150 results on '"Frangiosa, A"'
Search Results
2. Care partner evaluation of the behaviors in the Cohen-Mansfield Agitation Inventory
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Dorothee Oberdhan, Andrew Palsgrove, Christy Houle, Teya Lovell, A. Alex Levine, Terry Frangiosa, Ginny Biggar, and Meryl Comer
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patient-centered outcomes ,dementia ,Alzheimer's disease ,agitation ,meaningful change ,Medicine - Abstract
IntroductionAgitation is a common symptom in patients with Alzheimer's dementia. But agitation can be a heterogeneous symptom, encompassing a diverse array of behaviors exhibited by patients. The Cohen-Mansfield Agitation Inventory (CMAI) is a 29-item scale that is used to systematically assess the frequency and severity of agitation in older adults as rated by a primary caregiver. The CMAI was originally designed for use by professional care givers in institutional care settings. Alzheimer's dementia, however, is associated with a significant burden on family members, who provide the majority of care, and other informal care partners.MethodsOur qualitative study aimed to assess the accuracy and applicability of the CMAI according to the needs and perceptions of non-professional care partners. Specifically, we wanted to determine if the behaviors included in the instrument reflect: (a) the care partner's experience with agitation in Alzheimer's dementia patients, (b) how the behaviors and their frequency are related to the perception of agitation severity, and (c) what changes in agitation behaviors are meaningful to care partners. We interviewed 30 care partners for patients with Alzheimer's dementia in the United States.ResultsThe care partners confirmed all behaviors listed in the CMAI as relevant. The behaviors reflect a spectrum of severity, with aggressive behaviors considered more severe than non-aggressive behaviors and physical behaviors generally considered more severe than verbal behaviors. Any reduction or increase in the frequency of a behavior was meaningful to care partners. Generally, a change from physical to verbal behaviors and aggressive to non-aggressive was considered a meaningful improvement while a change from verbal to physical and non-aggressive to aggressive was considered a meaningful worsening.DiscussionThe CMAI appropriately captures relevant behaviors of agitation in Alzheimer's dementia and provides insight into the relative improvement or worsening of agitation symptoms.
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- 2024
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3. Evaluating Elements of the Care Partner Experience in Individuals Who Care for People with Alzheimer's Disease Across the Severity Spectrum
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Leigh F. Callahan, Brian Samsell, Dana DiBenedetti, Terry Frangiosa, Christina Slota, Virginia Biggar, Russ Paulsen, Debra Lappin, William L. Herring, and Carla Romano
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Alzheimer’s disease ,Care partner ,Caregiving ,Experience ,Hours ,Mild ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Introduction Non-professional care partners play an important and often evolving role in the care of persons living with Alzheimer’s disease (PLWAD). We investigated two elements of the care partner experience, namely time and strain incurred by care partners providing care to PLWAD across the severity spectrum. Methods Data gathered from the Alzheimer’s Disease Patient and Caregiver Engagement (AD PACE) What Matters Most (WMM) study series were analyzed to determine how much time care partners spent providing care to PLWAD based on where the care recipients lived. Additionally, quantitative assessments of weekly hours providing care and the strain experienced by care partners were conducted using the UsAgainstAlzheimer’s A-LIST Insights Series survey, which included the Modified Caregiver Strain Index (MCSI). Finally, a targeted literature review was conducted to contextualize findings and characterize the existing literature landscape. Results Care partners in the AD PACE WMM studies (n = 139) spent significantly more hours providing care for recipients who lived with someone (mean ± standard deviation [SD], 57.3 ± 44.3 h/week) than for recipients who lived alone (26.0 ± 12.0 h/week) (P = 0.0096) or lived in assisted living/nursing home (23.6 ± 14.4 h/week) (P = 0.0002). In the A-LIST Insights Series survey, care partners provided an overall mean (± SD) 58.1 ± 53.0 h of direct care each week, with caregiving hours increasing with increasing severity of AD/AD-related dementias (AD/ADRD). Additionally, care partners for recipients with mild (n = 14), moderate (n = 111), and severe AD/ADRD (n = 91) had overall mean MCSI scores of 9.0 ± 3.8 (range 2–14), 13.3 ± 4.8 (range 4–23), and 17.5 ± 5.3 (range 4–26), respectively, with higher scores suggesting greater care partner strain. Conclusions Persons living with AD require increasing levels of care along the spectrum of disease, and even individuals with early disease need care from partners. Early interventions that slow progression of AD and programs that improve family function may have beneficial impact on the experiences of care partners for recipients with mild, moderate, or severe AD.
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- 2023
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4. A Delphi Approach to Define Lucid Episodes in People Living With Dementia
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Bangerter, Lauren R., Griffin, Joan M., Kim, Kyungmin, Finnie, Dawn M., Lapid, Maria I., Gaugler, Joseph E., Biggar, Virginia S., and Frangiosa, Theresa
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- 2024
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5. Assessing What Matters to People Affected by Alzheimer’s Disease: A Quantitative Analysis
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Hauber, Brett, Paulsen, Russ, Krasa, Holly B., Vradenburg, George, Comer, Meryl, Callahan, Leigh F., Winfield, John, Potashman, Michele, Hartry, Ann, Lee, Daniel, Wilson, Hilary, Hoffman, Deborah L., Wieberg, Dan, Kremer, Ian N., Taylor, Geraldine A., Taylor, James M., Lappin, Debra, Martin, Allison D., Frangiosa, Terry, Biggar, Virginia, Slota, Christina, Romano, Carla, and DiBenedetti, Dana B.
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- 2023
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6. Assessing What Matters to People Affected by Alzheimer’s Disease: A Quantitative Analysis
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Brett Hauber, Russ Paulsen, Holly B. Krasa, George Vradenburg, Meryl Comer, Leigh F. Callahan, John Winfield, Michele Potashman, Ann Hartry, Daniel Lee, Hilary Wilson, Deborah L. Hoffman, Dan Wieberg, Ian N. Kremer, Geraldine A. Taylor, James M. Taylor, Debra Lappin, Allison D. Martin, Terry Frangiosa, Virginia Biggar, Christina Slota, Carla Romano, and Dana B. DiBenedetti
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Alzheimer’s disease ,Caregiver ,Patient ,Preference ,Clinical meaningfulness ,Outcomes ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Introduction In this phase of the ongoing What Matters Most study series, designed to evaluate concepts that are meaningful to people affected by Alzheimer’s disease (AD), we quantified the importance of symptoms, impacts, and outcomes of AD to people at risk for or with AD and care partners of people with AD. Methods We administered a web-based survey to individuals at risk for or with AD (Group 1: unimpaired cognition with evidence of AD pathology; Group 2: AD risk factors and subjective cognitive complaints/mild cognitive impairment; Group 3: mild AD) and to care partners of individuals with moderate AD (Group 4) or severe AD (Group 5). Respondents rated the importance of 42 symptoms, impacts, and outcomes on a scale ranging from 1 (“not at all important”) to 5 (“extremely important”). Results Among the 274 respondents (70.4% female; 63.1% white), over half of patient respondents rated all 42 items as “very important” or “extremely important,” while care partners rated fewer items as “very important” or “extremely important.” Among the three patient groups, the minimum (maximum) mean importance rating for any item was 3.4 (4.6), indicating that all items were at least moderately to very important. Among care partners of people with moderate or severe AD, the minimum (maximum) mean importance rating was 2.1 (4.4), indicating that most items were rated as at least moderately important. Overall, taking medications correctly, not feeling down or depressed, and staying safe had the highest importance ratings among both patients and care partners, regardless of AD phase. Conclusion Concepts of importance to individuals affected by AD go beyond the common understanding of “cognition” or “function” alone, reflecting a desire to maintain independence, overall physical and mental health, emotional well-being, and safety. Preservation of these attributes may be key to understanding whether interventions deliver clinically meaningful outcomes.
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- 2023
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7. Caring for Dementia Caregivers: Understanding Caregiver Stress During the COVID-19 Pandemic
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Lee Lancashire PhD, Virginia Biggar BA, Meryl Comer BS, Terry Frangiosa MBA, Allyson Gage PhD, Russ Paulsen MA, Amber Roniger BA, and Jessica Wolfe PhD
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Geriatrics ,RC952-954.6 - Abstract
More than 16 million Americans provide unpaid care for someone with Alzheimer’s disease and related dementias (ADRD). During the COVID-19 pandemic, unpaid caregivers experienced increased chronic severe stress from widespread closures and social distancing. We conducted eight surveys from March 2020 to March 2021 among a cohort of over 10,000 individuals. Cross-sectional analysis was conducted to investigate frequency and ratios of groups reporting increased stress across surveys. A longitudinal analysis was also performed with the 1,030 participants who took more than one survey. We found a growing crisis among dementia caregivers: By Survey 8, current caregivers reported 2.9 times higher stress levels than the comparator group. By that time, 64% of current caregivers reported having multiple stress symptoms typically found in people experiencing severe stress. Both analyses reported increased levels of stressors over time that were more associated with certain caregiver groups. Our findings underscore the urgent need for public policy initiatives and supportive community infrastructure to support ADRD caregivers.
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- 2023
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8. Going Gradeless, Grades 6-12: Shifting the Focus to Student Learning
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Burns, Elise, Frangiosa, David, Burns, Elise, and Frangiosa, David
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Great things happen when students are able to focus on their learning instead of their scores. However, assessment reform, including standards-based grading, remains a hotly debated issue in education. "Going Gradeless" shows that it is possible to teach and assess without the stress of traditional grading practices. Sharing their successful shifts to alternate assessment and their perspectives as experienced classroom teachers, the authors show you how to remove the negative impacts of grades while still maintaining a high level of accountability. Readers will find concrete examples of how these approaches can be developed and applied, plus: (1) sample assessments and rubrics; (2) student work samples from all grade levels; (3) an accountability checklist; and (4) a review of collected data. It is possible to go gradeless! Focusing less on letter grades allows students to interact with the content more deeply, develop better relationships with their teachers and peers, and gain confidence in the classroom, school, and beyond.
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- 2021
9. C-reactive protein but not procalcitonin may predict antibiotic response and outcome in infections following major abdominal surgery
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Perrella, A., Giuliani, A., De Palma, M., Castriconi, M., Molino, C., Vennarecci, G., Antropoli, C., Esposito, C., Calise, F., and Frangiosa, A.
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- 2022
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10. Assessing what matters most to patients with or at risk for Alzheimer’s and care partners: a qualitative study evaluating symptoms, impacts, and outcomes
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Dana B. DiBenedetti, Christina Slota, Samantha L. Wronski, George Vradenburg, Meryl Comer, Leigh F. Callahan, John Winfield, Ivana Rubino, Holly B. Krasa, Ann Hartry, Dan Wieberg, Ian N. Kremer, Debra Lappin, Allison D. Martin, Terry Frangiosa, Virginia Biggar, and Brett Hauber
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Alzheimer’s disease ,Caregiver ,Outcome ,Patient ,Qualitative ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background The What Matters Most (WMM) study was initiated to evaluate symptoms, AD-related impacts, treatment-related needs, preferences, and priorities among individuals with or at risk for Alzheimer’s disease (AD) and their care partners. The objective of this qualitative study phase was to identify a comprehensive set of concepts of interest that are meaningful to individuals across the AD continuum. Methods Interviews were conducted with 60 clinically referred individuals and care partners across 5 AD stages (n = 12 each): group 1 (non-clinically impaired individuals with AD pathology), group 2 (individuals with mild cognitive impairment and AD pathology), group 3 (individuals with mild AD), group 4 (individuals with moderate AD and their care partners), and group 5 (care partners of individuals with severe AD). Interviews were conducted by experienced interviewers, audio-recorded, and transcribed. Dominant trends were identified in each interview and compared across subsequent interviews to generate themes or patterns in descriptions of AD symptoms, impacts, and desired treatment outcomes. Results All participants endorsed current issues related to memory; nearly all participants (n = 55; 92%) across the five groups endorsed symptoms related to communication and language. Groups 1–3 reported an impact on mood/emotions (n = 23; 64%) and a decrease in social activities or outgoingness (n = 17; 47%). Current and future concerns reported by the overall sample included memory (n = 48; 80%), dependence (n = 40; 67%), and “other” concerns (n = 33; 55.0%) (e.g., uncertainty about the future, burdening others). The most desired AD treatment outcomes were improvement or restoration of memory (n = 40; 67%) and stopping AD progression (n = 35; 58.3%). Group-level differences were observed in the symptoms, impacts, and desired treatment outcomes among patients and care partners across the AD continuum. Conclusions Cognitive functioning issues—particularly in memory and communication—are present even in preclinical and early-stage AD, including among those without a formal AD diagnosis. While the impacts of AD vary across the disease-severity spectrum, improved memory and disease modification were treatment outcomes considered most important to participants across all 5 AD stages. Neuropsychological assessments traditionally used in AD clinical trials may not evaluate the often-subtle concepts that are important to patients and care partners. Results from this study will inform the second phase of the WMM project—a quantitative study to elicit the relative importance of these concepts of interest to people at risk for and living with AD and their care partners.
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- 2020
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11. Developing and describing a typology of lucid episodes among people with Alzheimer's disease and related dementias.
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Griffin, Joan M., Kim, Kyungmin, Finnie, Dawn M., Lapid, Maria I., Gaugler, Joseph E., Batthyány, Alexander, Bangerter, Lauren R., Biggar, Virginia S., and Frangiosa, Theresa
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INTRODUCTION: This study examined lucid episodes among people living with late‐stage Alzheimer's disease and related dementias (PLWD) and then developed a typology of these episodes to help characterize them. METHODS: Family caregivers of PLWD provided information about witnessed episodes, including proximity to death, cognitive status, duration, communication quality, and circumstances prior to lucid episodes on up to two episodes (caregiver N = 151; episode N = 279). Latent class analysis was used to classify and characterize empirically distinct clusters of lucid episodes. RESULTS: Four lucid episode types were identified. The most common type occurred during visits with family and among PLWD who lived > 6 months after the episode. The least common type coincided with family visits and occurred within 7 days of the PLWD's death. DISCUSSION: Findings suggest that multiple types of lucid episodes exist; not all signal impending death; and some, but not all, are precipitated by external stimuli. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Care partner evaluation of the behaviors in the Cohen-Mansfield Agitation Inventory.
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Oberdhan, Dorothee, Palsgrove, Andrew, Houle, Christy, Lovell, Teya, Levine, A. Alex, Frangiosa, Terry, Biggar, Ginny, and Comer, Meryl
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- 2024
- Full Text
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13. Assessing what matters most to patients with or at risk for Alzheimer’s and care partners: a qualitative study evaluating symptoms, impacts, and outcomes
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DiBenedetti, Dana B., Slota, Christina, Wronski, Samantha L., Vradenburg, George, Comer, Meryl, Callahan, Leigh F., Winfield, John, Rubino, Ivana, Krasa, Holly B., Hartry, Ann, Wieberg, Dan, Kremer, Ian N., Lappin, Debra, Martin, Allison D., Frangiosa, Terry, Biggar, Virginia, and Hauber, Brett
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- 2020
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14. Preoperative Assessment and Management of Cardiovascular Risk in Patients Undergoing Non-Cardiac Surgery: Implementing a Systematic Stepwise Approach during the COVID-19 Pandemic Era
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Eduardo Bossone, Filippo Cademartiri, Hani AlSergani, Salvatore Chianese, Rahul Mehta, Valentina Capone, Carlo Ruotolo, Imran Hayat Tarrar, Antonio Frangiosa, Olga Vriz, Vincenzo Maffei, Roberto Annunziata, Domenico Galzerano, Brigida Ranieri, Chiara Sepe, Andrea Salzano, Rosangela Cocchia, Massimo Majolo, Giuseppe Russo, Giuseppe Longo, Mario Muto, Paolo Fedelini, Ciro Esposito, Alessandro Perrella, Gianluca Guggino, Eliana Raiola, Mara Catalano, Maurizio De Palma, Luigia Romano, Gaetano Romano, Ciro Coppola, Ciro Mauro, and Rajendra H. Mehta
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non-cardiac surgery ,perioperative cardiovascular management ,COVID-19 ,teleconsulting ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Major adverse cardiac events, defined as death or myocardial infarction, are common causes of perioperative mortality and major morbidity in patients undergoing non-cardiac surgery. Reduction of perioperative cardiovascular risk in relation to non-cardiac surgery requires a stepwise patient evaluation that integrates clinical risk factors, functional status and the estimated stress of the planned surgical procedure. Major guidelines on preoperative cardiovascular risk assessment recommend to establish, firstly, the risk of surgery per se (low, moderate, high) and the related timing (elective vs. urgent/emergent), evaluate the presence of unstable cardiac conditions or a recent coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting), assess the functional capacity of the patient (usually expressed in metabolic equivalents), determine the value of non-invasive and/or invasive cardiovascular testing and then combine these data in estimating perioperative risk for major cardiac adverse events using validated scores (Revised Cardiac Risk Index (RCRI) or National Surgical Quality Improvement Program (NSQIP)). This stepwise approach has the potential to guide clinicians in determining which patients could benefit from cardiovascular therapy and/or coronary artery revascularization before non-cardiac surgery towards decreasing the incidence of perioperative morbidity and mortality. Finally, it should be highlighted that there is a need to implement specific strategies in the 2019 Coronavirus disease (COVID-19) pandemic to minimize the risk of transmission of COVID-19 infection during the preoperative risk assessment process.
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- 2021
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15. Sepsis Outcome after Major Abdominal Surgery Does Not Seem to Be Improved by the Use of Pentameric Immunoglobulin IgM: A Single-Center Retrospective Analysis.
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Perrella, Alessandro, Rinaldi, Luca, Guarino, Ilaria, Bernardi, Francesca Futura, Castriconi, Maurizio, Antropoli, Carmine, Pafundi, Pia Clara, Di Micco, Pierpaolo, Sarno, Marina, Capoluongo, Nicolina, Minei, Giuseppina, Perrella, Marco, Frangiosa, Antonio, and Capuano, Annalisa
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IMMUNOGLOBULIN M ,ABDOMINAL surgery ,SEPSIS ,BLOOD cell count ,MANN Whitney U Test ,BACTERIOLOGY technique - Abstract
Background: Sepsis still represents a major public health issue worldwide, and the immune system plays a main role during infections; therefore, its activity is mandatory to resolve this clinical condition. In this report, we aimed to retrospectively verify in a real-life setting the possible usefulness of pentameric IgM plus antibiotics in recovering patients with sepsis after major abdominal surgery. Materials/methods: We reviewed, from January 2013 until December 2019, all adult patients admitted to the ICU for sepsis or septic shock (2) after major abdominal surgery. Among these patients, were identified those that, according to legal indication and licenses in Italy, were treated with pentameric IgM plus antibiotics (Group A) or with antibiotics alone (Group B). The following parameters were evaluated: blood gas analysis, lactate, CRP, procalcitonin, endotoxin activity, liver and renal function, coagulation and blood cell count at different time points (every 48 h for at least 7 days). Differences between groups were analyzed using Fisher's exact test or a chi-square test for categorical variables. A Mann–Whitney U test or Kruskal–Wallis test were instead been performed to compare continuous variables. Univariate and multivariate analysis were also performed. Results: Over a period of 30 months, 24 patients were enrolled in Group A and 20 patients in Group B. In those subjects, no statistical differences were found in terms of bacterial or fungal infection isolates, when detected in a blood culture test, or according to inflammatory index, a score, lactate levels and mortality rate. A 48 h response was statistically more frequent in Group B than in Group A, while no differences were found in other clinical and laboratory evaluations. Conclusions: Based on our results, the use of pentameric IgM does not seem to give any clinical advantages in preventing sepsis after major abdominal surgery. [ABSTRACT FROM AUTHOR]
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- 2023
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16. Acute Heart Failure: Diagnostic-Therapeutic Pathways and Preventive Strategies-A Real-World Clinician's Guide
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Ciro Mauro, Salvatore Chianese, Rosangela Cocchia, Michele Arcopinto, Stefania Auciello, Valentina Capone, Mariano Carafa, Andreina Carbone, Giuseppe Caruso, Rossana Castaldo, Rodolfo Citro, Giulia Crisci, Antonello D’Andrea, Roberta D’Assante, Maria D’Avino, Francesco Ferrara, Antonio Frangiosa, Domenico Galzerano, Vincenzo Maffei, Alberto Maria Marra, Rahul M. Mehta, Rajendra H. Mehta, Fiorella Paladino, Brigida Ranieri, Monica Franzese, Giuseppe Limongelli, Salvatore Rega, Luigia Romano, Andrea Salzano, Chiara Sepe, Olga Vriz, Raffaele Izzo, Filippo Cademartiri, Antonio Cittadini, Eduardo Bossone, Mauro, Ciro, Chianese, Salvatore, Cocchia, Rosangela, Arcopinto, Michele, Auciello, Stefania, Capone, Valentina, Carafa, Mariano, Carbone, Andreina, Caruso, Giuseppe, Castaldo, Rossana, Citro, Rodolfo, Crisci, Giulia, D'Andrea, Antonello, D'Assante, Roberta, D'Avino, Maria, Ferrara, Francesco, Frangiosa, Antonio, Galzerano, Domenico, Maffei, Vincenzo, Marra, Alberto Maria, Mehta, Rahul M, Mehta, Rajendra H, Paladino, Fiorella, Ranieri, Brigida, Franzese, Monica, Limongelli, Giuseppe, Rega, Salvatore, Romano, Luigia, Salzano, Andrea, Sepe, Chiara, Vriz, Olga, Izzo, Raffaele, Cademartiri, Filippo, Cittadini, Antonio, and Bossone, Eduardo
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cardiac ultrasound ,acute heart failure ,computer tomography ,biomarker ,General Medicine ,therapeutic interventions ,preventive strategie - Abstract
Acute heart failure (AHF) is the most frequent cause of unplanned hospital admission in patients of >65 years of age and it is associated with significantly increased morbidity, mortality, and healthcare costs. Different AHF classification criteria have been proposed, mainly reflecting the clinical heterogeneity of the syndrome. Regardless of the underlying mechanism, peripheral and/or pulmonary congestion is present in the vast majority of cases. Furthermore, a marked reduction in cardiac output with peripheral hypoperfusion may occur in most severe cases. Diagnosis is made on the basis of signs and symptoms, laboratory, and non-invasive tests. After exclusion of reversible causes, AHF therapeutic interventions mainly consist of intravenous (IV) diuretics and/or vasodilators, tailored according to the initial hemodynamic status with the addition of inotropes/vasopressors and mechanical circulatory support if needed. The aim of this review is to discuss current concepts on the diagnosis and management of AHF in order to guide daily clinical practice and to underline the unmet needs. Preventive strategies are also discussed.
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- 2023
17. Integrated System for the Proactive Analysis on Infection Risk at a University Health Care Establishment Servicing a Large Area in the South of Italy.
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Montella, Emma, Iodice, Sabrina, Bernardo, Carlo, Frangiosa, Alessandro, Pascarella, Giacomo, Santalucia, Ida, and Triassi, Maria
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- 2023
- Full Text
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18. C-reactive protein but not procalcitonin may predict antibiotic response and outcome in infections following major abdominal surgery
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A Frangiosa, C Antropoli, M De Palma, Ciro Esposito, Alessandro Perrella, Antonio Giuliani, Fulvio Calise, Giovanni Vennarecci, Maurizio Castriconi, and Carlo Molino
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medicine.medical_specialty ,medicine.medical_treatment ,Peritonitis ,Abdominal surgery ,Gastroenterology ,Procalcitonin ,Sepsis ,Antimicrobialstewardship ,Internal medicine ,medicine ,Humans ,Receptors, Immunologic ,Inflammation ,biology ,business.industry ,Abdominal Infection ,C-reactive protein ,CRE ,Surgical infection ,medicine.disease ,Surgery ,Anti-Bacterial Agents ,C-Reactive Protein ,biology.protein ,Intraabdominal Infections ,Original Article ,Hepatectomy ,Segmental resection ,business ,Infection ,CRP ,Biomarkers - Abstract
We aimed to evaluate the usefulness of C-reactive protein (CRP) and procalcitonin (PCT) as markers of infection, sepsis and as predictors of antibiotic response after non-emergency major abdominal surgery. We enrolled, from June 2015 to June 2019, all patients who underwent surgery due to abdominal infection (peritoneal abscess, peritonitis) or having sepsis episode after surgical procedures (i.e. hepatectomy, bowel perforation, pancreaticoduodenectomy (PD), segmental resection of the duodenum (SRD) or biliary reconstruction in a Tertiary Care Hospital. Serum CRP (cut-off value < 5 mg/L) and PCT (cut-off value < 0.1mcg/L) were measured in the day when fever was present or within 24 h after abdominal surgery. Both markers were assessed every 48 h to follow-up antibiotic response and disease evolution up to disease resolution. We enrolled a total of 260 patients underwent non-emergency major abdominal surgery and being infected or developing infection after surgical procedure with one or more microbes (55% mixed Gram-negative infection including Klebsiella KPC, 35% Gram-positive infection, 10% with Candida infection), 58% of patients had ICU admission for at least 96 h, 42% of patients had fast track ICU (48 h). In our group of patients, we found that PCT had a trend to increase after surgical procedure; particularly, those undergoing liver surgery had higher PCT than those underwent different abdominal surgery (U Mann-Whitney p < 0.05). CRP rapidly increase after surgery in those developing infection and showed a statistical significant decrease within 48 h in those subject being responsive to antibiotic treatment and having a clinical response within 10 days independently form the pathogens (bacterial or fungal). Further we found that those having CRP higher than 250 mg/L had a reduced percentage of success treatment at 10 days compared to those < 250 mg/mL (U Mann-Whitney p < 0.05). PCT did not show any variation according to treatment response. CRP in our cohort seems to be a useful marker to predict antibiotic response in those undergoing non-emergency abdominal surgery, while PCT seem to be increased in those having major liver surgery, probably due to hepatic production of cytokines.
- Published
- 2021
19. Caring for Dementia Caregivers: Understanding Caregiver Stress During the COVID-19 Pandemic.
- Author
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Lancashire, Lee, Biggar, Virginia, Comer, Meryl, Frangiosa, Terry, Gage, Allyson, Paulsen, Russ, Roniger, Amber, and Wolfe, Jessica
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BURDEN of care ,COVID-19 pandemic ,CAREGIVERS ,ALZHEIMER'S disease ,DEMENTIA ,VASCULAR dementia - Abstract
More than 16 million Americans provide unpaid care for someone with Alzheimer's disease and related dementias (ADRD). During the COVID-19 pandemic, unpaid caregivers experienced increased chronic severe stress from widespread closures and social distancing. We conducted eight surveys from March 2020 to March 2021 among a cohort of over 10,000 individuals. Cross-sectional analysis was conducted to investigate frequency and ratios of groups reporting increased stress across surveys. A longitudinal analysis was also performed with the 1,030 participants who took more than one survey. We found a growing crisis among dementia caregivers: By Survey 8, current caregivers reported 2.9 times higher stress levels than the comparator group. By that time, 64% of current caregivers reported having multiple stress symptoms typically found in people experiencing severe stress. Both analyses reported increased levels of stressors over time that were more associated with certain caregiver groups. Our findings underscore the urgent need for public policy initiatives and supportive community infrastructure to support ADRD caregivers. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
20. Acute Heart Failure: Diagnostic–Therapeutic Pathways and Preventive Strategies—A Real-World Clinician's Guide.
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Mauro, Ciro, Chianese, Salvatore, Cocchia, Rosangela, Arcopinto, Michele, Auciello, Stefania, Capone, Valentina, Carafa, Mariano, Carbone, Andreina, Caruso, Giuseppe, Castaldo, Rossana, Citro, Rodolfo, Crisci, Giulia, D'Andrea, Antonello, D'Assante, Roberta, D'Avino, Maria, Ferrara, Francesco, Frangiosa, Antonio, Galzerano, Domenico, Maffei, Vincenzo, and Marra, Alberto Maria
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MEDICAL personnel ,ARTIFICIAL blood circulation ,SYMPTOMS ,CARDIAC output ,MEDICAL care costs ,CARDIOGENIC shock - Abstract
Acute heart failure (AHF) is the most frequent cause of unplanned hospital admission in patients of >65 years of age and it is associated with significantly increased morbidity, mortality, and healthcare costs. Different AHF classification criteria have been proposed, mainly reflecting the clinical heterogeneity of the syndrome. Regardless of the underlying mechanism, peripheral and/or pulmonary congestion is present in the vast majority of cases. Furthermore, a marked reduction in cardiac output with peripheral hypoperfusion may occur in most severe cases. Diagnosis is made on the basis of signs and symptoms, laboratory, and non-invasive tests. After exclusion of reversible causes, AHF therapeutic interventions mainly consist of intravenous (IV) diuretics and/or vasodilators, tailored according to the initial hemodynamic status with the addition of inotropes/vasopressors and mechanical circulatory support if needed. The aim of this review is to discuss current concepts on the diagnosis and management of AHF in order to guide daily clinical practice and to underline the unmet needs. Preventive strategies are also discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
21. Assessing what matters most to patients with or at risk for Alzheimer’s and care partners: a qualitative study evaluating symptoms, impacts, and outcomes
- Author
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Christina Slota, Dana B. DiBenedetti, Samantha L. Wronski, Dan Wieberg, Holly B. Krasa, Ian N. Kremer, Allison D. Martin, Virginia Biggar, Ann Hartry, Brett Hauber, Leigh F. Callahan, Ivana Rubino, John B. Winfield, Terry Frangiosa, Meryl Comer, Debra R. Lappin, and George Vradenburg
- Subjects
medicine.medical_specialty ,Neurology ,Cognitive Neuroscience ,Disease ,Neuropsychological Tests ,lcsh:RC346-429 ,lcsh:RC321-571 ,03 medical and health sciences ,0302 clinical medicine ,Alzheimer Disease ,Memory ,medicine ,Humans ,Cognitive Dysfunction ,030212 general & internal medicine ,Cognitive skill ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,lcsh:Neurology. Diseases of the nervous system ,Outcome ,Patient ,business.industry ,Research ,Neuropsychology ,Caregiver ,Clinical trial ,Mood ,Caregivers ,Neurology (clinical) ,business ,Qualitative ,Alzheimer’s disease ,030217 neurology & neurosurgery ,Geriatric psychiatry ,Clinical psychology ,Qualitative research - Abstract
Background The What Matters Most (WMM) study was initiated to evaluate symptoms, AD-related impacts, treatment-related needs, preferences, and priorities among individuals with or at risk for Alzheimer’s disease (AD) and their care partners. The objective of this qualitative study phase was to identify a comprehensive set of concepts of interest that are meaningful to individuals across the AD continuum. Methods Interviews were conducted with 60 clinically referred individuals and care partners across 5 AD stages (n = 12 each): group 1 (non-clinically impaired individuals with AD pathology), group 2 (individuals with mild cognitive impairment and AD pathology), group 3 (individuals with mild AD), group 4 (individuals with moderate AD and their care partners), and group 5 (care partners of individuals with severe AD). Interviews were conducted by experienced interviewers, audio-recorded, and transcribed. Dominant trends were identified in each interview and compared across subsequent interviews to generate themes or patterns in descriptions of AD symptoms, impacts, and desired treatment outcomes. Results All participants endorsed current issues related to memory; nearly all participants (n = 55; 92%) across the five groups endorsed symptoms related to communication and language. Groups 1–3 reported an impact on mood/emotions (n = 23; 64%) and a decrease in social activities or outgoingness (n = 17; 47%). Current and future concerns reported by the overall sample included memory (n = 48; 80%), dependence (n = 40; 67%), and “other” concerns (n = 33; 55.0%) (e.g., uncertainty about the future, burdening others). The most desired AD treatment outcomes were improvement or restoration of memory (n = 40; 67%) and stopping AD progression (n = 35; 58.3%). Group-level differences were observed in the symptoms, impacts, and desired treatment outcomes among patients and care partners across the AD continuum. Conclusions Cognitive functioning issues—particularly in memory and communication—are present even in preclinical and early-stage AD, including among those without a formal AD diagnosis. While the impacts of AD vary across the disease-severity spectrum, improved memory and disease modification were treatment outcomes considered most important to participants across all 5 AD stages. Neuropsychological assessments traditionally used in AD clinical trials may not evaluate the often-subtle concepts that are important to patients and care partners. Results from this study will inform the second phase of the WMM project—a quantitative study to elicit the relative importance of these concepts of interest to people at risk for and living with AD and their care partners.
- Published
- 2020
22. Association between COVID-19 and Sick Leave for Healthcare Workers in a Large Academic Hospital in Southern Italy: An Observational Study.
- Author
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Palladino, Raffaele, Mercogliano, Michelangelo, Fiorilla, Claudio, Frangiosa, Alessandro, Iodice, Sabrina, Sanduzzi Zamparelli, Stefano, Montella, Emma, Triassi, Maria, and Sanduzzi Zamparelli, Alessandro
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- 2022
- Full Text
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23. Symptoms and Treatment Needs of People with Dementia-Related Psychosis: A Mixed-Methods Study of the Patient Experience.
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Brandt, Teresa, Frangiosa, Theresa, Biggar, Virginia, Taylor, Angela, Valentine, James, Keller, Bill, Price, Mark, DeMuro, Carla, and Abler, Victor
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PATIENT experience ,CAREGIVER attitudes ,SENSES ,HALLUCINATIONS ,DELUSIONS ,PSYCHOSES ,RESEARCH methodology ,INTERVIEWING ,QUANTITATIVE research ,PATIENTS' attitudes ,QUALITATIVE research ,SURVEYS ,DEMENTIA ,INTERPERSONAL relations ,ANXIETY ,MEDICAL needs assessment ,DISEASE complications - Abstract
This study describes the person-centered experience and impact of symptoms and the treatment needs of dementia-related psychosis (DRP) from a patient and care partner perspective. Qualitative interviews and a quantitative survey were used to collect patient experience data from persons with DRP or their care partners. Sixteen participants (1 person with DRP, 15 care partners) completed the qualitative interview; 212 participants (26 persons with DRP, 186 care partners) completed the quantitative survey. The most commonly reported symptoms were visual hallucinations, auditory hallucinations, persecutory delusions, and distortion of senses. The most common impacts were difficulty differentiating what is real from what is not real, increased anxiety, and effects on personal relationships. Current treatments were less than moderately helpful, and the ability to distinguish what is real from what is not real and overall symptom improvement were described as the most important benefits of an ideal treatment. Patient experience data provide insights into urgent therapeutic needs of patients by describing the nature, frequency, and severity of symptoms and the impacts they have on individuals' lives. Patient experience data demonstrate an unmet need for treatments to reduce the symptoms and impacts of DRP. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
- View/download PDF
24. Early Descriptions of Family Caregivers' Experiences With Unexpected Lucidity
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Kyungmin Kim, Joan Griffin, Lauren Bangerter, Virginia Biggar, Dawn Finnie, Theresa Frangiosa, Joseph Gaugler, and Maria Lapid
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Abstracts ,Health (social science) ,Session 1180 (Symposium) ,Life-span and Life-course Studies ,AcademicSubjects/SOC02600 ,Health Professions (miscellaneous) - Abstract
To develop an operational definition of and typologies for episodes of lucidity (EL), we conducted a cross-sectional study of former/current family caregivers from UsAgainstAlzheimer’s A_LIST (N = 538). More than 60% of caregivers (n = 294, 62%) reported witnessing EL with their care recipient over the course of their dementia. Most episodes happened in late stages of dementia (71%). Only 10% happened within 7 days before death. The majority of episodes (71%) lasted
- Published
- 2021
25. Successful weaning from mechanical ventilation after Serratus Anterior Plane block in a chest trauma patient.
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D'Errico, Cristiano, Sellini, Manuela, Cafiero, Tullio, Romano, Giovanni Marco, and Frangiosa, Antonio
- Abstract
Objectives: Chest trauma is associated with severe pain, which can hamper normal breathing. Serratus Anterior Plane block (SAPB) is a novel technique, which provides analgesia for chest wall surgery. We describe an interesting clinical case about the use of SAPB to improve pain and pulmonary function in a patient with severe chest trauma. Case presentation: We report the pain management and the clinical evolution of a patient in ICU, with a severe chest trauma, after performing the SAPB. Following the SAPB, the patient had a reduction in pain intensity and an improvement in both respiratory mechanics and blood gas analysis allowing a weaning from mechanical ventilator. Conclusions: Pain control greatly affects mortality and morbidity in patients with chest trauma. SAPB seems to be safer and equally effective in pain control compared to epidural analgesia in patients with chest trauma. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
26. A Path to Early Diagnosis of MCI and Dementia: Integrating myMemCheck Into the Primary Care Workflow
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Steven P Simmons, Theresa Frangiosa, Ryan A Mace, Meryl Comer, Virginia Biggar, and William E Mansbach
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Health (social science) ,Computer science ,Primary care ,medicine.disease ,Health Professions (miscellaneous) ,Abstracts ,Workflow ,Dementia I ,medicine ,Dementia ,Operations management ,Life-span and Life-course Studies ,Session 2920 (Paper) ,AcademicSubjects/SOC02600 ,PATH (variable) - Abstract
Barriers to the early detection of mild cognitive impairment (MCI) and dementia can delay diagnosis and treatment. myMemCheck® was developed as a rapid free cognitive self-assessment tool that can be completed in the practice setting or at home to identify older adults that would benefit from a more comprehensive cognitive evaluation for MCI and dementia. Two prospective cross-sectional studies (N = 59; N = 357) were conducted to examine the psychometric properties and clinical utility of myMemCheck®. myMemCheck® evidenced adequate reliability (test-retest, r = 0.67) and strong construct validity (η2 = 0.29, discriminating normal, MCI, dementia). Receiver operating characteristic analysis evidenced an optional myMemCheck® cut score for identifying older adults with MCI or dementia (sensitivity = 0.80, specificity = 0.67, positive predictive value = 0.91, negative predictive value = 0.43). myMemCheck® explained 25% of cognitive status beyond basic patient information. We provide specific suggestions for integrating myMemCheck® into practice to optimize workflow. Study results are further interpreted in the context of two national online surveys (healthcare professionals, N = 181; consumers, N = 1740). Healthcare professionals widely agreed on the need (94%) and importance (86%) of cognitive self-assessments. Public demand for cognitive self-assessment was confirmed by consumers who trialed myMemCheck® as part of their survey participation—86% agreed on the need for a tool like myMemCheck®. Mixed methods findings suggest that myMemCheck® could fast- track the diagnostic process, facilitate appropriate referrals for cognitive and neuropsychological evaluation, reduce assessment burden in healthcare, and prevent negative outcomes associated with undetected cognitive impairment.
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- 2020
27. The Kidney in Heart Failure
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De Santo, Natale G., Cirillo, Massimo, Perna, Alessandra, Pollastro, Rosa Maria, Frangiosa, Annamaria, Di Stazio, Enzo, Iorio, Luigi, Andrea Di Leo, Vito, and Anastasio, Pietro
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- 2005
- Full Text
- View/download PDF
28. Caregiver appraisals of lucid episodes in people with late‐stage Alzheimer's disease or related dementias.
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Griffin, Joan M., Kim, Kyungmin, Gaugler, Joseph E., Biggar, Virginia S., Frangiosa, Theresa, Bangerter, Lauren R., Batthyany, Alexander, Finnie, Dawn M., and Lapid, Maria I.
- Subjects
ALZHEIMER'S disease ,CAREGIVERS ,DEMENTIA ,INFORMATION-seeking behavior - Abstract
Introduction: Little is known about how family caregivers who witness unexpected and spontaneous communication among people in late stages of Alzheimer's disease and related dementias (ADRD) appraise these episodes of lucidity (EL). Methods: In an electronic, cross‐sectional survey for former and current caregivers who participate in UsAgainstAlzheimer's A‐LIST®, participants who reported witnessing an EL were asked how positive and stressful ELs were, if they made or changed decisions based on an EL, and what resources they sought out to explain ELs. Results: Caregivers reported 72% of ELs to be quite a bit or very positive, 17% to be stressful, and 10% to be both stressful and positive. Twelve percent of caregivers changed care plans because of ELs and 13% sought out information about ELs. Discussion: These exploratory data suggest caregiver reactions to EL vary. Caregivers may change or postpone care decisions due to EL, and few resources exist to address caregiver queries about EL. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
29. Long-term catheterism of external iliac veins in hemodialysed patients: effective choice
- Author
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PUNZI, M., FRANGIOSA, A., VILLARI, V., and FERRO, F.
- Published
- 2007
30. ENGAGING FAMILY CAREGIVERS TO IMPROVE HEALTH CARE DELIVERY: ESTABLISHING CLINICAL BEST PRACTICES
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Lauren R. Bangerter, Virginia Biggar, Theresa Frangiosa, Joan M. Griffin, Rachel D. Havyer, and Meryl Comer
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Health (social science) ,Rehabilitation ,business.industry ,Family caregivers ,Best practice ,medicine.medical_treatment ,Qualitative property ,Health Professions (miscellaneous) ,Focus group ,Abstracts ,Nursing ,Health care ,medicine ,Disease management (health) ,Life-span and Life-course Studies ,business ,Psychology ,Family values - Abstract
Health care providers recognize that family can directly and indirectly affect adult patient health and reduce costs to healthcare systems. However, there is no consensus on the best practices for integrating caregivers into the healthcare experience. Research on how healthcare providers can integrate family abilities and values into patient plans of care for disease management, rehabilitation, or symptom control lags far behind the research on patient-centered care. Research on family engagement at critical points of patient care, such as hospital discharge or end-of-life decision making have been instrumental in highlighting opportunities to engage families to improve quality of care. Far less research has been done on integrating family values, capabilities, and capacity to care throughout a patient’s chronic disease continuum, leaving healthcare providers with few evidence-based, feasible or acceptable strategies they can offer to caregivers to improve patient outcomes and maintain their caregiver health. Using qualitative data from six focus groups with family caregivers of people with dementia and one focus group of people living with mild cognitive impairment, we identified potential “best practices” on engaging family caregivers in healthcare. Caregivers and patients reported clinical best practices would include coordination of services, personalized care, practices that enabled caregivers to provide optimal care (early identification of caregivers and routine assessment of caregiver health and capacity to care), and compassion and respect for the caregiver role and expertise. Data have been used to inform a new quantitative assessment to evaluate clinical best practices for engaging family caregivers.
- Published
- 2018
31. Measuring "What Matters Most™" to individuals living with Alzheimer's disease and care partners: A conceptual model of Alzheimer's Disease.
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Romano, Carla, Slota, Christina, Bratlee‐Whitaker, Emily, Edwards, Teresa, Herring, William L, McLeod, Lori, Callahan, Leigh F, Bullok, Kristin E, Raimundo, Karina, Taylor, James, Taylor, Geri, Kremer, Ian N., Lappin, Debra, Frangiosa, Theresa, Goss, Diana, Gnanasakthy, Kajan, Comer, Meryl, Monks, Doreen, Paulsen, Russ, and Hartry, Ann
- Abstract
Background: The Alzheimer's Disease Patient and Caregiver Engagement™ Initiative's What Matters Most™ (WMM) Research Program includes seminal studies to identify and measure treatment‐related needs, preferences, and priorities of people living with Alzheimer's disease (PLWAD) and their informal care partners (CPs). WMM research identified 42 concepts deemed to be of highest relevance and importance in treatment related needs across the AD spectrum (preclinical – severe AD). Now, the WMM Next Generation Studies (WMM NG) are generating data to contextualize findings through a conceptual model of disease, verify previously identified concepts, and learn of new emerging concepts from a more diverse and inclusive study sample. Results will be used to broaden the context of an online survey to inform additional studies, including health economic evaluations, across the Alzheimer's research field. Method: A draft conceptual model of disease was developed building on an existing model (Hartry, 2018) after careful examination of previously collected WMM data (DiBenedetti, 2020; Hauber, 2023). A cross‐sectional, observational qualitative research study was conducted, comprised of a series of individual, in‐depth interviews of those with clinically confirmed PLWAD and their CPs. Analyses of these data include qualitative content analysis and thematic analysis methods (Hsiu‐Fang, 2005). Result: The 42 WMM concepts were categorized across thought processing (14), communication (3), mood/emotions (6), daily activities (12), social life/activities, (3) and independence (4) domains to form a draft conceptual model of disease. A total of 64 PLWAD and CPs of diverse ethnic and cultural backgrounds participated in in‐depth, web‐based interviews. Results reaffirmed the 42 WMM concepts, informed the model structure, and added missing concepts. Further, cognitive debriefing approaches elucidated participant perception of the terms "bother" and "interference" describing emotional connotation of these words, compared to the assessment of "impact", to inform development of AD burden survey items. Conclusion: WMM concepts contextualized by domains offer a roadmap to support future clinical trials seeking to measure clinically meaningful outcomes and patient‐centric endpoints. WMM NG data collection will enhance robustness of the findings to evaluate the impact of disease symptoms and inform health economic evaluation. The conceptual model will be refined continuously over the WMM research. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
32. Acid-base balance in heart failure
- Author
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Frangiosa, Annamaria, De Santo, Luca S., Anastasio, Pietro, and De Santo, Natale G.
- Published
- 2006
33. Sevelamer worsens metabolic acidosis in hemodialysis patients
- Author
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De Santo, Natale G., Frangiosa, Annamaria, Anastasio, Pietro, Marino, Alfonsina, Correale, Giacomo, Perna, Alessandra, Di Stazio, Enzo, Stellato, Davide, Santoro, Domenico, Di Meglio, Elisabetta, Iacono, Giovanni, Ciacci, Cinzia, Savica, Vincenzo, and Cirillo, Massimo
- Published
- 2006
34. The effect of oral protein loading on renal acidification in patients with heart failure
- Author
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Frangiosa, Annamaria, De Santo, Luca S., Saviano, Caterina, Anastasio, Pietro, Cotrufo, Maurizio, Capasso, Giovambattista, Adrogué, Horacio J., and De Santo, Natale G.
- Published
- 2005
35. Enhancement of the thermooxidative degradability of polystyrene by chemical modification
- Author
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Botelho, Gabriela, Queirós, Arlete, Machado, Ana, Frangiosa, Paulo, and Ferreira, José
- Published
- 2004
- Full Text
- View/download PDF
36. Paradox of circulating advanced glycation end product concentrations in patients with congestive heart failure and after heart transplantation
- Author
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Heidland, A, Šebeková, K, Frangiosa, A, De Santo, L S, Cirillo, M, Rossi, F, Cotrufo, M, Perna, A, Klassen, A, Schinzel, R, and De Santo, N G
- Published
- 2004
37. Corticosteroids in patients with COVID-19: use and misuse.
- Author
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ROMANO, Giovanni M., CAFIERO, Tullio, FRANGIOSA, Antonio, and DE ROBERTIS, Edoardo
- Published
- 2021
- Full Text
- View/download PDF
38. PCR11 Understanding the Patient Experience of Erythropoietic Protoporphyria and X-Linked Protoporphyria: A Qualitative Study
- Author
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Whalley, D, Belongie, K, Frangiosa, T, Krasa, H, Mladsi, DM, Twiss, J, and Wolowacz, S
- Published
- 2022
- Full Text
- View/download PDF
39. Paradox of circulating advanced glycation end product concentrations in patients with congestive heart failure and after heart transplantation
- Author
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A. Heidland, K. Sebekova, A. Frangiosa, L. S. De Santo, M. Cirillo, F. Rossi, m. Cotrufo, A. Perna, A. Klassen, R. Shinzel, N. G. De Santo
- Subjects
Kidney function tests -- Analysis ,Congestive heart failure -- Analysis ,Health - Published
- 2004
40. CONTRASTING CIRCULATING AGEs IN CONGESTIVE HEART FAILURE AND AFTER HEART TRANSPLANTATION IN PATIENTS WITH IDENTICAL DECREASE OF RENAL FUNCTION
- Author
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Heidland, A., Sebekova, K., Frangiosa, A., De Santo, L., Chillo, M., Rossi, F., Cotrufo, M., Perna, A., Klassen, A., and De Santo, N.
- Published
- 2003
41. Level of hydration and renal function in healthy humans
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Anastasio, Pietro, Cirillo, Massimo, Spitali, Lucia, Frangiosa, Annamaria, Pollastro, Rosa Maria, and De Santo, Natale G.
- Published
- 2001
42. Production of lifetime controlled plastics: copolymers of styrene and substituted butadienes
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Frangiosa, P.C. and Catalani, L.H.
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- 2003
- Full Text
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43. New diagnosis of Eosinophilic Esophagitis (EoE) in patients undergoing Oral immunotherapy (OIT): a retrospective review of real-world Multi-foods or single-food OIT in 788 children and young adults.
- Author
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Frangiosa, Jessica, Diem, Luca, Hanna, Elizabeth, Lewis, Megan, Corrigan, Kristen, Shuker, Michele, Datta, Rahul, Gober, Laura, Kennedy, Katie, Kazatsky, Ashley, Ochfeld, Elisa, Buonanno, Jillian, Sanborne, Caroline, McManamon, Christine, Spergel, Jonathan, Muir, Amanda, Nguyen, Kim, and Cianferoni, Antonella
- Published
- 2024
- Full Text
- View/download PDF
44. Integrating Family Caregivers of People With Alzheimer's Disease and Dementias into Clinical Appointments: Identifying Potential Best Practices.
- Author
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Griffin, Joan M., Riffin, Catherine, Havyer, Rachel D., Biggar, Virginia S., Comer, Meryl, Frangiosa, Theresa L., and Bangerter, Lauren R.
- Abstract
Family caregiver engagement in clinical encounters can promote relationship-centered care and optimize outcomes for people with Alzheimer's disease and related dementias (ADRD). Little is known, however, about effective ways for health care providers to engage family caregivers in clinical appointments to provide the highest quality care. We describe what caregivers of people with ADRD and people with mild cognitive impairment (MCI) consider potential best practices for engaging caregivers as partners in clinical appointments. Seven online focus groups were convened. Three groups included spousal caregivers (n = 42), three included non-spousal caregivers (n = 36), and one included people with MCI (n = 15). Seven potential best practices were identified, including the following: "acknowledge caregivers' role and assess unmet needs and capacity to care" and "communicate directly with person with ADRD yet provide opportunities for caregivers to have separate interactions with providers." Participants outlined concrete steps for providers and health care systems to improve care delivery quality for people with ADRD. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
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45. Glomerular filtration rate in severely overweight normotensive humans
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Anastasio, Pietro, Spitali, Lucia, Frangiosa, Annamaria, Molino, Daniela, Stellato, Davide, Cirillo, Eleonora, Pollastro, Rosa Maria, Capodicasa, Laura, Sepe, Joseph, Federico, Pasquale, and Gaspare De Santo, Natale
- Published
- 2000
- Full Text
- View/download PDF
46. FINDINGS FROM THE ALZHEIMER'S DISEASE PATIENT AND CAREGIVER ENGAGEMENT (AD PACE) INITIATIVE'S WHAT MATTERS MOST QUALITATIVE STUDY
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Vradenburg, George, DiBenedetti, Dana B., Hauber, Brett, Slota, Christina, Wronski, Samantha L., Comer, Meryl, Callahan, Leigh F., Winfield, John, Rubino, Ivana, Krasa, Holly B., Hartry, Ann, Wieberg, Dan, Kremer, Ian N., Lappin, Debra, Martin, Allison D., Frangiosa, Terry, and Biggar, Virginia
- Published
- 2019
- Full Text
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47. Remifentanil-TCI and propofol-TCI for conscious sedation during fibreoptic intubation in the acromegalic patient
- Author
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Cafiero T, Gargiulo G, N. Mennella, L. M. Cavallo, Felice Esposito, Frangiosa A, P. Cappabianca, G. Fraioli, T., Cafiero, Esposito, Felice, G., Fraioli, G., Gargiulo, A., Frangiosa, Cavallo, LUIGI MARIA, N., Mennella, and Cappabianca, Paolo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Mean arterial pressure ,medicine.medical_treatment ,Sedation ,Remifentanil ,Conscious Sedation ,Blood Pressure ,Piperidines ,Heart Rate ,Intubation, Intratracheal ,Medicine ,Intubation ,Humans ,Prospective Studies ,Infusions, Intravenous ,Propofol ,Aged ,Analysis of Variance ,business.industry ,Tracheal intubation ,Middle Aged ,Surgery ,Anesthesiology and Pain Medicine ,Patient Satisfaction ,Anesthesia ,Acromegaly ,Mental Recall ,Midazolam ,Premedication ,Female ,medicine.symptom ,business ,Anesthetics, Intravenous ,medicine.drug - Abstract
BACKGROUND AND OBJECTIVE To evaluate the use of remifentanil-propofol administered as target-controlled infusion during awake fibreoptic intubation for anticipated difficult tracheal intubation in acromegalic patients. METHOD In all, 20 consecutive acromegalic patients underwent elective endonasal endoscopic transsphenoidal pituitary surgery. After premedication with midazolam 0.03 mg kg(-1), initially a target-controlled infusion of remifentanil 1.0 ng mL(-1) and propofol 1.5 microg mL(-1) was started. The fibreoptic intubation was performed by the same physician experienced with the fibreoptic technique. During the fibreoptic procedure the target concentrations of remifentanil and propofol ranged between 1.0 and 5.0 ng mL(-1), and between 1.5 and 3.5 microg mL(-1), respectively. Changes in heart rate and mean arterial pressure were recorded during airway manipulation, during tracheal intubation, and at 1 and 3 min after. On the first postoperative day, patient recall and level of discomfort during fibreoptic intubation were evaluated. RESULTS Endotracheal intubation was efficaciously and quickly secured in all patients. A significant increase in mean arterial pressure and heart rate was recorded only during tracheal intubation (P < 0.05). Oxygenation was sufficient and no bradypnea or apnoea was recorded. All patients later described their anaesthetic experience as satisfactory. During fibreoptic intubation, remifentanil (ng mL(-1)) and propofol (microg mL(-1)) mean effect-site concentrations were 3.2 +/- 0.3 and 2.0 +/- 1.0, respectively. CONCLUSION Remifentanil and propofol target-controlled infusion provided satisfactory conscious sedation allowing for successful oral fibreoptic intubation in acromegalic patients with no recall.
- Published
- 2008
48. Clinical comparison of remifentanil-sevoflurane vs. remifentanil-propofol for endoscopic endonasal transphenoidal surgery
- Author
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T. CAFIERO, A. FRANGIOSA, R. BURRELLI, CAVALLO, LUIGI MARIA, GARGIULO, GUIDO, CAPPABIANCA, PAOLO, DE DIVITIIS, ENRICO, T., Cafiero, Cavallo, LUIGI MARIA, A., Frangiosa, R., Burrelli, Gargiulo, Guido, Cappabianca, Paolo, and DE DIVITIIS, Enrico
- Published
- 2007
49. Monitored anesthesia care and loco-regional anesthesia. Vascular surgery use
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SAVOIA G, LORETO M, CANFORA G, FRANGIOSA A, CORTESANO P, RUSSO F., GRAVINO, ELVIRA, Savoia, G, Loreto, M, Gravino, Elvira, Canfora, G, Frangiosa, A, Cortesano, P, and Russo, F.
- Published
- 2005
50. Paradox of circulating advanced glycation end product concentrations in patients with congestive heart failure and after heart transplantation
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André Klassen, Alessandra F. Perna, Katarína Šebeková, N. G. De Santo, August Heidland, Massimo Cirillo, L.S. De Santo, Annamaria Frangiosa, Francesco Rossi, Reinhard Schinzel, Maurizio Cotrufo, Heidland, A, Sebeková, K, Frangiosa, A, DE SANTO, Luca Salvatore, Cirillo, M, Rossi, F, Cotrufo, M, Perna, Alessandra, Klassen, A, Schinzel, R, De Santo, N. G., Sebekova, K, DE SANTO, L, Cirillo, Massimo, Perna, A, and DE SANTO, N. G.
- Subjects
Adult ,Glycation End Products, Advanced ,Male ,medicine.medical_specialty ,Adolescent ,Heart disease ,medicine.medical_treatment ,Renal function ,Cardiovascular Medicine ,chemistry.chemical_compound ,Glycation ,Internal medicine ,medicine ,Humans ,Heart Failure ,Heart transplantation ,business.industry ,Lysine ,Immunosuppression ,Middle Aged ,medicine.disease ,Transplantation ,Cross-Sectional Studies ,Endocrinology ,chemistry ,Heart failure ,Cardiology ,Heart Transplantation ,Kidney Failure, Chronic ,Advanced glycation end-product ,Female ,Lipid Peroxidation ,Cardiology and Cardiovascular Medicine ,business ,Glomerular Filtration Rate - Abstract
Objectives: To analyse circulating concentrations of advanced glycation end products (AGEs) in patients with severe congestive heart failure (CHF) and after heart transplantation; to identify the potential contribution of kidney function to plasma AGE concentrations; and to determine whether AGE concentrations and parameters of oxidative stress are interrelated.Methods and results: Circulating N-epsilon-(carboxymethyl) lysine (CML) and AGE associated fluorescence (AGE-Fl), lipid peroxidation, and glomerular filtration rate (GFR) were measured in a cross sectional study of 22 patients with advanced CHF, 30 heart transplant recipients, and 20 healthy controls. Compared with the controls, the CHF patients had decreased CML (mean(SEM) 467.8 (20.0) ng/ml v 369.3 (22.3) ng/ml, p
- Published
- 2004
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