European Journal of Cardiovascular Nursing

Article	Citations
Living with heart failure- experience of using an online support program for patients with heart failure	124
Measuring cardiorespiratory fitness in a blood sample. Higher NT-pro-BNP and HS-CRP levels correlate with reduced VO2-peak but not 6-minute walk distance	109
Preparedness for caregiving among informal caregivers of people with heart failure: insights into challenges and areas for improvement	94
Informing health policy to strengthen the clinical nurse specialist workforce: Insights from Canada	88
Who wants to stay in hospital?	87
Impact on nurse workload and patient satisfaction of atrioventricular junction ablation performed simultaneously with conduction system pacing using a superior approach from the pocket compared with t	74
Determination of Factors Affecting Hypertension Awareness, Compliance to Treatment and Blood Pressure Control	58
The experience of living with congenital heart disease from the perspective of the affected child or adolescent and its family: a systematic qualitative review	55
Full spectrum of symptoms associated with heart failure: a mixed-method systematic review and narrative synthesis	55
Caregiver contributions to general and specific self-care of patients affected by heart failure and other chronic conditions	50
A further update on symptom clusters among patients with heart failure: a systematic review and meta-analysis	41
Echocardiographic parameters and Galectin-3 in patients with atrial fibrillation as a marker of left atrial fibrosis	38
Expectations and experiences of tele-yoga in persons with heart failure a longitudinal qualitative design	34
Optimization of antiplatelet therapy in patients with coronary artery disease and type 2 diabetes mellitus after percutaneous coronary interventions	33
Exploring patient, informal caregiver, and nurse experiences with home-based hospital-level care for decompensated heart failure: a mixed-methods study	31
Home-based, short-duration, high-intensity interval inspiratory muscle training improves exercise capacity of patients with chronic heart failure: a double-blind study	26
Silent struggles to self-manage high blood pressure among deaf sign language users: a qualitative study	25
Editor’s note	25
From validation to action: a commentary on caregiver preparedness in coronary heart disease	24
The right treatment for the right patient: utility of exergaming and medical yoga for heart failure patients	24
Stroke disease–specific quality of life trajectories and their associations with caregivers’ anxiety, depression, and burden in stroke population: a longitudinal, multicentre study	24
One patient’s perspective: the heart valve as the ticking sound of life	24
Understanding implementation outcomes of cardiovascular rehabilitation for transient ischaemic attack and mild stroke: a process evaluation	23
Kinematic parameters related to functional capacity, fatigue, and breathlessness during the 6-min walk test in older adults with heart failure with preserved ejection fraction	21
Perspectives on barriers and facilitators to lifestyle change after cardiac events among patients in Saudi Arabia: a qualitative study	21

Hair-y results suggest a link between stress and physical activity in patients with heart failure	20
The EU Safe Hearts Plan: from policy to real-world implementation	20
Measuring up: the significance of measurement invariance in cardiovascular research	19
Both sides of the fence: a cardiology journey	19
Validation of a novel method of assessing autonomic function using ultrasonography in patients with heart failure: a pilot cross-sectional study	19
Psychological screening in cardiovascular care	18
Exploring symptom clusters and core symptoms during the vulnerable phase in patients with chronic heart failure: a network-based analysis	18
Solutions to address low response rates in online surveys	18
Decrease in the prevalence of hypertension in Spanish schoolchildren from 2010 to 2017: Cuenca Study	18
Different levels of continuous training improve echocardiographic parameters, quality of life, and functional capacity in heart failure with reduced ejection fraction patients	17
The prevalence of negative attitudes towards nurses and depressive symptoms in nurses working in cardiology departments in Malopolska region, preliminary results.	17
Patients with and without history of atrial fibrillation after percutaneous coronary intervention increased focus on modifiable risk factors	17
Positive psychology differences and risk stratification between STEMI and NSTEMI	17
Sex differences in acute myocardial infarction - Preliminary results from an umbrella review	17
Symptom network structure of anxiety, depression, and their impact on quality of life in patients undergoing percutaneous coronary intervention: a cross-sectional study	16
The af virtual ward, right care, right time and right team	16
‘Replace uncertainty with information’: shared decision-making and decision quality surrounding catheter ablation for atrial fibrillation	15
The promise and potential pitfalls of artificial intelligence in risk prediction models	15
The patient experience of in-hospital telemetry monitoring: a qualitative analysis	15
The cardiac rehabilitation needs and preferences of women living in rural communities: a qualitative study of co-designing a women-focused cardiac rehabilitation program	15
‘Letter to the editor—interpreting the effectiveness of cognitive behavioural therapy and self-management strategies in heart failure patients for improving sleep’, in response to the article – ‘copin	15
Letters to the editor: questionable publishing practices in the ChatGPT era	14
Assessing of nutritional status of patients with heart failure on a cardiology ward	14
Nurse-led multi-component behavioural activation programme to improve health outcomes in patients with atrial fibrillation: a mixed-methods study and feasibility analysis	14
Pilot study of a nurse-led educational and follow-up intervention at the heart failure clinic	14
The length of the cardiovascular history influences the quality of life	14
Measuring what matters, measuring well: a call to strengthen health-related quality of life patient-reported outcome measures in cardiovascular care	14
Phases in the heart failure trajectory: perception of cardiac nurses	14
The invisible epidemic: alcohol and cardiovascular harm	14
Why should a national cardiology society affiliate with the Association of Cardiovascular Nursing and Allied Professions?	13
Assessing physical activity in heart failure with the CHAMPS physical activity questionnaire	13
Response to the letter to the editor – Brain Pro-TCT: a prospective, quasi-experimental study on early delirium detection with Delirium Observation Screening Scale versus single-channel EEG after card	13
Exploring how enrolment in the TARGET-CTCA clinical trial may modify patient perception of heart health	13
Management of modifiable risk factors and comorbidities in atrial fibrillation: suggestions for improvement from a patient perspective	13
The role of illness acceptance and social support in assessing readiness for hospital discharge following myocardial infarction	13
Spontaneous coronary artery dissection in cardiac rehab: an exploration of lived experiences of patients and the knowledge, understanding, and perceptions of healthcare professionals	13
Frailty changes after cardiac surgery: better or worse?	13
Understanding cumulative low income as a driver of cardiovascular health inequities	12
Coping, symptoms, and insomnia among people with heart failure during the COVID-19 pandemic	12
Embedding sustainability in organizational process—a critical step to addressing greenhouse gas emissions	11
Digital and technological solutions in cardiovascular nursing and perspectives for a smooth digital shift: a discussion paper	11
Different kinetics of NT-proBNP and sST2 highlight different therapeutic pathways of sacubitril/valsartan	11
Influence of sacubitril/valsartan on diastolic parameters in patients with chronic heart failure with reduced ejection fraction	11
Nursing e-learning solution staff experience	11
Minister for one day: how patient and public involvement drives cardiovascular policy making	11
Sex moderates the relationship between social support and cardiovascular prevention behaviors in middle-aged and older adults	11
Effects of exergaming and yoga on exercise capacity, symptoms, functional capacity, and physical and mental health in patients with heart failure	11
The Polish version of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q)	11
Effectiveness of therapist-supported internet-based cognitive behavioural therapy interventions on depression, anxiety and quality of life among patients with cardiovascular disease: a systematic revi	11
A mobile phone app for obtaining daily reports of symptoms, self-care, and decision making	11

Quality of life in patients with heart failure and implantable cardioverter defibrillator. Results from 42 heart failure clinics in norway	11
Increased heart attack mortality in a medium sized city in Germany: key informant interviews with local medical health care workers	11
Genomics in nursing student placement pilot within an inherited cardiac conditions clinic	10
Electrocardiographic findings and cardiovascular risk profile in paralympic athletes	10
Self-reported cognitive function and its relationship with self-reported health, psychological distress, and life satisfaction among cardiac arrest survivors - a nationwide register study	10
Quality of life up to one year after revascularisation with percutaneous coronary intervention in patients with previous coronary artery bypass surgery	10
An insight into healthcare professionals’ perspectives on discussing implantable cardioverter defibrillator deactivation	10
Patient reported experience and adherence to remote patient management in chronic heart failure patients: a posthoc analysis of the TIM-HF2 trial	10
Wearable ECG technology for cardiac monitoring	10
The 'scan and treat' clinic; early evaluation of an advanced clinical practitioner (ACP) led combined echocardiography and outpatient cardiology clinic	10
The detection of sudden cardiac death sports preparticipation in sports population adult: a narrative review	10
Optimizing support before and after cardiac resynchronization therapy implantation in co-creation with patients with heart failure, informal caregivers, and healthcare professionals	10
Are we expecting too much from digital applications in atrial fibrillation or is it about level of engagement?	10
Another call to action for physical and psychological SCAD-specific rehabilitation	10
Xerostomia in patients with heart failure - prevalence, intensity and reported strategies of symptom reduction	10
Can the use of a structured management approach using ABCDEF mnemonic to manage multi-morbdiity in HFpEF improve clinical outcomes?	10
A review and promise of digital health technologies to promote global cardiovascular health	10
The forgotten aspect of chronic disease management: caregivers in atrial fibrillation	9
Effects of a culturally tailored low-glycaemic index dietary educational intervention on reducing cardiometabolic risk among Chinese adults with obesity: a randomized controlled trial	9
Health-related quality-of-life for people with a Fontan circulation, their parents, and siblings	9
Developing a Cardiac TeleRehabilitation model using co-production with patients, family members, and healthcare professionals	9
Adverse clinical events during the first 24 h of bedrest following cardiac electronic device implantation: a prospective observational study	9
Co-designing an information map guiding patients on their journey to cardiac rehabilitation in Austria	9
What we say, when and how we say it: the ethics of patient communication	9
Associations between dyadic spirituality, caregiver burden, disability, and health-related quality of life in stroke survivor–caregiver dyads: a dyadic structural equation modelling study	9
Impact of comorbid anxiety and depression on heart failure diagnosis, hospitalisation, and survival outcomes: an observational study of over 400,000 patients in England	9
The Role of Cardiovascular Disease Journals in Reporting Sex and Gender in Research	9
Transcribing in the digital age: qualitative research practice utilizing intelligent speech recognition technology	9
Patient decision aids for aortic stenosis and chronic coronary artery disease: a systematic review and meta-analysis	9
Patient participation in hypertension care: do preferences matter?	8
Role of rapid 12-lead electrocardiogram in triage initiatives for ST-elevation myocardial infarction patients self-presenting in emergency departments: a systematic review and meta-analysis	8
Practical guidance for conducting research with older adults: creating reliable evidence to improve care	8
Marathon not sprint: fatigue and early symptoms detected with sympathetic dysfunction in patients with heart failure	8
Supported in principle, challenges prevail: Patients and healthcare professionals' perspectives on the implementation of shared decision-making for the treatment of aortic stenosis	8
Mapping non-pharmacological interventions across clinical, physical-functional, psycho-cognitive and social dimensions for frail people with heart failure: a scoping review	8
Setting research priorities for the use of digital technology in the self-management of heart health: the results of the James Lind Priority Setting Partnership	8
Nurse-led titration models of care for heart failure reduced ejection fraction: a systematic narrative review of characteristics, patient outcomes, and healthcare resource utilization	8
Efficacy and workload implications of the Triage-HF™ algorithm in a nurse- and allied professional-led heart failure care pathway	8
Silo based care as a guiding principle: a focused ethnographical study of clinical nursing practice in intrahospital transitions in cardiac care	8
Spontaneous coronary artery dissection (SCAD) websites: systematic appraisal of content, quality, readability and suitability of websites for SCAD survivors	8
Association between cumulative low-income status and cardiovascular event incidence and mediating effect of engagement in health behaviour: a retrospective cohort study	8
Improving the mental health of patients with heart disease	8
Sexual health after myocardial infarction: from an overlooked stigma to a professional advocacy action	8
Breaking barriers to heal hearts: community developed solutions to cardiac rehabilitation participation in south asian service users	8
Experience of integrating mobile applications in the self-management of patients with heart failure	7
Hemostasis of the radial artery after coronary angiography: a scoping review	7
Artificial intelligence agent for delirium screening among patients in oncology and cardiac intensive care units: a proof-of-concept study	7
Dyadic effects of family resilience and mutuality on self-care in chronic heart failure patients and caregivers: an Actor-Partner Interdependence Mediation Model	7
Sense of coherence and quality of life in the recovery of women and men with myocardial infarction: a 10-year follow-up study	7
Empowerment trajectories in patients with chronic heart failure: a descriptive correlational study	7
Open Access publishing: benefits and challenges	7
A better quality in the relationship between patients with heart failure and nurses reduces hospital admissions and adverse clinical events	7
Hypertension management and outcomes during the covid-19 pandemic: diagnosis, blood pressure telemonitoring use and mortality	7
Patient-reported outcomes in the aging population of adults with congenital heart disease: results from APPROACH-IS	7
Applications of artificial intelligence for nursing: has a new era arrived?	7
Artificial intelligence-generated podcasts open new doors to make science accessible: a mixed-method evaluation of quality and the potential for science communication	7
Does nurse-led point-of-care ultrasound (POCUS) improve the triage of elderly community patients with suspected heart failure? A feasibility study	7
Current status of social frailty and its associated physical-psychological factors in older adult patients hospitalized with heart failure: a cross-sectional study	7
Developing a care pathway for heart failure with preserved ejection fraction: patient perceptions of existing care and their needs	7
Management of the patient with a wearable cardiac defibrillator in a virtual remote monitoring clinic	7
Co-designing an online support program for and with informal carers of people with heart failure	7
A multidisciplinary team approach in the 2024 ESC guidelines for the management of patients with Atrial Fibrillation—what is the role of nurses and allied professionals? A Clinical Consensus Statement	7
Implementing caregiver-reported outcomes in cardiovascular diseases: Challenges with documentation and provision of services to support caregivers	7
A pilot randomized controlled trial to test the feasibility of a mobile health (mHealth) self-help intervention for adults after cardiac surgery	7
Modernization of cardiac rehabilitation: opportunities and considerations in smartphone technology supported cardiac rehabilitation	7
The global burden of cardiovascular disease in adults	7
Consequences of chronic heart failure on the persons social dimension	6
Role of compliance to dietary and physical activity recommendations for better quality of life in patients with chronic heart failure	6
Assessment of pain intensity and analgesic requirements in patients with diabetes mellitus after STEMI	6
Effects of internet-delivered cognitive behavioral therapy for patients with cardiovascular disease and depression on quality of life. A sub-analysis of a randomized controlled trial	6
The cost-effectiveness of nurse-led self-care interventions in patients with heart failure	6
Risk factors for readmission after isolated coronary bypass graft surgery: context matters	6
Complications in the postoperative period of heart transplantation: a retrospective cohort	6
Recovery from severe cardio-respiratory failure: the trajectory of muscle mass, strength, function and health related quality of life	6
Cost-effectiveness of an inpatient nurse practitioner in heart failure	6
Factors determining the lifestyle and the level of health behaviors of patients with circulatory failure	6
Developing a pathway for individuals with heart failure with preserved ejection fraction (hfpef): scoping the population accessing unscheduled care	6
Does the ESC chronic coronary syndrome pre-test probability score assist coronary artery disease diagnosis in an advanced nurse practitioner led integrated community chest pain clinic?	6
Infective endocarditis in octogenarians: a retrospective study in a single, high-volume surgical centre	6
Translating and validating the Parental Protection Scale (PPS) and the Child Vulnerability Scale (CVS) into arabic among children with and without congenital heart disease	6

Helping patients to make decisions about treatments for aortic stenosis and coronary artery disease	6
Psychometric evaluation of the Thai version of the Self-Care of Coronary Heart Disease Inventory Version 3	6
Navigating the complexities of addressing alcohol use in cardiology services	6
The transition to adult care for patients with congenital heart disease: Nurses' experiences. A qualitative study	6
The lived experience of loneliness and social isolation in patients with pulmonary arterial hypertension: A phenomenological study	6
Quality of life is an independent predictor of mortality in patients with heart failure: a prospective cohort study from the Colombian heart failure registry (RECOLFACA)	6
Factors associated with somatic symptoms perception in patients living with heart failure	6
What are the strengths, weaknesses, opportunities and threats of implementing exergaming in healthcare for persons with heart failure?	6
Nudging stroke survivors toward better self-management: a commentary	6
The impact of informal caregivers’ preparedness on short-term outcomes of heart failure patients with insufficient self-care	5
Measuring the psychological and social dimensions in patients with cardiac implantable electronic devices: a needed assessment	5
Review on clinical strategies for managing patients with elevated Lp(a): Cost-effectiveness of Lp(a) testing and awareness of lifestyle changes via Public Health Policy in absence of targeted therapy	5
Evaluation of a digital patient education programme for Chinese immigrants after a heart attack	5
Does the psychological risk exposure increase carotid plaque detection among the Chinese midlife population? A latent class and regression analysis	5
Effectiveness of psychological interventions in reducing post-traumatic stress among post-myocardial infarction patients: a systematic review and meta-analysis	5
Fear of progression in Chinese patients after cardiac valve replacement: profiles, influencing factors, and mechanisms	5
Equality, diversity, and inclusion in artificial intelligence-driven healthcare chatbots: addressing challenges and shaping strategies	5
Theoretical implications and considerations of transitional care interventions to improve health outcomes for patients after percutaneous coronary intervention	5
Development and psychometric testing of the Heart-Healthy Information Questionnaire	5
Mortality, morbidity, and cardiovascular risk factor outcomes from cardiac rehabilitation, in ethnic minorities: a systematic review and meta-analysis	5
Self-Care for a Heart-Healthy Lifestyle scale in cardiovascular disease prevention: development and psychometric testing	5
Factors influencing forearm swelling after transradial artery intervention and establishment of a predictive model: a prospective study	5
Pre-hospital delay intention and its associated factors in the high-risk population of stroke: a latent profile analysis	5
Psychometric validation of the Caregiver Preparedness Scale in family caregivers of patients with coronary heart disease	5
Two for the price of one: does treating depression in cardiac patients using internet-based cognitive behavioural therapy also reduce anxiety symptoms?	5
Using ChatGPT and Google Bard to improve the readability of written patient information: a proof of concept	5
Sex differences in the nutritional status and its association with long-term prognosis in patients with heart failure with reduced ejection fraction: a prospective cohort study	5
Candidate biomarkers of physical frailty in heart failure: an exploratory cross-sectional study	5
Patient empowerment in the clinical encounter and beyond	5
Educational inequalities among adolescents with a parent diagnosed with heart disease: a Danish National Register Study	5
Listening to the patient voice on home-based cardiac rehabilitation: a qualitative audit mapping patient-reported outcomes to current european guidelines	4
Progress with fear of progression post-cardiac valve replacement	4
Pharmacist-led education: a promising step towards optimal anticoagulation management in atrial fibrillation	4
Supportive care improves self-care management and knowledge of patients with heart failure and diabetes mellitus	4
Advancing cardiovascular health: photoplethysmography as a tool for electrocardiogram signal acquisition	4
Correction to: The importance of respectful language to enhance care. A statement of the Association of Cardiovascular Nurses & Allied Professions (ACNAP) of the ESC, the ESC Patient Forum and the	4
Determinants of adherence to diet and exercise behaviours among individuals with metabolic syndrome based on the Capability, Opportunity, Motivation, and Behaviour model: a cross-sectional study	4
Affective symptoms, cognitive function and self-care behaviours in adults with heart failure according to ejection fraction phenotype	4
Clinician perspectives on activity trackers for cardiac rehabilitation: a multinational study	4
Is Reiki effective in reducing heart rhythm, cortisol levels, and anxiety and improving biochemical parameters in individuals with cardiac disease? Randomized placebo-controlled trial	4
Vulnerability to environmental and climatic health provocations among women and men hospitalized with chronic heart disease: insights from the RESILIENCE TRIAL cohort	4
Dyadic relationships between informal caregivers and older adults with chronic heart failure: a systematic review and meta-synthesis	4
Remote monitoring program: a case study of 469 heart failure patients in a general hospital setting	4
Quality of life and frailty: an important issue for elderly patients with an implanted pacemaker.	4
Where are we now four years on-The uptake of influenza and COVID vaccinations amongst Heart Failure Patients?	4
Sex-related differences in the impact of nutritional status on in-hospital mortality in heart failure: a retrospective cohort study	4
Using m-health and wearable technologies to promote self-management and treatment adherence among cardiovascular disease patients: a clinical trial protocol	4
Spatial methods for measuring access to health care	4
An intervention to improve caregiver self-efficacy and contribution to self-care does not affect caregiver anxiety, depression, quality of life and sleep. Secondary outcome analysis of MOTIVATE-HF RCT	4
Anxious avoidance informs behavioural interventions for individuals with cardiovascular disease: a commentary	4
Comparative risk of permanent pacemaker implantation in SAVR with sutureless valve prosthesis versus TAVI	4
A simple dietary intervention to reduce inflammation and oxidative stress in individuals with metabolic syndrome	4
The surrogate decision-making experience of family members for patients with acute stroke: a qualitative meta-synthesis	4
‘Snapshot’ cohort study design across multi-site research settings: challenges, strategies, and solutions	4
The effect of standalone audio-visual feedback devices on the quality of chest compressions during laypersons’ cardiopulmonary resuscitation training: a systematic review and meta-analysis	4
A digital intervention for symptom management in patients with heart failure: an early-stage intervention development study	4
The effects of auricular acupressure on blood pressure, stress, and sleep in elders with essential hypertension: a randomized single-blind sham-controlled trial	4
When age is not a barrier, but frailty is	4
Cumulative complexity: a qualitative analysis of patients' experiences of living with heart failure with preserved ejection fraction	4
Developing Shared Decision-Making Workflow for Cardiovascular Health: A Modified Delphi Process	4
Clinical service organisation for adults with atrial fibrillation: Cochrane systematic review and meta-analysis	4
Reading between the lines: NLP, symptom documentation, and a new era of cardiovascular prognostication	4
Feasibility of alcohol interventions in cardiology: a mixed methods study of clinician perspectives in sweden	4
Template analysis: a practical guide	4
Essesment of short-term clinical outcomes in coronary artery disease patients after PCI on the background of low glycemic diet	4
The psychological, social, and quality of life outcomes of people with a cardiac implantable electronic device: an umbrella review	4
Why isn’t frailty being assessed on an ongoing basis within the cardiac setting?	4
The significant value of educated nurse in ECG Holter monitoring interpretation	4
Strengthening cardiovascular nursing education and workforce is a critical strategy for addressing the growing cardiovascular disease epidemic in Africa	4
Radiation exposure of patients undergoing transcatheter aortic valve implantation and factors contributing to it	4
Modelling presentation delay in stroke—what are we learning?	4
Player-centered, iterative, and interdisciplinary design and development of a mobile exergame for older cardiac patients	4
Prevalence and correlates of anxiety and depressive symptoms after spontaneous coronary artery dissection: a cross-sectional study	4
Call for the development and use of nurse practitioner sensitive outcome measures	4
Patient and public involvement in the management and prevention of cardiovascular disease: a statement of the Association of Cardiovascular Nursing and Allied Professions of the ESC and the ESC Patien	4
The why and the how of communicating research	4
Developing a cardiac telerehabilitation model in an outpatient clinic, using participatory action research design	4
Reducing waste in the cardiac catheterization laboratory: insights from a co-design workshop	4
Association between socioeconomic position and discontinuation of pharmacotherapy for heart failure after cardiac resynchronization therapy	4
Radial artery occlusion after coronary angiography with trans radial access: a nurse led study employing duplex ultrasonography and the reverse Barbeau test	4
Health literacy and prognosis of heart failure: a prospective propensity-matched study in the community	4
Blood pressure control and treatment burden from comorbidities	4
Feasibility of alcohol interventions in cardiology: a qualitative study of clinician perspectives in Sweden	4
Understanding anxiety and depression after spontaneous coronary artery dissection: targets for intervention	3
Research partnerships and collaboration in cardiovascular nursing	3
How is digital technology used to facilitate shared decision-making between healthcare professionals and patients in cardiovascular care? A scoping review	3
In memory of John Sharpley: a patient with HFpEF who really made a difference	3
Nutritional Status among patients with Heart Failure and Thyroid Diseases - Result of Nutritional Status Heart Study (NSHS)	3
Dietary behaviour changes occur in informal caregivers but not stroke survivors after a community programme: a prospective observational pilot study	3
Nurse-led care, safe and sedated with a framework?	3
Digital healthcare consumption: lessons about online information	3
Patient perspectives on oral anticoagulation for atrial fibrillation: can more specific communication on bleeding risk help?	3
The importance of actively engaging with close family members during and after in-hospital cardiopulmonary resuscitation in adult patients	3
The impact of fear of recurrence and progression on mental health after spontaneous coronary artery dissection: the role of illness uncertainty	3
Prognostic role of sarcopenia on major adverse cardiac events among patients who underwent successful percutaneous coronary intervention: a retrospective cohort study	3