***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objective To determine the distribution and importance of various factors , especially the preventable ones , that contribute to cardiac decompensation and subsequent hospital admission for heart failure . Methods During a one year period patients were prospect ively recruited and evaluated during their hospital stay by means of a structured personal interview by trained medical staff and through clinical examination and laboratory investigation . Setting The cardiological department at a teaching affiliated general community hospital in Berlin , Germany . Patients Consecutive sample of 179 patients admitted to hospital with acute decompensation of pre-existing heart failure . Main outcome measures Proportional distribution of causative factors leading to hospital admission for heart failure ; relative importance of preventable factors ; details of patient compliance with diet and medication , and knowledge about medication .  Results Mean ( SD ) age was 75.4 ( 9.9 ) years . Potential causative factors for decompensated heart failure were identified in 85.5 % of patients . Lack of adherence to the medical regimen was the most commonly identified factor and was regarded as the cause of the cardiac decompensation in 41.9 % of cases . Non-compliance with drugs was found in 23.5 % of patients . Other factors related to hospital admission were coronary ischaemia ( 13.4 % ) , cardiac arrhythmias ( 6.1 % ) , uncontrolled hypertension ( 5.6 % ) , and inadequate preadmission treatment ( 12.3 % ) . In all , 54.2 % of admissions could be regarded as preventable . Conclusions Many hospital admissions for decompensation of chronic heart failure in patients at a district hospital in Berlin are preventable . Measures are necessary to improve this situation and evaluation of programmes that include patient education , patient follow up , and physician training is needed OBJECTIVE Optimal self-care is crucial in patients with chronic heart failure ( HF ) . While the focus of research has been on negative mood states , adequate psychological re sources may be required to successfully engage in HF self-care . Therefore , the longitudinal associations of multiple positive affect measures in explaining HF self-care including consulting behavior were examined while adjusting for depressive symptoms and potential covariates ( e.g. , disease severity ) . METHODS In this prospect i ve cohort study , 238 patients ( mean age : 66.9 ± 8.6 years , 78 % men ) , with chronic HF completed question naires at baseline and 1-year follow-up .  Positive affect was assessed with the Positive and Negative Affect Schedule ( PANAS ) and the Global Mood Scale ( GMS ) . Anhedonia , i.e. diminished interest or pleasure , was assessed with a subscale of the Hospital Anxiety and Depression Scale ( HADS ) . The 9-item European Heart Failure Self-care Behaviour scale  was completed to assess HF self-care including consultation behavior . RESULTS Linear mixed modeling results showed that anhedonia was most strongly associated with both poor self-care ( estimate=-.72 , P<.001 ) and consulting behavior ( estimate=-.44 , P<.001 ) over time , after adjustment for covariates and depressive symptoms . GMS positive affect was related to better HF self-care adjusting for st and ard depressive symptoms but not when adjusting for anhedonia . PANAS positive affect was not independently related to self-care . CONCLUSION Anhedonia was associated with worse compliance with self-care among chronic HF patients over time , irrespective of disease severity and depression . Associations between positive affect and self-care were dependent on the measures used in multivariable analyses Objective : Depression is common in heart failure ( HF ) and associated with reduced cognitive function . The current study used Structrual Equation Modeling to examine whether depression adversely impacts cognitive function in HF through its adverse affects on exercise adherence and cardiovascular fitness . Method : 158 HF patients completed neuropsychological testing , physical fitness test , Beck Depression Inventory-II ( BDI-II ) , and measures assessing exercise adherence and physical exertion .  Results : The model demonstrated excellent model fit and increased scores on the BDI-II negatively affected exercise adherence and cardiovascular fitness . There was a strong inverse association between cardiovascular fitness and cognitive function . Sobel test showed a significant indirect pathway between the BDI-II and cognitive function through cardiovascular fitness . Discussion : This study suggests depression in HF may adversely impact cognitive function through reduced cardiovascular fitness . Prospect i ve studies are needed to determine whether treatment of depression can lead to better lifestyle behaviors and ultimately improve neurocognitive outcomes in HF The purpose of this paper is to describe electronic monitoring device ( EMD ) ( e.g. , MEMS caps ) use among HIV-infected adults enrolled in a r and omized clinical trial and to make explicit some of the benefits and caveats of using electronic monitoring device technology . This is a descriptive , exploratory study of EMD use among 128 HIV-infected adults treated with at least three antiretroviral agents . Thirty-six percent of the sample admitted that they did not use the  EMD  consistently . Forty-one percent of the subjects reported taking out more than one dose at a time and 26 % reported opening the EMD  but not taking the medication . Special subject-related issues accounted for only a small percentage of all reported problems with EMD use ( e.g. , transient housing , incarceration , substance abuse relapse and drug treatment ) . Results of this study suggest that EMDs may underestimate antiretroviral adherence among HIV-infected adults . Recommendations for improving EMD data quality are presented IMPORTANCE Depression and anxiety are associated with adverse cardiovascular outcomes in patients with recent acute cardiac events . There has been minimal study of collaborative care ( CC ) management models for mental health disorders in high-risk cardiac in patients , and no prior CC intervention has simultaneously managed depression and anxiety disorders . OBJECTIVE To determine the impact of a low-intensity CC intervention for depression , generalized anxiety disorder , and panic disorder among patients hospitalized for an acute cardiac illness . DESIGN , SETTING , AND PARTICIPANTS Single-blind r and omized clinical trial , with study assessors blind to group assignment , from September 2010 through July 2013 of 183 patients admitted to inpatient cardiac units in an urban academic general hospital for acute coronary syndrome , arrhythmia , or heart failure and found to have clinical depression , generalized anxiety disorder , or panic disorder on structured assessment . INTERVENTIONS Participants were r and omized to 24 weeks of a low-intensity telephone-based multicomponent CC intervention targeting depression and anxiety disorders ( n = 92 ) or to enhanced usual care ( serial notification of primary medical providers ; n = 91 ) . The CC intervention used a social work care manager to coordinate assessment and stepped care of psychiatric conditions and to provide support and therapeutic interventions as appropriate . MAIN OUTCOMES AND MEASURES Improvement in mental health-related quality of life ( Short Form-12 Mental Component Score [ SF-12 MCS ] ) at 24 weeks , compared between groups using a r and om-effects model in an intent-to-treat analysis . RESULTS Patients r and omized to CC had significantly greater estimated mean improvements in SF-12 MCS at 24 weeks ( 11.21 points [ from 34.21 to 45.42 ] in the CC group vs 5.53 points [ from 36.30 to 41.83 ] in the control group ; estimated mean difference , 5.68 points [ 95 % CI , 2.14 - 9.22 ] ; P = .002 ; effect size , 0.61 ) . Patients receiving CC also had significant improvements in depressive symptoms and general functioning , and higher rates of treatment of a mental health disorder ; anxiety scores , rates of disorder response , and adherence did not differ between groups . CONCLUSIONS AND RELEVANCE A novel telephone-based , low-intensity model to concurrently manage cardiac patients with depression and /or anxiety disorders was effective for improving mental health-related quality of life in a 24-week trial . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01201967 AIMS This paper is a report on the effectiveness of a self-management programme based on the self-efficacy construct , in older people with heart failure . BACKGROUND Heart failure is a major health problem worldwide , with high mortality and morbidity , making it a leading cause of hospitalization . Heart failure is associated with a complex set of symptoms that arise from problems in fluid and sodium retention . Hence , managing salt and fluid intake is important and can be enhanced by improving patients ' self-efficacy in changing their behaviour . DESIGN R and omized controlled trial . METHODS Heart failure patients attending cardiac clinics in northern Taiwan from October 2006-May 2007 were r and omly assigned to two groups : control ( n = 46 ) and intervention ( n = 47 ) . The intervention group received a 12-week self-management programme that emphasized self-monitoring of salt/fluid intake and heart failure-related symptoms . Data were collected at baseline as well as 4 and 12 weeks later . Data analysis to test the hypotheses used repeated- measures anova models . RESULTS Participants who received the intervention programme had significantly better self-efficacy for salt and fluid control , self-management behaviour and their heart failure-related symptoms were significantly lower than participants in the control group . However , the two groups did not differ significantly in health service use . CONCLUSION The self-management programme improved self-efficacy for salt and fluid control , self-management behaviours , and decreased heart failure-related symptoms in older Taiwanese out patients with heart failure . Nursing interventions to improve health-related outcomes for patients with heart failure should emphasize self-efficacy in the self-management of their disease OBJECTIVE Many patients with chronic heart failure ( CHF ) are thought to be non-adherent to their prescribed medications . The objective was to describe perceptions about and adherence to regular medicines and study medication at baseline and study end in CHF patients participating in a clinical trial . METHODS In the carvedilol or metoprolol European trial ( COMET ) , patients ( N = 3029 ) with CHF were r and omised and followed during a 58-month period . Patients at some Swedish centres answered a question naire at baseline and study end concerning their perception of their regular heart medication and study medication . Adherence was established through estimation of drug usage . RESULTS In the Swedish sub- study , 302 patients responded once to the question naire while 107 patients responded both at baseline and at follow-up . At baseline , 94 % of the patients stated that they believed that the study medication would make them feel better and 82 % believed that their regular heart medication would do so . During the study , patients ' belief in their regular cardiac medication significantly increased . Lack of belief in medication at the start of the study was a strong predictor of withdrawal from the trial ( 64 % versus 6.8 % ; p < 0.0001 ) . Those patients with very poor well-being and limited functional ability ( classified as NYHA III-IV ) at baseline significantly ( p = 0.01 ) increased their belief in the regular cardiac medication but not in their study medication . CONCLUSION Belief in medication may be related to how the patient experiences the medication 's impact on functional ability , symptoms and well-being . PRACTICE IMPLICATION S Early identification of patients ' beliefs about medication seem to be an important factor in counselling and information to patients with CHF OBJECTIVES To assess the influence of depressive symptoms on adherence with heart failure medications and to determine whether the effect of a pharmacy-based intervention to improve heart failure medication adherence is modified by depressive symptoms . DESIGN Secondary analysis of data from a r and omized controlled trial . SETTING University-affiliated ambulatory care practice . PATIENTS Patients 50 years or older with congestive heart failure r and omly assigned to usual care ( n = 192 ) or intervention ( n = 122 ) . INTERVENTION Pharmacist-provided intervention to improve heart failure medication adherence . MAIN OUTCOME MEASURES Medication adherence was measured via patient self-report and using electronic prescription lids ; depressive symptoms were measured using the Geriatric Depression Scale . General linear models examined the main effect of depressive symptoms on medication adherence and whether depressive symptoms modified the effectiveness of the intervention . RESULTS At baseline , 37 % ( n = 117 ) of participants screened positive for depression . In the usual care group , mean adjusted self-reported adherence was 75 % for depressed participants and 81 % for nondepressed participants ( P = 0.04 ) ; mean adjusted adherence measured electronically was 71 % for depressed participants and 69 % for nondepressed participants ( P = 0.65 ) . INTERVENTION effectiveness did not differ for depressed compared with nondepressed participants . CONCLUSION The effectiveness of a pharmacy-based intervention to improve adherence does not appear to be influenced by depression . However , the method used to measure adherence ( electronically measured versus self-reported ) influences the interpretation of the relationship between depression and heart failure medication adherence Background : Self-care is an integral component of successful heart failure ( HF ) management . Engaging patients in self-care can be challenging . Methods : Fifteen patients with HF enrolled during hospitalization received a motivational intervention design ed to improve HF self-care . A mixed method , pretest posttest design was used to evaluate the proportion of patients in whom the intervention was beneficial and the mechanism of effectiveness . Participants received , on average , 3.0 ± 1.5 home visits ( median 3 , mode 3 , range 1 - 6 ) over 
    Output:
    
Psychological factors ( depression , self-efficacy , and mental well-being ) were associated with specific self-care facets in patients with chronic HF .
These associations were predominantly observed with self-reported indices of self-care and not objective indices .