Matching Items (144)
Description
Health-related quality of life (HR-QOL) is a significant treatment outcome for persons with end-stage renal disease (ESRD); however, little is known about the HR-QOL of Mexican patients with ESRD. This pilot study describes relationships between demographics, sleep disorders, spirituality, mood, folk practices and dialysis modality on the HR-QOL of patients with ESRD residing in Guanajuato, Mexico. Mexican patients receiving continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and hemodialysis (HD) provided information on demographics, clinical health data including body mass index (BMI), and folk health practices. Measures included the Short Form (SF)-36 HR-QOL survey, Sleep Habits Questionnaire, Latin Spirituality Perspective Scale and Hospital Anxiety and Depression Scale. Data were analyzed using SAS software (V9.1). Signifi¬cance level for this pilot study was set at p<0.10. The Quality-Adjusted Life Year method was utilized to examine cost effectiveness for each dialysis modality. Demographics and clinical data showed participants (N=121) to be 59 (SD=13) years, predominantly men (55.4%), married (66.9%), Catholic (92.6%), and not currently working (78.3%). The majority were diabetic (72%) and slightly overweight (BMI M=26.1; SD=5.1). The CAPD group (n=39) demonstrated significantly lower HR-QOL scores compared to the APD (n=42) and HD (n=40) groups. Patients on HD reported higher rates and greater numbers of sleep disorders, including insomnia symptoms, non-restorative and insufficient sleep, and daytime somnolence compared to patients on CAPD and APD. Patients on CAPD reported more anxiety and depression compared to patients on HD and APD. Overall linear regression for HR-QOL found dialysis type, sleep disorders and income to be significant predictors and the model accounted for 31% of the variance. Cost analysis indicated APD as the preferred treatment because it is less costly and results in the best HR-QOL compared to the other treatment modalities. Findings provide the first SF-36 norms for Mexicans with ESRD. Sleep disorders and dialysis type greatly impinge on the HR-QOL of these patients, particularly their mental health. APD was identified as the preferred treatment based on low cost and improved HR-QOL. Results can inform clinical care and health policy for Mexican patients with ESRD.
ContributorsReynaga-Ornelas, Luxana (Author) / Baldwin, Carol M. (Thesis advisor) / Quan, Stuart F (Committee member) / Arcoleo, Kimberly (Committee member) / Arizona State University (Publisher)
Created2011
Description
Larger people generally have more muscle mass and are stronger than smaller people. Muscular strength usually decreases with age, possibly as a function of increases in body fat percentage. However, the effect of age, body fat, and lean mass on peak muscular strength or muscular fatigue is not clear. This was an observational study to determine: a) the relationship of fat mass (FM) and fat free mass (FFM) to peak knee extensor strength and fatigue in young (Y) and middle-aged (MA) women, and b) to determine differences in peak torque between Y and MA women. Participants included 132 women from two age cohorts (Y: 18-33 yrs, n = 70 and MA: 45-65 yrs, n = 62). Data from the MA cohort were collected as part of a previous study and combined with data from the Y group. Both cohorts completed physical activity questionnaires and were measured for body fat using bioelectrical impedance analysis. Both cohorts used identical procedures and machinery to assess isokinetic knee extensor peak torque (PT) at 60°/sec and to determine fatigue index (FI). FI was calculated as the percent decline of PT during 50 maximal repetitions at 240°/sec. Data were assessed for normality, and appropriate Pearson or Spearman correlations were used to compare PT and FI with body composition variables. A one-way ANOVA was used to examine differences in PT and body composition indices between age groups. In Y, FFM and FM were strongly correlated with peak torque. The correlation of FM to PT disappeared when controlling for FFM. There were no significant correlations between FFM or FM and PT in MA. PT was negatively correlated with FI in the combined groups. PT normalized for body mass and FFM were similar between age groups, but decreased with increasing size. In conclusion, PT was positively related to FFM in the combined age groups. Higher FM was not detrimental to absolute PT in Y or MA, but was detrimental to relative PT in both groups. These data suggest that perhaps FM may attenuate the normal relationship between PT and body mass.
ContributorsDeWeese, Robin (Author) / Swan, Pamela (Thesis advisor) / Pabedinskas, Joana (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2011
Description
Other studies have previously demonstrated that perceived stress and maladaptive stress management can lead to harmful outcomes including depression, morbidity, and mortality. College students (especially freshmen) have more difficulty dealing with stress, which can increase their susceptibility to engage in high risk behaviors. The importance of conducting this research is to discover the effects that perceived stress levels may have on depression outcomes in college students, and to evaluate the influence of health related behaviors on this relationship. This study used a retrospective cross-sectional correlational design to examine correlations between perceived stress, physical activity, and other health behaviors on clinical and perceived depression in college students. A random sample of 20,000 students was drawn from 62,476 students enrolled at Arizona State University (ASU). Participants included 2,238 students who volunteered to take the American College Health Association-National College Health Assessment (ACHA-NCHA) in spring 2009. Supplemental questions for ASU students were developed by ASU Wellness and administered as a part of the ACHA-NCHA II. The university sent an invitation email, wherein students were directed through a hyperlink to the survey website. ACHA provided institutional survey data in an SPSS file for analysis. The data were evaluated with Spearman Rho Correlation Analysis and Wilcoxon-Mann-Whitney test. There were more female participants (n = 580) than males (n = 483), both averaged 23 years of age. Men had greater height, weight, and body mass index than females, all were significant mean differences. There were more significant correlations between health factors and having perceived depression than with having real or diagnosed depression. Logistic regression showed that out of all variables and behaviors studied, only high levels of stress, poor general health, substance use, and gender (female) resulted in significant odds in predicting that a participant would be in one of the depression categories. This research suggests that addressing these factors may be important to prevent and reduce depression among college students. This study provides empirical evidence that there is a significant relationship between perceived stress and depression among college students, and that health behaviors such as substance abuse have a negative mediating effect on this relationship.
ContributorsSkipworth, Katherine (Author) / Swan, Pamela (Thesis advisor) / Woodruff, Larry (Committee member) / Moses, Karen (Committee member) / Arizona State University (Publisher)
Created2011
Description
ABSTRACT Fruit and vegetable intake is not uniform across levels of socioeconomic status (SES) and researchers have identified low SES as a risk factor for poor intake of fruits and vegetables. In an effort to eliminate public health disparities and increase fruit and vegetable intake, the Women, Infant, and Children (WIC) program implemented additional food assistance programs, with a specific emphasis on fresh fruits and vegetables. The Farmers' Market Nutrition Program (FMNP) provides pre-existing WIC clients with coupons to purchase fresh, locally grown produce at farmers' markets. In addition, Congress also approved the WIC Cash Value Voucher (CVV) program, which provides WIC participants with vouchers to purchase fresh fruits and vegetables at farmers' markets or grocery stores. The purpose of this thesis was to investigate the relation of FMNP coupon use with accessibility and WIC CVV redemption rates at farmers' markets. Furthermore, this thesis addressed whether WIC shoppers redeemed a higher percentage of their WIC CVV value at farmers' markets or grocery stores. WIC CVV and FMNP issuance and redemption data were analyzed to establish overall redemption rates and total perecent of WIC CVV value redeemed. Accessibility was assessed using the Geographic Information System, which allowed me to calculate the distance that WIC participants would have to travel to redeem their FMNP coupons at FMNP-approved farmers' markets. The results showed that less than 1% of WIC shoppers redeem their WIC CVVs at farmers'markets in Arizona. However, the redemption of WIC CVV was significantly higher during the months when shoppers had the option of using both WIC CVV and FMNP coupons at farmers' markets. Furthermore, the percent of total CVV value redeemed at farmers' markets was 99%, significantly higher than grocery stores (93.5%). Average FMNP coupon redemption rates for 2008-2010 was 43.3%, well below the national average of 59%. However, my spatial analysis revealed that there was no significant association between the distance traveled to farmers' markets and FMNP redemption rates. This indicates that the distance traveled to farmers' markets is not a major barrier to redemption of FMNP coupons in Arizona.
ContributorsTucker, Wesley Jack (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Vaughan, Linda (Committee member) / Johnston, Carol S (Committee member) / Arizona State University (Publisher)
Created2012
Description
"Too often, people in pain are stuck in limbo. With no diagnosis there is no prognosis. They feel that without knowing what is wrong, there is no way to make it right" (Lewandowski, 2006, p. ix). Research has shown that environmental factors, such as views of nature, positive distractions and natural light can reduce anxiety and pain (Ulrich, 1984). Patients with chronic, painful diseases are often worried, anxious and tired. Doctor's appointments for those with a chronic pain diagnosis can be devastating (Gilron, Peter, Watson, Cahill, & Moulin, 2006). The research question explored in this study is: Does the layout, seating and elements of positive distraction in the pain center waiting room relate to the patients experience of pain and distress? This study utilized a mixed-method approach. A purposive sample of 39 individuals participated in the study. The study employed the Positive and Negative Affect Schedule (PANAS), the Lewandowski Pain Scale (LPS) and a researcher developed Spatial Perception Instrument (SPI) rating the appearance and comfort of a pain center waiting room in a large metropolitan area. Results indicated that there were no significant correlations between pain, distress and the waiting room environment. It is intended that this study will provide a framework for future research in the area of chronic pain and distress in order to advance the understanding of research in the waiting area environment and the effect it may have on the patient.
ContributorsDraper, Heather (Author) / Bender, Diane (Thesis advisor) / Shraiky, James (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2012
Description
The effects of a long-term combat deployment on a soldier's physical fitness are not well understood. In active duty soldiers, combat deployment reduced physical fitness compared to pre-deployment status, but no similar research has been performed on Army National Guard soldiers. This study is the first to identify physical fitness changes in Arizona National Guard (AZNG) soldiers following deployment to a combat zone and to assess the relationships between physical fitness and non-combat injuries and illness (NCII). Sixty soldiers from the Arizona National Guard (AZNG) completed a battery of physical fitness tests prior to deployment and within 1-7 days of returning from a 12-month deployment to Iraq. Pre and post-deployment measures assessed body composition (Bod Pod), muscular strength (1RM bench press, back-squat), muscular endurance (push-up, sit-up), power (Wingate cycle test), cardiorespiratory fitness (treadmill run to VO2 peak), and flexibility (sit-and-reach, trunk extension, shoulder elevation). Post deployment, medical records were reviewed by a blinded researcher and inventoried for NCII that occurred during deployment. Data were analyzed for changes between pre and post-deployment physical fitness. Relationships between fitness and utilization of medical resources for NCII were then determined. Significant declines were noted in mean cardiorespiratory fitness (-10.8%) and trunk flexibility (-6.7%). Significant improvements were seen in mean level of fat mass (-11.1%), relative strength (bench press, 10.2%, back-squat 14.2%) and muscular endurance (push-up 16.4%, sit-up 11.0%). Significant (p < 0.05) negative correlations were detected between percentage change in fat mass and gastrointestinal visits (r = -0.37); sit-and-reach and lower extremity visits (r= -0.33); shoulder elevation and upper extremity visits (r= -0.36); and cardiorespiratory fitness and back visits (r= -0.31); as well as behavioral health visits (r= -0.28). Cardiorespiratory fitness changes were grouped into tertiles. Those who lost the greatest fitness had significantly greater number of NCII visits (8.0 v 3.1 v 2.6, p = .03). These data indicate a relationship between the decline in cardiorespiratory fitness and an overall increase in utilization of medical resources. The results may provide incentive to military leaders to ensure that soldiers maintain their cardiorespiratory fitness throughout the extent of their deployment.
ContributorsWarr, Bradley (Author) / Swan, Pamela (Thesis advisor) / Lee, Chong (Committee member) / Campbell, Kathryn (Committee member) / Erickson, Steven (Committee member) / Alvar, Brent (Committee member) / Arizona State University (Publisher)
Created2011
Description
Introduction: Several faith-based or faith-placed programs have focused on the physical dimension of wellness in efforts to improve health by increasing physical activity and improving diet behaviors. However, these programs were not designed to intervene on the mental dimension of wellness which is critical for stress reduction and health behavior change. Purpose: To evaluate the feasibility of a spirituality-based stress reduction and health behavior change intervention using the Spiritual Framework of Coping (SFC) model. Methods: This study was a quasi-experimental one group pretest posttest design. The study was a total of eight weeks conducted at a non-denominational Christian church. Participants were recruited from the church through announcements and flyers. The Optimal Health program met once a week for 1.5 hours with weekly phone calls during an additional four week follow-up period. Feasibility was assessed by the acceptability, demand, implementation, practicality, integration, and limited efficacy of the program. Analysis: Frequencies for demographics were assessed. Statistical analyses of feasibility objectives were assessed by frequencies and distribution of responses to feasibility evaluations. Limited efficacy of pretest and posttest measures were conducted using paired t-test (p <.05). Results: The Optimal Health Program was positively accepted by participants. The demand for the program was shown with average attendance of 78.7%. The program was successfully implemented as shown by meeting session objectives and 88% homework completion. The program was both practical for the intended participants and was successfully integrated within the existing environment. Limited efficacy changes within the program were mostly non-significant. Conclusion: This study tested the feasibility of implementing the Optimal Health program that specifically targeted the structural components of the Spiritual Framework of Coping Model identified to create meaning making and enhance well-being. This program may ultimately be used to help individuals improve and balance the spiritual, mental, and physical dimensions of wellness. However, length of study and limited efficacy measures will need to be reevaluated for program success.
ContributorsWalker, Jenelle R (Author) / Swan, Pamela (Thesis advisor) / Ainsworth, Barbara (Committee member) / Chisum, Jack (Committee member) / Fleury, Julie (Committee member) / Hooker, Steven (Committee member) / Arizona State University (Publisher)
Created2012
Description
ABSTRACT PHYSCIAL ACTIVITY AND EXECUTIVE FUNCTIONING IN COLLEGE STUDENTS INTRODUCTION: Regular physical activity may increase neurological development, which has been shown to increase cognitive functioning in older adults and those with dementia. Studies have also shown physical activity and exercise may positively affect executive functioning in children. Little is known about the influence of physical activity on executive functioning in college students between the ages of 18-21 years, a population that is traditionally thought of as healthy. Therefore, the purpose of this study is to explore the association between physical activity and executive functioning in college-aged students. We hypothesize that regular physical activity is positively associated with executive functioning scores and that this association is independent of adiposity. METHODS: Twenty males and 29 females (19.5 ± 0.1 yrs. old) participated in this study. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Executive function was assessed by Stroop Color and Word Association Test (Stroop) and Trail Making Test A & B. A verbal ability test (analogies, synonyms, antonyms) was given in order to control for intelligence. Body composition was determined by a Tanita TBF-300 Body Composition Analyzer. RESULTS: Partial correlations between physical activity/inactivity measures and measures of executive functioning were generally small (r-values ≤ 0.2) and not significant. However, there was a significant inverse correlation between log moderate physical activity minutes per week and Stroop interference scores (r=0.50, p=0.01). Also, a trend towards significance was noted for the correlation between sitting minutes per week and Stroop interference scores (r=0.4 p=0.08) CONCLUSION: These results suggest that in college students, moderate physical activity is inversely associated with executive functioning while sitting time may be positively associated with executive functioning. These findings are in contrast to previous studies in children and older adults, and may indicate a unique relationship between physical activity/inactivity and executive functioning in college students. Future studies to further examine this population in greater depth are warranted.
ContributorsBurks, Hillary (Author) / Shaibi, Gabriel (Thesis advisor) / Swan, Pamela (Committee member) / Limbers, Christine (Committee member) / Arizona State University (Publisher)
Created2012
Description
This study examined whether cognitive behavioral therapy and mindfulness interventions affect positive (PA) and negative affect (NA) reports for patients with rheumatoid arthritis (RA) before, during, and after stress induction. The study also investigated the effects of a history of recurrent depression on intervention effects and testing effects due to the Solomon-6 study design utilized. The 144 RA patients were assessed for a history of major depressive episodes by diagnostic interview and half of the participants completed a laboratory study before the intervention began. The RA patients were randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P), mindfulness meditation and emotion regulation therapy (M), or education only attention control group (E). Upon completion of the intervention, 128 of the RA patients participated in a laboratory session designed to induce stress in which they were asked to report on their PA and NA throughout the laboratory study. Patients in the M group exhibited dampened negative and positive affective reactivity to stress, and sustained PA at recovery, compared to the P and E groups. PA increased in response to induced stress for all groups, suggesting an "emotional immune response." History of recurrent depression increased negative affective reactivity, but did not predict reports of PA. RA patients who underwent a pre-intervention laboratory study showed less reactivity to stressors for both NA and PA during the post-intervention laboratory study. The M intervention demonstrated dampened emotional reactions to stress and lessened loss of PA after stress induction, displaying active emotion regulation in comparison to the other groups. These findings provide additional information about the effects of mindfulness on the dynamics of affect and adaptation to stress in chronic pain patients.
ContributorsArewasikporn, Anne (Author) / Zautra, Alex J (Thesis advisor) / Davis, Mary C. (Committee member) / Karoly, Paul (Committee member) / Arizona State University (Publisher)
Created2012
Description
This dissertation examines associations between religious affiliation, religious community context and health of women and their children in Mozambique focusing on the following issues: (1) attending prenatal consultations and delivering children in a health facility; (2) women's symptoms of STDs; and (3) under-five mortality. Estimation of random intercept Poisson regression for the outcome about attending prenatal consultations demonstrated a favorable effect of affiliation to Catholic or Mainline Protestant and Apostolic religious groups. The concentration of Zionist churches in the community had a negative influence. Random intercept logistic regression was used to estimate the relationship between religion and institutional child delivery. Affiliation to Catholic or Mainline Protestant denominations as well as concentration of Catholic or Mainline Protestant churches in the community had some beneficial effect on giving birth in health clinics. The presence of Zionist churches in the community had some negative effect and that of other groups no significant influence. Random intercept logistic regression was also employed for investigating the influence of religion on women's symptoms of STDs. Belonging to the Catholic or Mainline Protestant church had some protective effect on reporting symptoms of STDs. There was no effect of religious context, except that the concentration of Other Pentecostal churches had a positive effect on reporting symptoms of SDTs. Event-history analysis was conducted for examining relationships between maternal religious affiliation with under-five mortality. Affiliation to Catholic or Mainline Protestant churches and to Apostolic denominations increased the odds of child survival, although, the influence of having a mother belonging to Catholic or Mainline Protestant churches lost statistical significance after accounting particularly for the average level of education in the community, for the period of 5 years preceding the survey date. Taken together, the results in this dissertation show some protective effect of religion that varies primarily by denominational group to which women are affiliated. They also indicate that religious community context may have some negative effect on health of women and children. The nature of the effect of religious community context varies with the type of outcome considered and the type of religious mixture in the community.
ContributorsCau, Boaventura Manuel (Author) / Agadjanian, Victor (Thesis advisor) / Hayford, Sarah (Committee member) / Yabiku, Scott (Committee member) / Arizona State University (Publisher)
Created2011