Cardiac rehabilitation: structure, effectiveness and the future

Despite advances in the investigation and treatment of angina and myocardial infarction, and increased knowledge of the factors associated with the development and progression of ischaemic heart disease, it remains the leading cause of death and morbidity in the majority of industrialized countries. Cardiac rehabilitation provides a means of modifying lifestyle and other risk factors in patients presenting with established, symptomatic coronary artery disease, thereby reducing the risk of further cardiac events. It has also been proven to be cost-efficient.     

Bone marrow transplantation in children. Imaging assessment of complications

As the use of BMT increases for the treatment of a variety of malignant and nonmalignant diseases in children, awareness of the complications that can occur in these children is important. The imaging appearance of the complications that may occur in the central nervous system, paranasal sinus, lungs, abdomen, and pelvis in children following BMT have been reviewed. CT and MR imaging examination with the use of contrast material as indicated is important for defining pathology in the brain. Plain films should be supplemented with CT examination as needed to identify and characterize disease in the paranasal sinuses and lungs. Finally, the use of ultrasound and CT is crucial for defining complications that may occur in the abdomen and pelvis.     

Comparison of functional outcomes and treatment cost between a computer-based cognitive rehabilitation teletherapy program and a face-to-face rehabilitation program.

The authors compared outcomes of 19 participants who received computer-based cognitive teletherapy rehabilitation with 20 participants who received face-to-face speech-language rehabilitation. The study compared outcomes from 2 "real-word" treatment programs provided by an outpatient rehabilitation center. A total of 39 participants with moderate to severe closed head traumatic brain injuries and a minimum of 1 year following injury were analyzed. Outcome measures included clinical indicators of independent living status, return to work or school, and independent driving. Cost measures included the total cost of the treatment and a measure of service costs per hour. Time since injury was a covariate, and an analysis of covariance revealed no differences between groups in independent living, driving status, return to work or school, or total treatment costs. The computer-based teletherapy cognitive rehabilitation program provided similar functional outcomes as face-to-face speech-language therapy at a similar total cost. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MR safety: past, present, and future from a historical perspective

This article focuses on both static field effects and oscillating magnetic fields associated with MR imaging and spectroscopy. Contemporary experiments and theories on health effects demonstrate that currently MR imaging is practiced in a safe manner. Technological capabilities and medical science objectives, however, will lead to procedures that will challenge the thresholds of physiological effects. Thus progress in this field will require continual surveillance and better definitions of guidelines which at present are considered prudent but too restrictive.     

Organization of cardiologic rehabilitation in central Europe: retrospect, present, future outlook

Cardiological rehabilitation, the comprehensive efficient treatment of chronic cardiac patients, is presented with regard to its difficult theoretical and practical development from the viewpoint of a senior specialist in this field practising in Central Europe. The accompanying WHO lifestyle concept is now considered to be scientifically well-founded, but has not yet been practically implemented on a large scale nor incorporated in the teaching schedule. A requirement for the future is a special medical philosophy for chronic heart patients, i.e., further development of the theoretical basis of rehabilitation, practical application of the scientific recommendations on the importance of life-style alterations, a greatly improved network of all doctors treating chronic heart patients, updating of the training of general medical specialists as well as cardiologists in Public Health, and intensified objective assessment of research on the cardiological rehabilitation of in- and outpatients.     

Age differences in forgiveness: The role of future time perspective.

This study investigated whether the age trend in forgiveness is partly attributable to age differences in time perspective. Eighty-nine younger and 91 older adults were randomized into 3 experimental conditions: time-expanded, time-limited, and neutral. They responded to hypothetical offensive scenarios and rated the degree to which they would forgive the perpetrator. Results showed that older adults were more forgiving than younger adults, but regardless of age, those in the time-limited condition were more forgiving than those in the time-expanded or the neutral condition. An Age × Time perspective interaction showed that only in older adults did a time-expanded manipulation lead to lower forgiveness than the neutral condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

船舶用钢标准现状分析与展望

对我国船舶用钢标准的演变、取得的成绩、存在的问题以及下一步的工作等内容进行了全面地介绍和对比分析,对更好地了解船舶用钢标准具有一定的参考价值和现实意义。     

The transition to siblinghood: a developmental ecological systems perspective and directions for future research.

The birth of a baby sibling is a normative life event for many children. Few studies address this important transition period and changes in the older sibling's adjustment and family relationships following the sibling's birth. The present article presents a developmental ecological systems model for studying changes in family life and the older child's adjustment following the birth of a baby sibling. Simultaneous changes occurring in the family and how these changes are interrelated over time to predict patterns of adaptation after the transition to siblinghood are underscored. Recommendations for designing longitudinal studies that take advantage of recent developments in multilevel modeling are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Remaining time and opportunities at work: Relationships between age, work characteristics, and occupational future time perspective.

The authors adapted the concept of future time perspective (FTP) to the work context and examined its relationships with age and work characteristics (job complexity and control). Structural equation modeling of data from 176 employees of various occupations showed that age is negatively related to 2 distinct dimensions of occupational FTP: remaining time and remaining opportunities. Work characteristics (job complexity and control) were positively related to remaining opportunities and moderated the relationship between age and remaining opportunities, such that the relationship became weaker with increasing levels of job complexity and control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vascular rejection in heart transplantation: clinical correlation, treatment options, and future considerations

Vascular rejection injures the vascular endothelium in cardiac allografts in the absence of significant intramyocardial lymphocytic infiltration. When compared with cellular rejection, vascular rejection occurs earlier after transplantation, is more resistant to immunosuppressive augmentation, causes more allograft dysfunction, and is associated with a higher frequency of allograft loss. Between January 1990 and October 1992, acute hemodynamically significant vascular rejection developed in 13 of 170 patients (8%). Endomyocardial biopsy specimens revealed the typical findings of endothelial cell activation, immune complex deposition, and interstitial fibrin deposition in the absence of significant lymphocytic infiltration. All patients had clinical evidence of allograft dysfunction. In addition to high-dose corticosteroids, all patients received cyclophosphamide as an oral pulse for 4 days and underwent plasmapheresis for 3 consecutive days. Eight patients received OKT3 (n = 6) or antilymphoblast globulin (n = 2), and nine patients underwent systemic anticoagulation. Six patients required inotropic therapy for hemodynamic instability. Although one patient died during the initial episode, rejection resolved and left ventricular function returned to normal in 12 of 13 patients. However, vascular rejection recurred in three patients, two of whom subsequently died. Two other patients died during late follow-up because of noncompliance. Eight patients remain alive with normal allograft function and angiographically normal coronary arteries. Whereas the addition of cyclophosphamide and plasmapheresis may improve the outcome of vascular rejection, the results of treatment with currently available treatment modalities remain unacceptably poor.