Level: doctoral ❌
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Northeastern University
1.
David, Daniel.
Cognitive impairment and heart failure: identifying factors that diminish self-care.
Degree: PhD, School of Nursing, 2016, Northeastern University
URL: http://hdl.handle.net/2047/D20237537 
► The purpose of this research was to examine clinical, behavioral, and cognitive factors associated with the ability of heart failure (HF) patients to perform self-care…
(more)
▼ The purpose of this research was to examine clinical, behavioral, and cognitive factors associated with the ability of heart failure (HF) patients to perform self-care behavior and avoid rehospitalization. This dissertation includes three studies.; The first study consisted of a medical records review of 185 patients admitted to the cardiology service who received care from either nurse practitioner or physician provider. Individuals receiving care from a nurse practitioner were nearly three times less likely to be rehospitalized within 30 days as compared to those seen by a physician (OR, 2.905, p < 0.01).; The second study investigated provider differences in the discharge instructions given to HF patients. A content analysis of fifty (n=50) discharge instructions revealed differences between those provided by nurse practitioners and physicians. The content of the instructions given to discharged HF patients differed depending upon the type of healthcare provider. Nurse practitioners were more likely to schedule follow up appointments and placed a greater emphasis on symptom identification. These approaches may decrease HF rehospitalization.; The third study examined behavioral and cognitive factors associated with heart failure (HF) self-care behaviors. One hundred and fifty one (n=151) participants enrolled in the study. Using a brief cognitive exam, medical records review and patient questionnaires, the following variables were measured: HF self-care maintenance, HF self-care management, HF self-care confidence, cognition, HF knowledge, illness beliefs, health beliefs, social support, demographic factors, hospitalization and past medical history. The findings revealed that mild cognitive impairment (CI) was prevalent, as 30% of the sample had undiagnosed mild CI. Cognitive impairment was associated with decreased HF confidence and knowledge. Patient activation, illness perception, HF knowledge, social support, hospitalization history explained 31.9%, 29.2% and 32.4% of the variance in HF self-care maintenance, management, and confidence, respectively. Furthermore, the interaction of CI and hospitalization history had a significant effect on self-care management.
Subjects/Keywords: cognitive impairment; heart failure; hospitalization; nurse practitioner; rehospitalization; self-care
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APA (6th Edition):
David, D. (2016). Cognitive impairment and heart failure: identifying factors that diminish self-care. (Doctoral Dissertation). Northeastern University. Retrieved from http://hdl.handle.net/2047/D20237537
Chicago Manual of Style (16th Edition):
David, Daniel. “Cognitive impairment and heart failure: identifying factors that diminish self-care.” 2016. Doctoral Dissertation, Northeastern University. Accessed December 14, 2019.
http://hdl.handle.net/2047/D20237537.
MLA Handbook (7th Edition):
David, Daniel. “Cognitive impairment and heart failure: identifying factors that diminish self-care.” 2016. Web. 14 Dec 2019.
Vancouver:
David D. Cognitive impairment and heart failure: identifying factors that diminish self-care. [Internet] [Doctoral dissertation]. Northeastern University; 2016. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/2047/D20237537.
Council of Science Editors:
David D. Cognitive impairment and heart failure: identifying factors that diminish self-care. [Doctoral Dissertation]. Northeastern University; 2016. Available from: http://hdl.handle.net/2047/D20237537
2.
Farrell, Carole Denise.
An exploration of oncology specialist nurses’ roles in
nurse-led chemotherapy clinics.
Degree: 2014, University of Manchester
URL: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:224894
► The purpose of this study was to investigate nurses’ roles within nurse-led chemotherapy clinics. There has been a rapid expansion and development of nursing roles…
(more)
▼ The purpose of this study was to investigate
nurses’ roles within
nurse-
led chemotherapy
clinics. There has been
a rapid expansion and development of nursing roles and
responsibilities in oncology, but little understanding of how roles
are enacted and their impact on patient experiences and outcomes.
This was a two stage approach comprising a survey of UK oncology
specialist nurses followed by an ethnographic study of nurses’
roles in
nurse led chemotherapy
clinics. Ethics approval was
obtained prior to each study; research and development approval was
obtained from each hospital site prior to Study 2. Study 1 used a
questionnaire survey to explore the scope of nurses’ roles. A
purposive sample of oncology specialist nurses perceived to be
undertaking
nurse-
led clinics was obtained using snowball methods.
Data analysis included descriptive and inferential statistics.
Study 2 used ethnographic methods to explore nurses’ roles in
nurse-
led chemotherapy
clinics, which included clinical
observations, interviews with
nurse participants and studying
documentation (protocols0 for
nurse-
led chemotherapy
clinics.
Findings were coded and thematic analysis undertaken. In study 1,
103 completed questionnaires were received with a response rate of
64%, however analysis identified 79 (76.7%) nurses undertaking
nurse-
led clinics, therefore statistical analysis was limited to
this sample of 79 nurses. An additional 12 (11.7%) nurses wanted to
undertake
nurse-
led clinics, therefore findings from this group
were analysed separately. There was little congruence between
nurses’ titles and clinical roles, with significant differences in
practice between different groups of nurses, in relation to
history-taking (p=.036), assessing response to treatment (p=.033).
Although there was no difference in the number of nurses
undertaking clinical examinations (p=.065), there were differences
in the nature of examinations undertaken, including respiratory (p=
.002). There were also significant differences between groups of
nurses in relation to
nurse prescribing (p<.0001). Study 2
included observations (61 consultations by 13 nurses) and
interviews (n=11). There was variability in patient numbers within
nurse-
led clinics, identifying implications for service delivery
and sustainability. Disparities in nurses’ roles and
responsibilities revealed four different levels of
nurse-
led
chemotherapy
clinics, from chemotherapy administration to totally
nurse-
led clinics. The identification of four levels of
nurse-
led
chemotherapy is a new finding, and suggests a framework for
nurse-
led chemotherapy
clinics that could link with
nurse
competencies and training. Five main themes were identified in
study 2; a central theme of autonomy linked with themes of
knowledge, skills, power and beliefs. A key finding was the reduced
emphasis on compassionate care with greater medical (clinical)
responsibilities within nurses’ roles, and poor communication
skills by some nurses. Despite a great diversity in oncology
specialist nurses’ roles, the lack of clarity in roles…
Advisors/Committee Members: WALSHE, CATHERINE CE, Walshe, Catherine, Molassiotis, Alexander.
Subjects/Keywords: Nurse-led; Chemotherapy
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APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Farrell, C. D. (2014). An exploration of oncology specialist nurses’ roles in
nurse-led chemotherapy clinics. (Doctoral Dissertation). University of Manchester. Retrieved from http://www.manchester.ac.uk/escholar/uk-ac-man-scw:224894
Chicago Manual of Style (16th Edition):
Farrell, Carole Denise. “An exploration of oncology specialist nurses’ roles in
nurse-led chemotherapy clinics.” 2014. Doctoral Dissertation, University of Manchester. Accessed December 14, 2019.
http://www.manchester.ac.uk/escholar/uk-ac-man-scw:224894.
MLA Handbook (7th Edition):
Farrell, Carole Denise. “An exploration of oncology specialist nurses’ roles in
nurse-led chemotherapy clinics.” 2014. Web. 14 Dec 2019.
Vancouver:
Farrell CD. An exploration of oncology specialist nurses’ roles in
nurse-led chemotherapy clinics. [Internet] [Doctoral dissertation]. University of Manchester; 2014. [cited 2019 Dec 14].
Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:224894.
Council of Science Editors:
Farrell CD. An exploration of oncology specialist nurses’ roles in
nurse-led chemotherapy clinics. [Doctoral Dissertation]. University of Manchester; 2014. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:224894
University of Lund
3.
Bala, Sidona-Valentina.
Person-centered care in nurse-led outpatient rheumatology
clinics. From experience to measurement.
Degree: 2017, University of Lund
URL: http://lup.lub.lu.se/record/31dc68ec-2183-4b79-ae78-fdd146490e25
;
https://portal.research.lu.se/ws/files/29318446/Person_centered_care_in_nurse_led_outpatient_rheumatology_clinics_From_experience_to_measurement.pdf
► AbstractAim: To describe and understand patients’ experiences as a means to conceptualize and evaluate outpatient person-centered care (PCC) in nurse-led rheumatoid arthritis (RA) clinics.Methods: Persons…
(more)
▼ AbstractAim: To describe and understand patients’
experiences as a means to conceptualize and evaluate outpatient
person-centered care (PCC) in nurse-led rheumatoid arthritis (RA)
clinics.Methods: Persons with RA were interviewed about how they
experienced their nurse-led outpatient care and about the meaning
of living with persistent RA. Interviews were analyzed by
qualitative content analysis and hermeneuticphenomenology. Based on
these results, existing PCC frameworks and hypothetical logical
reasoning, a conceptual framework for nurse-led outpatient PCC was
developed and used to operationalize a PCC instrument for
outpatientcare in rheumatology (PCCoc/rheum). Acceptability and
content validity of the PCCoc/rheum were evaluated, and its
measurement properties were tested according to Rasch measurement
theory (RMT).Results: The experience of nurse-led outpatient care
was expressed as social environment, professional approach and
value-adding measures, all relating to the degree of PCC. Living
with persistent RA was revealed as an existence dominated by
painful symptoms and treatment, radical changes and limitations in
life, a continual struggle to cope with life and to master the
illness, and a dependency on those who are close by and the world
around. Results also pointed to the need for a stronger PCC
approach. An outpatient framework was conceptualized with five
related domains, and was used to develop the PCCoc/rheum, which
showed good acceptability and contentvalidity. RMT supported the
accordance between the PCCoc/rheum and the conceptual framework,
and its measurement properties were generally
supported.Conclusions: Experiences of persons with RA support a
central role for PCC. The conceptual framework and the PCCoc/rheum
have potentials to improve implementation and evaluation of
outpatient PCC and contribute to qualityof care from a PCC
perspective in nurse-led rheumatoid arthritis
clinics.
Subjects/Keywords: Medical and Health Sciences; lived experience; measurement instrument; nurse-led rheumatology clinics; outpatient framework; person-centered care; rheumatoid arthritis; patient perspective; personcentrerad vård; mätinstrument; reumatologisk öppenvård; sjuksköterskemottagning
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APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Bala, S. (2017). Person-centered care in nurse-led outpatient rheumatology
clinics. From experience to measurement. (Doctoral Dissertation). University of Lund. Retrieved from http://lup.lub.lu.se/record/31dc68ec-2183-4b79-ae78-fdd146490e25 ; https://portal.research.lu.se/ws/files/29318446/Person_centered_care_in_nurse_led_outpatient_rheumatology_clinics_From_experience_to_measurement.pdf
Chicago Manual of Style (16th Edition):
Bala, Sidona-Valentina. “Person-centered care in nurse-led outpatient rheumatology
clinics. From experience to measurement.” 2017. Doctoral Dissertation, University of Lund. Accessed December 14, 2019.
http://lup.lub.lu.se/record/31dc68ec-2183-4b79-ae78-fdd146490e25 ; https://portal.research.lu.se/ws/files/29318446/Person_centered_care_in_nurse_led_outpatient_rheumatology_clinics_From_experience_to_measurement.pdf.
MLA Handbook (7th Edition):
Bala, Sidona-Valentina. “Person-centered care in nurse-led outpatient rheumatology
clinics. From experience to measurement.” 2017. Web. 14 Dec 2019.
Vancouver:
Bala S. Person-centered care in nurse-led outpatient rheumatology
clinics. From experience to measurement. [Internet] [Doctoral dissertation]. University of Lund; 2017. [cited 2019 Dec 14].
Available from: http://lup.lub.lu.se/record/31dc68ec-2183-4b79-ae78-fdd146490e25 ; https://portal.research.lu.se/ws/files/29318446/Person_centered_care_in_nurse_led_outpatient_rheumatology_clinics_From_experience_to_measurement.pdf.
Council of Science Editors:
Bala S. Person-centered care in nurse-led outpatient rheumatology
clinics. From experience to measurement. [Doctoral Dissertation]. University of Lund; 2017. Available from: http://lup.lub.lu.se/record/31dc68ec-2183-4b79-ae78-fdd146490e25 ; https://portal.research.lu.se/ws/files/29318446/Person_centered_care_in_nurse_led_outpatient_rheumatology_clinics_From_experience_to_measurement.pdf
4.
De Jesus, Millicent Guiaya.
Technology versus Touch: Targeting Heart Failure Self-Care in Older Adults.
Degree: PhD, Nursing, 2017, University of San Diego
URL: https://digital.sandiego.edu/dissertations/75
► Heart failure (HF) affects over 5.1 million people in the United States resulting in poor clinical outcomes, early mortality, and increased readmission rates despite…
(more)
▼ Heart failure (HF) affects over 5.1 million people in the United States resulting in poor clinical outcomes, early mortality, and increased readmission rates despite advances in technology and treatment modalities. Healthcare costs are projected to rise from 31 billion in 2012 to 70 billion by 2030. Telemonitoring (“technology”) allows self-monitoring of daily weight, blood pressure, and clinical symptoms. Remote access to patient data facilitates communication and timely follow-up between healthcare teams and patients. However, older adults with HF often lack appropriate training and support when introduced to new technology and may not recognize or interpret early HF-related symptoms due to poor self-care behavior or lack of skill-building. Nurse coaching (“touch”) reinforces HF education and promotes self-care behavior. Telemonitoring and nurse coaching combined demonstrate potential benefits; however, both care transition approaches are costly with mixed results. No studies have explored dose effects of technology and touch on self-care, self-care confidence, and clinical outcomes.
The purpose of this study was to examine relationships among selected patient characteristics, dose intervention of technology and touch, self-care, self-care confidence, and 30-day outcomes in older adults with HF. A descriptive correlation design using secondary analysis of data collected for the Better Effectiveness After Transition – Heart Failure Randomized Clinical Trial was used. Measures included sociodemographic and clinical characteristics, Self-Care of Heart Failure Index scores, dose intervention of technology and touch, and 30-day readmission rates. Descriptive findings are presented. Statistical analyses included chi square, t-tests, and analysis of variance. Four dose intervention subgroups were identified: Low Tech Low Touch (LTLT), Low Tech High Touch (LTHT), High Tech Low Touch (HTLT), and High Tech High Touch (HTHT). Dose intervention was significantly associated (p < .05) with race/ethnicity, education level, employment status, household income, and New York Heart Association status. The LTHT subgroup demonstrated the most improvement in self-care maintenance scores (p < .05) compared to the HTLT and HTHT subgroups. Implications for nursing practice, education, research, and health policy are discussed. Understanding the balance of nursing intervention and telemonitoring is key to maximizing the effectiveness of technology and improving self-care behavior and patient outcomes.
Subjects/Keywords: Dose intervention; Heart failure; Nurse coaching; Self-care; Self-care management; Telemonitoring; Cardiology; Geriatric Nursing
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APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
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Manager
APA (6th Edition):
De Jesus, M. G. (2017). Technology versus Touch: Targeting Heart Failure Self-Care in Older Adults. (Doctoral Dissertation). University of San Diego. Retrieved from https://digital.sandiego.edu/dissertations/75
Chicago Manual of Style (16th Edition):
De Jesus, Millicent Guiaya. “Technology versus Touch: Targeting Heart Failure Self-Care in Older Adults.” 2017. Doctoral Dissertation, University of San Diego. Accessed December 14, 2019.
https://digital.sandiego.edu/dissertations/75.
MLA Handbook (7th Edition):
De Jesus, Millicent Guiaya. “Technology versus Touch: Targeting Heart Failure Self-Care in Older Adults.” 2017. Web. 14 Dec 2019.
Vancouver:
De Jesus MG. Technology versus Touch: Targeting Heart Failure Self-Care in Older Adults. [Internet] [Doctoral dissertation]. University of San Diego; 2017. [cited 2019 Dec 14].
Available from: https://digital.sandiego.edu/dissertations/75.
Council of Science Editors:
De Jesus MG. Technology versus Touch: Targeting Heart Failure Self-Care in Older Adults. [Doctoral Dissertation]. University of San Diego; 2017. Available from: https://digital.sandiego.edu/dissertations/75
Universiteit Utrecht
5.
Bruggink-André de la Porte, P.W.F.
Effects of heart failure management programmes.
Degree: 2009, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/31842
► Abstract of the thesis “Effects of heart failure management programmes” The main purpose of the studies presented in this thesis, was to assess whether an…
(more)
▼ Abstract of the thesis “Effects of
heart failure management programmes” The main purpose of the studies presented in this thesis, was to assess whether an intensive 1-year intervention at a
heart failure clinic for patients with
heart failure, NYHA classification III or IV, reduces the incidence of hospitalisation for worsening
heart failure and/or all cause mortality and improves functional status and quality of life at acceptable costs and whether the observed effects may be (partly) attributable to beneficial changes in patient adherence to drug therapy. Important differences with many previous studies were that our
heart failure clinic was directed by a combination of a clinician and a
heart failure nurse and that the study was performed in a country with a relatively strong primary care health-care system. In a systematic review in the beginning of the thesis, the results of previous studies on
heart failure management programmes are reviewed critically and their applicability to countries, such as the Netherlands, with well-structured primary care facilities is discussed. In the core chapters of the thesis the main results of the Deventer-Alkmaar
Heart Failure study (DEAL-HF study) are presented first: the number of admissions for worsening
heart failure and/or all-cause deaths in the intervention group was lower than in the control group (23 vs. 47; relative risk(RR) 0.49; 95% confidence interval 0.30 to 0.81; p= 0.001). There also was an improvement of the left ventricular ejection fraction (LVEF) in the intervention group (plus 2.6%) compared with a decrease in the usual care group (minus 3.1%; p=0.004). Patients in the intervention group were hospitalised for a total of 359 days, compared with 644 days for those in the usual care group. Beneficial effects were also observed on NYHA functional class, quality of life, self-care behaviour and health care costs. Then, several sub-studies within the DEAL-HF population are presented. First, we assessed the effect of the
heart failure management programme on adherence of prescribers and patients to the medication regimes: beta-blocker dosaging and the number of patients using spironolactone increased. This may have been an important contributor to the observed improved clinical outcomes. Then we investigated the correlation between the change in a biochemical parameter, NT-proBNP, and the change in quality of life and functional class during the follow-up of the main study. Long-term changes in NT-proBNP were indeed accompanied by similar changes in quality of life, functional status and echo parameters. Finally we studied the costs of the
heart failure management programme in relation to the observed effects. This more detailed analysis of the costs and effects of the
heart failure management programme studied in the DEAL HF study confirms that such a programme exerts beneficial clinical benefit and saves costs.
Advisors/Committee Members: Hoes, A.W., Veldhuisen, D.J. van.
Subjects/Keywords: Geneeskunde; Congestive heart failure; heart failure management programmes; review; combined physician-and-nurse-directed heart failure clinic; patient education; hospitalisation for worsening heart failure; adherence; longterm changes in NT-proBNP; cost-effectiveness
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APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Bruggink-André de la Porte, P. W. F. (2009). Effects of heart failure management programmes. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/31842
Chicago Manual of Style (16th Edition):
Bruggink-André de la Porte, P W F. “Effects of heart failure management programmes.” 2009. Doctoral Dissertation, Universiteit Utrecht. Accessed December 14, 2019.
http://dspace.library.uu.nl:8080/handle/1874/31842.
MLA Handbook (7th Edition):
Bruggink-André de la Porte, P W F. “Effects of heart failure management programmes.” 2009. Web. 14 Dec 2019.
Vancouver:
Bruggink-André de la Porte PWF. Effects of heart failure management programmes. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2009. [cited 2019 Dec 14].
Available from: http://dspace.library.uu.nl:8080/handle/1874/31842.
Council of Science Editors:
Bruggink-André de la Porte PWF. Effects of heart failure management programmes. [Doctoral Dissertation]. Universiteit Utrecht; 2009. Available from: http://dspace.library.uu.nl:8080/handle/1874/31842
University of Manchester
6.
Farrell, Carole Denise.
An exploration of oncology specialist nurses' roles in nurse-led chemotherapy clinics.
Degree: PhD, 2014, University of Manchester
URL: https://www.research.manchester.ac.uk/portal/en/theses/an-exploration-of-oncology-specialist-nurses-roles-in-nurseled-chemotherapy-clinics(9e4907a5-92ac-4719-90f9-12dba4942b0e).html
;
http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.617985
► The purpose of this study was to investigate nurses’ roles within nurse-led chemotherapy clinics. There has been a rapid expansion and development of nursing roles…
(more)
▼ The purpose of this study was to investigate nurses’ roles within nurse-led chemotherapy clinics. There has been a rapid expansion and development of nursing roles and responsibilities in oncology, but little understanding of how roles are enacted and their impact on patient experiences and outcomes. This was a two stage approach comprising a survey of UK oncology specialist nurses followed by an ethnographic study of nurses’ roles in nurse led chemotherapy clinics. Ethics approval was obtained prior to each study; research and development approval was obtained from each hospital site prior to Study 2. Study 1 used a questionnaire survey to explore the scope of nurses’ roles. A purposive sample of oncology specialist nurses perceived to be undertaking nurse-led clinics was obtained using snowball methods. Data analysis included descriptive and inferential statistics. Study 2 used ethnographic methods to explore nurses’ roles in nurse-led chemotherapy clinics, which included clinical observations, interviews with nurse participants and studying documentation (protocols) for nurse-led chemotherapy clinics. Findings were coded and thematic analysis undertaken. In study 1, 103 completed questionnaires were received with a response rate of 64%, however analysis identified 79 (76.7%) nurses undertaking nurse-led clinics, therefore statistical analysis was limited to this sample of 79 nurses. An additional 12 (11.7%) nurses wanted to undertake nurse-led clinics, therefore findings from this group were analysed separately. There was little congruence between nurses’ titles and clinical roles, with significant differences in practice between different groups of nurses, in relation to history-taking (p=.036), assessing response to treatment (p=.033). Although there was no difference in the number of nurses undertaking clinical examinations (p=.065), there were differences in the nature of examinations undertaken, including respiratory (p= .002). There were also significant differences between groups of nurses in relation to nurse prescribing (p<.0001). Study 2 included observations (61 consultations by 13 nurses) and interviews (n=11). There was variability in patient numbers within nurse-led clinics, identifying implications for service delivery and sustainability. Disparities in nurses’ roles and responsibilities revealed four different levels of nurse-led chemotherapy clinics, from chemotherapy administration to totally nurse-led clinics. The identification of four levels of nurse-led chemotherapy is a new finding, and suggests a framework for nurse-led chemotherapy clinics that could link with nurse competencies and training. Five main themes were identified in study 2; a central theme of autonomy linked with themes of knowledge, skills, power and beliefs. A key finding was the reduced emphasis on compassionate care with greater medical (clinical) responsibilities within nurses’ roles, and poor communication skills by some nurses. Despite a great diversity in oncology specialist nurses’ roles, the lack of clarity in roles…
Subjects/Keywords: 610.73; Nurse-led; Chemotherapy
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Record Details
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APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Farrell, C. D. (2014). An exploration of oncology specialist nurses' roles in nurse-led chemotherapy clinics. (Doctoral Dissertation). University of Manchester. Retrieved from https://www.research.manchester.ac.uk/portal/en/theses/an-exploration-of-oncology-specialist-nurses-roles-in-nurseled-chemotherapy-clinics(9e4907a5-92ac-4719-90f9-12dba4942b0e).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.617985
Chicago Manual of Style (16th Edition):
Farrell, Carole Denise. “An exploration of oncology specialist nurses' roles in nurse-led chemotherapy clinics.” 2014. Doctoral Dissertation, University of Manchester. Accessed December 14, 2019.
https://www.research.manchester.ac.uk/portal/en/theses/an-exploration-of-oncology-specialist-nurses-roles-in-nurseled-chemotherapy-clinics(9e4907a5-92ac-4719-90f9-12dba4942b0e).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.617985.
MLA Handbook (7th Edition):
Farrell, Carole Denise. “An exploration of oncology specialist nurses' roles in nurse-led chemotherapy clinics.” 2014. Web. 14 Dec 2019.
Vancouver:
Farrell CD. An exploration of oncology specialist nurses' roles in nurse-led chemotherapy clinics. [Internet] [Doctoral dissertation]. University of Manchester; 2014. [cited 2019 Dec 14].
Available from: https://www.research.manchester.ac.uk/portal/en/theses/an-exploration-of-oncology-specialist-nurses-roles-in-nurseled-chemotherapy-clinics(9e4907a5-92ac-4719-90f9-12dba4942b0e).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.617985.
Council of Science Editors:
Farrell CD. An exploration of oncology specialist nurses' roles in nurse-led chemotherapy clinics. [Doctoral Dissertation]. University of Manchester; 2014. Available from: https://www.research.manchester.ac.uk/portal/en/theses/an-exploration-of-oncology-specialist-nurses-roles-in-nurseled-chemotherapy-clinics(9e4907a5-92ac-4719-90f9-12dba4942b0e).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.617985
University of New South Wales
7.
Jabbour, Andrew.
Recombinant Human Neuregulin-1 in Myocardial Ischaemia-Reperfusion Injury and Chronic Heart Failure.
Degree: Clinical School - St Vincent's Hospital, 2010, University of New South Wales
URL: http://handle.unsw.edu.au/1959.4/45525
;
https://unsworks.unsw.edu.au/fapi/datastream/unsworks:8820/SOURCE02?view=true
► Neuregulin-1, a ligand of the ErbB family of receptor tyrosine kinases is produced by endocardial and myocardial microvascular endothelial cells and acts in a paracrine…
(more)
▼ Neuregulin-1, a ligand of the ErbB family of receptor tyrosine kinases is produced by endocardial and myocardial microvascular endothelial cells and acts in a paracrine fashion on adjacent cardiac myocytes. Neuregulin-1-ErbB signalling critically regulates cardiac development and the adaptation of the
heart to injury; inhibiting apoptosis, inducing cardiomyocyte proliferation and improving cardiac function and survival in animal models of cardiomyopathy.Neuregulin-1-ErbB signalling also involves pathways involved in protecting against ischaemia-reperfusion injury.This thesis reports the first human studies exploring the acute and chronic haemodynamic responses to a series of recombinant human Neuregulin-1 (rhNeuregulin-1) infusions in patients with stable chronic
heart failure and also reports a series of studies aimed at enhancing cardiac preservation in
heart transplantation by rhNeuregulin-1 supplementation of a cardiac storage solution.During a 6-hour rhNeuregulin-1 infusion cardiac output increased by 30% (p<0.01), pulmonary artery wedge pressure and systemic vascular resistance decreased 30% and 20% respectively at two hours (p<0.01). A 47% reduction in serum noradrenaline, a 55% reduction in serum aldosterone and a 3.6-fold increase in N-terminal fragment of B-type natriuretic peptide levels were concurrently observed (p<0.001). These acute haemodynamic effects were sustained, as demonstrated by a 12% increase in left ventricular ejection fraction from 32.2±2.0% (baseline) to 36.1±2.3% (mean±1SE, p<0.001) at 84 days. The therapy was well tolerated.In a rodent model of global ischaemia-reperfusion injury, rhNeuregulin-1 supplemented Celsior storage solution improved functional recovery of hearts after 6 hours of hypothermic storage, an effect abrogated by the phosphatidylinositol-3-kinase inhibitor, wortmannin. When storage times were extended out to 10 hours, rhNeuregulin-1 further enhanced cardiac preservation when used in combination with other activators of pro-survival pathways (p<0.01). Functional improvements were accompanied by increased phosphorylation of Akt, extracellular signal-regulated protein kinases 1/2, signal transducer and activator of transcription 3 and glycogen synthase kinase 3β (Western blotting) and a reduction in the cleaved form of caspase-3 (immunohistochemical staining).rhNeuregulin-1produces favourable acute and chronic haemodynamic effects in patients with stable chronic
heart failure on optimal medical therapy and improves preservation of the rat
heart after prolonged hypothermic storage. It shows promise as a novel therapy in
heart failure and transplantation.
Advisors/Committee Members: Macdonald, Peter, Clinical School - St Vincent's Hospital, Faculty of Medicine, UNSW, Hayward, Christopher, Clinical School - St Vincent's Hospital, Faculty of Medicine, UNSW.
Subjects/Keywords: Heart Transplantation; Neuregulin; Heart Failure
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APA (6th Edition):
Jabbour, A. (2010). Recombinant Human Neuregulin-1 in Myocardial Ischaemia-Reperfusion Injury and Chronic Heart Failure. (Doctoral Dissertation). University of New South Wales. Retrieved from http://handle.unsw.edu.au/1959.4/45525 ; https://unsworks.unsw.edu.au/fapi/datastream/unsworks:8820/SOURCE02?view=true
Chicago Manual of Style (16th Edition):
Jabbour, Andrew. “Recombinant Human Neuregulin-1 in Myocardial Ischaemia-Reperfusion Injury and Chronic Heart Failure.” 2010. Doctoral Dissertation, University of New South Wales. Accessed December 14, 2019.
http://handle.unsw.edu.au/1959.4/45525 ; https://unsworks.unsw.edu.au/fapi/datastream/unsworks:8820/SOURCE02?view=true.
MLA Handbook (7th Edition):
Jabbour, Andrew. “Recombinant Human Neuregulin-1 in Myocardial Ischaemia-Reperfusion Injury and Chronic Heart Failure.” 2010. Web. 14 Dec 2019.
Vancouver:
Jabbour A. Recombinant Human Neuregulin-1 in Myocardial Ischaemia-Reperfusion Injury and Chronic Heart Failure. [Internet] [Doctoral dissertation]. University of New South Wales; 2010. [cited 2019 Dec 14].
Available from: http://handle.unsw.edu.au/1959.4/45525 ; https://unsworks.unsw.edu.au/fapi/datastream/unsworks:8820/SOURCE02?view=true.
Council of Science Editors:
Jabbour A. Recombinant Human Neuregulin-1 in Myocardial Ischaemia-Reperfusion Injury and Chronic Heart Failure. [Doctoral Dissertation]. University of New South Wales; 2010. Available from: http://handle.unsw.edu.au/1959.4/45525 ; https://unsworks.unsw.edu.au/fapi/datastream/unsworks:8820/SOURCE02?view=true
University of Louisville
8.
Lewis, Robert K., 1977-.
Inflammatory cell tumor necrosis factor signaling modulates post-infarction left ventricular remodeling.
Degree: PhD, 2010, University of Louisville
URL: 10.18297/etd/820
;
https://ir.library.louisville.edu/etd/820
► The fundamental question of the exact nature of the role played by TNF in the failing myocardium remains one of contention. Many preclinical studies have…
(more)
▼ The fundamental question of the exact nature of the role played by TNF in the failing myocardium remains one of contention. Many preclinical studies have demonstrated beneficial effects with TNF antagonism and recently the dichotomous role played by the two TNF receptors in chronic ischemic injury has come to light. The failing
heart has also been determined to have low levels of inflammatory cell infiltration. As these cells are known to be potent producers of inflammatory cytokines, we hypothesized that inflammatory cell localized TNF receptors play an important role in the progression of LV remodeling following ischemic injury. To isolate the in vivo effects of inflammatory cell TNF receptors, we generated chimeric mice. Wild-type (WT, C57BLl6) mice underwent radiation-induced bone marrow (BM) ablation followed by reconstitution with BM from WT mice (WTc control, n=30), TNFR 1-/- mice (R1-/-c, n = 30) or TNFR2 -/- mice (R2-/-c, n = 30). Six weeks later, WTc, R1-/-c, and R2-/-c mice were subjected to coronary ligation to induce
heart failure (HF) or sham operation. Our results demonstrated that compared to WTc sham, 4 weeks after surgery, WTc HF hearts exhibited significantly (p < O.OS): 1) increased LV size (EDV 96.7 ±. 13.7 vs. 26.6 ± 8.2 IJL) and dysfunction (LVEF 2S.S ± 7.S vs. 69.8 ± 4.S%); 2) greater hypertrophy (LV/tibia length [TL] 3.91 ± 0.S3 vs. 2.9 ± 0.4, -4-fold greater atrial natriuretic factor [ANF] mRNA); 3) increased fibrosis (16.10 ± 8.16% vs. 1.4 ± 0.4%) and connective tissue growth factor (CTGF) mRNA expression, and 4) increased (-2-fold) mRNA levels of TNF, interleukin (IL)-1j3, and IL-6. WTc HF mice also had markedly reduced survival (60% vs. 100%) and increased blood levels of activated F4/80+/CD11 b+ monocytes vs. WTc sham mice. In contrast, compared to WTc HF, R1-1-c HF mice exhibited significantly (p < O.OS): 1) improved survival (80%), 2) less LV dilatation and improved LVEF (42.9 ± 4.2%), 3) less cardiac hypertrophy (LVITL 3.14 ± 0.2) and ANF mRNA expression, 4) less cardiac fibrosis (S.48 ± 2.26%) and CTGF mRNA expression, and S) less cardiac TNF and IL-1j3 mRNA expression. Also, compared to WTc HF, R2-/-c HF mice exhibited significantly (p < O.OS) greater circulating F4/80+/CD11 b+ monocytes (1S.32 ± 4.41 vs. 12.1 ±1.24%), and greater cardiac fibrosis (21.92 ±.10.81%). Also noted was an increase, although not significant, in EDV and ESV. In parallel in vitro studies, the contribution of inflammatory cell TNFR1 and TNFR2 (Le., macrophage-derived) to cardiac contractile dysfunction was investigated. Macrophages isolated from WT mice with HF 4 week postinfarction, when co-cultured with na"lve cardiomyocytes induced contractile dysfunction and myocyte reactive oxygen species (ROS) generation in a juxtacrine but not paracrine maner (p<O.001). Interestingly the effect on contractile dysfunction was diminished with the loss of TNFR1 in the HF macrophages but remained unchanged upon loss of TNFR2. Of note, ROS production in these groups followed a similar pattern in that loss of TNFR1 resulted…
Advisors/Committee Members: Prabhu, Sumanth D..
Subjects/Keywords: TNF; Heart failure
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APA (6th Edition):
Lewis, Robert K., 1. (2010). Inflammatory cell tumor necrosis factor signaling modulates post-infarction left ventricular remodeling. (Doctoral Dissertation). University of Louisville. Retrieved from 10.18297/etd/820 ; https://ir.library.louisville.edu/etd/820
Chicago Manual of Style (16th Edition):
Lewis, Robert K., 1977-. “Inflammatory cell tumor necrosis factor signaling modulates post-infarction left ventricular remodeling.” 2010. Doctoral Dissertation, University of Louisville. Accessed December 14, 2019.
10.18297/etd/820 ; https://ir.library.louisville.edu/etd/820.
MLA Handbook (7th Edition):
Lewis, Robert K., 1977-. “Inflammatory cell tumor necrosis factor signaling modulates post-infarction left ventricular remodeling.” 2010. Web. 14 Dec 2019.
Vancouver:
Lewis, Robert K. 1. Inflammatory cell tumor necrosis factor signaling modulates post-infarction left ventricular remodeling. [Internet] [Doctoral dissertation]. University of Louisville; 2010. [cited 2019 Dec 14].
Available from: 10.18297/etd/820 ; https://ir.library.louisville.edu/etd/820.
Council of Science Editors:
Lewis, Robert K. 1. Inflammatory cell tumor necrosis factor signaling modulates post-infarction left ventricular remodeling. [Doctoral Dissertation]. University of Louisville; 2010. Available from: 10.18297/etd/820 ; https://ir.library.louisville.edu/etd/820
9.
Maggio, Nancy J.
THE EFFECT OF HEART FAILURE EDUCATION ON NURSING STAFFS
KNOWLEDGE AND CONFIDENCE IN A SKILLED NURSING FACILITY.
Degree: Doctor of Nursing Practice, School of Nursing, 2017, Case Western Reserve University Doctor of Nursing Practice
URL: http://rave.ohiolink.edu/etdc/view?acc_num=casednp1492024614598638
► With the high prevalence of heart failure (HF) admissions to skilled nursing facilities (SNF), the need for competent nursing staff knowledgeable in HF education principles…
(more)
▼ With the high prevalence of
heart failure (HF)
admissions to skilled nursing facilities (SNF), the need for
competent nursing staff knowledgeable in HF education principles
reflected in American
Heart Association and American College of
Cardiology Foundation guidelines is warranted. Limited knowledge of
evidence-based guidelines and basic principles of HF management has
the potential to delay early symptom recognition and reporting;
putting patients at risk for exacerbation and hospitalization. A
pre-test, post-test design was used to assess nursing staff’s
knowledge of HF education principles and confidence before and
after an education intervention. Initially, one hundred and
fifty-three registered
nurse, licensed practical
nurse and
certified nursing assistant participants (RN, LPN, and CNA)
completed pre-intervention surveys. Seventy participants completed
the study protocol. Paired sample t-tests on two HF knowledge
surveys showed statistically significant differences in RN mean
test scores (p=0.002 and p=0.001) after completing the educational
intervention. Statistically significant differences were also noted
in CNA scores after completing the educational intervention
(p=0.010 and p<0.0005). No statistically significant differences
were noted in LPN mean test scores (p= 0.295 and p=0.0630) after
completing the educational intervention. Paired-sample t-tests also
evaluated the effect of education on RN, LPN and CNA confidence
scores. Confidence to care for HF patients increased significantly
for all nursing staff after the education (RN, p= 0.001; LPN and
CNA, p< 0.0005). Findings of this scholarly project indicate an
evidence-based education intervention can increase nursing staff’s
knowledge and confidence to monitor and manage HF patients in
skilled nursing facilities.
Advisors/Committee Members: Lindell, Deborah (Committee Chair).
Subjects/Keywords: Nursing; Education; heart failure; nurse knowledge; education; evidence based practice; best practice guidelines; skilled nursing facilities; nursing homes; long-term care
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APA (6th Edition):
Maggio, N. J. (2017). THE EFFECT OF HEART FAILURE EDUCATION ON NURSING STAFFS
KNOWLEDGE AND CONFIDENCE IN A SKILLED NURSING FACILITY. (Doctoral Dissertation). Case Western Reserve University Doctor of Nursing Practice. Retrieved from http://rave.ohiolink.edu/etdc/view?acc_num=casednp1492024614598638
Chicago Manual of Style (16th Edition):
Maggio, Nancy J. “THE EFFECT OF HEART FAILURE EDUCATION ON NURSING STAFFS
KNOWLEDGE AND CONFIDENCE IN A SKILLED NURSING FACILITY.” 2017. Doctoral Dissertation, Case Western Reserve University Doctor of Nursing Practice. Accessed December 14, 2019.
http://rave.ohiolink.edu/etdc/view?acc_num=casednp1492024614598638.
MLA Handbook (7th Edition):
Maggio, Nancy J. “THE EFFECT OF HEART FAILURE EDUCATION ON NURSING STAFFS
KNOWLEDGE AND CONFIDENCE IN A SKILLED NURSING FACILITY.” 2017. Web. 14 Dec 2019.
Vancouver:
Maggio NJ. THE EFFECT OF HEART FAILURE EDUCATION ON NURSING STAFFS
KNOWLEDGE AND CONFIDENCE IN A SKILLED NURSING FACILITY. [Internet] [Doctoral dissertation]. Case Western Reserve University Doctor of Nursing Practice; 2017. [cited 2019 Dec 14].
Available from: http://rave.ohiolink.edu/etdc/view?acc_num=casednp1492024614598638.
Council of Science Editors:
Maggio NJ. THE EFFECT OF HEART FAILURE EDUCATION ON NURSING STAFFS
KNOWLEDGE AND CONFIDENCE IN A SKILLED NURSING FACILITY. [Doctoral Dissertation]. Case Western Reserve University Doctor of Nursing Practice; 2017. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=casednp1492024614598638
University of Arizona
10.
Young, Janay R.
Defining Clinical Events for Heart Failure Patients
.
Degree: 2017, University of Arizona
URL: http://hdl.handle.net/10150/624519
► Heart failure (HF) is a serious, life limiting chronic illness and is the most common cause of <30-day hospital readmission, which is costly both in…
(more)
▼ Heart failure (HF) is a serious, life limiting chronic illness and is the most common cause of <30-day hospital readmission, which is costly both in its profound negative impact on patient mortality and quality of life, and in economics. Limited access to care in rural communities increases the prevalence of hospitalizations for
heart disease in rural areas. The aims of this project using data mined from Arizona Health Sciences Center Clinical Research Data Warehouse, are to define clinical events (fever, pain, changes in respiratory status, change in level of consciousness, changes in output, bleeding, and suicide ideation) for patients with
heart failure, and determine what assessment values are for chronically ill patients and compare to "normal" assessment values for non-chronically ill patients. A literature review was completed to determine how to define clinical events for chronically ill patients with HF, and how decision making is used at home to manage chronic illness. Assessment value data was mined from the clinical research data warehouse and compared to “normal” assessment values, with identification of associations between clinical events and action taken in the hospital. The project results support that there are differences in "normal" assessment values for fever, pain, and change in respiratory status between chronically ill patients with HF, and non-chronically ill patients; there was insufficient data to define bleeding, change in output, or suicide ideation. Impacts to care include earlier recognition of worsening HF symptoms that could result in an earlier call or visit to primary care provider forestalling the need for emergent care and hospital readmission. Application of the mined clinical may inform development of evidenced-based algorithm to guide decision-making at home, and it may also provide the foundation for the development of a tool for patient use to prevent <30-day hospital readmission.
Advisors/Committee Members: Carrington, Jane M (advisor), Carrington, Jane M. (committeemember), Love, Rene (committeemember), Pacheco, Christy L. (committeemember).
Subjects/Keywords: Decreasing Hospital Readmission;
Heart Failure Decision-Making;
Heart Failure Clinical Events;
Heart Failure Self-Management
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APA ·
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MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Young, J. R. (2017). Defining Clinical Events for Heart Failure Patients
. (Doctoral Dissertation). University of Arizona. Retrieved from http://hdl.handle.net/10150/624519
Chicago Manual of Style (16th Edition):
Young, Janay R. “Defining Clinical Events for Heart Failure Patients
.” 2017. Doctoral Dissertation, University of Arizona. Accessed December 14, 2019.
http://hdl.handle.net/10150/624519.
MLA Handbook (7th Edition):
Young, Janay R. “Defining Clinical Events for Heart Failure Patients
.” 2017. Web. 14 Dec 2019.
Vancouver:
Young JR. Defining Clinical Events for Heart Failure Patients
. [Internet] [Doctoral dissertation]. University of Arizona; 2017. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/10150/624519.
Council of Science Editors:
Young JR. Defining Clinical Events for Heart Failure Patients
. [Doctoral Dissertation]. University of Arizona; 2017. Available from: http://hdl.handle.net/10150/624519
University of Aberdeen
11.
Dalzell, Jonathan.
The novel peptide apelin and its putative role in cardiovascular regulation in health and heart failure.
Degree: Thesis (M.D.), 2012, University of Aberdeen
URL: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=192161
;
http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569598
► Heart failure is associated with significant morbidity, mortality and economic cost. Over the past 30 years our understanding of the pathophysiology of heart failure has…
(more)
▼ Heart failure is associated with significant morbidity, mortality and economic cost. Over the past 30 years our understanding of the pathophysiology of heart failure has advanced greatly. However, morbidity and mortality remain high and further improvements in therapy are necessary. Pre-clinical data suggest that the novel peptide apelin, acting through the APJ receptor, has anti-hypertensive, vasodilator, diuretic and inotropic actions and an antagonistic relationship with angiotensin-II. These findings are of obvious interest in heart failure, particularly as plasma and myocardial apelin concentrations are reduced in patients with advanced heart failure. Consequently, it is hypothesised that upregulation of the apelin-APJ system may be of therapeutic value. The aims of this doctoral thesis were therefore to delineate the actions, mechanisms of action and relative efficacy of apelin; compare the arterial vasodilator action of apelin in health and heart failure; and examine the interactions of apelin with other key neurohormones in health and heart failure. This was achieved using wire myography and organ bath techniques in an array of animal and human blood vessels and in a validated rabbit model of post-myocardial infarction heart failure. Apelin is a modest nitric oxide and prostanoid dependent vasodilator at supra-physiological concentrations in small arteries. No such effect was noted in larger arteries or veins. This vasodilator action is abolished in heart failure, whilst response to acetylcholine is preserved suggesting an apelin-APJ specific abnormality in this syndrome. Apelin has an antagonistic relationship with endothelin-1 and synergistic relationship with B-type natriuretic peptide in normal small arteries. Again, these putative cardioprotective properties are lost in heart failure. These data suggest that the putative cardioprotective properties of apelin are lost in heart failure.
Subjects/Keywords: 610; Peptides; Heart failure
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APA ·
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MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Dalzell, J. (2012). The novel peptide apelin and its putative role in cardiovascular regulation in health and heart failure. (Doctoral Dissertation). University of Aberdeen. Retrieved from http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=192161 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569598
Chicago Manual of Style (16th Edition):
Dalzell, Jonathan. “The novel peptide apelin and its putative role in cardiovascular regulation in health and heart failure.” 2012. Doctoral Dissertation, University of Aberdeen. Accessed December 14, 2019.
http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=192161 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569598.
MLA Handbook (7th Edition):
Dalzell, Jonathan. “The novel peptide apelin and its putative role in cardiovascular regulation in health and heart failure.” 2012. Web. 14 Dec 2019.
Vancouver:
Dalzell J. The novel peptide apelin and its putative role in cardiovascular regulation in health and heart failure. [Internet] [Doctoral dissertation]. University of Aberdeen; 2012. [cited 2019 Dec 14].
Available from: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=192161 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569598.
Council of Science Editors:
Dalzell J. The novel peptide apelin and its putative role in cardiovascular regulation in health and heart failure. [Doctoral Dissertation]. University of Aberdeen; 2012. Available from: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=192161 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569598
University of Aberdeen
12.
Beadle, Roger.
Metabolic manipulation in chronic heart failure.
Degree: PhD, 2013, University of Aberdeen
URL: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=201651
;
http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.577622
► Treatments aimed at modifying cardiac substrate utilisation are designed to improve metabolic efficiency. In the fasting state, the heart mainly relies on fatty acid oxidation…
(more)
▼ Treatments aimed at modifying cardiac substrate utilisation are designed to improve metabolic efficiency. In the fasting state, the heart mainly relies on fatty acid oxidation for its energy production. The heart can adapt to metabolise glucose, lactate and amino acids depending on the predominate milieu and demands placed upon it. A shift from fatty acid oxidation to carbohydrate oxidation leads to a lower oxygen consumption per unit of adenosine triphosphate produced. It is this concept of improving cardiac efficiency by a reduction in oxygen demand that underpins the use of metabolic manipulating agents as a therapeutic strategy in heart failure. Cardiac energy starvation is increasingly recognised as playing a central role in the pathophysiology of heart failure. Alterations in substrate utilisation thus underlie the hope that metabolic manipulating agents will be of benefit in heart failure of both ischaemic and non-ischaemic origin. This metabolic shift is achieved by promoting glucose utilisation and reducing the utilisation of fatty acids. This leads to a greater production of adenosine triphosphate per unit of oxygen consumed. With an ongoing demand for treatment options in ischaemic heart disease and the growing burden of chronic heart failure, new treatment modalities beyond contemporary therapy warrant consideration. This thesis aims to investigate the short term effects of metabolic manipulation on changes in cardiac energetic status, cardiac function, efficiency and substrate utilisation.
Subjects/Keywords: 610; Heart failure; Metabolism
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APA ·
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MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Beadle, R. (2013). Metabolic manipulation in chronic heart failure. (Doctoral Dissertation). University of Aberdeen. Retrieved from http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=201651 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.577622
Chicago Manual of Style (16th Edition):
Beadle, Roger. “Metabolic manipulation in chronic heart failure.” 2013. Doctoral Dissertation, University of Aberdeen. Accessed December 14, 2019.
http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=201651 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.577622.
MLA Handbook (7th Edition):
Beadle, Roger. “Metabolic manipulation in chronic heart failure.” 2013. Web. 14 Dec 2019.
Vancouver:
Beadle R. Metabolic manipulation in chronic heart failure. [Internet] [Doctoral dissertation]. University of Aberdeen; 2013. [cited 2019 Dec 14].
Available from: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=201651 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.577622.
Council of Science Editors:
Beadle R. Metabolic manipulation in chronic heart failure. [Doctoral Dissertation]. University of Aberdeen; 2013. Available from: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=201651 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.577622
Oregon State University
13.
Anthony, Katherine (Katherine Philippoff).
Perceived Usefulness of Remote Health Monitoring among Healthcare Providers, Mexican-origin and non-Hispanic White Heart Failure Patients and Informal Caregivers.
Degree: PhD, Public Health, 2016, Oregon State University
URL: http://hdl.handle.net/1957/59977
► Few remote health monitoring (RHM) studies have included Mexican-origin Latinos, and even fewer have explored RHM acceptance and utility, reasons for RHM uptake success or…
(more)
▼ Few remote health monitoring (RHM) studies have included Mexican-origin Latinos, and even fewer have explored RHM acceptance and utility, reasons for RHM uptake success or
failure, or how cultural values influence RHM use among this population. The primary purpose of this study was to determine the remote health monitoring (RHM) needs and goals of health care providers, older adult
heart failure (HF) patients, and their informal caregivers with a focus on Mexican-origin Latino and non-Hispanic white patients and caregivers. Qualitative semi-structured interviews were used to determine the remote health monitoring needs and goals of participants. Content and thematic analysis of interview transcripts revealed that perceptions of RHM were influenced by attitude towards health management and, among caregivers, RHM emerged as a potential partner in care that could ease caregiver concerns. The findings from this study can be used to inform the development of appropriate remote health monitoring systems and interventions for both Mexican-origin and non-Hispanic white
heart failure patients and their caregivers to reduce both
heart failure patient hospital readmissions and caregiver burden.
Advisors/Committee Members: Mendez-Luck, Carolyn (advisor), Geldhof, John (committee member).
Subjects/Keywords: heart failure; Patient monitoring
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APA ·
Chicago ·
MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Anthony, K. (. P. (2016). Perceived Usefulness of Remote Health Monitoring among Healthcare Providers, Mexican-origin and non-Hispanic White Heart Failure Patients and Informal Caregivers. (Doctoral Dissertation). Oregon State University. Retrieved from http://hdl.handle.net/1957/59977
Chicago Manual of Style (16th Edition):
Anthony, Katherine (Katherine Philippoff). “Perceived Usefulness of Remote Health Monitoring among Healthcare Providers, Mexican-origin and non-Hispanic White Heart Failure Patients and Informal Caregivers.” 2016. Doctoral Dissertation, Oregon State University. Accessed December 14, 2019.
http://hdl.handle.net/1957/59977.
MLA Handbook (7th Edition):
Anthony, Katherine (Katherine Philippoff). “Perceived Usefulness of Remote Health Monitoring among Healthcare Providers, Mexican-origin and non-Hispanic White Heart Failure Patients and Informal Caregivers.” 2016. Web. 14 Dec 2019.
Vancouver:
Anthony K(P. Perceived Usefulness of Remote Health Monitoring among Healthcare Providers, Mexican-origin and non-Hispanic White Heart Failure Patients and Informal Caregivers. [Internet] [Doctoral dissertation]. Oregon State University; 2016. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/1957/59977.
Council of Science Editors:
Anthony K(P. Perceived Usefulness of Remote Health Monitoring among Healthcare Providers, Mexican-origin and non-Hispanic White Heart Failure Patients and Informal Caregivers. [Doctoral Dissertation]. Oregon State University; 2016. Available from: http://hdl.handle.net/1957/59977
University of Manchester
14.
Gibbons, Stephen.
Insights into the cardiovascular complications of a novel mouse model of diabetes mellitus : a mechanistic view.
Degree: PhD, 2011, University of Manchester
URL: https://www.research.manchester.ac.uk/portal/en/theses/insights-into-the-cardiovascular-complications-of-a-novel-mouse-model-of-diabetes-mellitus-a-mechanistic-view(d1c68010-8059-4371-a50f-be3614703471).html
;
http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549096
► Heart failure (HF) is one of the commonest complications of Diabetes Mellitus (DM) with the prevalence of DM reported at around 30% in many pivotal…
(more)
▼ Heart failure (HF) is one of the commonest complications of Diabetes Mellitus (DM) with the prevalence of DM reported at around 30% in many pivotal heart failure studies. However the pathophysiological mechanisms that contribute to HF development in diabetes are poorly understood. To investigate this we used a novel human relevant mouse model of DM (GENA348) in which there is a point mutation in the glucokinase (Gck) gene, the glucose sensor which regulates insulin secretion. A mutation in the same gene is known to underlie Maturity Onset Diabetes of the Young Type 2 (MODY 2) in humans. The mutant mice developed significant hyperglycaemia with normal insulin levels due to the altered glucose sensing. We examined the molecular mechanisms that contribute to the HF phenotype in DM. Mean random blood glucose was found to be increased in the GENA348 mutant(HO) mice compared to wild type (WT) litter mates (WT 6.9±0.3mmol/L vs HO20.6±0.8mmol/L, P<0.001). Serial echocardiography was performed, at 3, 6 and 12 months. No significant changes in echocardiographic parameters were observed at 3 months, although by 6 months development of significant cardiachypertrophy in HO mice was observed characterised by a 20% increase in the diastolic posterior wall thickness (dPW). At 12 months of age left ventricular dilatation was also evident. Systolic function was preserved although significant diastolic dysfunction was evident at 6 and 12 months. Histological staining illustrated significant cellular hypertrophy with real time PCR data demonstrating a relative 150% increase in the hypertrophic marker BNP. Hypertrophic pathways were examined through western blot analysis revealing an age dependent increase in Akt phosphorylation (6 months-140%, 12 months-460%). Serum levels of advanced glycation end products (AGEs) and expression of their receptors RAGE were also elevated. In vitro cellular experiments also revealed AGEs directly activate Akt through phosphorylation and increase levels of the receptor RAGE. AGE induced phosphorylation of Akt is inhibited in the presence of wortmannin, suggesting a PI3K dependent signalling mechanism. Wortmannin blocked the development of cardiac hypertrophy in the diabetic mice. In conclusion we demonstrate that the human relevant GENA348 mouse model of diabetes develops a progressive cardiac phenotype including cardiachypertrophy, LV dilatation and diastolic dysfunction similar to the clinical manifestations of diabetic cardiomyopathy. We propose a novel RAGE/PI3K/Akt pathway that for the first time provides insight into the molecular mechanisms that underlie the development of HF. Moreover, we show raised glucose alone is able to cause cardiotoxicity independently of insulin.
Subjects/Keywords: 616.4; diabetes mellitus; heart failure
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APA (6th Edition):
Gibbons, S. (2011). Insights into the cardiovascular complications of a novel mouse model of diabetes mellitus : a mechanistic view. (Doctoral Dissertation). University of Manchester. Retrieved from https://www.research.manchester.ac.uk/portal/en/theses/insights-into-the-cardiovascular-complications-of-a-novel-mouse-model-of-diabetes-mellitus-a-mechanistic-view(d1c68010-8059-4371-a50f-be3614703471).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549096
Chicago Manual of Style (16th Edition):
Gibbons, Stephen. “Insights into the cardiovascular complications of a novel mouse model of diabetes mellitus : a mechanistic view.” 2011. Doctoral Dissertation, University of Manchester. Accessed December 14, 2019.
https://www.research.manchester.ac.uk/portal/en/theses/insights-into-the-cardiovascular-complications-of-a-novel-mouse-model-of-diabetes-mellitus-a-mechanistic-view(d1c68010-8059-4371-a50f-be3614703471).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549096.
MLA Handbook (7th Edition):
Gibbons, Stephen. “Insights into the cardiovascular complications of a novel mouse model of diabetes mellitus : a mechanistic view.” 2011. Web. 14 Dec 2019.
Vancouver:
Gibbons S. Insights into the cardiovascular complications of a novel mouse model of diabetes mellitus : a mechanistic view. [Internet] [Doctoral dissertation]. University of Manchester; 2011. [cited 2019 Dec 14].
Available from: https://www.research.manchester.ac.uk/portal/en/theses/insights-into-the-cardiovascular-complications-of-a-novel-mouse-model-of-diabetes-mellitus-a-mechanistic-view(d1c68010-8059-4371-a50f-be3614703471).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549096.
Council of Science Editors:
Gibbons S. Insights into the cardiovascular complications of a novel mouse model of diabetes mellitus : a mechanistic view. [Doctoral Dissertation]. University of Manchester; 2011. Available from: https://www.research.manchester.ac.uk/portal/en/theses/insights-into-the-cardiovascular-complications-of-a-novel-mouse-model-of-diabetes-mellitus-a-mechanistic-view(d1c68010-8059-4371-a50f-be3614703471).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549096
Louisiana State University
15.
Wang, Yujie.
Lifestyle Factors and Risk of Heart Failure: A Prospective Cohort Study.
Degree: PhD, Human Ecology, 2013, Louisiana State University
URL: etd-07082013-145752
;
https://digitalcommons.lsu.edu/gradschool_dissertations/678
► Heart failure (HF) has become a major health problem with its high prevalence, poor clinical outcomes, and large health-care costs. Compared with medical intervention, the…
(more)
▼ Heart failure (HF) has become a major health problem with its high prevalence, poor clinical outcomes, and large health-care costs. Compared with medical intervention, the prevention of HF through lifestyle approaches is free of side effect. Therefore, the prevention of HF through lifestyle approaches is of special interest. In this project, we aim to investigate 1) the association of different levels of occupational, commuting and leisure-time physical activity with HF risk; 2) the association of coffee consumption with HF risk; 3) the role of lifestyle factors in explaining the risk of HF; and 4) the association between antihypertensive drug treatment and HF risk with the association between engaging in a healthy lifestyle and HF risk. We conducted prospective studies among Finnish men and women who were 25 to 74 years of age and free of HF at baseline. Cox proportional hazards regression models were used to estimate the associations of interest. Partial population attributable risk was calculated to estimate the proportion of new HF cases occurring in this population that hypothetically could have been prevented if all subjects had certain health lifestyle factors. Our study results showed that 1) moderate and high levels of occupational or leisure-time physical activity are associated with a reduced risk of HF in both sexes; A simultaneous engagement in two or three types of physical activity showed a slightly stronger protective effect than participation in only one type of physical activity; 2) coffee consumption does not increase the risk of HF in Finnish men and women; In women, we observed an inverse association between low-to-moderate coffee consumption and the risk of HF; 3) maintaining a body mass index ¡Ü25, consuming vegetable ¡Ý3 times a week, abstaining from smoking and engaging in moderate or high level of physical activity were individually and jointly associated with a decreased risk of HF among both men and women; The relationship between the number of healthy lifestyle factors one engaged in and HF risk was dose-response; and 4) HF risk was lower in hypertensive patients who engaged in a healthy lifestyle but higher in hypertensive people using antihypertensive drug treatment.
Subjects/Keywords: epidemiology; heart failure; lifestyle factors
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APA (6th Edition):
Wang, Y. (2013). Lifestyle Factors and Risk of Heart Failure: A Prospective Cohort Study. (Doctoral Dissertation). Louisiana State University. Retrieved from etd-07082013-145752 ; https://digitalcommons.lsu.edu/gradschool_dissertations/678
Chicago Manual of Style (16th Edition):
Wang, Yujie. “Lifestyle Factors and Risk of Heart Failure: A Prospective Cohort Study.” 2013. Doctoral Dissertation, Louisiana State University. Accessed December 14, 2019.
etd-07082013-145752 ; https://digitalcommons.lsu.edu/gradschool_dissertations/678.
MLA Handbook (7th Edition):
Wang, Yujie. “Lifestyle Factors and Risk of Heart Failure: A Prospective Cohort Study.” 2013. Web. 14 Dec 2019.
Vancouver:
Wang Y. Lifestyle Factors and Risk of Heart Failure: A Prospective Cohort Study. [Internet] [Doctoral dissertation]. Louisiana State University; 2013. [cited 2019 Dec 14].
Available from: etd-07082013-145752 ; https://digitalcommons.lsu.edu/gradschool_dissertations/678.
Council of Science Editors:
Wang Y. Lifestyle Factors and Risk of Heart Failure: A Prospective Cohort Study. [Doctoral Dissertation]. Louisiana State University; 2013. Available from: etd-07082013-145752 ; https://digitalcommons.lsu.edu/gradschool_dissertations/678
University of Manchester
16.
Lawless, Michael.
An integrative assessment of phosphodiesterase 5
inhibition on cardiac function in heart failure.
Degree: 2014, University of Manchester
URL: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:244109
► Heart failure is the leading cause of morbidity and mortality in the world. It is an incurable disease and most treatment strategies aim to treat…
(more)
▼ Heart failure is the leading cause of morbidity and
mortality in the world. It is an incurable disease and most
treatment strategies aim to treat the symptoms or slow the
progression of the condition. Cardiac contractility is governed by
calcium homeostasis within cardiac myocytes and is modulated by the
sympathetic nervous system. Both mechanisms are detrimentally
altered in
heart failure. An important group of enzymes,
phosphodiesterases, are fundamental to the sympathetic
(beta-adrenergic) modulation of calcium cycling in cardiac
myocytes. The selective inhibition of phosphodiesterase 5 (PDE5)
has recently been considered as a potential therapy for
heart
failure; having beneficial effects in human and animal models of
the disease. The present study employs a large animal model of
tachypacing induced
heart failure to test the effect of PDE5
inhibition on myocyte and whole
heart contractility and
beta-adrenergic function, to assess the molecular mechanisms by
which PDE5 inhibition is beneficial to the failing myocardium.In
initial experiments the PDE5 inhibitor sildenafil was applied
acutely to voltage clamped ventricular myocytes from uninstrumented
sheep. PDE5 inhibition reduced baseline L-type calcium current and
systolic calcium transient amplitude, suggesting it is negatively
inotropic. Furthermore, the positive inotropic effects of
beta-adrenergic stimulation were somewhat reversed by acute PDE5
inhibition. Interestingly, such negative inotropic effects of acute
PDE5 inhibition were not observed in failing ventricular myocytes,
which have dysfunctional calcium homeostasis and beta-adrenergic
reserve. When delivered chronically over 3 weeks to tachypaced
animals, PDE5 inhibition restored and augmented the systolic
calcium transient and beta-adrenergic responsiveness at both the
whole
heart and myocyte level. These effects were associated with
changes to the expression and phosphorylation status of the
proteins that control calcium homeostasis in left ventricular
tissue. In vivo, PDE5 inhibition prolonged longevity and reduced
the onset of clinical signs of
heart failure in sheep, as well as
arresting cardiac dilatation and wall thinning. Chronic PDE5
inhibition however had no effect on cardiac contractility or
heart
failure induced changes in cardiac electrophysiology.This study
presents a novel mechanism by which PDE5 inhibition may be
beneficial in a large animal model of
heart failure by restoring
calcium homeostasis and beta-adrenergic responsiveness. This study
may have important implications for the management of
heart failure
in clinical practice.
Advisors/Committee Members: EISNER, DAVID DA, Eisner, David, Trafford, Andrew.
Subjects/Keywords: heart failure; phosphodiesterase 5; calcium
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Manager
APA (6th Edition):
Lawless, M. (2014). An integrative assessment of phosphodiesterase 5
inhibition on cardiac function in heart failure. (Doctoral Dissertation). University of Manchester. Retrieved from http://www.manchester.ac.uk/escholar/uk-ac-man-scw:244109
Chicago Manual of Style (16th Edition):
Lawless, Michael. “An integrative assessment of phosphodiesterase 5
inhibition on cardiac function in heart failure.” 2014. Doctoral Dissertation, University of Manchester. Accessed December 14, 2019.
http://www.manchester.ac.uk/escholar/uk-ac-man-scw:244109.
MLA Handbook (7th Edition):
Lawless, Michael. “An integrative assessment of phosphodiesterase 5
inhibition on cardiac function in heart failure.” 2014. Web. 14 Dec 2019.
Vancouver:
Lawless M. An integrative assessment of phosphodiesterase 5
inhibition on cardiac function in heart failure. [Internet] [Doctoral dissertation]. University of Manchester; 2014. [cited 2019 Dec 14].
Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:244109.
Council of Science Editors:
Lawless M. An integrative assessment of phosphodiesterase 5
inhibition on cardiac function in heart failure. [Doctoral Dissertation]. University of Manchester; 2014. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:244109
University of New Mexico
17.
Overbaugh, Kristen Jayne.
Exploring Personal Growth in Individuals Living with Heart Failure.
Degree: College of Nursing, 2015, University of New Mexico
URL: http://hdl.handle.net/1928/27889
► This exploratory study described levels of personal growth and examined relationships among personal growth, demographic, clinical, and cognitive factors in a convenience sample (N =…
(more)
▼ This exploratory study described levels of personal growth and examined relationships among personal growth, demographic, clinical, and cognitive factors in a convenience sample (N = 103) of community-residing adults with New York
Heart Association (NYHA) functional class II-IV
heart failure (HF). The study was guided by Mishels reconceptualized uncertainty in illness theory and Tedeschi and Calhoun's post-traumatic growth model. The following research questions were addressed: (1) Do adults living with NYHA class II-IV HF report personal growth following their diagnosis of HF? (2) To what extent are age, sex, ethnicity, disease severity, time since diagnosis, symptom status, and uncertainty levels associated with personal growth in individuals with HF? and (3) Which variables (age, sex, ethnicity, disease severity, time since diagnosis, symptom status, or uncertainty levels) make independent contributions to personal growth in individuals living with NYHA class II-IV HF? Participants completed a demographic and clinical survey, the Posttraumatic Growth Inventory (PTGI), the Mishel Uncertainty in Illness Scale-Community Version, and the Memorial Symptom Assessment Scale—
Heart Failure. Participants reported moderate levels of personal growth (M = 48.6, SD = 28.6). There were no significant differences in personal growth by sex, ethnicity, or disease severity. Personal growth had a weak, negative correlation with age (r = —.20, p < .05) and a weak, positive correlation with symptom burden (r = .20, p < .05). Uncertainty was positively correlated with symptom burden (r = .49, p < .01) and disease severity (r = .28, p < .01), but was not significantly correlated with PTGI scores. A hierarchical regression model that included age, sex, ethnicity, NYHA classification, years since diagnosis, uncertainty, and symptom burden did not account for significant variance in PTGI scores. Findings provide foundational knowledge to guide future study of personal growth in HF and add to the overall literature on personal growth in relation to uncertainty and symptoms within chronic illness.
Advisors/Committee Members: Parshall, Mark, Boursaw, Blake, Haozous, Emily A., Decker, Ilene M..
Subjects/Keywords: Personal growth; Heart failure; Uncertainty
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APA (6th Edition):
Overbaugh, K. J. (2015). Exploring Personal Growth in Individuals Living with Heart Failure. (Doctoral Dissertation). University of New Mexico. Retrieved from http://hdl.handle.net/1928/27889
Chicago Manual of Style (16th Edition):
Overbaugh, Kristen Jayne. “Exploring Personal Growth in Individuals Living with Heart Failure.” 2015. Doctoral Dissertation, University of New Mexico. Accessed December 14, 2019.
http://hdl.handle.net/1928/27889.
MLA Handbook (7th Edition):
Overbaugh, Kristen Jayne. “Exploring Personal Growth in Individuals Living with Heart Failure.” 2015. Web. 14 Dec 2019.
Vancouver:
Overbaugh KJ. Exploring Personal Growth in Individuals Living with Heart Failure. [Internet] [Doctoral dissertation]. University of New Mexico; 2015. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/1928/27889.
Council of Science Editors:
Overbaugh KJ. Exploring Personal Growth in Individuals Living with Heart Failure. [Doctoral Dissertation]. University of New Mexico; 2015. Available from: http://hdl.handle.net/1928/27889
University of Minnesota
18.
Heinis, Frazer.
Molecular dissection of compensatory pathways in models of severe heart failure.
Degree: PhD, Biochemistry, Molecular Bio, and Biophysics, 2015, University of Minnesota
URL: http://hdl.handle.net/11299/185607
► Cardiovascular diseases are the leading cause of death in America, and heart failure (HF) is an important and increasingly difficult to manage disease. HF, a…
(more)
▼ Cardiovascular diseases are the leading cause of death in America, and heart failure (HF) is an important and increasingly difficult to manage disease. HF, a clinical syndrome of impaired heart pump function, has poor prognosis, increasing incidence, and no cure. Clinical treatment guidelines focus on the treatment of symptoms rather than acting to directly restore heart pump function, and better therapeutics are necessary to reverse the course of HF pathology. Normal heart pump function is driven by the release and reuptake of Ca2+ ions from the cytoplasm of cardiac myocytes. In healthy cardiac tissue, transient release of Ca2+ occurs rapidly to trigger contraction, and removal is likewise swift in order to allow the heart to relax and refill with blood for the next beat. In failing myocardium, Ca2+ release is weak and reuptake is slow, which leads to inadequate ejection of blood to the body and poor refilling for the next beat. Over time, this results in the progressive loss of cardiac pump function and, subsequently, worsening quality of life. The protein responsible for most diastolic Ca2+ reuptake to the cardiac sarcoplasmic reticulum (SR) compartment is the SR Ca2+ ATPase, SERCA2a. SERCA2a expression and activity are decreased in failing hearts, and experimental therapeutics are currently under development to restore its activity in humans. We have utilized a mouse model of inducible Serca2 deletion, the Serca2fl/fl mouse, to study the progression of cardiac dysfunction as this key enzyme is lost. Surprisingly, Serca2KO mice survive 7-10 weeks following inducible Serca2 deletion and loss of most SERCA2a protein. The mechanisms by which Serca2KO mice maintain survival for so long with minimal apparent in vivo pathology are not well defined, so we investigated cardiac performance in Serca2KO hearts and mice by several methods. We determined the function of KO hearts outside the body, in the absence of systemic signaling that may be supporting function in vivo, and found that isolated KO hearts had severely impaired function even at short times following gene deletion; we studied adaptive changes in cardiac Ca2+ handling proteins, including SERCA2a, that occur in hibernating mammals between the summer and winter seasons; and we enacted a thorough mechanistic dissection of ß-adrenergic signaling pathways in SERCA2a-depleted hearts. We found that Serca2KO hearts deficient in normal Ca2+ handling remained able to support a significant functional response to adrenergic stimulation, despite the near complete absence of SERCA2a, which is normally a key functional substrate for the adrenergic response. This finding indicated that other targets of adrenergic signaling in SERCA-deficient heart were surprisingly capable of supporting significant pump function despite poor cardiac Ca2+ transport capabilities, and we have identified the myofilament protein, cardiac troponin I (cTnI), as a key component of an intact adrenergic response under pathological Ca2+ handling conditions.
Subjects/Keywords: Calcium; Heart Failure; Hibernation; SERCA
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APA (6th Edition):
Heinis, F. (2015). Molecular dissection of compensatory pathways in models of severe heart failure. (Doctoral Dissertation). University of Minnesota. Retrieved from http://hdl.handle.net/11299/185607
Chicago Manual of Style (16th Edition):
Heinis, Frazer. “Molecular dissection of compensatory pathways in models of severe heart failure.” 2015. Doctoral Dissertation, University of Minnesota. Accessed December 14, 2019.
http://hdl.handle.net/11299/185607.
MLA Handbook (7th Edition):
Heinis, Frazer. “Molecular dissection of compensatory pathways in models of severe heart failure.” 2015. Web. 14 Dec 2019.
Vancouver:
Heinis F. Molecular dissection of compensatory pathways in models of severe heart failure. [Internet] [Doctoral dissertation]. University of Minnesota; 2015. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/11299/185607.
Council of Science Editors:
Heinis F. Molecular dissection of compensatory pathways in models of severe heart failure. [Doctoral Dissertation]. University of Minnesota; 2015. Available from: http://hdl.handle.net/11299/185607
University of Minnesota
19.
Peng, Szu-Yi.
Understanding Taiwanese family adaptation to chronic heart failure.
Degree: PhD, Family Social Science, 2014, University of Minnesota
URL: http://hdl.handle.net/11299/163881
► This hermeneutic phenomenological study explored the lived experiences of individuals and families adapting to living with chronic heart failure, using the Family Adjustment and Adaptation…
(more)
▼ This hermeneutic phenomenological study explored the lived experiences of individuals and families adapting to living with chronic heart failure, using the Family Adjustment and Adaptation Response Model as the guiding theoretical framework. The report was based on the analyses of 17 interviews with either individuals or families from a medical center in a metropolitan city in Taiwan. The findings showed that chronic heart failure struck the family with ripple effects to multiple areas of family life, including the well-being of individual family members, family functioning and interactions, and the relationships between the family and its social networks and community. The processes of adaptation involved families' efforts to reduce or manage demands by utilizing their existing capabilities, to strengthen and expand resources (including improving family functioning patterns), and to change meanings that shaped how they responded to their situations. Many aspects of the experiences reported by these families in Taiwan were similar to what has been described in previous studies of family experiencing chronic heart failure in other countries. Nevertheless, the findings demonstrated that the influences of cultural or religious beliefs in family meanings played an important role in the process of family juggling the pile-up of demands with their capabilities. Implications for health care providers and future research are offered.
Subjects/Keywords: Family adaptation; Heart failure; Taiwan
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APA (6th Edition):
Peng, S. (2014). Understanding Taiwanese family adaptation to chronic heart failure. (Doctoral Dissertation). University of Minnesota. Retrieved from http://hdl.handle.net/11299/163881
Chicago Manual of Style (16th Edition):
Peng, Szu-Yi. “Understanding Taiwanese family adaptation to chronic heart failure.” 2014. Doctoral Dissertation, University of Minnesota. Accessed December 14, 2019.
http://hdl.handle.net/11299/163881.
MLA Handbook (7th Edition):
Peng, Szu-Yi. “Understanding Taiwanese family adaptation to chronic heart failure.” 2014. Web. 14 Dec 2019.
Vancouver:
Peng S. Understanding Taiwanese family adaptation to chronic heart failure. [Internet] [Doctoral dissertation]. University of Minnesota; 2014. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/11299/163881.
Council of Science Editors:
Peng S. Understanding Taiwanese family adaptation to chronic heart failure. [Doctoral Dissertation]. University of Minnesota; 2014. Available from: http://hdl.handle.net/11299/163881
University of Newcastle
20.
Walweel, Kafa.
Regulation of calcium release channels (RyR2) in healthy and failing human hearts.
Degree: PhD, 2014, University of Newcastle
URL: http://hdl.handle.net/1959.13/1055964
► Research Doctorate - Doctor of Philosophy (PhD)
Heart failure (HF) is a complex disorder that involves changes in Ca2+ handling protein expression, Ca2+ homeostasis and…
(more)
▼ Research Doctorate - Doctor of Philosophy (PhD)
Heart failure (HF) is a complex disorder that involves changes in Ca2+ handling protein expression, Ca2+ homeostasis and tissue remodelling. A general feature of heart dysfunction associated with HF is aberrant Ca2+ flux across the sarcolemma and the sarcoplasmic reticulum (SR) of cardiac cells. The Ca2+ release channel (RyR2) activates and modulates heart function by controlling the Ca2+ release from the SR. The RyR2 forms a complex with many accessory proteins that regulate channel activity. The regulation of the RyR2 from human heart by intracellular Ca2+ and Mg2+ is still poorly defined. In this study single channel recordings of RyR2s were used to compare Ca2+ and Mg2+ regulation of RyR2s from patients with healthy, cystic fibrosis (CF) and failing hearts, specifically, Ischaemic cardiomyopathy (ICM) and Emery Dreifuss muscular dystrophy (EDMD, a rare inherited disorder that affects skeletal and cardiac muscle). We also compared these functional changes with r emodelling of the macromolecular structural properties using Western blot. RyR2s from healthy human hearts (n=4) were incorporated into lipid bilayers and the channel gating was measured at diastolic [Ca2+]. Under these conditions, at least 90% of the channels had open probabilities (Po) that comprised a normal distribution on a logarithmic scale with a mean Po= 0.02 and a standard deviation of 6.3 fold. Grouping the data according to the four donor hearts revealed no significant difference between these groups in the Ca2+ and Mg2+ regulation of RyRs. Initially, a CF heart was the only source of non-failing samples. However, as the study progressed and hearts became available from healthy donors, it became clear that RyR2 from the CF heart differed from those obtained from four healthy hearts and these are now reported as a separate group. This thesis is the first to report on the regulation by Ca2+ and Mg2+ of native RyR2 receptor activity from healthy human hearts. Human RyR2s displayed cytoplasmic Ca2+ activation (Ka = 6 μM) and inhibition by cytoplasmic Mg2+ (Ki = 10 μM at 100 nM cytoplasmic Ca2+). The Ka for luminal Ca2+ activation was 35 μM and the Ki for luminal Mg2+ inhibition was 550 μM (cytoplasmic [Ca2+] = 100 nM). Modulation of RyR2 gating by luminal Ca2+ and Mg2+ only occurred when the cytoplasmic [Ca2+] was less than 1 μM. In this range, luminal and cytoplasmic Ca2+have a synergistic action on the RyR2 opening rate where cytoplasmic Ca2+ increased the luminal Ca2+ response. The activation response of RyR2 to luminal and cytoplasmic Ca2+ was strongly dependent on the Mg2+ concentration. Addition of physiological levels (1 mM) of Mg2+ raised the Ka for cytoplasmic Ca2+ to 25 μM and raised the Ka for luminal Ca2+ from below 60 μM to ~1 mM. Single channel studies showed that RyRs from CF and failing human hearts exhibited higher activity (4-fold for CF, 5-fold for ICM, 13-fold for EDMD, and 35-fold for ICM trabecule) where cytoplasmic solutions contained diastolic concentrations of Ca2+ (100…
Advisors/Committee Members: University of Newcastle. Faculty of Health & Medicine, School of Biomedical Science and Pharmacy.
Subjects/Keywords: heart failure; Ca2+ release channels
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APA ·
Chicago ·
MLA ·
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Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Walweel, K. (2014). Regulation of calcium release channels (RyR2) in healthy and failing human hearts. (Doctoral Dissertation). University of Newcastle. Retrieved from http://hdl.handle.net/1959.13/1055964
Chicago Manual of Style (16th Edition):
Walweel, Kafa. “Regulation of calcium release channels (RyR2) in healthy and failing human hearts.” 2014. Doctoral Dissertation, University of Newcastle. Accessed December 14, 2019.
http://hdl.handle.net/1959.13/1055964.
MLA Handbook (7th Edition):
Walweel, Kafa. “Regulation of calcium release channels (RyR2) in healthy and failing human hearts.” 2014. Web. 14 Dec 2019.
Vancouver:
Walweel K. Regulation of calcium release channels (RyR2) in healthy and failing human hearts. [Internet] [Doctoral dissertation]. University of Newcastle; 2014. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/1959.13/1055964.
Council of Science Editors:
Walweel K. Regulation of calcium release channels (RyR2) in healthy and failing human hearts. [Doctoral Dissertation]. University of Newcastle; 2014. Available from: http://hdl.handle.net/1959.13/1055964
Rutgers University
21.
Swerdel, Joel, 1960-.
Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation.
Degree: PhD, Public Health, 2019, Rutgers University
URL: https://rucore.libraries.rutgers.edu/rutgers-lib/60068/
► Heart failure (HF) and atrial fibrillation (AF) are chronic diseases with high costs, both in human and monetary terms in the US and the world.…
(more)
▼ Heart failure (HF) and atrial fibrillation (AF) are chronic diseases with high costs, both in human and monetary terms in the US and the world. While the cost of each disease is high, the cost of the two as comorbid conditions is exceedingly high. To be able to predict, early on, which patients with newly diagnosed AF will go on to develop HF will allow clinicians the opportunity to address the problem and prevent or delay the onset of HF. The goal of this research was to develop predictive models for incident HF in subjects with newly diagnosed AF.
HF is a clinical syndrome wherein the
heart is unable to supply sufficient blood flow for the body’s needs. HF can be due to a deficit on either the left or the right side of the
heart. Left side HF is the focus of this research. The prevalence of HF is nearly 6 million in the US and over 23 million people worldwide, with yearly costs over 20B in the US and over 100B worldwide. There are 2 types of HF based on the proportion of blood ejected from the left ventricle during systole. Normally, 50-70% of the blood in the left ventricle is ejected during systole. In HF with reduced ejection fraction (HFrEF), the
heart ejects less than 40% of the blood volume in the left ventricle during the contractile phase of the cardiac cycle. In HF with preserved ejection fraction (HFpEF), a normal proportion of the ventricular volume is ejected during systole. In this form of HF, the total volume of blood ejected is insufficient for the body’s needs due to lower ventricular filling during diastole, the relaxation phase of the
heart cycle.
AF is the most common form of cardiac arrythmia. It is an abnormal atrial rhythm initiated by ectopic foci in the atria and pulmonary veins and manifested by circular, uncoordinated depolarization of the atrial muscle, ineffective atrial contraction, and rapid irregular conduction of depolarizations through the atrioventricular node to the ventricles. Worldwide, it is estimated that AF occurs in about 0.5% or 33.5M people. The rates are higher in the US and western Europe with estimates of 3.3% in men and 2.6% in women.
AF by itself tends to reduce cardiac output and is a risk factor for HF. The function of the atria, which normally aid ventricular filling by contracting just before ventricular systole, is lost; and filling time may be shortened by too rapid a pulse. Over time, tachycardia from the abnormal rhythm may lead to cardiomyopathy which may progress into HF. Outcomes for patients who develop HF after AF are poor. In a study involving the Framingham cohort, the mortality rate in patients with AF who developed HF was 3 times that of subjects who did not develop HF. The ability to predict, early on, those who will develop HF after AF may reduce the health burden from these diseases.
There are many examples of predictive model use in health care. For example, the Charlson index is used to predict mortality using 19 indicators. These models provide additional information for the clinician and the patient on risk assessment…
Advisors/Committee Members: Rhoads, George G (chair), Kostis, William (internal member), Marshall, Elizabeth (internal member), Ryan, Patrick (outside member), School of Graduate Studies.
Subjects/Keywords: Heart failure; Atrial fibrillation
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APA (6th Edition):
Swerdel, Joel, 1. (2019). Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation. (Doctoral Dissertation). Rutgers University. Retrieved from https://rucore.libraries.rutgers.edu/rutgers-lib/60068/
Chicago Manual of Style (16th Edition):
Swerdel, Joel, 1960-. “Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation.” 2019. Doctoral Dissertation, Rutgers University. Accessed December 14, 2019.
https://rucore.libraries.rutgers.edu/rutgers-lib/60068/.
MLA Handbook (7th Edition):
Swerdel, Joel, 1960-. “Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation.” 2019. Web. 14 Dec 2019.
Vancouver:
Swerdel, Joel 1. Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation. [Internet] [Doctoral dissertation]. Rutgers University; 2019. [cited 2019 Dec 14].
Available from: https://rucore.libraries.rutgers.edu/rutgers-lib/60068/.
Council of Science Editors:
Swerdel, Joel 1. Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation. [Doctoral Dissertation]. Rutgers University; 2019. Available from: https://rucore.libraries.rutgers.edu/rutgers-lib/60068/
University of Manchester
22.
Lawless, Michael.
An integrative assessment of phosphodiesterase 5 inhibition on cardiac function in heart failure.
Degree: PhD, 2015, University of Manchester
URL: https://www.research.manchester.ac.uk/portal/en/theses/an-integrative-assessment-of-phosphodiesterase-5-inhibition-on-cardiac-function-in-heart-failure(5d4e804f-591d-4131-8443-9f8c1b722f5d).html
;
https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.764360
► Heart failure is the leading cause of morbidity and mortality in the world. It is an incurable disease and most treatment strategies aim to treat…
(more)
▼ Heart failure is the leading cause of morbidity and mortality in the world. It is an incurable disease and most treatment strategies aim to treat the symptoms or slow the progression of the condition. Cardiac contractility is governed by calcium homeostasis within cardiac myocytes and is modulated by the sympathetic nervous system. Both mechanisms are detrimentally altered in heart failure. An important group of enzymes, phosphodiesterases, are fundamental to the sympathetic (beta-adrenergic) modulation of calcium cycling in cardiac myocytes. The selective inhibition of phosphodiesterase 5 (PDE5) has recently been considered as a potential therapy for heart failure; having beneficial effects in human and animal models of the disease. The present study employs a large animal model of tachypacing induced heart failure to test the effect of PDE5 inhibition on myocyte and whole heart contractility and beta-adrenergic function, to assess the molecular mechanisms by which PDE5 inhibition is beneficial to the failing myocardium. In initial experiments the PDE5 inhibitor sildenafil was applied acutely to voltage clamped ventricular myocytes from uninstrumented sheep. PDE5 inhibition reduced baseline L-type calcium current and systolic calcium transient amplitude, suggesting it is negatively inotropic. Furthermore, the positive inotropic effects of beta-adrenergic stimulation were somewhat reversed by acute PDE5 inhibition. Interestingly, such negative inotropic effects of acute PDE5 inhibition were not observed in failing ventricular myocytes, which have dysfunctional calcium homeostasis and beta-adrenergic reserve. When delivered chronically over 3 weeks to tachypaced animals, PDE5 inhibition restored and augmented the systolic calcium transient and beta-adrenergic responsiveness at both the whole heart and myocyte level. These effects were associated with changes to the expression and phosphorylation status of the proteins that control calcium homeostasis in left ventricular tissue. In vivo, PDE5 inhibition prolonged longevity and reduced the onset of clinical signs of heart failure in sheep, as well as arresting cardiac dilatation and wall thinning. Chronic PDE5 inhibition however had no effect on cardiac contractility or heart failure induced changes in cardiac electrophysiology. This study presents a novel mechanism by which PDE5 inhibition may be beneficial in a large animal model of heart failure by restoring calcium homeostasis and beta-adrenergic responsiveness. This study may have important implications for the management of heart failure in clinical practice.
Subjects/Keywords: phosphodiesterase 5; calcium; heart failure
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APA ·
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APA (6th Edition):
Lawless, M. (2015). An integrative assessment of phosphodiesterase 5 inhibition on cardiac function in heart failure. (Doctoral Dissertation). University of Manchester. Retrieved from https://www.research.manchester.ac.uk/portal/en/theses/an-integrative-assessment-of-phosphodiesterase-5-inhibition-on-cardiac-function-in-heart-failure(5d4e804f-591d-4131-8443-9f8c1b722f5d).html ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.764360
Chicago Manual of Style (16th Edition):
Lawless, Michael. “An integrative assessment of phosphodiesterase 5 inhibition on cardiac function in heart failure.” 2015. Doctoral Dissertation, University of Manchester. Accessed December 14, 2019.
https://www.research.manchester.ac.uk/portal/en/theses/an-integrative-assessment-of-phosphodiesterase-5-inhibition-on-cardiac-function-in-heart-failure(5d4e804f-591d-4131-8443-9f8c1b722f5d).html ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.764360.
MLA Handbook (7th Edition):
Lawless, Michael. “An integrative assessment of phosphodiesterase 5 inhibition on cardiac function in heart failure.” 2015. Web. 14 Dec 2019.
Vancouver:
Lawless M. An integrative assessment of phosphodiesterase 5 inhibition on cardiac function in heart failure. [Internet] [Doctoral dissertation]. University of Manchester; 2015. [cited 2019 Dec 14].
Available from: https://www.research.manchester.ac.uk/portal/en/theses/an-integrative-assessment-of-phosphodiesterase-5-inhibition-on-cardiac-function-in-heart-failure(5d4e804f-591d-4131-8443-9f8c1b722f5d).html ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.764360.
Council of Science Editors:
Lawless M. An integrative assessment of phosphodiesterase 5 inhibition on cardiac function in heart failure. [Doctoral Dissertation]. University of Manchester; 2015. Available from: https://www.research.manchester.ac.uk/portal/en/theses/an-integrative-assessment-of-phosphodiesterase-5-inhibition-on-cardiac-function-in-heart-failure(5d4e804f-591d-4131-8443-9f8c1b722f5d).html ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.764360
Queen Mary, University of London
23.
Hincapie, Paula Andrea Ruiz.
Performance characteristics of centrifugal pump impeller for heart failure therapy : numerical and in-vitro approach.
Degree: PhD, 2016, Queen Mary, University of London
URL: http://qmro.qmul.ac.uk/xmlui/handle/123456789/23884
;
https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.765831
► Heart failure (HF) is a common cause of hospitalisation and mortality across industrialised countries. The number of hospitalisations and deaths attributed to heart failure is…
(more)
▼ Heart failure (HF) is a common cause of hospitalisation and mortality across industrialised countries. The number of hospitalisations and deaths attributed to heart failure is increasing, and this trend is predicted to continue. Numerical and in-vitro simulations of the human cardiovascular system constitute the basic tools for enhancing diagnostic and therapeutic technologies for HF and this would in turn, have significant effects on morbidity,mortality, and healthcare expenditure. Mechanical Circulatory Support (MCS) as a destination therapy for HF is rising significantly as it provides a cost-effective alternative to long-term treatment and cardiac transplantation. However, long-term versatility is far from ideal and incidence of transient and permanent neurological events is still high. To this end, evolution of MCS devices calls for more sophisticated design and evaluation methods. The purpose of this work is to develop a numerical model and to implemented a novel in-vitro model of the cardiovascular system with the intention of evaluating the performance characteristics of a purposely selected centrifugal pump impeller for the treatment of both Class III and IV HF conditions when placed in series with the heart at two different anatomic locations: Ascending Aorta and Descending Aorta. An existing lumped-parameter model of the CV system, that included models for the heart, the pulmonary and the systemic circulatory loops by adapting a modified version of the fourth-element Windkessel model was enhanced by dividing the systemic circulation into six parallel vascular beds, and by including an autoregulatory system to control both pressures and volumes throughout the system. As part of the novelty of the present work, a volume reflex loop was included with the purpose of simulating volume overload conditions, as commonly found in HF conditions, and obtaining a more realistic analysis of volume displacement, while using a MCS device. The in-vitro model implemented in this work adopted most of the features included in the mathematical counterpart with the purpose of validating the numerical results. As a result of the combination of models and proper optimisation of the system parameters, predictions of pathophysiological trends and MCS usage are satisfactorily obtained. The models implemented in this work offer a valuable tool for the selection and performance evaluation of MCS devices for the treatment of HF conditions.
Subjects/Keywords: Heart failure; Mechanical Circulatory Support
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APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Hincapie, P. A. R. (2016). Performance characteristics of centrifugal pump impeller for heart failure therapy : numerical and in-vitro approach. (Doctoral Dissertation). Queen Mary, University of London. Retrieved from http://qmro.qmul.ac.uk/xmlui/handle/123456789/23884 ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.765831
Chicago Manual of Style (16th Edition):
Hincapie, Paula Andrea Ruiz. “Performance characteristics of centrifugal pump impeller for heart failure therapy : numerical and in-vitro approach.” 2016. Doctoral Dissertation, Queen Mary, University of London. Accessed December 14, 2019.
http://qmro.qmul.ac.uk/xmlui/handle/123456789/23884 ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.765831.
MLA Handbook (7th Edition):
Hincapie, Paula Andrea Ruiz. “Performance characteristics of centrifugal pump impeller for heart failure therapy : numerical and in-vitro approach.” 2016. Web. 14 Dec 2019.
Vancouver:
Hincapie PAR. Performance characteristics of centrifugal pump impeller for heart failure therapy : numerical and in-vitro approach. [Internet] [Doctoral dissertation]. Queen Mary, University of London; 2016. [cited 2019 Dec 14].
Available from: http://qmro.qmul.ac.uk/xmlui/handle/123456789/23884 ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.765831.
Council of Science Editors:
Hincapie PAR. Performance characteristics of centrifugal pump impeller for heart failure therapy : numerical and in-vitro approach. [Doctoral Dissertation]. Queen Mary, University of London; 2016. Available from: http://qmro.qmul.ac.uk/xmlui/handle/123456789/23884 ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.765831
24.
Bruggink-André de la Porte, P.W.F.
Effects of heart failure management programmes.
Degree: 2009, University Utrecht
URL: http://dspace.library.uu.nl/handle/1874/31842
;
URN:NBN:NL:UI:10-1874-31842
;
urn:isbn:9789090238241
;
URN:NBN:NL:UI:10-1874-31842
;
http://dspace.library.uu.nl/handle/1874/31842
► Abstract of the thesis “Effects of heart failure management programmes” The main purpose of the studies presented in this thesis, was to assess whether an…
(more)
▼ Abstract of the thesis “Effects of
heart failure management programmes” The main purpose of the studies presented in this thesis, was to assess whether an intensive 1-year intervention at a
heart failure clinic for patients with
heart failure, NYHA classification III or IV, reduces the incidence of hospitalisation for worsening
heart failure and/or all cause mortality and improves functional status and quality of life at acceptable costs and whether the observed effects may be (partly) attributable to beneficial changes in patient adherence to drug therapy. Important differences with many previous studies were that our
heart failure clinic was directed by a combination of a clinician and a
heart failure nurse and that the study was performed in a country with a relatively strong primary care health-care system. In a systematic review in the beginning of the thesis, the results of previous studies on
heart failure management programmes are reviewed critically and their applicability to countries, such as the Netherlands, with well-structured primary care facilities is discussed. In the core chapters of the thesis the main results of the Deventer-Alkmaar
Heart Failure study (DEAL-HF study) are presented first: the number of admissions for worsening
heart failure and/or all-cause deaths in the intervention group was lower than in the control group (23 vs. 47; relative risk(RR) 0.49; 95% confidence interval 0.30 to 0.81; p= 0.001). There also was an improvement of the left ventricular ejection fraction (LVEF) in the intervention group (plus 2.6%) compared with a decrease in the usual care group (minus 3.1%; p=0.004). Patients in the intervention group were hospitalised for a total of 359 days, compared with 644 days for those in the usual care group. Beneficial effects were also observed on NYHA functional class, quality of life, self-care behaviour and health care costs. Then, several sub-studies within the DEAL-HF population are presented. First, we assessed the effect of the
heart failure management programme on adherence of prescribers and patients to the medication regimes: beta-blocker dosaging and the number of patients using spironolactone increased. This may have been an important contributor to the observed improved clinical outcomes. Then we investigated the correlation between the change in a biochemical parameter, NT-proBNP, and the change in quality of life and functional class during the follow-up of the main study. Long-term changes in NT-proBNP were indeed accompanied by similar changes in quality of life, functional status and echo parameters. Finally we studied the costs of the
heart failure management programme in relation to the observed effects. This more detailed analysis of the costs and effects of the
heart failure management programme studied in the DEAL HF study confirms that such a programme exerts beneficial clinical benefit and saves costs.
Advisors/Committee Members: Hoes, A.W., Veldhuisen, D.J. van.
Subjects/Keywords: Congestive heart failure; heart failure management programmes; review; combined physician-and-nurse-directed heart failure clinic; patient education; hospitalisation for worsening heart failure; adherence; longterm changes in NT-proBNP; cost-effectiveness
Record Details
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Share »
Record Details
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« Share
❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Bruggink-André de la Porte, P. W. F. (2009). Effects of heart failure management programmes. (Doctoral Dissertation). University Utrecht. Retrieved from http://dspace.library.uu.nl/handle/1874/31842 ; URN:NBN:NL:UI:10-1874-31842 ; urn:isbn:9789090238241 ; URN:NBN:NL:UI:10-1874-31842 ; http://dspace.library.uu.nl/handle/1874/31842
Chicago Manual of Style (16th Edition):
Bruggink-André de la Porte, P W F. “Effects of heart failure management programmes.” 2009. Doctoral Dissertation, University Utrecht. Accessed December 14, 2019.
http://dspace.library.uu.nl/handle/1874/31842 ; URN:NBN:NL:UI:10-1874-31842 ; urn:isbn:9789090238241 ; URN:NBN:NL:UI:10-1874-31842 ; http://dspace.library.uu.nl/handle/1874/31842.
MLA Handbook (7th Edition):
Bruggink-André de la Porte, P W F. “Effects of heart failure management programmes.” 2009. Web. 14 Dec 2019.
Vancouver:
Bruggink-André de la Porte PWF. Effects of heart failure management programmes. [Internet] [Doctoral dissertation]. University Utrecht; 2009. [cited 2019 Dec 14].
Available from: http://dspace.library.uu.nl/handle/1874/31842 ; URN:NBN:NL:UI:10-1874-31842 ; urn:isbn:9789090238241 ; URN:NBN:NL:UI:10-1874-31842 ; http://dspace.library.uu.nl/handle/1874/31842.
Council of Science Editors:
Bruggink-André de la Porte PWF. Effects of heart failure management programmes. [Doctoral Dissertation]. University Utrecht; 2009. Available from: http://dspace.library.uu.nl/handle/1874/31842 ; URN:NBN:NL:UI:10-1874-31842 ; urn:isbn:9789090238241 ; URN:NBN:NL:UI:10-1874-31842 ; http://dspace.library.uu.nl/handle/1874/31842
25.
Bruggink-André de la Porte, P.W.F.
Effects of heart failure management programmes.
Degree: 2009, University Utrecht
URL: http://dspace.library.uu.nl/handle/1874/31842
;
URN:NBN:NL:UI:10-1874-31842
;
urn:isbn:9789090238241
;
URN:NBN:NL:UI:10-1874-31842
;
http://dspace.library.uu.nl/handle/1874/31842
► Abstract of the thesis “Effects of heart failure management programmes” The main purpose of the studies presented in this thesis, was to assess whether an…
(more)
▼ Abstract of the thesis “Effects of
heart failure management programmes” The main purpose of the studies presented in this thesis, was to assess whether an intensive 1-year intervention at a
heart failure clinic for patients with
heart failure, NYHA classification III or IV, reduces the incidence of hospitalisation for worsening
heart failure and/or all cause mortality and improves functional status and quality of life at acceptable costs and whether the observed effects may be (partly) attributable to beneficial changes in patient adherence to drug therapy. Important differences with many previous studies were that our
heart failure clinic was directed by a combination of a clinician and a
heart failure nurse and that the study was performed in a country with a relatively strong primary care health-care system. In a systematic review in the beginning of the thesis, the results of previous studies on
heart failure management programmes are reviewed critically and their applicability to countries, such as the Netherlands, with well-structured primary care facilities is discussed. In the core chapters of the thesis the main results of the Deventer-Alkmaar
Heart Failure study (DEAL-HF study) are presented first: the number of admissions for worsening
heart failure and/or all-cause deaths in the intervention group was lower than in the control group (23 vs. 47; relative risk(RR) 0.49; 95% confidence interval 0.30 to 0.81; p= 0.001). There also was an improvement of the left ventricular ejection fraction (LVEF) in the intervention group (plus 2.6%) compared with a decrease in the usual care group (minus 3.1%; p=0.004). Patients in the intervention group were hospitalised for a total of 359 days, compared with 644 days for those in the usual care group. Beneficial effects were also observed on NYHA functional class, quality of life, self-care behaviour and health care costs. Then, several sub-studies within the DEAL-HF population are presented. First, we assessed the effect of the
heart failure management programme on adherence of prescribers and patients to the medication regimes: beta-blocker dosaging and the number of patients using spironolactone increased. This may have been an important contributor to the observed improved clinical outcomes. Then we investigated the correlation between the change in a biochemical parameter, NT-proBNP, and the change in quality of life and functional class during the follow-up of the main study. Long-term changes in NT-proBNP were indeed accompanied by similar changes in quality of life, functional status and echo parameters. Finally we studied the costs of the
heart failure management programme in relation to the observed effects. This more detailed analysis of the costs and effects of the
heart failure management programme studied in the DEAL HF study confirms that such a programme exerts beneficial clinical benefit and saves costs.
Advisors/Committee Members: Hoes, A.W., Veldhuisen, D.J. van.
Subjects/Keywords: Congestive heart failure; heart failure management programmes; review; combined physician-and-nurse-directed heart failure clinic; patient education; hospitalisation for worsening heart failure; adherence; longterm changes in NT-proBNP; cost-effectiveness
Record Details
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Share »
Record Details
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❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Bruggink-André de la Porte, P. W. F. (2009). Effects of heart failure management programmes. (Doctoral Dissertation). University Utrecht. Retrieved from http://dspace.library.uu.nl/handle/1874/31842 ; URN:NBN:NL:UI:10-1874-31842 ; urn:isbn:9789090238241 ; URN:NBN:NL:UI:10-1874-31842 ; http://dspace.library.uu.nl/handle/1874/31842
Chicago Manual of Style (16th Edition):
Bruggink-André de la Porte, P W F. “Effects of heart failure management programmes.” 2009. Doctoral Dissertation, University Utrecht. Accessed December 14, 2019.
http://dspace.library.uu.nl/handle/1874/31842 ; URN:NBN:NL:UI:10-1874-31842 ; urn:isbn:9789090238241 ; URN:NBN:NL:UI:10-1874-31842 ; http://dspace.library.uu.nl/handle/1874/31842.
MLA Handbook (7th Edition):
Bruggink-André de la Porte, P W F. “Effects of heart failure management programmes.” 2009. Web. 14 Dec 2019.
Vancouver:
Bruggink-André de la Porte PWF. Effects of heart failure management programmes. [Internet] [Doctoral dissertation]. University Utrecht; 2009. [cited 2019 Dec 14].
Available from: http://dspace.library.uu.nl/handle/1874/31842 ; URN:NBN:NL:UI:10-1874-31842 ; urn:isbn:9789090238241 ; URN:NBN:NL:UI:10-1874-31842 ; http://dspace.library.uu.nl/handle/1874/31842.
Council of Science Editors:
Bruggink-André de la Porte PWF. Effects of heart failure management programmes. [Doctoral Dissertation]. University Utrecht; 2009. Available from: http://dspace.library.uu.nl/handle/1874/31842 ; URN:NBN:NL:UI:10-1874-31842 ; urn:isbn:9789090238241 ; URN:NBN:NL:UI:10-1874-31842 ; http://dspace.library.uu.nl/handle/1874/31842
University of Lund
26.
Stagmo, Martin.
Aspects on implementation of coronary heart disease
prevention in clinical practice.
Degree: 2005, University of Lund
URL: http://lup.lub.lu.se/record/545430
;
http://portal.research.lu.se/ws/files/4891967/545432.pdf
► Prevention of first time disease or recurrence of coronary heart disease (CHD) is a major task for the health service. Guidelines regarding CHD prevention have…
(more)
▼ Prevention of first time disease or recurrence of
coronary heart disease (CHD) is a major task for the health
service. Guidelines regarding CHD prevention have been issued but
studies have shown that treatment goals are inadequately met in
clinical practice and there is urgent need for improved methods of
implementation of guidelines. There is also a need for better risk
stratification tools in order to identify asymptomatic subjects
with a high risk for future CHD. This thesis has shown that: A
structured, one-year, hospital-based secondary prevention programme
after CHD, mainly led by specialist nurses with physician backup,
could positively influence the use of lipid-lowering drugs and
serum cholesterol levels several years after the end of the
programme. A quality control system based on patient empowerment
and education with continuous feedback to patients, nurses and
physicians seemed to be welcomed by both patients and participating
health care professionals. However, our system based on voluntary
participation and report cards did not seem to be feasible at this
time due to a high dropout rate. Reasons why targets for serum
lipids were not met in the EUROASPIRE II study were that too few
patients received lipid-lowering drugs, and that of those who did
receive such treatment many were treated with sub-optimal doses.
Ambulatory ECG with ST-analysis could add significant information
on which healthy subjects with a certain accumulation of risk
factors who would suffer from a major coronary event (death, AMI or
revascularisation) over a 15-year time period.
Subjects/Keywords: Kardiologi; Medicin (människa och djur); Kardiovaskulära systemet; Cardiovascular system; Medicine (human and vertebrates); nurse-led clinics; risk stratification; Implementation; Coronary hert disease; prevention
Record Details
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Record Details
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Cite
« Share
❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Stagmo, M. (2005). Aspects on implementation of coronary heart disease
prevention in clinical practice. (Doctoral Dissertation). University of Lund. Retrieved from http://lup.lub.lu.se/record/545430 ; http://portal.research.lu.se/ws/files/4891967/545432.pdf
Chicago Manual of Style (16th Edition):
Stagmo, Martin. “Aspects on implementation of coronary heart disease
prevention in clinical practice.” 2005. Doctoral Dissertation, University of Lund. Accessed December 14, 2019.
http://lup.lub.lu.se/record/545430 ; http://portal.research.lu.se/ws/files/4891967/545432.pdf.
MLA Handbook (7th Edition):
Stagmo, Martin. “Aspects on implementation of coronary heart disease
prevention in clinical practice.” 2005. Web. 14 Dec 2019.
Vancouver:
Stagmo M. Aspects on implementation of coronary heart disease
prevention in clinical practice. [Internet] [Doctoral dissertation]. University of Lund; 2005. [cited 2019 Dec 14].
Available from: http://lup.lub.lu.se/record/545430 ; http://portal.research.lu.se/ws/files/4891967/545432.pdf.
Council of Science Editors:
Stagmo M. Aspects on implementation of coronary heart disease
prevention in clinical practice. [Doctoral Dissertation]. University of Lund; 2005. Available from: http://lup.lub.lu.se/record/545430 ; http://portal.research.lu.se/ws/files/4891967/545432.pdf
University of Arizona
27.
Veleta, Patricia M.
Evaluating the Effects of Heart Failure Clinic Enrollment on Hospital Admission and Readmission Rates: A Retrospective Data Analysis
.
Degree: 2016, University of Arizona
URL: http://hdl.handle.net/10150/613159
► Heart failure (HF) is a clinical syndrome associated with high morbidity and mortality with a large economic burden, and is the leading cause of hospitalizations…
(more)
▼ Heart failure (HF) is a clinical syndrome associated with high morbidity and mortality with a large economic burden, and is the leading cause of hospitalizations among Medicare beneficiaries in the United States. Healthcare reform has focused on strategies to reduce HF readmissions, including outpatient HF
clinics. Purpose: The purpose of this DNP Project was to answer the following question: In adult patients diagnosed with HF, how does enrollment in the HF clinic, compared to non-enrollment affect hospital admission and readmission rates? Methods: A retrospective analysis of 767 unique patients and their 1,014 respective admissions and readmissions was conducted. Continuous and categorical data was analyzed and presented as a mean (M), standard deviation (SD), absolute number (N) and percentage (%). A Pearson Chi Square test was used for categorical variables and Analysis of Variance was used for age and ejection fraction (EF). Results: Study sample demographics (N=767); age (M=79.72, SD=7.48); gender (57.6 % male) and EF (M=0.43, SD=0.16) were evaluated. The No HF clinic (No HFC) and HF clinic (HFC) enrollment groups (N=573) were compared for age (M=79.49, SD=7.65) (M=80.39, SD=6.94), male gender (54.6%, 66.5%) and EF (M= 0.44, SD=0.17) (M=0.42, SD=0.15), respectively. Each sample patient had at least one admission for HF during 2015; of which 573 (46.2%) were in the No HFC group and 194 (8.4%) were in the HFC group (p<0.001). There was no difference in all-cause readmissions between the No HFC group [n=95(14.5%)] and the HFC group [n=37(16.2%)] (p=0.534) and no difference in HF-related readmissions between the No HFC group [n=72(11.0%)] and the HFC group [n=23(10.0%)] (p=0.700). Conclusions: This DNP project demonstrated a significant difference in HF admission rates in favor of the HFC group. While no differences were found in all-cause or HF-related readmission rates in No HFC and HFC groups, the rates are less than the national average. Unintended findings were that datasets can be very poorly constructed and populated, resulting in large amounts of unusable data. Recommendations are for more rigor in the organization of datasets to assure accurate comparisons between admission and readmission rates based on enrollment in HF
clinics.
Advisors/Committee Members: Shea, Kimberly D (advisor), Gephart, Sheila M. (committeemember), Buchner, Brian R. (committeemember), Shea, Kimberly D. (committeemember).
Subjects/Keywords: Heart Failure Clinic;
Hospital Admissions;
Hospital Readmissions;
Nursing;
Heart Failure
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APA (6th Edition):
Veleta, P. M. (2016). Evaluating the Effects of Heart Failure Clinic Enrollment on Hospital Admission and Readmission Rates: A Retrospective Data Analysis
. (Doctoral Dissertation). University of Arizona. Retrieved from http://hdl.handle.net/10150/613159
Chicago Manual of Style (16th Edition):
Veleta, Patricia M. “Evaluating the Effects of Heart Failure Clinic Enrollment on Hospital Admission and Readmission Rates: A Retrospective Data Analysis
.” 2016. Doctoral Dissertation, University of Arizona. Accessed December 14, 2019.
http://hdl.handle.net/10150/613159.
MLA Handbook (7th Edition):
Veleta, Patricia M. “Evaluating the Effects of Heart Failure Clinic Enrollment on Hospital Admission and Readmission Rates: A Retrospective Data Analysis
.” 2016. Web. 14 Dec 2019.
Vancouver:
Veleta PM. Evaluating the Effects of Heart Failure Clinic Enrollment on Hospital Admission and Readmission Rates: A Retrospective Data Analysis
. [Internet] [Doctoral dissertation]. University of Arizona; 2016. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/10150/613159.
Council of Science Editors:
Veleta PM. Evaluating the Effects of Heart Failure Clinic Enrollment on Hospital Admission and Readmission Rates: A Retrospective Data Analysis
. [Doctoral Dissertation]. University of Arizona; 2016. Available from: http://hdl.handle.net/10150/613159
University of Melbourne
28.
Shi, William Y.
The changing face of heart failure in children and young adults.
Degree: 2017, University of Melbourne
URL: http://hdl.handle.net/11343/194189
► Heart failure (HF) carries a high risk of mortality and morbidity. This is accentuated in those who are diagnosed during childhood, with productive years are…
(more)
▼ Heart failure (HF) carries a high risk of mortality and morbidity. This is accentuated in those who are diagnosed during childhood, with productive years are lost to premature mortality and disability. Our understanding of paediatric heart failure is evolving, as emerging information from longitudinal studies have shed light on the natural history of the various manifestations of paediatric HF. The impact of surgical correction of congenital heart disease (CHD) has altered the clinical profile of children and young adults living with heart failure today.
This project aimed to expands our understanding of the prognosis and long-term outcomes of children and young adults with heart failure with and without CHD. It also explored the evolving role of the surgical therapies, especially amongst those with single ventricle physiology. This has enabled better understanding of the composition, outcomes and risk factors of the population with the ultimate goal to improve health service provision. This thesis also describes initial data from a randomised-controlled trial of remote ischaemic precondition on myocardial protection in heart transplant recipients.
The predictors of transplant waiting-list mortality are analysed while demonstrating the utility of ventricular-assist device therapy in children and young adults with heart failure. The work presented in this thesis also explored the negative prognostic impact of left ventricular non-compaction and thromboembolism in children with cardiomyopathy. The adverse outcomes associated with onset of arrhythmia in those with a Fontan circulationis examined and quantified. We also show that heart transplantation in CHD, while associated with early operative risk, can be performed with good short and long-term outcomes. Despite this, the transplantation rates in those with a failing Fontan are shown to be low, with unequal access to transplantation across local regions, suggesting a benefit in centralisation of services.
As our understanding and patient population changes, so too do our strategies of caring for this patient population. Improving the lives of children and young adults with heart failure may yet become our specialty’s greatest achievement.
Subjects/Keywords: Heart failure; Heart transplantation; Congenital heart disease; Cardiomyopathy
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APA ·
Chicago ·
MLA ·
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Export
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Manager
APA (6th Edition):
Shi, W. Y. (2017). The changing face of heart failure in children and young adults. (Doctoral Dissertation). University of Melbourne. Retrieved from http://hdl.handle.net/11343/194189
Chicago Manual of Style (16th Edition):
Shi, William Y. “The changing face of heart failure in children and young adults.” 2017. Doctoral Dissertation, University of Melbourne. Accessed December 14, 2019.
http://hdl.handle.net/11343/194189.
MLA Handbook (7th Edition):
Shi, William Y. “The changing face of heart failure in children and young adults.” 2017. Web. 14 Dec 2019.
Vancouver:
Shi WY. The changing face of heart failure in children and young adults. [Internet] [Doctoral dissertation]. University of Melbourne; 2017. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/11343/194189.
Council of Science Editors:
Shi WY. The changing face of heart failure in children and young adults. [Doctoral Dissertation]. University of Melbourne; 2017. Available from: http://hdl.handle.net/11343/194189
University of Dundee
30.
Wong, Aaron K. F.
Insulin resistance, chronic heart failure and potential treatment.
Degree: Thesis (M.D.), 2013, University of Dundee
URL: http://hdl.handle.net/10588/4b513bf1-6e14-4c68-9bce-7b5c75c70130
► Diabetes Mellitus (DM) and insulin resistant (IR) are highly prevalent among heart failure (HF) patients. There is now increasing evidence to suggest a bidirectional relationship…
(more)
▼ Diabetes Mellitus (DM) and insulin resistant (IR) are highly prevalent among heart failure (HF) patients. There is now increasing evidence to suggest a bidirectional relationship between IR and HF. DM and IR not only lead to heart failure, but heart failure can also lead to the development of DM or IR. The degree of IR also correlates with the severity and mortality of CHF. The pathophysiology of IR in CHF has yet to be fully defined. Activation of sympathetic nervous system, abnormal regulation of adipocytokines systems, activation of inflammatory and coagulation cascade, accumulation of glycated products, endothelial dysfunction and hyperinsulinaemia are potential explanations of the development of IR in CHF. Additionally, it remains to be determined if IR is merely a marker reflecting the severity of CHF or whether it contributes to the disease in CHF. If IR is truly a culprit that worsens CHF, reversing IR may potentially be a new target for treatment in CHF, which may result in an improvement in symptoms and even mortality in patients with CHF. However, there are concerns over the use of certain insulin sensitizers, most notably, the thiazolidinediones (TZDs), which has been linked with increased risk of hospitalizations for CHF and concerns regarding its association with increased myocardial infarction. Despite previous concerns of lactic acidosis, there is now evidence that metformin may not only be safe but could potentially be useful in the setting of CHF. We have conducted a randomised double-blind, placebo-controlled trial testing the hypothesis of reversing IR with metformin in insulin-resistant CHF will have beneficial effects. If IR is a possible target for the treatment of CHF, what are the new and potential treatment modalities? We have now had better understandings of the adipocytokines systems, which may prove to be a therapeutic option to improve IR in CHF. AMP-activated protein kinase (AMPK) pathway has become the focus of research as a novel therapeutic target in cardio-metabolic disease. It has been shown to mediate, at least in part, the effects of a number of physiological and pharmacological factors that improve IR. It also exerts beneficial effects on the vasculature and the heart. There have been some new AMPK activators that are currently being tested in vivo setting or phase 1-2 trials, and the early results are somewhat promising. Increased understandings and refreshed insights of IR and CHF have opened a new horizon and encouraged us to explore more therapeutics options in CHF.
Subjects/Keywords: Insulin resistance; Heart failure; Metformin; Exercise
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Record Details
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❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Wong, A. K. F. (2013). Insulin resistance, chronic heart failure and potential treatment. (Doctoral Dissertation). University of Dundee. Retrieved from http://hdl.handle.net/10588/4b513bf1-6e14-4c68-9bce-7b5c75c70130
Chicago Manual of Style (16th Edition):
Wong, Aaron K F. “Insulin resistance, chronic heart failure and potential treatment.” 2013. Doctoral Dissertation, University of Dundee. Accessed December 14, 2019.
http://hdl.handle.net/10588/4b513bf1-6e14-4c68-9bce-7b5c75c70130.
MLA Handbook (7th Edition):
Wong, Aaron K F. “Insulin resistance, chronic heart failure and potential treatment.” 2013. Web. 14 Dec 2019.
Vancouver:
Wong AKF. Insulin resistance, chronic heart failure and potential treatment. [Internet] [Doctoral dissertation]. University of Dundee; 2013. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/10588/4b513bf1-6e14-4c68-9bce-7b5c75c70130.
Council of Science Editors:
Wong AKF. Insulin resistance, chronic heart failure and potential treatment. [Doctoral Dissertation]. University of Dundee; 2013. Available from: http://hdl.handle.net/10588/4b513bf1-6e14-4c68-9bce-7b5c75c70130
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Open Access Theses and Dissertations
