Matching Items (287)
Description
With the development of technology, using photographs to measure plate waste is an increasing
trend. These photographs are later analyzed when the data is being entered into a form or
system. Previously, these forms or systems have not been assessed for usability. This research
study looks at three iterations of a digital plate waste observation system developed for the
School Lunch Study at Arizona State University. The System Usability Scale was used to
understand the functionality of the digital plate waste observation system. An area for free
responses was used to understand aspects of the system that were liked by research assistants
and what technical difficulties the research assistants encountered. These responses were used to
develop the next version of the digital plate waste observation system. Time to complete a task
was calculated to see the trends across all versions of the system. With each version, the System
Usability Scale scores increased along with the time to complete a task. This study found that
following the workflow of research assistants, being able to manipulate a photograph, having
menu items populated, and decreasing the amount of typing performed by adding selections to be
useful design aspects. Future digital plate waste observation systems can implement the
successful design aspects of this system, be aware of errors experienced, and implement helpful
features not found in this system. Future studies can look at the effect proctored training sessions
have on the time to complete a task and the relation of System Usability Scale scores with the
success of data entry.
trend. These photographs are later analyzed when the data is being entered into a form or
system. Previously, these forms or systems have not been assessed for usability. This research
study looks at three iterations of a digital plate waste observation system developed for the
School Lunch Study at Arizona State University. The System Usability Scale was used to
understand the functionality of the digital plate waste observation system. An area for free
responses was used to understand aspects of the system that were liked by research assistants
and what technical difficulties the research assistants encountered. These responses were used to
develop the next version of the digital plate waste observation system. Time to complete a task
was calculated to see the trends across all versions of the system. With each version, the System
Usability Scale scores increased along with the time to complete a task. This study found that
following the workflow of research assistants, being able to manipulate a photograph, having
menu items populated, and decreasing the amount of typing performed by adding selections to be
useful design aspects. Future digital plate waste observation systems can implement the
successful design aspects of this system, be aware of errors experienced, and implement helpful
features not found in this system. Future studies can look at the effect proctored training sessions
have on the time to complete a task and the relation of System Usability Scale scores with the
success of data entry.
ContributorsStott, Dahlia (Author) / Adams, Marc (Thesis director) / Barto, Henry (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-12
Description
“Let Food be Thy Medicine” focuses on alternative treatment for patients suffering from obesity, diabetes mellitus type 2, hypertension, and coronary artery disease. Nutrition is an important aspect of overall health and can contribute to prevention and management of these conditions, especially when combined with medication and physical activity. Obesity is a condition that people worldwide struggle with. Adequate nutrition can play a major role in contributing to the prevention of and management of obesity not only through calorie and macronutrient intake but also by affecting hormonal and energy balances in the body. Recommended physical activity levels are included along with dietary
utritional intake recommendations on the educational pamphlet to give patients a starting guideline and better understanding how to help this condition. Type 2 diabetes, high blood pressure, and coronary artery disease are also common conditions treated by healthcare professionals. There are currently several medications on the market to help manage these conditions that range in price and have many side effects. Nutrition and exercise are two factors that can further contribute to the management of type 2 diabetes, high blood pressure, and coronary artery disease, but they can also help prevent and delay their onset. Nutrition and physical activity education along with examples of certain foods that can aid in reaching nutritional goals are outlined in the educational pamphlet to give patients a visual of what is in the academic paper.
utritional intake recommendations on the educational pamphlet to give patients a starting guideline and better understanding how to help this condition. Type 2 diabetes, high blood pressure, and coronary artery disease are also common conditions treated by healthcare professionals. There are currently several medications on the market to help manage these conditions that range in price and have many side effects. Nutrition and exercise are two factors that can further contribute to the management of type 2 diabetes, high blood pressure, and coronary artery disease, but they can also help prevent and delay their onset. Nutrition and physical activity education along with examples of certain foods that can aid in reaching nutritional goals are outlined in the educational pamphlet to give patients a visual of what is in the academic paper.
ContributorsCarson, Caitlin Colleen (Author) / Day, Kimberly (Thesis director) / Levinson, Simin (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
This paper reviews a creative project designed to enhance the simulation experience for College of Nursing and Health Innovation nursing students at Arizona State University. Simulation allows students to practice imperative skills in a safe environment, free from the risk of injury to patients and the consequences of making these errors, in order to master skills that are essential in the clinical setting. Students are able to practice a wide range of invasive and noninvasive skills and hone in on their clinical judgement and critical thinking to make decisions that may be life threatening in a clinical situation. The group members designed written training materials and created corresponding video vignettes that would be utilized to enhance the confederate role and provide the students a deeper understanding of their simulated patient and the simulation scenario. The written training materials that were developed include confederate background information, patient and family education, and guided questions and answers for the video vignettes. The written training materials will be used to guide the students that are portraying the family member during the simulation. Trained standardized patients were hired to play the confederate role in the four video vignettes. The video vignettes portrayed interviews with a family member of the patient that delved into how they felt about their family member's hospitalization and what they hoped to learn from the nurses during their family member's hospitalization. The vignettes will be used to guide students to the needs of the patients and families in the corresponding scenarios. These vignettes will be accessible by students before the start of simulation in order to enhance understanding of the patient and ultimately, the scenario.
ContributorsBenn, Allie (Co-author) / Kiesling, Hannah (Co-author) / O'Brien, Janet (Thesis director) / Calacci, Margaret (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
The objective of this study was to evaluate and compare the content of nutrition marketing materials within the cafeterias of schools in Central Arizona. By collecting photographs of marketing material from three elementary schools, one K-8 school, three middle schools and three high schools, 59 pieces of nutrition marketing were gathered. The schools chosen were a convenience sample and selected from schools that were already participating in ASU' s School Lunch Study. The photographs were sorted by grade level and then coded quantitatively and qualitatively for their purpose, visual components, strategies used and relevance. Results from this novel study provided insight into prevalence, size, textual content, educational content, strategies for fruit and vegetable marketing, messaging and overall design of existing nutrition marketing within the sample schools. This study found that the prevalence of nutrition marketing within all school cafeterias appeared to be low, particularly within elementary and middle schools. Diverse types of messaging were present among elementary, middle and high schools and a variety of appeals were utilized with little consistency. Many of the strategies used in the nutrition marketing appeared disconnected from the population it was intended to appeal to. Educational components were notably lacking within middle school cafeterias but were often effectively integrated into high school nutrition marketing. The results are unique to this population, and further research is required to evaluate the content of existing nutrition material on a larger scale, so efforts can be made to improve the persuasiveness of nutrition marketing in promoting fruit and vegetable consumption.
ContributorsXavier, Raevyn Francine (Author) / Bruening, Meg (Thesis director) / Adams, Marc (Committee member) / School of Nutrition and Health Promotion (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Background
African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women.
Methods
Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction.
Results
All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = −74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = −34 minutes/week) in comparison to PI participants (all P’s < .05). No between group differences for accelerometer measured moderate-to-vigorous intensity physical activity were observed (P > .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P < .001) and social support from family for physical activity (P = .044). Satisfaction with the FI was also high: 100% reported physical activity-related knowledge gains and 100% would recommend the program to a friend.
Conclusions
A culturally-relevant Facebook and text message delivered physical activity program was associated with several positive outcomes, including decreased sedentary behavior, increased light- and moderate-lifestyle intensity physical activity, enhanced psychosocial outcomes, and high participant satisfaction. Future studies with larger samples are warranted to further explore the efficacy of technology-based approaches to promote physical activity among African American women.
African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women.
Methods
Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction.
Results
All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = −74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = −34 minutes/week) in comparison to PI participants (all P’s < .05). No between group differences for accelerometer measured moderate-to-vigorous intensity physical activity were observed (P > .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P < .001) and social support from family for physical activity (P = .044). Satisfaction with the FI was also high: 100% reported physical activity-related knowledge gains and 100% would recommend the program to a friend.
Conclusions
A culturally-relevant Facebook and text message delivered physical activity program was associated with several positive outcomes, including decreased sedentary behavior, increased light- and moderate-lifestyle intensity physical activity, enhanced psychosocial outcomes, and high participant satisfaction. Future studies with larger samples are warranted to further explore the efficacy of technology-based approaches to promote physical activity among African American women.
ContributorsJoseph, Rodney (Author) / Keller, Colleen (Author) / Adams, Marc (Author) / Ainsworth, Barbara (Author) / College of Health Solutions (Contributor) / School of Nutrition and Health Promotion (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2015-03-27
Description
Background
Increasing empirical evidence supports associations between neighborhood environments and physical activity. However, since most studies were conducted in a single country, particularly western countries, the generalizability of associations in an international setting is not well understood. The current study examined whether associations between perceived attributes of neighborhood environments and physical activity differed by country.
Methods
Population representative samples from 11 countries on five continents were surveyed using comparable methodologies and measurement instruments. Neighborhood environment × country interactions were tested in logistic regression models with meeting physical activity recommendations as the outcome, adjusted for demographic characteristics. Country-specific associations were reported.
Results
Significant neighborhood environment attribute × country interactions implied some differences across countries in the association of each neighborhood attribute with meeting physical activity recommendations. Across the 11 countries, land-use mix and sidewalks had the most consistent associations with physical activity. Access to public transit, bicycle facilities, and low-cost recreation facilities had some associations with physical activity, but with less consistency across countries. There was little evidence supporting the associations of residential density and crime-related safety with physical activity in most countries.
Conclusion
There is evidence of generalizability for the associations of land use mix, and presence of sidewalks with physical activity. Associations of other neighborhood characteristics with physical activity tended to differ by country. Future studies should include objective measures of neighborhood environments, compare psychometric properties of reports across countries, and use better specified models to further understand the similarities and differences in associations across countries.
Increasing empirical evidence supports associations between neighborhood environments and physical activity. However, since most studies were conducted in a single country, particularly western countries, the generalizability of associations in an international setting is not well understood. The current study examined whether associations between perceived attributes of neighborhood environments and physical activity differed by country.
Methods
Population representative samples from 11 countries on five continents were surveyed using comparable methodologies and measurement instruments. Neighborhood environment × country interactions were tested in logistic regression models with meeting physical activity recommendations as the outcome, adjusted for demographic characteristics. Country-specific associations were reported.
Results
Significant neighborhood environment attribute × country interactions implied some differences across countries in the association of each neighborhood attribute with meeting physical activity recommendations. Across the 11 countries, land-use mix and sidewalks had the most consistent associations with physical activity. Access to public transit, bicycle facilities, and low-cost recreation facilities had some associations with physical activity, but with less consistency across countries. There was little evidence supporting the associations of residential density and crime-related safety with physical activity in most countries.
Conclusion
There is evidence of generalizability for the associations of land use mix, and presence of sidewalks with physical activity. Associations of other neighborhood characteristics with physical activity tended to differ by country. Future studies should include objective measures of neighborhood environments, compare psychometric properties of reports across countries, and use better specified models to further understand the similarities and differences in associations across countries.
ContributorsDing, Ding (Author) / Adams, Marc (Author) / Sallis, James F. (Author) / Norman, Gregory J. (Author) / Hovell, Melbourn F. (Author) / Chambers, Christina D. (Author) / Hofstetter, C. Richard (Author) / Bowles, Heather R. (Author) / Hagstromer, Maria (Author) / Craig, Cora L. (Author) / Fernando Gomez, Luis (Author) / De Bourdeaudhuij, Ilse (Author) / Macfarlane, Duncan J. (Author) / Ainsworth, Barbara (Author) / Bergman, Patrick (Author) / Bull, Fiona C. (Author) / Carr, Harriette (Author) / Klasson-Heggebo, Lena (Author) / Inoue, Shigeru (Author) / Murase, Norio (Author) / Matsudo, Sandra (Author) / Matsudo, Victor (Author) / McLean, Grant (Author) / Sjostrom, Michael (Author) / Tomten, Heidi (Author) / Lefevre, Johan (Author) / Volbekiene, Vida (Author) / Bauman, Adrian E. (Author) / College of Health Solutions (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2013-05-14
Description
Background
Neighborhood environment studies of physical activity (PA) have been mainly single-country focused. The International Prevalence Study (IPS) presented a rare opportunity to examine neighborhood features across countries. The purpose of this analysis was to: 1) detect international neighborhood typologies based on participants’ response patterns to an environment survey and 2) to estimate associations between neighborhood environment patterns and PA.
Methods
A Latent Class Analysis (LCA) was conducted on pooled IPS adults (N=11,541) aged 18 to 64 years old (mean=37.5 ±12.8 yrs; 55.6% women) from 11 countries including Belgium, Brazil, Canada, Colombia, Hong Kong, Japan, Lithuania, New Zealand, Norway, Sweden, and the U.S. This subset used the Physical Activity Neighborhood Environment Survey (PANES) that briefly assessed 7 attributes within 10–15 minutes walk of participants’ residences, including residential density, access to shops/services, recreational facilities, public transit facilities, presence of sidewalks and bike paths, and personal safety. LCA derived meaningful subgroups from participants’ response patterns to PANES items, and participants were assigned to neighborhood types. The validated short-form International Physical Activity Questionnaire (IPAQ) measured likelihood of meeting the 150 minutes/week PA guideline. To validate derived classes, meeting the guideline either by walking or total PA was regressed on neighborhood types using a weighted generalized linear regression model, adjusting for gender, age and country.
Results
A 5-subgroup solution fitted the dataset and was interpretable. Neighborhood types were labeled, “Overall Activity Supportive (52% of sample)”, “High Walkable and Unsafe with Few Recreation Facilities (16%)”, “Safe with Active Transport Facilities (12%)”, “Transit and Shops Dense with Few Amenities (15%)”, and “Safe but Activity Unsupportive (5%)”. Country representation differed by type (e.g., U.S. disproportionally represented “Safe but Activity Unsupportive”). Compared to the Safe but Activity Unsupportive, two types showed greater odds of meeting PA guideline for walking outcome (High Walkable and Unsafe with Few Recreation Facilities, OR= 2.26 (95% CI 1.18-4.31); Overall Activity Supportive, OR= 1.90 (95% CI 1.13-3.21). Significant but smaller odds ratios were also found for total PA.
Conclusions
Meaningful neighborhood patterns generalized across countries and explained practical differences in PA. These observational results support WHO/UN recommendations for programs and policies targeted to improve features of the neighborhood environment for PA.
Neighborhood environment studies of physical activity (PA) have been mainly single-country focused. The International Prevalence Study (IPS) presented a rare opportunity to examine neighborhood features across countries. The purpose of this analysis was to: 1) detect international neighborhood typologies based on participants’ response patterns to an environment survey and 2) to estimate associations between neighborhood environment patterns and PA.
Methods
A Latent Class Analysis (LCA) was conducted on pooled IPS adults (N=11,541) aged 18 to 64 years old (mean=37.5 ±12.8 yrs; 55.6% women) from 11 countries including Belgium, Brazil, Canada, Colombia, Hong Kong, Japan, Lithuania, New Zealand, Norway, Sweden, and the U.S. This subset used the Physical Activity Neighborhood Environment Survey (PANES) that briefly assessed 7 attributes within 10–15 minutes walk of participants’ residences, including residential density, access to shops/services, recreational facilities, public transit facilities, presence of sidewalks and bike paths, and personal safety. LCA derived meaningful subgroups from participants’ response patterns to PANES items, and participants were assigned to neighborhood types. The validated short-form International Physical Activity Questionnaire (IPAQ) measured likelihood of meeting the 150 minutes/week PA guideline. To validate derived classes, meeting the guideline either by walking or total PA was regressed on neighborhood types using a weighted generalized linear regression model, adjusting for gender, age and country.
Results
A 5-subgroup solution fitted the dataset and was interpretable. Neighborhood types were labeled, “Overall Activity Supportive (52% of sample)”, “High Walkable and Unsafe with Few Recreation Facilities (16%)”, “Safe with Active Transport Facilities (12%)”, “Transit and Shops Dense with Few Amenities (15%)”, and “Safe but Activity Unsupportive (5%)”. Country representation differed by type (e.g., U.S. disproportionally represented “Safe but Activity Unsupportive”). Compared to the Safe but Activity Unsupportive, two types showed greater odds of meeting PA guideline for walking outcome (High Walkable and Unsafe with Few Recreation Facilities, OR= 2.26 (95% CI 1.18-4.31); Overall Activity Supportive, OR= 1.90 (95% CI 1.13-3.21). Significant but smaller odds ratios were also found for total PA.
Conclusions
Meaningful neighborhood patterns generalized across countries and explained practical differences in PA. These observational results support WHO/UN recommendations for programs and policies targeted to improve features of the neighborhood environment for PA.
ContributorsAdams, Marc (Author) / Ding, Ding (Author) / Sallis, James F. (Author) / Bowles, Heather R. (Author) / Ainsworth, Barbara (Author) / Bergman, Patrick (Author) / Bull, Fiona C. (Author) / Carr, Harriette (Author) / Craig, Cora L. (Author) / De Bourdeaudhuij, Ilse (Author) / Fernando Gomez, Luis (Author) / Hagstromer, Maria (Author) / Klasson-Heggebo, Lena (Author) / Inoue, Shigeru (Author) / Lefevre, Johan (Author) / Macfarlane, Duncan J. (Author) / Matsudo, Sandra (Author) / Matsudo, Victor (Author) / McLean, Grant (Author) / Murase, Norio (Author) / Sjostrom, Michael (Author) / Tomten, Heidi (Author) / Volbekiene, Vida (Author) / Bauman, Adrian (Author) / College of Health Solutions (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2013-03-07
Description
The aim of this review is to explore the effects of mindfulness-based interventions on Registered Nurse's rate of burnout and stress. Particularly focusing on the mitigation and decrease of burnout. Burnout is a multifaceted, complex issue that has become engrained in the culture of nursing and a widespread epidemic. Burnout has detrimental effects for the quality of life of the nurse, patient outcomes, interprofessional collaboration, and nursing practice. A systematic literature review incorporating qualitative data and analyzing the quantitative data was conducted. Studies on the effects of mindfulness-based interventions for nurses relating to burnout published between January 2008 and May 2018 were identified through a systematic search in electronic databases: CINHAL, Cochrane, Embase, Medline, PsycInfo, and PubMed. Gray literature was searched through Scopus and clinical trials were explored through clincialtrials.gov. Data analysis was based on 8 data points that were extracted from the research. A total of 17 articles were selected for inclusion in the systematic literature review. There were several different types of studies including single group intervention study, randomized control trial interventions studies, mixed model, quasi-experimental studies with controls, and a non-randomized controlled comparison. All relied on self-reporting scales and questionnaire for quantitative pre-post intervention changes. Overall, the 10 of the 17 studies found that there was a statistically significant decrease in burnout rates and an increase in mindfulness post intervention. Several other factors improved in a number of studies such as quality of life, decreased stress, increased sense of personal accomplishment, and decreased emotional exhaustion. There were also indications of an improvement in the individual's holistic well-being (e.g. inner state of calmness, awareness and enthusiasm) relating to improved mindfulness levels in 12 of the studies. Based on the results of this systematic review, mindfulness may be considered a potentially effective intervention for decreasing nurse burnout and mitigating future burnout. This intervention could be useful in a number of contexts including on-site and off-site programs with institutional support. Future research should explore longitudinal outcomes of mindfulness practice, symptom focused outcome measures, and multi-modal studies.
ContributorsGeurtz, Heidi Frances (Author) / Larkey, Linda (Thesis director) / Costello, Jennifer (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Research has shown that environmental stressors that occur during childhood and early adolescence are associated with multiple deficits in physiological and psychological functioning later in life. The hypothalamic-pituitary-adrenal (HPA) axis has been proposed as a potential biological mechanism through which these phenotypic alterations occur as studies have shown a link between early life adversity and altered diurnal cortisol patterns (Goldman-Mellor, Hamer, & Steptoe, 2012; Gunnar & Quevedo, 2008). Given research has shown that diurnal cortisol levels are influenced by genetic factors (Veen et al., 2011), but that a majority of differences across subjects can be attributed to the environment (Schreiber et al., 2006), phenotypic associations were explored between the quality of the home environment and children's diurnal cortisol patterns. The first aim of this study was to determine the level of genetic and environmental contributions to different parameters of diurnal cortisol rhythm. The second aim of this study was to examine whether the quality of the home environment, particularly indicators involving parenting and the physical environment, was associated with these same diurnal cortisol measures. A diverse sample of 320 twin children were assessed at 8 years using gold standard home environment interviews and a measure of diurnal cortisol rhythm across three days with three samples taken from each twin every day. Twin intraclass correlations indicated high levels of heritability for the morning to afternoon diurnal cortisol slope as well as the afternoon to evening slope, while measures of cortisol in the afternoon, evening, and across the day showed low levels of heritability, which suggested that differences in the environment were a more influential factor. Multilevel regression analyses showed that the overall quality of the home environment was found to be significantly negatively associated with cortisol levels at bedtime and negatively associated across the morning to afternoon slope at a trend level. The physical environment and emotional climate of the home were not significantly associated with any indicators of the diurnal cortisol pattern. A unique seasonality effect was noted as cortisol measurements taken from participants during the summer were significantly increased when compared to participants throughout the rest of the year. Overall, these findings showed a unique association between the quality of the home environment and diurnal cortisol levels at bedtime and perhaps the change in cortisol levels across the morning to afternoon, as well as a possible seasonal covariate which may affect diurnal cortisol measurements and one which often goes overlooked in cortisol research.
ContributorsSmith, Trevor James (Author) / Doane, Leah (Thesis director) / Lemery-Chalfant, Kathryn (Committee member) / School of Molecular Sciences (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Glioblastoma (GBM) is the most common malignant primary brain tumor in adults and is linked to poor survival in affected patients due to its invasive and aggressive nature. The potential role of sexual dimorphism in GBM outcomes has long been overlooked. Notably, males and females differ in tumor behavior across many cancers1, which may be attributable to differences in genetic makeup and physiology, and in GBM there is a difference in incidence rate between males and females. The aim of the study was to investigate sex differences in GBM patients and compare median survival outcomes (OS) and progression-free survival outcomes (PFS) between sexes based on tumor location, laterality, age, tumor volume, and extent of resection. Patients who received standard-of-care (Stupp protocol) consisting of surgical intervention, concomitant chemoradiation, and 6 cycles of adjuvant temozolomide (TMZ) were included in this study to investigate sex differences in tumor characteristics (n = 216; males: n = 129, females: n = 87). Pre-surgical MRIs, specifically T1Gd sequences, were analyzed to determine tumor laterality and location. The patient cohort was divided into two groups indicating the extent of resection (EOR) they received: Gross Total Resection (GTR) and Subtotal Resection (STR). Additionally, the patient cohort was split into three age groups (Group I: 18-29, Group II: 30-49, and Group III: >50). Analyses were done using independent t-test and Cox proportional hazard modeling to determine which variables affect patient survival. The log-rank test was utilized to compare differences in survival rate in Kaplan-Meier analysis.
Overall, our results suggest that female patients receiving standard-of-care may have a better prognosis than male patients. There was a significant difference in OS and PFS in females showing an increase in survival. Additionally, survival was significantly different between sexes following resection, with female patients receiving STR or GTR having longer OS and PFS than males. The difference in median OS between sexes is more pronounced among younger patients. Among five different brain locations, female patients who possess a frontal lobe tumor may live longer than male patients. The apparent difference in OS for patients living >1000 days in the Kaplan-Meier plot warrants further investigation in a larger cohort. Following tumor resection, female patients with a frontal lobe tumor may survive longer in comparison to male patients. Comparing brain hemispheres, patients who possessed a tumor on the left may survive longer. Investigating tumor location and tumor laterality, our results suggests that female patients with a left frontal lobe tumor show a significant survival advantage in comparison to females who possess a right frontal lobe tumor.
ContributorsLorence, Julia (Author) / Swanson, Kristin (Thesis director) / Massey, Susan Christine (Committee member) / Rubin, Joshua (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / School of Life Sciences (Contributor) / School of Mathematical and Natural Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05