of exercises, provide a supportive environment through informal caregiving to facilitate relaxation and safety.
O- Outcome: the outcome of the study is an improved overall safety of a patient living with dementia to reduce re-hospitalizations that result from injuries.
T- Time- this will show the time required in addressing the problem of dementia among home care patients.
Background information
Dementia generally is used to refer to the symptoms shown by individuals and mostly relate to memory. There have been complaining about the existence of rare signs amongst patients who visit clinical institutions. This included the loss of memory hence reducing their ability to carry out their daily tasks appropriately. However, it had been clearly proven that there was little that was done in realizing the desired the desired solutions to help out the patients. At higher stages patients showed problems in communication and language, focusing and paying attention, perceptions relating to visions, judgment and how the patients reasoned out. This, therefore, prompted the need to carry out a qualitative and quantitative study with a major aim of presenting ethical issues that relate to patients with dementia. The study was based on scholarly articles to present appropriate information that can help curb such instances in most or all medical and clinical institutions hence saving the patients. It is evident that the lack of patient care and safety acted as the major reason as to.
Discussion post reply APA Format2 references for each discussiLyndonPelletier761
Discussion post reply
APA Format
2 references for each discussion post with intext citation.
Make it short and simple.
Post # one
Misty B
I have chosen to become a Psychiatric Mental Health Nurse Practitioner. I chose this path because I feel God is calling me to help guide and mentor people through this age of transition. With the increase of the digital age, social media specifically, and the COVID Pandemic, peoples’ mental health needs need to be cared for in a better manner than how they are currently being managed. “The role of the PMHNP is to assess, diagnose and treat the mental health needs of patients. Many PMHNPs provide therapy and prescribe medication for patients who have mental health disorders or substance abuse problems.” (American Association of Nurse Practitioners, n.d.) I believe your overall health begins with a healthy mind. When your mental health is not healthy you can spiral out of control and turn to substances (illicit drugs, alcohol, food, etc.) or self-harm. This can lead to other health problems such as obesity, diabetes, cardiovascular disorders, liver disorders, kidney disorders, etc. I feel as a PMHNP I will be able to start with the root cause of a patient’s overall health. I waxed and waned with my decision between a PMHNP and FNP. I feel starting with PMHNP is the best option for me at the moment and continuing afterward to have a dual certification as an FNP.
Professional Organization
“Another factor essential to a nurse’s professional development is active membership in 1 or more professional organization. Memberships provide exposure and access to education resources (eg, websites, webinars, publications, and conferences) and rewarding networking opportunities with peers and colleagues.” (Cherry et all, 2019)
Having been a member of the Emergency Nurses Association (ENA) for 8 years, I too feel it is important to become a member of your of an association for your nursing specialty. I have chosen to become a member of the American Psychiatric Nurses Association. Their mission statement and beliefs are parallel to my own.
APNA is committed to the practice of psychiatric-mental health nursing, health and wellness promotion through identification of mental health issues, prevention of mental health problems, and the care and treatment of persons with mental health disorders. APNA champions psychiatric-mental health nursing and mental health care through the development of positions on key issues, the dissemination of current knowledge and developments in PMH nursing, and collaboration with stakeholders to promote advances in recovery-focused assessment, diagnosis, treatment, and evaluation of persons with mental health disorders. (American Psychiatric Nurses Association, n.d.)
Becoming a member was as easy as going to their website www.apna.org and selecting your membership type, fill in the required information, and pay the fee. Being a member will give me access to educational oppo ...
Effectiveness of Nurse Led Heart Failure Management Program on Quality of Lif...ijtsrd
Background Heart failure HF is characterized by poor quality of life QOL with high hospitalization rates, and poor prognosis. Younger age groups are more affected in developing countries like India. HF can be very disabling, and QOL of patients can be severely affected Objectives 1. To assess the Quality of Life of Heart Failure patients in Experimental and Control Group. 2. To Compare the effectiveness of Nurse Led Heart Failure Management Program on Quality of life of heart failure patients in Experimental and Control Group. Method The study was conducted for 3 months from 1 Dec to 1 March 2019, in cardiology OPD, at KGMU, U.P, based on simple random sampling the groups were divided into control group and experimental group in which the control group received no intervention and Interventions of Nurse led Heart failure management program was given in experimental group with a Log book which they have to fill once a week for 3 months. Post test questionnaire for Quality of life and log book data will be collected from both the groups after 3 months. Results The result showed significant difference between Quality of life P 0.002 as measured by KCCQ, mean Quality of life was found to be significantly higher among the subjects of Experimental group 60.50±12.10 than control group 46.73±16.23 at post intervention. Conclusion Simple systemic educational intervention that was targeted towards patient to provide a tailored educational intervention through an holistic Perspective, focused on preserving or enhancing health and Self management goal achievement has improve quality of life of heart failure patients those who received NLP i.e, Experimental group, Their Quality Scores were High as Compared to Control group. Conclusion The study concluded that, structured information brochure is an effective way to improve the knowledge and reduce the anxiety among the patient planned for angioplasty. The study recommended that structured information brochure about the post procedural care about the angioplasty should be implemented to improve the knowledge and reduce the anxiety among the patient for providing a better care. Richi Lal | Rashmi P. John | Sharad Chandra "Effectiveness of Nurse-Led Heart Failure Management Program on Quality of Life of Heart Failure Patients in Cardiology OPD, at KGMU, U.P" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd48046.pdf Paper URL: https://www.ijtsrd.com/medicine/cardiology/48046/effectiveness-of-nurseled-heart-failure-management-program-on-quality-of-life-of-heart-failure-patients-in-cardiology-opd-at-kgmu-up/richi-lal
Similar to Depression Involved in the Chemotherapy Induced Event-based Prospective Memory Impairment in Breast Cancer Survivors (20)
Welcome to WIPAC Monthly the magazine brought to you by the LinkedIn Group Water Industry Process Automation & Control.
In this month's edition, along with this month's industry news to celebrate the 13 years since the group was created we have articles including
A case study of the used of Advanced Process Control at the Wastewater Treatment works at Lleida in Spain
A look back on an article on smart wastewater networks in order to see how the industry has measured up in the interim around the adoption of Digital Transformation in the Water Industry.
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About
Indigenized remote control interface card suitable for MAFI system CCR equipment. Compatible for IDM8000 CCR. Backplane mounted serial and TCP/Ethernet communication module for CCR remote access. IDM 8000 CCR remote control on serial and TCP protocol.
• Remote control: Parallel or serial interface.
• Compatible with MAFI CCR system.
• Compatible with IDM8000 CCR.
• Compatible with Backplane mount serial communication.
• Compatible with commercial and Defence aviation CCR system.
• Remote control system for accessing CCR and allied system over serial or TCP.
• Indigenized local Support/presence in India.
• Easy in configuration using DIP switches.
Technical Specifications
Indigenized remote control interface card suitable for MAFI system CCR equipment. Compatible for IDM8000 CCR. Backplane mounted serial and TCP/Ethernet communication module for CCR remote access. IDM 8000 CCR remote control on serial and TCP protocol.
Key Features
Indigenized remote control interface card suitable for MAFI system CCR equipment. Compatible for IDM8000 CCR. Backplane mounted serial and TCP/Ethernet communication module for CCR remote access. IDM 8000 CCR remote control on serial and TCP protocol.
• Remote control: Parallel or serial interface
• Compatible with MAFI CCR system
• Copatiable with IDM8000 CCR
• Compatible with Backplane mount serial communication.
• Compatible with commercial and Defence aviation CCR system.
• Remote control system for accessing CCR and allied system over serial or TCP.
• Indigenized local Support/presence in India.
Application
• Remote control: Parallel or serial interface.
• Compatible with MAFI CCR system.
• Compatible with IDM8000 CCR.
• Compatible with Backplane mount serial communication.
• Compatible with commercial and Defence aviation CCR system.
• Remote control system for accessing CCR and allied system over serial or TCP.
• Indigenized local Support/presence in India.
• Easy in configuration using DIP switches.
Immunizing Image Classifiers Against Localized Adversary Attacksgerogepatton
This paper addresses the vulnerability of deep learning models, particularly convolutional neural networks
(CNN)s, to adversarial attacks and presents a proactive training technique designed to counter them. We
introduce a novel volumization algorithm, which transforms 2D images into 3D volumetric representations.
When combined with 3D convolution and deep curriculum learning optimization (CLO), itsignificantly improves
the immunity of models against localized universal attacks by up to 40%. We evaluate our proposed approach
using contemporary CNN architectures and the modified Canadian Institute for Advanced Research (CIFAR-10
and CIFAR-100) and ImageNet Large Scale Visual Recognition Challenge (ILSVRC12) datasets, showcasing
accuracy improvements over previous techniques. The results indicate that the combination of the volumetric
input and curriculum learning holds significant promise for mitigating adversarial attacks without necessitating
adversary training.
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Industrial Training at Shahjalal Fertilizer Company Limited (SFCL)MdTanvirMahtab2
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Cosmetic shop management system project report.pdfKamal Acharya
Buying new cosmetic products is difficult. It can even be scary for those who have sensitive skin and are prone to skin trouble. The information needed to alleviate this problem is on the back of each product, but it's thought to interpret those ingredient lists unless you have a background in chemistry.
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Data file handling has been effectively used in the program.
The automated cosmetic shop management system should deal with the automation of general workflow and administration process of the shop. The main processes of the system focus on customer's request where the system is able to search the most appropriate products and deliver it to the customers. It should help the employees to quickly identify the list of cosmetic product that have reached the minimum quantity and also keep a track of expired date for each cosmetic product. It should help the employees to find the rack number in which the product is placed.It is also Faster and more efficient way.
Depression Involved in the Chemotherapy Induced Event-based Prospective Memory Impairment in Breast Cancer Survivors
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Depression Involved in the Chemotherapy
Induced Event-based Prospective Memory
Impairment in Breast Cancer Survivors
Zhonglian Huang #
, Wen Li#
, Chen Gan, Yue Lv, Haijun Chen, Zhen Yang and Huaidong Cheng*
Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China
#Co-first author: Zhonglian Huang and Wen Li contributed equally to this work.
*Corresponding to:
Huaidong Cheng,
Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei
Economic and Technological Development Zone, Hefei 230601, China
Tel: +86 551 63869542, Fax: +86 551 63869400
Running Title: Prospective Memory Impairment in Breast Cancer Patients
Abstract— The aim of this study was to investigate the
relationships between depression and occurrence of
chemotherapy induced prospective memory impairment in
patients with breast cancer (BC).The 63 BC patients
before and after chemotherapy were administered with the
self-rating depression scale (SDS) and a battery of
cognitive neuropsychological tests including event-based
and time-based prospective memory (EBPM and TBPM,
respectively) tasks. The changes in their prospective
memory and cognitive neuropsychological characteristics
before and after chemotherapy were compared. Compared
with the scores before chemotherapy, the EBPM score
exhibited a statistically significant difference after
chemotherapy (t = 6.069, P < 0.01), while the TBPM score
showed no significant difference (t = 1.087, P > 0.05).
Further, compared with the patients without depression,
the patients with depression exhibited a statistically
significant difference in the EBPM score (t = -4.348, P <
0.01), while the TBPM scores did not show a statistically
significant difference between the two groups (t = -1.260,
P > 0.05). Post-chemotherapy, EBPM and overall
cognitive functions in BC patients merged with depression
were found to decline, while TBPM did not show a
significant change, suggesting that the combination of
chemotherapy and depression might be related with the
occurrence of post-chemotherapy EBPM impairment.
Keywords— Breast cancer, depression, cognitive
impairment, prospective memory.
I. INTRODUCTION
Chemotherapy-related cognitive impairment (CICI) refers
to the impairment of cognitive functions-such as memory,
information processing speed, and attention- that occurs in
cancer patients during or after chemotherapy. Some
studies1
have suggested that the impact of CICI in long-
term survivors of breast cancer (BC) was even worse than
the recurrence and metastasis of BC itself, and that it had
become an important factor that might affect patients’
quality of life. Recently, several studies have examined
CICI in BC. Psycho-Oncology, Journal of Clinical
Oncology, and other such journals have published the
latest research and systematic reviews in this field2,3
. It
was found that CICI in BC survivors exhibited significant
heterogeneity. Evidently, The CICI in BC have become a
hot topic in the field of psycho-oncology.
In recent years, a large number of studies have found that
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BC patients exhibit cognitive impairment after
chemotherapy. For instance, Park et al. found that BC
patients exhibited subjective and objective cognitive
impairments after chemotherapy4
. Similarly, Wefel et al.
found that one or more cognitive functions tend to decline
in BC patients after chemotherapy 5
. Some studies also
suggested that the brain exhibited certain heterogeneity
after BC chemotherapy. Jim et al. showed that the changes
of language and visuospatial functions in the brain were
significant after BC chemotherapy2
. Chen et al. performed
multidimensional neuropsychological scale tests on 42 BC
patients before and after chemotherapy, and found that the
patients exhibited different levels of impairment in
memory, attention, social cognition, and other aspects after
chemotherapy6
. Some recent studies have also found that
the brain memory impairment was prominent after BC
chemotherapy, and that the extent of impairment was also
different among different memory components. Cheng et
al. found that after BC chemotherapy, the brain exhibited
prospective memory (PM) impairment, which mainly
manifested as the impairment of event-based prospective
memory (EBPM)7
. Thus, CICI in BC has been found to be
influenced by a number of factors. Most recently, Paquet
et al. studied 80 cases of early BC survivors and found that
fatigue after BC chemotherapy could facilitate PM
impairment in patients with early BC, and it was thought
that the symptoms of fatigue had certain correlation with
memory impairment in patients8
.
PM is the memory required for future plans or intentions
and the memory component most closely related to human
daily lives. McDaniel et al. divided PM into event-based
prospective memory (EBPM) and time-based prospective
memory (TBPM)9
. Recent studies suggested that the BC
patients with CICI presented PM impairment, which was
mainly exhibited as EBPM impairment8
. However, the
specific impacting factors are not clear yet. Studies have
found emotion to be an important factor affecting
memory10
,and depression was one of the most common
mental disorders in BC patients11
. Depression could affect
physiological functions, treatment compliance, cognitive
functions, and quality of life in BC patients12
. However,
whether CICI and PM impairment were related to patients’
depression is not clear yet. Particularly, there is no report
about whether depression is related to chemotherapy-
induced EBPM.
This study attempted to investigate whether chemotherapy
and depression in BC patients were together related to the
occurrence of PM impairment. The study subjects included
63 BC patients after chemotherapy. Cognitive
neuropsychological tests to assess PM were used to
investigate the impact of chemotherapy along with
depression on the changes in PM in BC patients.
II. MATERIALS AND METHODS
Clinical data of patients enrolled
We selected 63 patients who underwent adjuvant
chemotherapy after BC surgery in the Department of
Oncology and Department of Beast Surgery, The Second
Affiliated Hospital of Anhui Medical University, from
October 2013 to August 2014. Out of them, 59 cases were
identified as those of invasive ductal carcinoma and 4 as
invasive lobular carcinoma by postoperative pathology.
The tumor differentiation grade ranged from I-III, with 18
cases in Grade I, 38 in Grade II, and 7 in Grade III. The
postoperative staging ranged from I-III. All subjects had
undergone at least 5 years of formal education, were right-
handed, had normal or corrected vision, and acceptable
binaural hearing. Therefore, they all could cooperate with
the tests. This study was conducted in accordance with the
declaration of Helsinki. This study was conducted with
approval from the Ethics Committee of Anhui Medical
University. Written informed consent was obtained from
all participants.
Grouping criteria
The following were the inclusion criteria for BC patients:
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had undergone modified BC radical mastectomy; had a
clear histopathological diagnosis; initially treated but did
not undergo endocrine therapy or brain radiotherapy after
surgery; had a life expectancy of ≥3 months; planned for
standard FAC chemotherapy after surgery (fluorouracil
500 mg/m2
, intravenous infusion on the first day,
adriamycin 50 mg/m2
, intravenous infusion on the first day,
cyclophosphamide 500 mg/m2
, intravenous bolus on the
first day, with a 21-day cycle for a total of 6 cycles) and
conduct normal activities of daily living; had a Karnofsky
functional score (KPS) ≥80 points or ECOG score on
physical performance within 0 to 1 point; and did not have
any hearing, vision, language, or other dysfunction.
The exclusion criteria were having late cachexia or distant
metastasis; had undergone endocrine therapy, brain
radiotherapy, or other adjuvant therapies; had significant
anxiety, depression, and other mental disorders that could
disturb their participation in the study; had other physical
or mental illnesses that could lead to cognitive impairment;
had a history of alcohol or drug dependency; were
administered other drugs that could improve cognitive
functions, such as donepezil; had intracranial metastases
and other abnormalities according to the brain CT or MRI;
had an ECOG score of >2 points; and had other severe
diseases related to the heart, liver, kidney, brain, and
hematopoietic system.
Depression assessment
The SDS was developed by Zung (1965), as a self-rating
scale to measure the severity of depression and its changes
during treatment. According to Chinese standards, the
degrees of depression were divided into 53-62 points: mild
depression, 63-72 points: moderate depression, and >72
points: severe depression.
Cognitive neuropsychological tests
The mini-mental status examination (MMSE), verbal
fluency test (VFT), and digital span (DS) were used to
assess cognitive functioning. A battery of tests was
administered to all subjects to assess general cognitive and
memory functions. MMSE was used to assess the
cognitive functions, including time and spatial orientation,
short-term memory, calculation, language, and visuospatial
skills. The Verbal Fluency Test (VFT),in which the
subjects were asked to name as many animals as possible
within one minute, was used to evaluate the executive
function. The Digit Span (DS) test, in which the subjects
were asked to recall a series of numbers after hearing them
in a randomized order, was used to measure working
memory and attention. The total score was determined by
the number of digits recalled in a correct serial order.
PM tests
The EBPM test: Before the test, the subjects were
instructed to pick out two words belonging to a subclass
from each card in the subsequent trials. When the two
selected words represented animals (target word), the
subjects had to tap the table once. At the end of the test,
the subjects were instructed to speak out their telephone
number (without any other hint at the end of the test). The
test stimuli included 32 cards with 12 high-frequency and
real-meaning Chinese words, among which 10 words
belonged to a larger category, while the other 2 words
belonged to a subclass. In the learning stage, the subjects
were asked to speak out two words of a subclass as the
first two cards were for trial. In the trial, the first card did
not include the target word, while the second card
contained the target word. Following the instructions that
were provided before test, when the target word, i.e., a
kind of animal, appeared, the subjects’ EBPM task was to
tap the table once. The other EBPM task was to remember
to speak out their phone number when the card selection
ended.
Recording method: We referred to the method developed
by McDaniel and Einstein13
. Thus, when a predetermined
target word appeared, the subject was expected to perform
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a target behavior, and the number of times the same was
correctly executed was recorded as EBPM score. This test
comprised a total of six target cards (numbered as 5, 10, 15,
20, 24, and 29). When the target card appeared, the correct
response was recorded as 1 point, and remembering to
speak out the phone number at end of the test was recorded
as 2 points. Thus, the total score on the EBPM test was 8
points.
The TBPM test: Before the test, the subjects were
instructed to tap the table once at 5, 10, and 15 min,
respectively after the test began, to choose the maximum
and minimum numbers from each card. One clock was
placed in front of the subjects, such that the subjects could
be sure about the time through this clock. The clock was
set at 0:00:00 at the beginning of the test. Test stimuli
included 100 cards, when the clock started, the subjects
were presented the cards one at a time. Each card had 12
double digits, out of which the subjects had to select the
minimum and maximum numbers to complete the TBPM.
Meanwhile, the subjects were also expected to complete
another TBPM task (i.e., taping the table at 5, 10, and 15
min after the commencement of the test). The test was
stopped at 17 min.
Recording method: Referring to the method developed by
McDaniel and Einstein13
, the number of times the target
behavior was correctly executed at correct time intervals
was recorded as the TBPM score. If the action was
performed within 10 seconds before or after each target
time, it would be record as 2 points. Further, if it was
performed within 30 seconds, it was recorded as 1 point.
Thus, the total score on the TBPM test was 6 points.
Statistical analysis
The SPSS 17.0 software was used for data processing. Test
scores before and after chemotherapy were compared
using a paired-sample t-test, while the general information
and neuropsychological characteristics between the
depression and non-depression groups were compared
using two independent samples t-tests.
III. RESULTS
General information
In total, 63 BC patients were evaluated after chemotherapy,
out of which, 29 patients were found to have depression,
while 34 patients were not. There was no significant
difference in age (50.66 ± 7.76 vs. 47.35 ± 8.56) and years
of education (7.90 ± 3.36 vs. 9.44 ± 3.57), and other
general characteristics between the depression and non-
depression groups (P > 0.05).
Comparison of depression, neuropsychological tests, and
PM
Compared with the results before chemotherapy, SDS and
MMSE scores exhibited a statistically significant
difference after chemotherapy, while frontal fluency and
DS showed no statistically significant differences.
Table 1
Further, as compared with the results before chemotherapy,
the EBPM score exhibited a statistically significant
difference after chemotherapy (t = 6.069, P < 0.01), while
the TBPM score showed no significant difference (t =
1.087, P > 0.05)
Table 2
Comparison of neuropsychological tests and PM
After chemotherapy, the MMSE and VFT scores of the
depression group were found to be significantly lower than
those of the non-depression group, while the DS score
showed no statistically significant difference.
Table 3
Further, as compared with the depression group, the
EBPM score of the non-depression group was significantly
different (t = -4.348, P < 0.01), while the TBPM score
showed no significant difference (t = -1.260, P > 0.05).
Table 4
IV. DISCUSSION
Currently, CICI in BC patients is one of the major issues
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concerning the field of psycho-oncology. The high
incidence and relatively long survival time of BC has
provided an important window for studies on CICI in BC
patients. Existing studies suggested that CICI in BC
patients was mainly related to the following areas: memory,
attention, executive function, information processing speed,
language function, and visuospatial function14-16
. The
present study found that BC patients exhibited an overall
decline in cognitive functions after chemotherapy, which is
similar to the findings of other studies15,16
. Meanwhile, we
also found that chemotherapy, when combined with
depression, might be associated with EBPM impairment.
Memory is one of the important human cognitive functions,
which refers to the psychological processes through which
the brain accumulates and preserves individual experiences.
Therefore, it has a prominent place in all human mental
activities. According to the time of occurrence of an event,
memory could be divided into retrospective memory (RM)
and PM13
. Other than RM, PM is one of the most
important forms of human memory. EBPM refers to the
memory required to carry out certain actions when a
specific event occurs, for example, remembering to go
shopping after work. Volle et al. found that the
spontaneous extraction of EBPM information was related
to the functions of the prefrontal cortex17
. In one of our
previous studies, we found that the patients with frontal
lobe impairment tended to exhibit significant EBPM
impairment18
. The present study suggested that the BC
patients with depression had significant EBPM impairment
after chemotherapy, which might be related with the
changes in the prefrontal structures and insufficient
functioning of the same.
Depression is a common mental state in women with BC.
Since the 1960s, foreign countries have paid attention to
BC women’s depression. Fann et al.retrospectively
analyzed the occurrence of depression within 1 year after
BC diagnosis over the last 20 years19
, and found that its
incidence after BC surgery was about 10% to 25%.
Similarly, Luutonen et al. 20
studied and reported that the
incidence of depressive symptoms in patients with newly
diagnosed BC was up to 32.1%. Further, in 19.4% of them
the depression was moderate or mild, while in 12.7%
patients it was moderate or severe. Chemotherapy is one of
the important treatment to BC patients. However, most BC
patients have had a certain fear towards chemotherapy.
Additionally, the incidence of depression in BC patients
after chemotherapy has been reported to be even higher
than patients before chemotherapy. Lekovich et al.21
statistically analyzed the incidence of depression in 95 BC
patients within 1-6 months after chemotherapy, and
reported it to be up to 67%. Recently, certain studies have
found that depression in BC patients was not temporary,
and some patients have even exhibited high levels of
depressive symptoms after the completion of treatment22-24
.
Studies have also found that not all BC patients suffer
from depression, and that those with depression have also
exhibited differences in the degree, manifestation, and
duration of depression19-21
. The main causes of depression
in BC patients have been reported as follows: shock from
the BC diagnosis; special importance of breasts to females,
and as most BC patients prefer surgical treatment, the
physical change would result in a double whammy
physically and mentally; socio-demographic factors such
as age, educational level, employment status, household
income, obesity, and marital status (all these have been
reported to affect patient’s depression; however, this idea
is still controversial); the side effects of treatment, such as
the impact of chemotherapy on fertility, sexual function,
perimenopausal period, and related health problems, which
have been reported to cause significant anxiety and pain in
BC patients25
. The present study found that depression
caused by various factors might be involved in the
occurrence of CICI in BC patients. The mechanisms of
CICI in BC patients are not clear yet. However, recently
there has been active research in this field. Several studies
have found that CICI is manifested differently in BC
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patients, with many impacting factors and complex
pathogeneses. Therefore, several multi-disciplinary studies,
such as those on molecular biology and neuroimaging,
have been conducted. The present study provided evidence
for the incidence of EBPM impairment after BC
chemotherapy from the perspective of the effect of
emotions on memory, thus providing a clinical basis for
further exploring the biological mechanisms of EBPM
impairment after BC chemotherapy.
Previous studies have confirmed that patients with
depression exhibited significant cognitive impairment. The
present study found that the MMSE, VFT, and EBPM
scores in depressed patients after BC chemotherapy were
lower than those in the non-depressed patients. Therefore,
we believe that chemotherapy, together with depression,
would further aggravate cognitive impairment in BC
patients. Particularly, the changes in EBPM were
prominent, suggesting that the combined effect of BC
chemotherapy and post-chemotherapy depression might be
one of the important factors affecting EBPM impairment
after BC chemotherapy.
In conclusion, this study showed that the BC patients with
post-chemotherapy depression would exhibit a decline in
their general cognitive function and EBPM, suggesting
that depression might be associated with the occurrence of
PM impairment after BC chemotherapy.
V. CONCLUSION
This study indicated that EBPM and overall cognitive
functions in BC patients merged with depression were
found to decline, while TBPM did not show a significant
change, suggesting that the combination of chemotherapy
and depression might be related with the occurrence of
post-chemotherapy EBPM impairment.
Financial Support: This research was supported by the
National Natural Science Foundation of China (No.
81372487).
Conflict of interest: All of the authors declare that they
have no conflicts of interest regarding this paper.
Acknowledgements: No.
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Table.1: Comparison of depression and neuropsychological background testing between the 2 groups before and after
chemotherapy
Group N SDS MMSE VFT DS
Before chemotherapy 63 37.44±6.74# 27.84±1.73# 11.32±1.59 7.66±0.60
After chemotherapy 63 48.31±13.09 26.19±1.77 11.27±1.71 7.67±0.51
Note: # P<0.05. Abbreviations: SDS, the self-rating depression scale; MMSE, mini-mental state examination; VFT, verbal
fluency test; DS, Digit span.
Table.2: Comparison of EBPM and TBPM scores between the 2 groups before and after chemotherapy
Group N EBPM TBPM
Before chemotherapy 63 3.10±1.12# 4.95±0.99
After chemotherapy 63 1.87±1.14 4.75±1.14
Note:# P0.01. Abbreviations: EBPM, event-based prospective memory; TBPM, time-based prospective memory.
Table.3: Comparison of neuropsychological background testing between the depression group and the non-depression group
after chemotherapy:
Group N MMSE VFT DS
Depression group 29 25.14±1.19# 10.69±1.50# 7.55±0.57
Non-depression group 34 27.01±1.67 11.76±1.76 7.76±0.43
Note: # P<0.05. Abbreviations: MMSE, mini-mental state examination; VFT, verbal fluency test; DS, Digit span.
Table.4: Comparison of EBPM and TBPM scores between the 2 groups after chemotherapy
Group N EBPM TBPM
Depression group 29 1.28±0.96# 4.55±1.18
Non-depression group 34 2.38±1.04 4.91±1.08
Note:# P0.01. Abbreviations: EBPM, event-based prospective memory; TBPM, time-based prospective memory.