PURPOSE: This thesis intends to evaluate the factors which positively and negatively influence patient compliance to performing weekly home-based digital 6-minute-walk-tests (d6MWT) using a smartphone and smart watch. PROBLEM: Long term patient engagement in mobile health apps have proven to be a challenge to maintain. In this thesis, factors that influence patient engagement will be identified when it comes to retaining participants that are using the VascTrac mobile health research application. METHODS: Patient compliance will be calculated based on how many d6MWT are completed out of the expected total. The population is split into four levels of compliance groups from least compliant (0-25% compliance (Group A)) to most compliant (75.1-100% compliance (Group D)). “Open Walk” and survey data are collected and compared amongst these groups to see if there are any direct relationships that could be found. An “End of Study Survey” is also conducted to better understand the reasons behind differing compliance levels. RESULTS: The overall compliance level is 66.1% for all comers with half of the patients scoring above 80%. Patients with higher compliance tend to have a higher weekly “Open Walk” average (correlation coefficient = 0.3). The average of weekly “Open Walk” is 0.53 walks/week. CONCLUSION: Factors that negatively affect whether patients would be compliant to doing the weekly d6MWT are medical issues, technical difficulties, hospitalization, and lack of motivation. Being motivated and having a desire for self-improvement positively influences compliance levels. Decrease use of walking aids correlates to higher compliance and being smartphone naïve at beginning of study correlates to lower compliance. The other factors (age, co-morbidities, smoking habit, etc.) considered did not predict compliance levels.

Increasingly, the emphasis in health care is on wellness and prevention, and efforts are focused on keeping patients out of costly healthcare centres. High-risk cardiovascular patients are identified and incorporated into risk reduction and management programmes. The aim of this study was to explore the role of the nurse in such a programme and make recommendations about the expansion of this role. By conducting a literature study, the ideal role of the nurse in a risk reduction and management programme was analysed, thereby reaching the study’s first objective. The second objective was met by conducting qualitative research on the current role of the nurse in cardiovascular health risk management in South Africa. The researcher then compared the empirical data to the ideal role as it emerged from the literature. The findings were presented as areas for expansion of the role of the nurse in a cardiovascular risk management programme. / Dissertation (MCur (Clinical))--University of Pretoria, 2008. / Nursing Science / unrestricted

Non invasive in vivo imaging will lead to better understanding of Angiotensin II Type 1 Receptor’s (AT1R) role in disease progression and may guide therapy in cardiovascular patients. Two models were used in this project: 5/6 nephrectomy and transient left anterior descending (LAD) ligation. Rats were scanned with [13N]ammonia and [11C]methyl-candesartan, both of which are Positron Emission Tomography (PET) tracers, at 8 weeks (nephrectomy) and 2 weeks (LAD ligation) after surgery. Western blot analysis was used to corroborate PET data. Nephrectomy: Renal AT1R image analysis displayed a 40% decrease in kidney AT1R in nephrectomized animals compared to sham (p<0.05) which was confirmed with Western blot and biodistribution. LAD ligation: Left Ventricle AT1R Western blot analysis exhibited a 60% increase in 20min ligation (p<0.05) with maintained myocardial blood flow. In conclusion, changes in renal AT1R were successfully imaged using [11C]methyl-candesartan in nephrectomized animals, and 20min LAD ligation/reperfusion is an appropriate model to image an increase in cardiac AT1R following ischemic injury.

Non invasive in vivo imaging will lead to better understanding of Angiotensin II Type 1 Receptor’s (AT1R) role in disease progression and may guide therapy in cardiovascular patients. Two models were used in this project: 5/6 nephrectomy and transient left anterior descending (LAD) ligation. Rats were scanned with [13N]ammonia and [11C]methyl-candesartan, both of which are Positron Emission Tomography (PET) tracers, at 8 weeks (nephrectomy) and 2 weeks (LAD ligation) after surgery. Western blot analysis was used to corroborate PET data. Nephrectomy: Renal AT1R image analysis displayed a 40% decrease in kidney AT1R in nephrectomized animals compared to sham (p<0.05) which was confirmed with Western blot and biodistribution. LAD ligation: Left Ventricle AT1R Western blot analysis exhibited a 60% increase in 20min ligation (p<0.05) with maintained myocardial blood flow. In conclusion, changes in renal AT1R were successfully imaged using [11C]methyl-candesartan in nephrectomized animals, and 20min LAD ligation/reperfusion is an appropriate model to image an increase in cardiac AT1R following ischemic injury.

Non invasive in vivo imaging will lead to better understanding of Angiotensin II Type 1 Receptor’s (AT1R) role in disease progression and may guide therapy in cardiovascular patients. Two models were used in this project: 5/6 nephrectomy and transient left anterior descending (LAD) ligation. Rats were scanned with [13N]ammonia and [11C]methyl-candesartan, both of which are Positron Emission Tomography (PET) tracers, at 8 weeks (nephrectomy) and 2 weeks (LAD ligation) after surgery. Western blot analysis was used to corroborate PET data. Nephrectomy: Renal AT1R image analysis displayed a 40% decrease in kidney AT1R in nephrectomized animals compared to sham (p<0.05) which was confirmed with Western blot and biodistribution. LAD ligation: Left Ventricle AT1R Western blot analysis exhibited a 60% increase in 20min ligation (p<0.05) with maintained myocardial blood flow. In conclusion, changes in renal AT1R were successfully imaged using [11C]methyl-candesartan in nephrectomized animals, and 20min LAD ligation/reperfusion is an appropriate model to image an increase in cardiac AT1R following ischemic injury.

Non invasive in vivo imaging will lead to better understanding of Angiotensin II Type 1 Receptor’s (AT1R) role in disease progression and may guide therapy in cardiovascular patients. Two models were used in this project: 5/6 nephrectomy and transient left anterior descending (LAD) ligation. Rats were scanned with [13N]ammonia and [11C]methyl-candesartan, both of which are Positron Emission Tomography (PET) tracers, at 8 weeks (nephrectomy) and 2 weeks (LAD ligation) after surgery. Western blot analysis was used to corroborate PET data. Nephrectomy: Renal AT1R image analysis displayed a 40% decrease in kidney AT1R in nephrectomized animals compared to sham (p<0.05) which was confirmed with Western blot and biodistribution. LAD ligation: Left Ventricle AT1R Western blot analysis exhibited a 60% increase in 20min ligation (p<0.05) with maintained myocardial blood flow. In conclusion, changes in renal AT1R were successfully imaged using [11C]methyl-candesartan in nephrectomized animals, and 20min LAD ligation/reperfusion is an appropriate model to image an increase in cardiac AT1R following ischemic injury.