Background: A crucial part of rehabilitation of cardiovascular disease is to increase aerobic capacity. High intensity intervals are an emerging field in cardiac rehabilitation. Adhering to physical training has been shown to be quite hard for these patients. There is no systematic review of different training intensities for these patients that also include interventions towards changing and adhering to new training behaviors. Objective: Map out changes in VO2peak from high intensity intervals or moderate continuous training in cardiac rehabilitation and to see if theories or techniques for behavioral change was applied to maintain and increase adherence to physical activity. Method: This systematic review was done with the databases of PubMed and PEDro. The studies could only include patients with heart failure or coronary artery diseases. Articles were assessed for quality and given a preliminary level of evidence. Results: 11 articles were included; ten studies showed a significant increase in VO2peak. Three studies showed a significant increase in VO2peak between groups in favor of high intensity intervals. Some behavior change techniques could be interpreted by the authors, but no theories were used. Conclusion: This review could not conclude that one specific modality of training is superior in cardiac rehabilitation.

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns of referral to mental health professionals (MHPs). Though starting with a quantitative design, difficulties encountered throughout the project eventually led to a largely qualitative analysis, which did yield useful information. A pilot project demonstrated anxiety and mood disorders were commonly noted in patients’ medical charts (46%), but also found referrals were rarely made for mental health services (7%), despite colocation of a licensed psychologist and licensed clinical social worker within the practice. This indicated that services available to provide comprehensive integrated total health care may not be have been used to their full potential. In the main project, 59 participants from a family medicine clinic and 20 PCPs from that clinic participated. The My Mood Monitor (M3) was administered to the patients and became part of their Electronic Medical Records (EMR). The M3 screens for anxiety, depression, and bipolar disorders within primary care settings. In 2 separate noon conferences, PCPs were trained on diagnostic criteria for anxiety disorders and mood disorders, interpretation of M3 results, and the internal Mental Health Professional referral process. The project was hampered by a full-scale switch from paper-based medical records to an EMR and accompanying lack of user experience with EMR functions, lack of efficient transfer of M3 results into the EMR, and an unforeseen switch of psychologists mid-way through the study. However, results were obtained that showed relatively low levels of PCP review of M3 results, potentially high rates of anxiety disorders and mood disorders within the setting, relatively high levels of PCP knowledge of diagnostic criteria for anxiety and mood disorders, and that patients may not prefer a ‘warm handoff’ model of mental health referral. These findings are couched within a number of important caveats, but future directions for research were clearly implied.