Maison Arabe de Software et de Hardware (Tunisia)

Patients with heart failure (HF) reported poor quality of life (QOL) due to different reasons among which fatigue is the most important. Improving QOL is a crucial objective for patients with HF and their primary health care providers. Managing fatigue with medication is not enough. Benson's relaxation technique (BRT) is a complementary therapy used to manage fatigue among different populations with limited studies checking its effect among patients diagnosed with HF. The purpose of this quasi-experimental study was to check the effect of BRT on fatigue and QOL among 140 (68 intervention and 72 control) patients diagnosed with HF. Intervention group performed BRT for 20 minutes twice a day for 2 months. Control group received regular care from their health care providers. At baseline, there were no differences between intervention and control groups regarding fatigue, physical component summary, and mental component summary. At follow-up, intervention group had higher scores in physical and mental component summaries than control group (45.48 ± 10.52 vs 37.97 ± 14.78) and (46.22 ± 8.39 vs 41.01 ± 10.36), respectively. Also, intervention group had lower levels of fatigue than control group (2.54 ± 0.87 vs 6.33 ± 0.61). In conclusion, the use of BRT as a complementary therapy for patients with HF might decrease fatigue level and improve QOL.

Penelitian ini dilatarbelakangi oleh Kurang maksimalnya pelaksanaan pengelolaan proses pembelajaran bagi guru-guru di SD Negeri 2 Buntok Kecamatan Dusun Selatan Kabupaten Barito Selatan.Hal ini disebabkan Kurangnya informasi tentang pengelolaan proses pembelajaran dan Kurangnya bimbingan tentang pengelolaan proses pembelajaran bagi guru-guru di SD Negeri 2 Buntok Kecamatan Dusun Selatan Kabupaten Barito Selatan. Melalui Supervisi Akademik di SD Negeri 2 Buntok diharapkan dapat meningkatkan kemampuan guru dalam pengelolaan proses pembelajaran. Penelitian ini dilakukan di SD Negeri Buntok dengan aspek-aspek penilaian antara lain Penilaian Bidang Rencana Pelaksanaan, Penilaian Bidang Pelaksanaan Proses Pembelajaran, Penilaian Bidang Penilaian Hasil dan Penilaian Bidang Pengawasan Proses Pembelajaran. Dari hasil penelitian tersebut maka dapat disimpulkan bahwa supervisi akademik secara berkelanjutan terbukti secara ilmiah dapat meningkatkan kemampuan guru dalam pengelolaan proses pembelajaran di SD Negeri 2 Buntok Kecamatan Dusun Selatan Kabupaten Barito Selatan 2 Buntok Kecamatan Dusun Selatan Kabupaten Barito Selatan terbukti dengan meningkatnya kemampuan guru dalam pengelolaan proses pembelajaran pada tiap-tiap aspek penilaian.

Backgrounds: Hyponatremia is associated with not only mortality, but also excessive neurohumoral drive including sympathetic overactivation in patients (pts) with chronic heart failure (CHF). However, the prognostic significance of persistent hyponatremia (per-hypoNa) remains to be unclear in CHF pts. Cardiac metaiodobenzylguanidine (MIBG) imaging, which is useful for the estimation of cardiac sympathetic nerve activity, provides prognostic information in CHF pts. We sought to investigate whether per-hypoNa would provide the additional prognostic information to MIBG imaging in CHF pts. Methods: We studied 103 CHF outpatients with LVEF <40% in our prospective cohort study. The cardiac MIBG heart-to-mediastinum ratio (H/M) washout rate (WR) were calculated from the chest anterior view images obtained at 20 and 200 min after isotope injection. We also measured serum sodium concentration at entry and every 6month for the initial 3 years. Per-hypoNa was defined that hyponatremia (<137mEq/L) was observed for more than 6 months. Results: During a follow up period of 8.0±4.0 years, 41 pts died. At multivariate Cox analysis, per-hypoNa (p=0.01) and abnormal WR (p=0.007) were significantly independently associated with the mortality, although H/M showed the significant association with the mortality at the univariate analysis. Pts with per-hypoNa had a significantly higher risk of mortality than pts without per-hypoNa (67% vs 35%, p=0.03). Pts with both per-hypoNa and abnormal WR had a significantly greater risk of mortality than pts with either per-hypoNa or abnormal WR (80% vs 48% p=0.01, adjusted HR 2.8[1.2-6.5]). Furthermore, pts with either per-hypoNa or abnormal WR also had a significantly greater risk of mortality than pts with neither per-hypoNa nor abnormal WR (48% vs 22% p=0.009, adjusted HR 2.6 [1.2-5.4]). Conclusion: The combination of persistent hyponatremia and cardiac MIBG imaging could provide the improved prediction of mortality in CHF pts.