Background. Cardiovascular disease (CVD) is a major cause of increased morbidity and mortality globally. Clinical practice guidelines recommend that individuals with CVD are routinely instructed to engage in self-care including diet restrictions, medication adherence, and symptom monitoring. Objectives. To describe the nature of nurse-led CVD self-care interventions, identify limitations in current nurse-led CVD self-care interventions, and make recommendations for addressing them in future research. Design. Integrative review of nurse-led CVD self-care intervention studies from PubMed, MEDLINE, ISI Web of Science, and CINAHL. Primary studies (n = 34) that met the inclusion criteria of nurse-led RCT or quasiexperimental CVD self-care intervention studies (years 2000 to 2012) were retained and appraised. Quality of the review was assured by having at least two reviewers screen and extract all data. Results. A variety of self-care intervention strategies were studied among the male (57%) and Caucasian (67%) dominated samples. Combined interventions were common, and quality of life was the most frequent outcome evaluated. Effectiveness of interventions was inconclusive, and in general results were not sustained over time. Conclusions. Research is needed to develop and test tailored and inclusive CVD self-care interventions. Attention to rigorous study designs and methods including consistent outcomes and measurement is essential.

Second-order rate constants have been measured spectrophotometrically for the reactions of p-nitrophenyl acetate (PNPA) with three α-effect nucleophiles, benzohydroxamate (BHA-), p-methylbenzohydroxamate (MBHA-), and p-methyl-N-methylbenzohydroxamate (M2BHA-), and a corresponding normal nucleophile, m-chlorophenoxide (ClPhO-), in MeCN−H2O mixtures of varying compositions at 25.0 °C. The reactivity of ClPhO- and M2BHA- toward PNPA decreases upon additions of MeCN into the reaction medium up to near 30−40 mol % MeCN and is followed by a gradual increase upon further additions of MeCN. BHA- and MBHA- also exhibit initial rate decreases upon the addition of MeCN up to near 40 mol % MeCN. However, unlike the ClPhO- and M2BHA- systems, the rate enhancement beyond 40 mol % MeCN is negligible for the BHA- and MBHA- systems. The present benzohydroxamates exert a large α-effect in H2O. Interestingly, BHA- and MBHA- show a decreasing α-effect trend with increasing mol % MeCN, while M2BHA- exhibits an increasing α-effect trend, indicating that the magnitude of the α-effect is significantly solvent dependent. Based on the results of the kinetic study and relative basicity measurements, the decreasing α-effect trend shown by BHA- and MBHA- has been attributed to an equilibrium shift of these hydroxamates (I) toward their isomeric structures (II or III) upon the addition of MeCN. The solvent dependent α-effect has led a conclusion that the solvent effect on the α-effect is significant; however, the ground state contribution is not solely responsible for the α-effect in the present system.

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