Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed June 5, 2008). Includes bibliographical references.

Lic.-avh. (sammanfattning) Stockholm : Karolinska institutet, 2009.

Thesis (M.S.)--University of Michigan, 1985. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.N.)--Memorial University of Newfoundland, School of Nursing, 1996. / Typescript. Bibliography: leaves 115-123. Also available online.

Thesis (M.S.)--University of Michigan, 1985.

Thesis (M.Sc.)--York University, 2008. Graduate Programme in Biology. / Typescript. Includes bibliographical references (leaves 77-94). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR51626

Bakgrund: Ungefär en femtedel av ischemiskt hjärtsjuka individer lider av depressiva besvär. Depression hos ischemiskt hjärtsjuka individer leder till ökad dödlighet. Tidigare forskning har visat att fysisk aktivitet har effekt på människors mentala hälsa vid depression. Dödligheten i  ischemisk hjärtsjukdom minskar och behovet av en väl fungerande hjärtrehabilitering ökar. Syfte: Syftet var att undersöka vilken inverkan fysisk aktivitet har på individers mentala hälsa vid ischemisk hjärtsjukdom samt beskriva de inkluderade studiernas undersökningsgrupper.   Metod: En beskrivande litteraturstudie av 11 kvantitativa vetenskapliga artiklar. Artiklarna söktes i databaserna PubMed och Cinahl. Huvudresultat: Fysisk aktivitet hade en positiv effekt på depression och nedstämdhet hos patienter med ischemisk hjärtsjukdom. Enbart den fysiska träningens effekt på depression och nedstämdhet var svår att mäta och bevisa, men forskningen visade på att förbättrad kondition i många fall ledde till minskning av depressiva besvär. Effekterna av fysisk aktivitet skiljde sig åt mellan könen. Deltagarantalet i studierna låg mellan 62-522 och fler män än kvinnor deltog. Merparten av studierna hade en medelålder på deltagarna mellan 61 – 67,5 år. Slutsats: Fysisk aktivitet förbättrade den mentala hälsan hos ischemiskt hjärtsjuka individer. Det var svårt att bevisa att fysisk aktivitet enbart var det som påverkade den mentala hälsan, eftersom många aspekter, förutom fysisk aktivitet ingår i ett rehabiliteringsprogram. Att belysa vikten av fysisk aktivitet ur fler än en aspekt, borde dock öka förutsättningarna att motivera fler till att delta vid träningsbaserad hjärtrehabilitering. Det blir inte bara en vinst för patienten utan också en vinst för samhället i stort. / Background: One in five individuals with ischemic heart disease suffer from depressive disorders. Depression in individuals with ischemic heart disease leads to increased mortality. Previous research has shown that physical activity has an effect on people`s mental health in depression. Mortality in ischemic heart disease decreases and the need for cardiac rehabilitation increases. Aim: The purpose was to investigate the impact physical activity had on the mental health of individuals with ischemic heart disease, as well as describe the study groups of the included studies. Method: A descriptive literature study of 11 quantitative scientific articles. The articles were searched in the databases PubMed and Cinahl. Main results: Physical activity had a positive effect on depression and sedation in patients with ischemic heart disease. Only the physical exercise`s effect on depression was difficult to measure and prove, but research showed that improved fitness in many cases led to a reduction of depressive disorders. The effects of physical activity tended to differ between men and women. The number of participants in the studies was between 62-522 and more men than women participated. The majority of the studies had an average age of participants between 61-67.5 years. Conclusion: Physical activity improved the mental health of individuals with ischemic heart disease. It was difficult to prove that physical activity alone, was what affected mental health, because many aspects apart from physical activity, are part of a rehabilitation program. However, highlighting the importance of physical activity from more than one aspect should increase the conditions to motivate more people to participate in exercise-based cardiac rehabilitation. It will not only be a benefit to the patient but also a profit for the society.

Introdução: O aumento da tolerância do miocárdio isquêmico observado durante o segundo de dois testes de esforços seqüenciais, o fenômeno do pré-aquecimento, foi proposto como um modelo clínico do pré-condicionamento isquêmico. Bloqueadores dos canais de K-ATP dependentes, tais como as sulfoniluréias, podem induzir a perda do pré-condicionamento isquêmico, o qual poderia estar envolvido no aumento dos eventos cardiovasculares. A repaglinida é um agente hipoglicemiante oral, pertencente à família da meglitinida e supostamente dotada de menor efeito no pré-condicionamento isquêmico, ainda que o fármaco tenha seu principal mecanismo de ação nos canais de K-ATP dependentes. Objetivos e Métodos: O objetivo foi investigar os efeitos da repaglinida no fenômeno do pré-condicionamento isquêmico em pacientes diabéticos com doença coronariana estável. Foram estudados 42 pacientes diabéticos tipo 2, com angina estável e doença arterial documentada. Todos os pacientes tinham testes ergométricos positivos para isquemia. Na primeira fase do teste, a sulfoniluréia e os betabloqueadores foram suspensos por trinta dias e sete dias, respectivamente. Os pacientes foram submetidos a dois testes ergométricos seqüenciais, com intervalo de trinta minutos (testes 1 e 2). Na segunda fase, os pacientes receberam repaglinida por sete dias e mais dois testes ergométricos foram repetidos (testes 3 e 4). Resultados: Todos os pacientes alcançaram ST >1 mm na primeira fase (Teste 1 e 2). O tempo alcançado no teste 2 foi maior que aquele alcançado no teste 1 (4:44s. x 5:37s. p=0,001), como também foi maior a duração do exercício (6:15s x 6:29s. p=0,008), denotando pré-condicionamento isquêmico. Após o uso da repaglinida, nos testes 3 e 4, observou-se menor tempo alcançado para atingir isquemia no teste 4 (5:37s. x 4:58s. p=0,001). Observou-se, ainda, menor tempo de tolerância ao exercício na fase 2 (6:57s x 6:34s. p=0,007). Em relação ao surgimento de angina, não se constataram diferenças estatísticas entre as duas fases. Conclusão: Nos pacientes diabéticos com doença coronariana estável, a repaglinida bloqueou o pré-condicionamento isquêmico. / Background: The increase of tolerance to myocardial ischemia observed during the second of two sequential exercise tests, the warm-up phenomenon, has been proposed as a clinical model of ischemic preconditioning. Blockers of K-ATP channels, such as the Sulfonylurea drugs, can induce loss of ischemic preconditioning, what could be involved in an increase of cardiac events. Repaglinide is a hypoglycemic agent with supposedly lower influence on ischemic preconditioning, despite acting in K-ATP channels. Objectives and Methods: This study investigated the effects of repaglinide on the ischemic preconditioning in diabetic patients with CAD. There were 42 patients and inclusion criteria were positive treadmill test for myocardial ischemia. Sulphonylureas and beta-blocking agents were withdrawn 30 and 7 days respectively before phase 1 of the study. In this phase, the patients underwent two consecutive treadmill exercise tests at 30 minute intervals (test 1 and test 2). In phase 2 of the study, all patients received repaglinide 2 mg three times daily during 7 days before treadmill exercise test (test 3 and test 4). Results: All patients achieved 1.0 mm ST-segment depression during phase 1. The time achieved to ST depression during test 2 was greater than that during test 1 (4:44s vs. 5:37s. p=0.001) as well as the duration of the exercise (6:15s vs.6: 29s. p=0.008), suggesting a higher ischemic threshold. In phase 2 after repaglinide, all patients achieved 1 mm ST-segment depression. However, the time achieved to ST depression, as well as the duration of the exercise, was lower in test 4 comparing with test 3. There were no statistical differences regarding angina episodes in phase 1 or phase 2. Conclusions: In diabetic patients with stable coronary disease, the oral hypoglycemic agent repaglinide abolished the myocardial ischemic preconditioning.

This study used the research method of phenomenology to elicit the patient's perspective of the illness experience following a myocardial infarction (MI). The purpose of studying this experience was to gain an understanding of what it meant to men and women to have a MI, what the learning needs were following a MI, and how these learning needs were met. It was proposed that patients would view the illness experience differently from health professionals, thus the patients would identify different learning needs. Anderson's (1985) adaptation of Kleinman's health care system framework was used to conceptualize this problem. Three males and two females, ranging in age from 42 to 77 years, participated in the study. Data were collected through 11 in-depth interviews. From analysis of this data significant statements were extracted to provide a description of the phenomenon under study. The findings of this study suggest that health professionals and patients do view the MI experience from different perspectives. The emphasis of the patients on understanding the MI experience from the reality of their world is reflected in their attempts to rationalize the occurrence of the MI and their desires to know more about their own MI, prognosis, and treatment. In order to plan patient education that will assist post-MI patients in their recovery health professionals must assess patients individually for their: (1) beliefs regarding risk factors and causes of MI; (2) desire for Information; (3) preference for method of instruction; and, (4) preference for timing of education. / Applied Science, Faculty of / Nursing, School of / Graduate

This descriptive correlational and longitudinal study was designed to assess the changes in cognitive appraisal of emotions and coping strategies which myocardial infarction (Ml) patients used at two points in time. Additionally, the variables of cognitive appraisal of emotions were investigated for their relationships to coping strategies. A convenience sample of 21 confirmed first MI patients was selected from coronary care units (CCU) of four hospitals in western Canada. Participants completed the Emotion Appraisal Scale, the Revised Ways of Coping checklist as well as an information sheet. Overall, the participants experienced a wide range of the four appraisal types of threat, harm, challenge and benefit. Challenge emotions were the most frequent appraisal type at both interviews. Initially-, benefit emotions were the least frequent appraisal type, while harm emotions were the least frequent at the second period. While results indicated changes, no significant changes were found in the four emotion appraisals of threat, harm, challenge and benefit over time. The complexity of emotions experienced reflects the multifacated nature of the MI situation influencing patients in early phases of recovery. The participants used a variety of coping strategies which are related to emotion-focused and problem-focused coping to manage the demands of their MI. Most of the participants used all eight available types of coping. The strategies of seeking social support, distancing and positive reappraisal were the most predominant types of coping at both interviews. The strategies of self-controlling, planful problem-solving and accepting responsibility were moderately used, while escape-avoidance and confrontive coping were the least used types of coping at both times. The findings suggest that coping with a cardiac event is a complex process. The MI crisis present the patients with multiple tasks which require a combination of coping strategies. At the initial period, a significant relationship was found between threat emotions and planful problem-solving coping. Harm emotions were significantly and positively correlated with accepting responsibility, planful problem-solving and confrontive coping. Similarly, challenge emotions correlated with seeking social support and positive reappraisal coping. Significant relationships were found between benefit emotions and two forms of coping: confrontive and seeking social support coping. At the second period, only two significant correlations were found: benefit emotions significantly correlated with self-controlling and accepting responsibility. The findings suggest that a heart attack is appraised as moderately stressful by first MI patients in early phases of recovery. The MI patients' perception or understanding of the contextual factors affect appraisal of harm, threat, benefit and challenge emotions which in turn influence the choice of coping strategies. / Applied Science, Faculty of / Nursing, School of / Graduate