published_or_final_version / Nursing Studies / Master / Master of Nursing

A learning effect has been shown to be present in the repeated performance of the six-minute walk test and contributes to the variability of walk distance up to the third walk test. The purpose of this study was to see if education about the performance of the walk test could minimize the learning effect. It was hypothesized that education about the learning effect would decrease the learning effect. There were a total of 18 subjects (5 female and 13 male) with a mean age of 63.7+12.1 years that completed three standardized six-minute walk tests. The subjects were randomly assigned to either a Learning Effect Education (LEE) group or a Usual Care (UC) group. The LEE group was provided with education material about the learning effect approximately two days prior to their first walk test, with additional instruction immediately prior to their first walk test. The mean walk distances for the LEE group over the three walk tests were 1,248±297.4, 1,361.9±275.7, and 1,355.1+291.7 feet, respectively. Mean walk distances for the UC group over the three walk tests were 1,149.6+392.3, 1,123.6+427.5, and 1,209.9±368.7 feet, respectively. The hypothesis was tested and the repeated measures ANOVA showed a significant (p=0.033) interaction between the groups with respect to six-minute walk distance. A Bonferroni's post hoc analysis showed that mean walk distance (113.9+42.3 feet) increased significantly (p=0.048) from test one to test two in the LEE group. There was no significant difference between mean walk distance from test two and test three (6.8+31.1 feet) in the LEE group. In the UC group, there was no significant increase in mean walk distance from test one to test two (-26+42.3 feet), while there was a significant (p=0.04) increase in mean walk distance from test two to test three (86.3+31.1 feet). There was a significant difference between walk tests (p=0.011) with no significant difference between groups (p=0.333). In conclusion, the results from this study suggest that education may reduce the number of familiarization trials needed prior obtaining an accurate baseline six-minute walk test distance. / School of Physical Education

Thesis (Ph. D.)--Ohio State University, 2006. / Title from first page of PDF file. Includes bibliographical references (p. 48-54).

According to the American Heart Association, there are currently 5 million Americans diagnosed with congestive heart failure and that number is steadily increasing (AHA, 2003). The alarming problem of congestive heart failure and other related medical complications has created a need for devices that not only assist the heart but also help the heart to grow and remodel back to its normal configuration. Currently, there are several direct cardiac compression devices (DCCDs) that do assist the heart, however, they do not help the heart to grow and remodel correctly. Dr. John C. Criscione of Texas A&M University has proposed a novel DCCD, in which the compression of the device reinforces the natural curvature of the heart, helping it to grow and remodel correctly. It is hypothesized that with the support of the device, the cells of the heart will be stimulated to grow and remodel back to their normal size and return to their proper function. Two key components necessary to the novel DCCD were designed and constructed for this study. The first component was an adjustable outer shell which enabled the device to become smaller as the failing heart returned to normal size. The second component was an inflatable inner membrane that applies direct pressure to the outer wall of the heart in a way that promotes physiological stress and strain patterns.

Abstract not available

In previous studies on heartbeat series, it has been proposed that the healthy heartbeat pattern represents complex nonlinear dynamics, and such cardiac nonlinearity may be used as a clinical indicator for the diagnosis of certain types of heart disease. However, it is still not quite clear whether there is any difference among the heartbeat series of patients with congestive heart failure (CHF), or whether cardiac nonlinearity represents a severe heart disease situation. In the present study, parallel cascade identification (PCI), which frequently requires only short stretches of data to obtain highly promising results, is used to distinguish severe congestive heart failure, a clinical situation associated with a high-risk of sudden death, from low-risk CHF. Parallel cascade identification is an accurate and robust method for identifying dynamic nonlinear systems. The PCI algorithm combined with a specified statistical test may be used as a severe congestive heart failure marker by comparing a nonlinear model with a “linear” model (more precisely, a first-order Volterra series). In this thesis, PCI is applied to distinguish R-R wave intervals of CHF patients who died from those of patients who survived in a 5-year study. The detection accuracy of the PCI detector is evaluated over a first set of 49 patients, and then over a larger set of a further 352 patients, and consistent results are obtained between the two sets. Over the larger set, Matthews' correlation coefficient of nonlinearity with unfavorable outcome (death) is , sensitivity for predicting unfavorable outcome is , while the specificity is . The R-R wave interval exhibits nonlinearity in patients who died during the 5-year study. However, typically nonlinearity cannot be detected in patients who survived during the study. These findings show that for patients with congestive heart failure, nonlinearity is associated with unfavorable outcome (death), while patients for whom nonlinearity cannot be detected overwhelmingly have good outcomes. This is significant for clinical diagnosis and prognosis of severe congestive heart failure. / Thesis (Master, Electrical & Computer Engineering) -- Queen's University, 2007-09-28 11:54:57.695

Thesis (M.S.)--Ball State University, 2008. / Title from PDF t.p. (viewed on Aug. 21, 2009). Research paper (M.S.), 3 hrs. Includes bibliographical references (p. 68-74).

Thesis (Ph. D.)--Dept. of Psychology. University of Missouri--Kansas City, 2005. / "A dissertation in psychology." Advisor: C. Keith Haddock. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed June 20, 2006. Includes bibliographical references (leaves 91-113). Online version of the print edition.

The theophylline clearance was evaluated in patients with liver dysfunction and/or congestive heart failure. One hundred and twenty two patients were categorized into four groups; Group I: Liver dysfunction (n=20), Group II: Congestive heart failure (CHF, n=22), Group III: Both liver dysfunction and CHF (n=12), and Group IV: Control group (n=68). The severity of liver dysfunction and CHF were evaluated using Child-Turcotte- Pugh index (CTP) and a Cardiac Function index, respectively. Theophylline clearance was significantly decreased in Groups I, II, and III when compared to the control group; but, no significant difference was found among these three groups (mean values were 0.515, 0.479, 0.417, and 0.682 mllmin/kg, respectively). Moreover, patients with compensated cirrhosis or moderate to severe CHF had the lowest theophylline clearance values (mean values 0.344, and 0.335 ml/min/kg, respectively). There was a significant correlation between Cardiac Function index and theophylline clearance (r=-0.621) in Group II. Smokers had larger theophylline clearance values than those of nonsmokers in Groups I, II, and IV. Impairment of theophylline clearance did not correlate well with any of the indices of liver function or the CTP index. A model for prediction of the clearance in CHF was developed, which consisted of a Cardiac Function index and smoking habit. This model accounts for approximately 60% of the variation of theophylline clearance. However, models describing theophylline clearance in liver dysfunction and in congestive heart failure with liver dysfun ction did not appear to be useful. Thus, routine laboratory data and indices of liver function were not helpful in evaluating the impaired hepatic theophylline elimination. The Cardiac Function index appeared to be useful in estimation of theophylline clearance in CHF; however, the association between the theophylline clearance and severe CHF needs to be evaluated further.

Thesis (M.D.)—Boston University