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Heart failure is a major worldwide health concern and is the leading cause of hospitalization among elderly Americans. Approximately 50% of those diagnosed with heart failure have heart failure with preserved ejection fraction (HFPEF). HFPEF presents a therapeutic dilemma because pharmacological strategies that are effective for the treatment of heart failure and reduced ejection fraction have failed to show benefit in HFPEF. Long term moderate intensity exercise programs have been shown to improve diastolic function in patients HFPEF. High intensity interval training (HIIT) has been shown to improve diastolic function in patients with heart failure and reduced ejection fraction. However, the effects of high intensity interval training in patients with HFPEF are unknown. Fourteen patients with HFPEF were randomized to either: (1) a novel program of high-intensity aerobic interval training (n = 8), or (2) a commonly prescribed program of moderate-intensity (MOD) aerobic exercise training (n = 6). Before and after four weeks of exercise training, patients underwent a treadmill graded exercise test for the determination of peak oxygen uptake (VO2peak), a brachial artery reactivity test for assessment of endothelium-dependent flow-mediated dilation (BAFMD), aortic pulse wave velocity assessment as an index of vascular stiffness and two-dimensional echocardiography for assessment of left ventricular diastolic and systolic function. I hypothesized that (1) high-intensity aerobic interval training would result in superior improvements in FMD, aortic pulse wave velocity, VO2peak, diastolic function and, (2) changes in these parameters would be correlated with changes in VO2peak. The principal findings of the study were that a one month long high intensity interval training program resulted in significant improvements in diastolic function as measured by two-dimensional echocardiography [pre diastolic dysfunction (DD) grade - 2.13 + 0.4 vs. post DD grade - 1.25 + 0.7, p = 0.03]. The left atrial volume index was reduced in the HIIT group compared to MOD ( - 4.4 + 6.2 ml/m2 vs. 5.8 + 10.7 ml/m2, p = 0.02). Early mitral flow (E) improved in the HIIT group (pre - 0.93 + 0.2 m/s vs. post - 0.78 + 0.3 m/s, p = 0.03). A significant inverse correlation was observed between change in BAFMD and change in diastolic dysfunction grade (r = - 0.585, p = 0.028) when all the data were pooled. HIIT appears to be a time-efficient and safe strategy for improving diastolic function in patients with heart failure and preserved ejection fraction. These data may have implications for cardiovascular risk reduction in this population.
ContributorsAngadi, Siddhartha (Author) / Gaesser, Glenn A (Thesis advisor) / Mookadam, Farouk (Committee member) / Swan, Pamela (Committee member) / Vega-Lopez, Sonia (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2012
Description
The number of undergraduate students participating in short-term experiences in global health (STEGHs) abroad has increased dramatically in recent years (Eyler 2002, Drain et al. 2007). These experiences, in tandem with classroom learning, are designed to help students master skills related to global health competencies, including cultural humility and sensitivity, collaborating with community partners, and sociocultural and political awareness. Although STEGHs offer potential benefits to both students and to sending institutions, these experiences can sometimes be problematic and raise ethical challenges. As the number of students engaged in STEGHs continues to increase, it is important to better understand the impact of these programs on student learning. Current ethical and best practice guidelines for STEGHs state that programs should establish evaluation methods to solicit feedback from students both during and on completion of the program (Crump et al. 2010). However, there is currently no established method for gathering this feedback because of the many different global health competency frameworks, types and duration of programs, and different models of student engagement in such programs. Assessing the quality of a STEGH is a profoundly important and difficult question that cannot be answered as succinctly and quantitatively as classroom performance, which has more standard and established assessment metrics. The goal of this project is to identify the most appropriate and useful assessment metric(s) for determining educational quality and impact for STEGHs at ASU by comparing a typical quantitative evaluation tool (pre-post survey with brief open-ended questions) to a more in-depth qualitative method (key informant interviews). In performing my analysis I seek to examine if the latter can produce a richer narrative of student experiences to inform ongoing program evaluations. My research questions are: 1. What are the current qualitative and quantitative evaluation methods available to assess student learning during short-term experiences in global health? 2. How can current methodology for assessing student experiences with short-term experiences in global health be adapted to collect the most information from students? 3. How do student knowledge and attitudes change before and after their short-term experience in global health? Why is understanding those changes important for adapting programs? My end goal would be to use these new, optimal assessment methods for gathering student perspectives and experiences to adapt pre-departure trainings and post-experience debriefings for study abroad programs, both of which I believe will lead to more sustainable partnerships and a healthier understanding of global health work for students.
ContributorsHale, Brittany Ann (Author) / Jehn, Megan (Thesis director) / Wutich, Amber (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Social Transformation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Due to artificial selection, dogs have high levels of phenotypic diversity, yet, there appears to be low genetic diversity within individual breeds. Through their domestication from wolves, dogs have gone through a series of population bottlenecks, which has resulted in a reduction in genetic diversity, with a large amount of linkage disequilibrium and the persistence of deleterious mutations. This has led to an increased susceptibility to a multitude of diseases, including cancer. To study the effects of artificial selection and life history characteristics on the risk of cancer mortality, we collected cancer mortality data from four studies as well as the percent of heterozygosity, body size, lifespan and breed group for 201 dog breeds. We also collected specific types of cancer breeds were susceptible to and compared the dog cancer mortality patterns to the patterns observed in other mammals. We found a relationship between cancer mortality rate and heterozygosity, body size, lifespan as well as breed group. Higher levels of heterozygosity were also associated with longer lifespan. These results indicate larger breeds, such as Irish Water Spaniels, Flat-coated Retrievers and Bernese Mountain Dogs, are more susceptible to cancer, with lower heterozygosity and lifespan. These breeds are also more susceptible to sarcomas, as opposed to carcinomas in smaller breeds, such as Miniature Pinschers, Chihuahuas, and Pekingese. Other mammals show that larger and long-lived animals have decreased cancer mortality, however, within dog breeds, the opposite relationship is observed. These relationships could be due to the trade-off between cellular maintenance and growing fast and large, with higher expression of growth factors, such as IGF-1. This study further demonstrates the relationships between cancer mortality, heterozygosity, and life history traits and exhibits dogs as an important model organism for understanding the relationship between genetics and health.
ContributorsBalsley, Cassandra Sierra (Author) / Maley, Carlo (Thesis director) / Wynne, Clive (Committee member) / Tollis, Marc (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
Walking interventions focused on increasing step counts are typically associated with salutary effects on glycemia, fasting insulin, insulin resistance and blood lipids which may be in turn associated with improvements in cardiorespiratory fitness (peak oxygen uptake – VO2peak) and vascular stiffness. We hypothesized that a novel 4-month, behavioral economics-based walking intervention would have favorable effects on glucose homeostasis and blood lipids and that these in turn would be related to VO2peak and vascular stiffness (carotid femoral pulse wave velocity – cfPWV).
We carried out secondary analyses on a subsample of sedentary, overweight/obese adults who participated in a 4-month, 2x2, randomized-controlled walking intervention examining the effects of goal setting (static v. adaptive goals) and rewards (immediate v. delayed) on steps/day (N=96). Fasting blood samples (n=58) were collected from participants before and after the intervention. Premenopausal females were in the follicular phase of their menstrual cycles. Lipid and glucose levels were measured using an automated chemistry analyzer, while insulin was measured using radio-immunoassay. Homeostatic model of insulin resistance (HOMA-IR) was calculated using the following formula (HOMA-IR=glucose x insulin / 405). We examined associations [partial correlations (adjusted for age)] between changes in blood biomarkers and VO2peak and cfPWV, irrespective of group, and we used linear mixed models to examine between-group differences in levels of and change in biomarker outcomes.
Groups did not differ in overall levels of, or degree of change in, biomarker outcomes (all p>0.05). Mean changes, irrespective of group, in biomarkers were as follows: glucose Δ= 0.74± 4.5mg/dl; insulin Δ= 0.09 ± 4.1 µU/ml; total cholesterol Δ= 0.24 ± 20.6 mg/dl; HDL-C Δ= 0.27 ± 5.1 mg/dl; LDL-C Δ= 1.3 ± 19.9 mg/dl; triglycerides Δ= 1.7 ± 27.2 mg/dl; HOMA-IR Δ = -.0548 ± 1.05). We found no significant associations between change in biomarker levels and change in VO2peak or change in cfPWV (all correlation coefficients < 0.15; p > 0.05).
A 4-month, behavioral economics-based mHealth intervention focused on increasing steps/day did not bring about favorable changes on markers of glycemia, insulin resistance and blood lipids.
We carried out secondary analyses on a subsample of sedentary, overweight/obese adults who participated in a 4-month, 2x2, randomized-controlled walking intervention examining the effects of goal setting (static v. adaptive goals) and rewards (immediate v. delayed) on steps/day (N=96). Fasting blood samples (n=58) were collected from participants before and after the intervention. Premenopausal females were in the follicular phase of their menstrual cycles. Lipid and glucose levels were measured using an automated chemistry analyzer, while insulin was measured using radio-immunoassay. Homeostatic model of insulin resistance (HOMA-IR) was calculated using the following formula (HOMA-IR=glucose x insulin / 405). We examined associations [partial correlations (adjusted for age)] between changes in blood biomarkers and VO2peak and cfPWV, irrespective of group, and we used linear mixed models to examine between-group differences in levels of and change in biomarker outcomes.
Groups did not differ in overall levels of, or degree of change in, biomarker outcomes (all p>0.05). Mean changes, irrespective of group, in biomarkers were as follows: glucose Δ= 0.74± 4.5mg/dl; insulin Δ= 0.09 ± 4.1 µU/ml; total cholesterol Δ= 0.24 ± 20.6 mg/dl; HDL-C Δ= 0.27 ± 5.1 mg/dl; LDL-C Δ= 1.3 ± 19.9 mg/dl; triglycerides Δ= 1.7 ± 27.2 mg/dl; HOMA-IR Δ = -.0548 ± 1.05). We found no significant associations between change in biomarker levels and change in VO2peak or change in cfPWV (all correlation coefficients < 0.15; p > 0.05).
A 4-month, behavioral economics-based mHealth intervention focused on increasing steps/day did not bring about favorable changes on markers of glycemia, insulin resistance and blood lipids.
ContributorsHook, Benjamin E. (Author) / Angadi, Siddhartha (Thesis director) / Gaesser, Glenn (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Triops (Branchiopoda: Notostraca) and Streptocephalus (Branchiopoda: Anostraca) are two crustaceans which cohabitate in ephemeral freshwater pools. They both lay desiccation resistant eggs that disperse passively to new hydrologically isolated environments. The extent of genetic distance among regions and populations is of perennial interest in animals that live in such isolated habitats. Populations in six natural ephemeral pool habitats located in two different regions of the Sonoran Desert and a transition area between the Sonoran and Chihuahuan Deserts were sampled. Sequences from Genbank were used for reference points in the determination of species as well as to further identify regional genetic distance within species. This study estimated the amount of within and between genetic distance of individuals from each region and population through the use of a neutral marker, cytochrome oxidase I (COI). We concluded that, although the method of passive dispersal may differ between the two genera, the differences do not results in different patterns of genetic distances between regions and populations. Furthermore, we only found the putative species, Triops longicaudatus "short", with enough distinct speciation. Although Triops longicaudatus "long" and Triops newberryi may be in the early stages of speciation, this study does not find enough support to conclude that they have separated.
ContributorsMurphy Jr., Patrick Joseph (Author) / Rutowski, Ronald (Thesis director) / Cartwright, Reed (Committee member) / Lessios, Nikos (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Volunteer motivation and satisfaction were assessed at Project CURE, a nonprofit that collects, sorts, tests, and ships donated medical supplies and equipment to healthcare facilities in developing countries. This research was the result of a yearlong partnership between the Community Action Research Experiences (CARE) program and Project CURE. Volunteers at Project CURE were surveyed (N=147) after completing a volunteer session to assess their motivation for volunteering, satisfaction with their experience, and any recommendations they had for improving the volunteer program. Five categories of motivating factors were assessed and it was found that the Values and Understanding categories were the strongest motivating factors. Overall, volunteers rated their experience highly, but the results indicated a number of small changes that Project CURE could make to better meet volunteers' needs, and better communicate the impact of volunteers' work, which could pave the way to increases in the numbers of volunteer hours Project CURE receives and increased quality of volunteer work.
ContributorsStepanek, Rachel (Author) / Reesing, Amy (Thesis director) / Dumka, Larry (Committee member) / School of Molecular Sciences (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
This purpose of this thesis study was to examine variables of the "War on Cancer" frame, loss-gain prime, and patient gender on treatment decision for advanced cancer patients. A total of 291 participants (141 females) participated in an online survey experiment and were randomly assigned to one of eight possible conditions, each of which were comprised of a combination of one of two levels for three total independent variables: war frame ("War on Cancer" frame or neutral frame), loss-gain prime (loss prime or gain prime), and patient gender (female or male). Each of the three variables were operationalized to determine whether or not the exposure to the war on cancer paradigm, loss-frame language, or male patient gender would increase the likelihood of a participant choosing a more aggressive cancer treatment. Participants read a patient scenario and were asked to respond to questions related to motivating factors. Participants were then asked to report preference for one of two treatment decisions. Participants were then asked to provide brief demographic information in addition to responding to questions about military history, war attitudes, and cancer history. The aforementioned manipulations sought to determine whether exposure to various factors would make a substantive difference in final treatment decision. Contrary to the predicted results, participants in the war frame condition (M = 3.85, SD = 1.48) were more likely to choose the pursuit of palliative care (as opposed to aggressive treatment) than participants in the neutral frame condition (M = 3.54, SD = 1.23). Ultimately, these significant findings suggest that there is practical information to be gained from treatment presentation manipulations. By arming healthcare providers with a more pointed understanding of the nuances of treatment presentation, we can hope to empower patients, their loved ones, and healthcare providers entrenched in the world of cancer treatment.
ContributorsKnowles, Madelyn Ann (Author) / Kwan, Virginia S. Y. (Thesis director) / Presson, Clark (Committee member) / Salamone, Damien (Committee member) / Department of Psychology (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
The purpose of this study was to create an evaluation plan for the Preventing Abusive Conduct (PAC/Peace) program, within the community-based organization Chrysalis. PAC/Peace is a program that provides treatment for domestic abuse offenders through psycho-educational counseling groups. This study analyzed evaluation methods used by similar programs to determine which methods were successful, as well as what criteria were used to evaluate these programs. A literature review was conducted on similar studies to find which measures should be used to determine whether a treatment program met the desired goals for its participants. The literature review, along with interviews with Chrysalis staff were used as resources to create a cost-effective evaluation plan for Chrysalis to measure the effectiveness of their offender treatment program. The results indicated a two part evaluation plan would be the most beneficial for Chrysalis at this time. The first part consists of official reports of recidivism collected at one year, and three years post-graduation from the program. The second is utilization of The Revised Conflict Tactics Scale as an offender self-reporting measure, administered at program intake and exit, as well as one year post-graduation. When implemented, the results of this evaluation will give Chrysalis insight to which aspects of the treatment are working, and which aspects might be improved upon. The results acquired from the evaluation may also help PAC/Peace to become an evidence-based program.
ContributorsScouras, Natasha Elexa (Author) / Low, Sabina (Thesis director) / Dumka, Larry (Committee member) / School of Social Transformation (Contributor) / School of Molecular Sciences (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Background: The purpose of this study was to determine the acceptability of a survey for MPN patients about: a) how patients with MPN cancer perceive information relayed from their healthcare providers in regards to integrative medicine and b) how patients use integrative medicine modalities to cope with their symptom burden (i.e. fatigue, headaches, abdominal discomfort). Additionally, we assessed what MPN patients thought about the survey (i.e., questions asked, how it could be modified, acceptability). This paper presents the patient's assessment of the survey. This information will be used to finalize the survey and distribute nationally to address integrative medicine and symptom burden in MPN patients. Methods: The survey was taken by 366, English speaking patients previously diagnosed with essential thrombocythemia, polycythemia vera, or myelofibrosis (primary and post polycythemia vera/post essential thrombocythemia) and ages 18 or older. The survey had XX questions and took approximately 20 minutes to complete. Acceptability questions were qualitatively analyzed and used to construct recurring themes and modifications for the final MPN Integrative Survey. Results: The following themes were recurrent in the acceptability responses; MPN symptom burden comments, views on healthcare, comments about demographics, and requests for survey modifications. When asked which Integrative Therapies have been used to treat symptom burden, participants most commonly named guidance therapy (i.e. counseling, prayer), physiotherapy ,and supplements administered orally, intravenously, intramuscularly, and topically. Conclusions: These results suggest this survey is an acceptable and feasible tool for MPN patients to assess how patients with MPN cancer perceive information relayed from their healthcare providers in regards to integrative medicine, and how patients use integrative medicine modalities to cope with their symptom burden. These findings also provide a better understanding of what facilitates and prevents MPN patients from using Integrative Medicine to treat MPN symptoms, as well as suggests useful survey modifications to inform the final MPN Integrative Survey.
ContributorsLebowitz, Nicole (Author) / Huberty, Jennifer (Thesis director) / Gowin, Krisstina (Committee member) / School of Nutrition and Health Promotion (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Parkinson's disease is a neurodegenerative disorder in the central nervous system that affects a host of daily activities and involves a variety of symptoms; these include tremors, slurred speech, and rigid muscles. It is the second most common movement disorder globally. In Stage 3 of Parkinson's, afflicted individuals begin to develop an abnormal gait pattern known as freezing of gait (FoG), which is characterized by decreased step length, shuffling, and eventually complete loss of movement; they are unable to move, and often results in a fall. Surface electromyography (sEMG) is a diagnostic tool to measure electrical activity in the muscles to assess overall muscle function. Most conventional EMG systems, however, are bulky, tethered to a single location, expensive, and primarily used in a lab or clinical setting. This project explores an affordable, open-source, and portable platform called Open Brain-Computer Interface (OpenBCI). The purpose of the proposed device is to detect gait patterns by leveraging the surface electromyography (EMG) signals from the OpenBCI and to help a patient overcome an episode using haptic feedback mechanisms. Previously designed devices with similar intended purposes utilize accelerometry as a method of detection as well as audio and visual feedback mechanisms in their design.
ContributorsAnantuni, Lekha (Author) / McDaniel, Troy (Thesis director) / Tadayon, Arash (Committee member) / Harrington Bioengineering Program (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05