Ideal Family Size and Fertility in Egypt: An Overview of Recent Trends

Egypt is already the most populous Arab country in the world with 93 million citizens in 2016 which may grow to about 120 million by 2030 if the same level of fertility continues. This paper aims to offer an overview of the evolution over time of the ideal number of children in Egypt, assessing previous researches and giving a particular emphasis on most recent data on such topic. In a context of raising fertility, whose causes are still unknown, we test the persistence of a high ideal number of children among younger cohorts

Characteristics of structured physical training currently provided in cardiac patients: insights from the Exercise Training in Cardiac Rehabilitation (ETCR) Italian survey

Uncertainty exists about current delivery levels of exercise training (ET) during Cardiac Rehabilitation (CR) programmes. The aim of this study was to evaluate ET modalities in the real world of CR facilities in Italy. This was an observational survey of aggregate data, collected from CR facilities on a voluntary basis. Snapshots of a single working day at a local site were made, in terms of characteristics of patients and ET programmes delivered. Overall, 612 patients from 26 CR units were included, with an in-patient vs out-patient ratio of 3:1. Coronary artery disease (57.6%), heart failure (20.3%), and valve disease/surgery (22.1%) were the most represented target groups. The prevalence of endurance continuous training, interval training, and resistance/strength training was 66.7%, 11.1%, and 9.0%; other non-aerobic endurance and non-resistance training modalities such as respiratory muscle training and calisthenics were reported in 39.9% and 42.9% of cases respectively. Workloads for endurance exercise training were determined by cardiopulmonary test, conventional 12-leads ECG exercise testing, 6minwalking test, theoretical determination of heart rate, and rating of perceived exertion in 9%, 8%, 27%, 9%, and 40% of cases respectively. The average duration of the programmes (on an intention to treat basis) was 25 sessions of 42±11 min, with a frequency of >4 sessions/week in 67% of patients. Despite advances in CR interventions, there is a significant need for improvement of functional evaluation and exercise training prescription, and consideration of a wider range of training modalities in Ital

On the stability of standing waves of Klein-Gordon equations in a semiclassical regime

We investigate the orbital stability and instability of standing waves for two classes of Klein-Gordon equations in the semi-classical regime.Comment: 9 page

Advances in exercise rehabilitation for patients with Lower Extremity Peripheral Artery Disease

Patients with Lower Extremity Peripheral Artery Disease (LEPAD) have been recently identified as target groups for structured Cardiac Prevention and Rehabilitation (CPR) programs, whose core components and intervention goals are now well recognized. Historically, exercise training (ET) programs have been employed for the treatment of LEPAD with typical intermittent claudication, and several meta-analysis documented improvements in walking distances of enrolled patients. Both in American and European guidelines, a frequency of at least 3 sessions per week and program duration of 12 weeks were judged as optimal, while recommended sessions lengths were 30-45 minutes and 30-60 minutes respectively. Among emerging aspects in the field of LEPAD rehabilitation, 1) the extended role of CPR programs in stages other than that of intermittent claudication, 2) an updated identification of predictors of poor outcome after ET, 3) the attributable effect of exercise on global cardio-respiratory fitness in LEPAD, 4) the combination of ET and invasive measures for advanced stages of LEPAD, and 5) the role of community walking programs have been discussed

Diffeomorphism-invariant properties for quasi-linear elliptic operators

For quasi-linear elliptic equations we detect relevant properties which remain invariant under the action of a suitable class of diffeomorphisms. This yields a connection between existence theories for equations with degenerate and non-degenerate coerciveness.Comment: 16 page

Frailty and cardiac rehabilitation : A call to action from the EAPC Cardiac Rehabilitation Section

Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation.The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients.Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients

Metabolic syndrome and related dietary intervention among patients with coronary and peripheral arterial disease attending cardiovascular rehabilitation programs

Aim of the study: To provide estimates of the prevalence of metabolic syndrome (MS) among patients with coronary artery disease (CAD) or peripheral arterial obstructive disease (PAOD) attending cardiac rehabilitation (CR) programs, as well as related dietary needs targeted on the single core components of the syndrome. Methods: Observational study enrolling 209 patients (males 75%, mean age 65±8 yrs.) referred to a CR facility because of silent ischemia (11%), chronic stable angina (28%), acute coronary syndrome (41%), or peripheral arterial disease (20%). The MS was diagnosed according to the 2005-modified NCEP ATP III criteria. Dietary regimens were classified into four areas of intervention (weight control, lipid control, glycaemic control, and blood pressure control) and compared in patients with and without MS. Results: MS accounted for 26% of all patients, with the highest prevalence (31%) among those admitted after acute coronary syndromes. All four dietary regimens were significantly more prescribed (p< 0.001) among patients with MS as compared to controls, with low sodium (95%) and low fat (90%) diets as the most represented patterns. All patients with MS were prescribed multiple dietary patterns, with adoption of a comprehensive low energy, low fat, and low glucose diet in up to one fifth of cases. Conclusion: Patients with CAD or PAOD referred to CR programs often display an high cardiometabolic risk and need a broad regimen of dietary modification

The GICR polls: a new instrument for Cardiovascular Prevention and Rehabilitation in Italy

During the year 2015 GICR-IACPR, a scientific society for Cardiovascular Prevention and Rehabilitation (CRP) in Italy, carried out several "Polls" based on its website, in order to know current attitudes of health operators involved in the management and care of cardiac patients. The Poll #1 focused on post revascularization residual myocardial ischemia, familial dyslipidemia, erectile dysfunction, sleep apnoea, and hyperuricaemia, all conditions being paradigmatic of well known situations of high cardiovascular risk and disability in the CRP setting. In the present report feasibility and results of the GICR Poll #1 are discussed