Bakgrund och problemformulering: Kvinnors symtom och upplevelser vid akut hjärtinfarkt är ofta svårtolkade. Det beror på att deras symtom är atypiska. Kranskärlssjukdom har länge ansetts vara ett manligt problem varför kvinnor har uteslutits ur vetenskapliga studier. Detta har medfört att kunskapen om kvinnans hjärt-kärlsjukdom inte är lika god som mannens. För att kunna ge rätt behandling och god omvårdnad är det viktigt för ambulanssjuksköterskan att få kunskap om kvinnors atypiska symtom.Syfte: Studien syftar till att beskriva kvinnors symtom och upplevelser vid akut hjärtinfarkt för att ambulanssjuksköterskan ska kunna ge rätt behandling och god omvårdnad.Metod: Vi har gjort en litteraturstudie där fokus har lagts på kvalitativa artiklar som beskriver kvinnors symtom och upplevelser vid akut hjärtinfarkt. Materialet analyserades och sammanställdes enligt David Evans granskningsmodell.Resultat: I studien har vi sett att kvinnor som drabbas av hjärtinfarkt oftast uppvisar andra symtom än vad männen gör. Dessa symtom är buksmärta, andfåddhet, illamående, kräkning, diarré, olustkänsla, epigastriella smärtor, yrsel och aptitlöshet. Kvinnorna beskrev mer smärta i arm och/eller skuldrorna, nacke, käke och hals. Smärtan kunde vara utstrålande i tinningen och även ge tandvärk. Orkeslöshet i armar och skuldror var också symtom som upplevdes.Diskussion: Forskningen visar att kvinnor med akut hjärtinfarkt har svårt att tolka sina symtom och relatera dem till hjärtat, eftersom de uppvisar andra symtom än män. Kvinnor behöver få kunskap om mer att de uppvisar andra symtom vid hjärtinfarkt. Den kunskapen behöver även ambulanssjuksköterskan få så att kvinnor kan få snabb och adekvat behandling. Vi anser att forskning behöver bedrivas kring kvinnors symtom och upplevelser vid akut hjärtinfarkt. / <p>Program: Specialistsjuksköterskeutbildning med inriktning mot ambulanssjukvård</p><p>Uppsatsnivå: D</p>

Made available in DSpace on 2014-12-17T15:38:48Z (GMT). No. of bitstreams: 1 AlineBM_DISSERT.pdf: 325548 bytes, checksum: 4bd22857a5710c579b86fe1b662b429e (MD5) Previous issue date: 2010-04-04 / This paper aims to discuss the concept of symptom in psychopedagogy and psychoanalysis, drawing the consequences for the direction of treatment for each of these fields. Learning Problems has been the name given by various fields of knowledge to what does not happen as expected in the learning process. To address these problems several professionals are called upon. Faced with this demand a new field of knowledge is created: the psycho-pedagogy. In Brazil, it is established as a field of work and research from the contributions of Alicia Fern?ndez. This author, supported by the work of French philosopher and educator Sara Pa?n, takes the concept of Freudian-Lacanian symptom as a fundamental concept to read the so-called "learning problems". Given this one must question whether the concept of symptom Fernandez is really the same as psychoanalysis. Are they the same? If yes, how to sustain as different fields? If not, what are consequences for the direction of treatment for each of these fields? For this study, the theoretical works of Alicia Fern?ndez and Sara Pain were read aiming to clarify the concept of symptom in psychopedagogy. To discuss the psychoanalytic concept of symptom we turned to the texts of Freud, Lacan and commentators in which this issue is discussed. The results show that Pain and Fernandez seek psychoanalysis as a theory to be coupled with others to solve the learning problems. The concept of symptom as a return of the repressed and as an indicator of a sense to be found in the history of the subject is similar to the psychoanalytical one, however, in psychopedagogy other fields of knowledge and techniques are used as reference and these are sometimes incompatible with the concept of symptom presented. The use of psychological tests for the diagnosis, the idea of transference without the notion of subject supposed to know and the proposed treatment are indications of a different treatment approach from what the ethics of psychoanalysis proposes / Esse trabalho visa discutir a concep??o de sintoma na psicopedagogia e na psican?lise, extraindo as conseq??ncias para a dire??o do tratamento em cada um desses campos. Problemas de aprendizagem tem sido o nome dado por diversas ?reas do conhecimento ao que, na escola, n?o coincide com o esperado. Para tratar desses problemas v?rios profissionais s?o convocados. Diante dessa demanda surge um novo campo de saber: a psicopedagogia. No Brasil, se estabelece como campo de trabalho e pesquisa a partir das contribui??es da psicopedagoga argentina Alicia Fern?ndez. Esta autora, respaldada pelos trabalhos da fil?sofa e educadora francesa Sara Pa?n, toma a concep??o freudo-lacaniana de sintoma como um conceito fundamental para ler os chamados problemas de aprendizagem . Diante disso cabe questionar se a concep??o de sintoma de Fern?ndez ? realmente a mesma da psican?lise. Trata-se do mesmo? Se sim, como justificar campos diferentes? Se n?o, quais as conseq??ncias para a dire??o do tratamento em cada um desses campos? Para tanto realizamos um estudo te?rico das obras de Alicia Fernand?z e Sara Pa?n, buscando esclarecer o conceito de sintoma na psicopedagogia. Para discutir como o conceito psicanal?tico de sintoma foi tomado pelas duas autoras, recorremos aos textos de Freud, Lacan e comentadores nos quais esse tema ? discutido de modo privilegiado. Os resultados encontrados evidenciam que Pa?n e Fern?ndez buscam a psican?lise como uma teoria a ser somada com outras para a solu??o dos problemas de aprendizagem. Utilizando o conceito de sintoma como retorno do recalcado e como indicador de um sentido a ser encontrado na hist?ria do sujeito se aproximam da psican?lise, no entanto, na psicopedagogia outros campos de saber e t?cnicas s?o tomadas como refer?ncia e estas s?o, por vezes, incompat?veis com o conceito de sintoma apresentado. A utiliza??o de testes psicol?gicos visando o diagn?stico, o lugar que o terapeuta se coloca visando estabelecer uma transfer?ncia sem o suposto saber do paciente e as propostas de tratamento que s?o indicadas apontam para uma dire??o do tratamento diferente da ?tica da psican?lise

A recuperação e a restauração florestal de ecossistemas degradados podem não acontecer das maneiras desejadas, se houver carência nutricional ou suprimento inadequado de nutrientes às plantas no estádio inicial de desenvolvimento de espécies florestais nativas. O objetivo da presente investigação foi avaliar os efeitos da deficiência de nutrientes nas plantas na fase inicial de desenvolvimento das espécies florestais nativas Schinus terebinthifolius Raddi (aroeira-pimenteira), Cordia superba Cham. (baba-de-boi) e Cariniana estrellensis (Raddi) Kintze (jequitibá-branco). Foram observadas as alterações ultra-estruturais e teciduais das células do mesofilo das folhas, foi descrita a sintomatologia visual de deficiência nutricional, foram feitas as determinações de teores de macro e micronutrientes, das taxas de assimilação de gás carbônico e de transpiração, e as mensurações da altura e da produção de biomassa. O experimento foi conduzido em casa de vegetação, em blocos ao acaso, com três repetições e treze tratamentos para cada espécie, empregando a técnica de diagnose por subtração (-N, -P, -K, -Ca, -Mg, -S, -B, -Cu, -Fe, -Mn, -Mo, -Zn), sendo que em um dos tratamentos, as espécies nativas foram cultivadas em solução nutritiva completa, com todos os macros e micronutrientes. Durante o experimento e em sua análise, foi observada a seqüência de eventos que motivaram os sintomas de deficiência e a diminuição na produção de biomassa. Sabe-se que falta de um nutriente provoca alteração molecular, o que alterou as ultraestruturas celulares das folhas que foram observadas por microscopia. Essas modificações celulares provocaram alterações no tecido vegetal que induziram nas plantas os sintomas visuais específicos de cada nutriente que foram descritos. Como efeito fisiológico da deficiência nutricional, de forma geral, constataram-se diminuições nas taxas de fotossíntese e de transpiração e, por conseguinte, na produção de biomassa. Estes resultados claramente evidenciam o fato de que projetos de implantação de florestas ou de recuperação e restauração de ecossistemas degradados por meio do plantio das três espécies florestais nativas, em solos que necessitem de suplementação nutricional, poderão ter seu sucesso comprometido se não houver complementação nutricional / The recovery and forest restoration of degraded ecosystems may not be occur as desired if there is a nutritional deficiency or an inadequate supply of nutrients in the initial phase development of native forest species. The objective of this research was to evaluate the macronutrient and micronutrient deficiency effects on Brazilian native species young plants: Schinus terebinthifolius Raddi, Cordia superba Cham. and Cariniana estrellensis (Raddi) Kintze. Ultrastructural and tissue of the mesophyll cells of leaves changes were observed by microscopy, the visual symptom of nutritional deficiencies were described, the nutrient contents were analyzed, the carbon assimilation and transpiration rates were measured, the plant heights and the biomass production were measured. The experiment was carried on a greenhouse in a randomized block design with three replications and thirteen treatments for each species, using the technique of diagnosis by subtraction (-N, -P, -K, -Ca, -Mg, -S, -B, - Cu, -Fe, -Mn, -Mo, -Zn) and in one of the treatments the species were grown in a nutrient solution with all macro and micronutrients. It was observed, during the experiment and its analysis, a sequence of events that caused the visual symptoms and decreased the biomass production. It is known that the nutrient deficiency causes molecular alterations, which consequently led the changes in cellular ultrastructure of the leaves and they were observed by microcopy. These cellular changes caused modifications in the foliar tissue, and the plants showed specific visual symptoms of each nutrient, which they were described. As physiological effect of nutritional deficiency, in general decreases the photosynthesis and transpiration taxes, and consequently the biomass production were decreased. These results clearly project that forest implantation or recovery and restoration of damaged ecosystems by planting the three native species in soils that require nutritional supplementation may have its success compromised if there is no a nutritional supplementation

Notre thèse porte sur les troubles des comportements alimentaires (TCA). Ces derniers ont certaines spécificités représentatives des nouvelles formes de symptômes. La dimension de jouissance y est prédominante et a tendance à étouffer la dimension d’appel propre à toute formation symptomatique. Au regard de ces particularités, les traitements dits « habituels » sont fréquemment inopérants, ce qui peut amener certains patients à entrer dans un protocole de soin hospitalier. Lieu, offrant de multiples scènes de soins qui œuvrent de façon convergente pour vider le symptôme d’une partie de sa jouissance.La thèse montre que la démarche clinique auprès de ceux qui souffrent de TCA, doit amener le psychologue clinicien, à faire preuve de créativité et prendre une posture active, s’il veut permettre au sujet de s’ouvrir à sa division subjective / Our research dealt with eating disorders. They have specific characteristics that represent new forms of symptoms. The ‘Jouissance’ dimension is predominant and tends to overwhelm the ‘address dimension’ corresponding to any symptomatic formation. In view of these particularities, treatments called ‘usual’ are frequently ineffective, leading some of the patients to medical care. The clinical environment allows a multidisciplinary team to meet and work together under certain conditions in order to remove part of the ‘jouissance’ in the symptoms. This work aims to show that the clinical procedure addressed to those who suffer from eating disorders must provide a clinical psychologist who will have to prove creativity and an active behaviour in order to give the subject the possibility to access his unconcious

The perinatal period is increasingly recognized as a vulnerable time for the development and exacerbation of psychopathology symptoms. Research has often focused on perinatal depression, with limited information on perinatal anxiety. This study examined the psychometric structure of all anxiety and depressive disorder symptoms as well as explored the relation between perinatal internalizing symptoms and sociodemographic, obstetric, and psychological risk factors. Obsessive-Compulsive Disorder (OCD) is a common perinatal anxiety disorder that is now classified with the Obsessive-Compulsive Spectrum (OCS) (hoarding, body dysmorphic, trichotillomania, and excoriation disorders). This study also aimed to determine the prevalence of clinically significant OCS symptoms and their association with postpartum adjustment. Participants recruited from the University of Iowa Hospitals and Clinics (N =246) completed an online questionnaire and a structured clinical interview during pregnancy (28-32 weeks gestation) and the postpartum (6-8 weeks). Questionnaires assessed demographics, pregnancy complications, anxiety sensitivity, coping strategies, maternal attitudes and experiential avoidance. Clinical interviews dimensionally assessed all anxiety and depressive symptoms as well as past psychiatric diagnoses. Confirmatory factor analyses identified three factors: Distress (depression, GAD, irritability, and panic); Fear (social anxiety, agoraphobia, specfic phobia, and OCD); and Bipolar (mania and OCD) during pregnancy and the postpartum. During pregnancy, structural equation modeling demonstrated that past psychiatric history predicted Distress and Fear symptoms. Experiential avoidance mediated the relation between negative coping strategies and Fear symptoms. In the postpartum, negative maternal attitudes predicted Distress symptoms. Experiential avoidance mediated the relation between negative coping strategies and Fear symptoms as well as between anxiety sensitivity and Fear symptoms. There were low rates of clinically significant OCS symptoms, except for body dysmorphic disorder symptoms. Elevations in all OCS disorder symptoms were significantly associated with more difficulty adjusting to the postpartum. Past psychiatric history, negative maternal attitudes, and experiential avoidance are particularly important risk factors for perinatal anxiety. Future clinical research should be aimed at identifying at-risk women and modifying experiential avoidance during the perinatal period. Elevated OCS symptoms, particularly body dysmorphic disorder symptoms, affect postpartum adjustment. Future intervention work should focus on assessing and treating perinatal body dysmorphic disorder symptoms.

The Personality Assessment Inventory (PAI) is a commonly used instrument in neuropsychological assessment; however, it lacks a symptom validity test (SVT) that is sensitive to cognitive response bias (also referred to as non-credible responding), as defined by performance on cognitive performance validity tests (PVT). Therefore the purpose of the present study was to derive from the PAI item pool a new SVT, named the Cognitive Response Bias Scale (CRBS), that is sensitive to non-credible responding, and to provide initial validation evidence supporting the use of the CRBS in a clinical setting. The current study utilized an existing neuropsychological outpatient clinical database consisting of 306 consecutive participants who completed the PAI and PVTs and met inclusion criteria. The CRBS was empirically derived from this database utilizing primarily an Item Response Theory (IRT) framework. Out of 40 items initially examined, 10 items were ultimately retained based on their empirical properties to form the CRBS. An examination of the internal structure of the CRBS indicated that 8 items on the CRBS demonstrated good fit to the graded response IRT model. Overall scale reliability was good (Cronbach’s alpha = 0.77) and commensurate with other SVTs. Examination of item content revealed the CRBS consisted of items related to somatic complaints, psychological distress, and denial of fault. Items endorsed by participants exhibiting lower levels of non-credible responding consisted of vague and non-specific complaints, while participants with high levels of non-credible responding endorsed items indicating ongoing active pain and distress. The CRBS displayed expected relationships with other measures, including high positive correlations with negative impression management (r = 0.73), depression (r = 0.78), anxiety (r = 0.78), and schizophrenia (r = 0.71). Moderate negative correlations were observed with positive impression management (r = -0.31), and treatment rejection (r = -0.42). Two hierarchical logistic regression models showed the CRBS has significant predictive power above and beyond existing PAI SVTs and clinical scales in accurately predicting PVT failure. The overall classification accuracy of the CRBS in detecting failure on multiple PVTs was comparable to other SVTs (area under the curve = 0.72), and it displayed moderate sensitivity (i.e., 0.31) when specificity was high (i.e., 0.96). These operating characteristics suggest that the CRBS is effective at ruling in the possibility of non-credible responding, but not for ruling it out. The conservative recommended cut score was robust to effects of differential prediction due to gender and education. Given the extremely small sample subsets of forensic-only and non-Caucasian participants, future validation is required to establish reliable cut-offs when inferences based on comparisons to similar populations are desired. Results of the current study indicate the CRBS has comparable psychometric properties and clinical utility to analogous SVTs in similar personality inventories to the PAI. Furthermore, item content of the CRBS is consistent with and corroborates existing theory on non-credible responding and cognitive response bias. This study also demonstrated that a graded response IRT model can be useful in deriving and validating SVTs in the PAI, and that the graded response model provides unique and novel information into the nature of non-credible responding.

The purpose of this dissertation was to evaluate the biological, behavioral, and psychosocial attributes of individuals diagnosed with chronic obstructive pulmonary disease (COPD). Specific aims were to: 1) explore the predictive power of spirometry measures for event-free survival in patients with heart failure and suspected COPD, focusing on the differences in survival between those with and without airflow limitation; 2) examine the psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS) in patients with concomitant COPD and heart failure; and 3) test the efficacy of a theory-based, multidimensional, self-care educational intervention using an eHealth platform on measures of symptom severity and variability, anxiety and depressive symptoms, perceived self-care ability, perceived self-care adherence, and selfcare information needs (knowledge) in a sample of adult patients with stable COPD. Specific aim one was addressed by evaluation of the predictive power of spirometry measures (forced expiratory volume/second [FEV1], forced vital capacity [FVC], and the ratio of FEV1/FVC) for event-free time to combined hospitalization/mortality after controlling for clinical and sociodemographic variables. This analysis revealed that those patients with airflow limitation were 2.2 times more likely to experience hospitalization/mortality compared to those without airflow limitation. The second specific aim was addressed with a psychometric evaluation of the Multidimensional Scale of Perceived Social support (MSPSS) which included determination of internal consistency reliability, the factor structure and construct validity by hypothesis testing in participants with comorbid COPD and heart failure. The MSPSS was a valid and reliable instrument to measure perceived social support in patients with comorbid COPD and heart failure. The third specific aim was addressed by a trial of an eHealth educational intervention in participants with COPD (N = 20). This intervention resulted in significant change in symptom severity evaluation in patients categorized as having medium symptom severity for the following symptoms: distress due to cough, chest tightness, dyspnea with activity and fatigue; these symptoms were perceived as more severe in the intervention period. Anxiety, depressive symptoms and perceived self-care ability were unchanged; however, perceived self-care adherence scores improved, and knowledge needs were significantly reduced after the intervention.

Chronic pulmonary diseases include a wide range of illnesses that differ in etiology, prevalence, symptomatology and available therapy. A common link among these illnesses is their impact on patients’ vital function of breathing, high symptom burden and significantly impaired quality of life. This dissertation research evaluates disease severity, symptom burden and health behaviors of patients with three different chronic pulmonary conditions. First, alpha-1 antitrypsin deficiency (AATD) is an inherited condition that typically is associated with an increased risk of early onset pulmonary emphysema. This study examines differences in demographic, health, and behavioral characteristics and compares clinical outcomes and health related behaviors and attitudes between two severe genotypes of AATD - ZZ and SZ. The findings of the study suggest that patients with SZ genotype and less severe form of deficiency report higher number of exacerbations, comorbidities, as well as unhealthy behaviors such as lack of exercise and current smoking. In addition, individuals with the more severely deficient ZZ genotype are more adherent to disease management and prevention program recommendations and maintain a healthier lifestyle than individuals with SZ genotype. Second chronic lung disease examined in this research was chronic obstructive pulmonary disease (COPD), the fourth leading cause of death and second leading cause of disability in the United States. Prevalence and burden of cough and phlegm, two of the most common symptoms of the COPD, were assessed among participants of the COPD Foundation’s Patient-Powered Research Network (COPD PPRN). In addition, association between patient-reported levels of phlegm and cough, clinical outcomes and patients’ quality of life were evaluated. Participants’ quality of life was assessed using Patient Reported Outcome Measurement Information System instrument PROMIS-29. Association between changes in symptom severity over time and patient-reported quality of life were examined. Findings of this study indicated that severity of cough and phlegm were associated with higher number of exacerbations, greater dyspnea, and worsened patient-reported quality of life including physical and social functioning. Improvement in cough and phlegm severity over time was associated with better patient-reported quality of life. Third pulmonary illness described in this dissertation is non-cystic fibrosis bronchiectasis (NCFB), a rare and etiologically diverse condition characterized by dilated bronchi, poor mucus clearance and susceptibility to bacterial infection. Association between presence of Pseudomonas aeruginosa (PA), one of the most frequently isolated pathogens in patients with NCFFB, and disease severity was assessed utilizing enrollment data from the Bronchiectasis and NTM Research Registry (BRR). NCFB disease severity was evaluated using modified versions of validated in large international cohorts instruments, the Bronchiectasis Severity Index (BSI) and FACED. The findings of this study indicate that PA infection is common in NCFB patients, and presence of PA in patients’ sputum is associated with having moderate and high severity of bronchiectasis. In addition, the results of this study suggest that the two severity assessment instruments classify patients with NCFB differently which may be attributed to a greater number of severity markers utilized in the calculation of the BSI compared to FACED. In conclusion, the proposed dissertation aims to enhance understanding of differences in health outcomes between genotypes of AATD within AlphaNet registry, and to guide future health-promoting behaviors. It highlights the burden of common symptoms such as cough and phlegm in patients with COPD within COPD PPRN and their association with patients’ quality of life. In addition, it introduces modified indices of NCFB severity and emphasizes high burden of the disease in patients with presence of PA within the US BRR.

Les troubles du comportement sont fréquents chez les sujets âgés avec ou sans troubles cognitifs. En Afrique subsaharienne, très peu de données sont disponibles en population générale sur les troubles du comportement chez le sujet âgé et aucune n’a encore été réalisée en Afrique Centrale. L’objectif général de ce travail était de contribuer à une meilleure connaissance des troubles du comportement chez les sujets âgés en Afrique Centrale en République Centrafricaine et au Congo. Nos objectifs spécifiques étaient de : 1) décrire les troubles du comportement, leur gravité, leur retentissement, leurs facteurs associés et les symptômes associés aux démences ; 2) évaluer l’association entre les troubles du comportement et l’Apolipoprotéine E ε4 ; 3) évaluer l’association entre les troubles du comportement, la mortalité et le déclin cognitif. A partir des données des programmes EPIDEMCA et EPIDEMCA-FU, nous avons pu déterminer que la prévalence des troubles du comportement était de 63,7% (IC95% : 59,5-67,8). Le score médian global de gravité était de 9 [IQR : 6-12] et le score médian global de retentissement était de 7 [IQR : 4-10]. Vivre à Gamboma (zone rurale du Congo), l’audition normale et les liens amicaux étaient protecteurs des troubles du comportement. Le sexe féminin, la démence, la personnalité dépendante et le handicap physique ont été identifiés comme étant associés à la présence des troubles du comportement. Les idées délirantes, la dépression, l’apathie, la désinhibition et le comportement moteur aberrant étaient associés à la présence de démences dans notre étude. Dans nos travaux, les troubles du comportement n’étaient pas associés à l’Apolipoprotéine E ε4. Ces symptômes étaient associés à la mortalité des sujets âgés à deux ans mais pas au déclin cognitif. Ces résultats permettent une amélioration de la connaissance des troubles du comportement en Afrique Centrale et de nombreuses perspectives liées à leur prise en charge s’en dégagent. / Neuropsychiatric symptoms are common among older adults with or without cognitive disorders. In sub-Saharan Africa, few population-based studies are focused on these symptoms and to our knowledge no study was conducted in Central Africa. Our main objectivewas to improve the knowledge of neuropsychiatric symptoms in Central Africa (Central African Republic: CAR and Republic of Congo: ROC). Specifically we aimed at describing the neuropsychiatric symptoms, their severity, their distress and associated factors; 2) evaluating the association between neuropsychiatric symptoms and Apolipoprotein E ε4; 3) evaluating the association between neuropsychiatric symptoms, mortality and cognitive decline among older adults We performed the studies, using data from the EPIDEMCA and EPIDEMCA-FU programmes. The prevalence of neuropsychiatric symptoms was 63.7% (95%CI: 59.5-67.8).The overall median score of severity was 9 [IQR: 6-12] and the overall median score of distress was 7 [IQR: 4-10]. Living in Gamboma (rural ROC), normal hearing and having friends in the community were protective while female sex, dementia, dependent personality, and physical disability were risk factors for neuropsychiatric symptoms. Delusions, depression, apathy, disinhibition and aberrant motor behavior were specifically associated with dementia. We are not able to confirm the relationship between neuropsychiatric symptoms and Apolipoprotein E ε4. Neuropsychiatric symptoms were associated with mortality after two years of follow-up but not associated with cognitive decline. This thesis allowed us to improve the knowledge of behavioral disorders in Central Africa. Due to their burden among caregivers, a better management of these symptoms must be performed.

Only one third of older breast cancer survivors (BCS) meet national physical activity (PA) guidelines. Theories of self-regulation and research with older adults suggest that executive function (EF) plays an important role in PA, yet the impact of lower EF on older survivors’ PA is unknown. My project addressed this gap using secondary data from the Thinking and Living with Cancer (TLC) cohort study, which examined cognitive function among older BCS pre-treatment, followed every 12 months, and contemporaneously assessed matched controls. My first aim was to test two hypotheses regarding EF change and PA and determine if these relationships differ between BCS and controls. My hypotheses were: 1) EF decline from baseline to 12 months will predict lower PA at 24 months, and 2) lower PA at 12 months will predict EF decline from 12 to 24 months. My second aim was to explore whether the effects of EF change on PA in BCS differed based on risk factors for accelerated cognitive decline (i.e., older age, more advanced cancer stage, comorbidity, and <i>APOE</i> ε4 genotype). The TLC study measured EF with neuropsychological tests and PA with the International Physical Activity Questionnaire-Short Form. For aims 1 and 2, I used multiple regression with multiple imputation. Primary results showed no significant effect of EF change from baseline to 12 months on PA at 24 months (β=-0.01, p=0.88) and no significant group (BCS vs. controls) by EF interaction (β=-0.05, p=0.33). Separate models in BCS and controls showed similar findings. In the entire sample, PA at 12 months significantly predicted EF change from 12 to 24 months (β=0.17, p=0.01), but there was no significant group by PA interaction (β=-0.06, p=0.54). Separate analyses by group found a significant effect of PA for controls (β=0.07, p=0.02), but not for BCS (β=0.05, p=0.27). Regarding the second aim, there were no significant interactions between EF change and the proposed risk factors on PA. Findings were largely inconsistent with theory and prior research. Continued research in this area will inform future exercise interventions to improve physical and cognitive health for the growing population of older cancer survivors.