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Description
In this project I explored the relationship between Qigong and Tai Chi Easy meditative practices and cardiometabolic risk factors, specifically looking at obesity and stress. The meditative focus of Qigong and Tai Chi Easy was expected to improve cardiac vagal tone which should lead to decreases in the inflammatory effects of stress. Additionally, due to the decreases in the harmful effects of stress, we expect to see a decrease in obesity through decreases in BMI and in waist circumference.
ContributorsRameshkumar, Ramya (Author) / Larkey, Linda (Thesis director) / James, Dara (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D. Recent evidence suggests high-intensity interval training (HIT) may yield similar or superior benefits in a shorter amount of time compared to traditional continuous exercise training. The purpose of this study was to compare the effects of HIT to continuous (CONT) exercise training for the improvement of endothelial function, glucose control, and visceral adipose tissue. Seventeen obese men (N=9) and women (N=8) were randomized to eight weeks of either HIT (N=9, age=34 years, BMI=37.6 kg/m2) or CONT (N=8, age=34 years, BMI=34.6 kg/m2) exercise 3 days/week for 8 weeks. Endothelial function was assessed via flow-mediated dilation (FMD), glucose control was assessed via continuous glucose monitoring (CGM), and visceral adipose tissue and body composition was measured with an iDXA. Incremental exercise testing was performed at baseline, 4 weeks, and 8 weeks. There were no changes in weight, fat mass, or visceral adipose tissue measured by the iDXA, but there was a significant reduction in body fat that did not differ by group (46±6.3 to 45.4±6.6%, P=0.025). HIT led to a significantly greater improvement in FMD compared to CONT exercise (HIT: 5.1 to 9.0%; CONT: 5.0 to 2.6%, P=0.006). Average 24-hour glucose was not improved over the whole group and there were no group x time interactions for CGM data (HIT: 103.9 to 98.2 mg/dl; CONT: 99.9 to 100.2 mg/dl, P>0.05). When statistical analysis included only the subjects who started with an average glucose at baseline > 100 mg/dl, there was a significant improvement in glucose control overall, but no group x time interaction (107.8 to 94.2 mg/dl, P=0.027). Eight weeks of HIT led to superior improvements in endothelial function and similar improvements in glucose control in obese subjects at risk for T2D and CVD. HIT was shown to have comparable or superior health benefits in this obese sample with a 36% lower total exercise time commitment.
ContributorsSawyer, Brandon J (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Lee, Chong (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2013
Description
Purpose: The purpose of this study was to examine the acute effects of two novel intermittent exercise prescriptions on glucose regulation and ambulatory blood pressure. Methods: Ten subjects (5 men and 5 women, ages 31.5 ± 5.42 yr, height 170.38 ± 9.69 cm and weight 88.59 ± 18.91 kg) participated in this four-treatment crossover trial. All subjects participated in four trials, each taking place over three days. On the evening of the first day, subjects were fitted with a continuous glucose monitor (CGM). On the second day, subjects were fitted with an ambulatory blood pressure monitor (ABP) and underwent one of the following four conditions in a randomized order: 1) 30-min: 30 minutes of continuous exercise at 60 - 70% VO2peak; 2) Mod 2-min: twenty-one 2-min bouts of walking at 3 mph performed once every 20 minutes; 3) HI 2-min: eight 2-min bouts of walking at maximal incline performed once every hour; 4) Control: a no exercise control condition. On the morning of the third day, the CGM and ABP devices were removed. All meals were standardized during the study visits. Linear mixed models were used to compare mean differences in glucose and blood pressure regulation between the four trials. Results: Glucose concentrations were significantly lower following the 30-min (91.1 ± 14.9 mg/dl), Mod 2-min (93.7 ± 19.8 mg/dl) and HI 2-min (96.1 ± 16.4 mg/dl) trials as compared to the Control (101.1 ± 20 mg/dl) (P < 0.001 for all three comparisons). The 30-min trial was superior to the Mod 2-min, which was superior to the HI 2-min trial in lowering blood glucose levels (P < 0.001 and P = 0.003 respectively). Only the 30-min trial was effective in lowering systolic ABP (124 ± 12 mmHg) as compared to the Control trial (127 ± 14 mmHg; P < 0.001) for up to 11 hours post exercise. Conclusion: Performing frequent short (i.e., 2 minutes) bouts of moderate or high intensity exercise may be a viable alternative to traditional continuous exercise in improving glucose regulation. However, 2-min bouts of exercise are not effective in reducing ambulatory blood pressure in healthy adults.
ContributorsBhammar, Dharini Mukeshkumar (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Buman, Matthew (Committee member) / Swan, Pamela (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2013
Description
Health and healing in the United States is in a moment of deep and broad transformation. Underpinning this transformation is a shift in focus from practitioner- and system-centric perspectives to patient and family expectations and their accompanying localized narratives. Situated within this transformation are patients and families of all kinds. This shift's interpretation lies in the converging and diverging trails of biomedicine, a patient-centric perspective of consensus between practitioner and patient, and postmodern philosophy, a break from prevailing norms and systems. Lending context is the dynamic interplay between increasing ethnic/cultural diversity, acculturation/biculturalism, and medical pluralism. Diverse populations continue to navigate multiple health and healing paradigms, engage in the process of their integration, and use health and healing practices that run corollary to them. The way this experience is viewed, whether biomedically or philosophically, has implications for the future of healthcare. Over this fluid interpenetration, with its vivid nuance, loom widespread health disparities. The adverse effects of static, fragmented healthcare systems unable to identify and answer diverse populations' emergent needs are acutely felt by these individuals. Eradication of health disparities is born from insight into how these populations experience health and healing. The resulting strategy must be one that simultaneously addresses the complex intricacies of patient-centered care, permits emergence of more localized narratives, and eschews systems that are no longer effective. It is the movement of caregivers across multiple health and healing sources, managing care for loved ones, that provides this insight and in which this project is keenly interested. Uncovering the emergent patterns of caregivers' management of these sources reveals a rich and nuanced spectrum of realities. These realities are replete with opportunities to re-frame health and healing in ways that better reflect what these diverse populations of caregivers and care recipients need. Engaging female Mexican American caregivers, a population whose experience is well-suited to aid in this re-frame, this project begins to provide that insight. Informed by a parent framework of Complexity Science, and balanced between biomedical and postmodern perspectives, this constructivist grounded theory secondary analysis charts these caregivers' processes and offers provocative findings and recommendations for understanding their experiences.
ContributorsKrahe, Jennifer Anne Eve (Author) / Lamb, Gerri (Thesis advisor) / Evans, Bronwynne (Committee member) / Larkey, Linda (Committee member) / Arizona State University (Publisher)
Created2013
Description
ABSTRACT Despite significant advancements in drug therapy, cardiovascular disease (CVD) is still the leading cause of death in the United States. Given this, research has begun to seek out alternative approaches to reduce CVD risk. One of these alternative approaches is Vitamin D supplementation. Current research has shown a link between Vitamin D status and CVD risk in both healthy and diseased populations. Among the possible mechanisms is a positive effect of Vitamin D on vascular endothelial function, which can be measured with noninvasive techniques such as flow-mediated dilation (FMD) of conduit vessels using high-resolution ultrasound. This dissertation is comprised of two studies. The first examines whether Vitamin D supplementation can improve FMD in older adults within a time period (two weeks) associated with peak increases in plasma Vitamin D concentrations after a single-dose supplementation. The second examines the effect of Vitamin D supplementation in people with Rheumatoid Arthritis (RA). The reason for looking at an RA population is that CVD is the leading cause of early mortality in people with RA. In the first study 29 Post-Menopausal Women received either 100,000 IU of Vitamin D3 or a Placebo. Their FMD was measured at baseline and 2 weeks after supplementation. After 2 weeks there was a significant increase in FMD in the Vitamin D group (6.19 + 4.87 % to 10.69 + 5.18 %) as compared to the Placebo group (p=.03). In the second study, 11 older adults with RA were given 100,000 IU of Vitamin D or a Placebo. At baseline and one month later their FMD was examined as well as plasma concentrations of Vitamin D and tumor necrosis factor-alpha; (TNF-alpha;). They also filled out a Quality of Life Questionnaire and underwent a submaximal exercise test on the treadmill for estimation of maximum oxygen uptake (VO2max). There was no significant change in FMD in Vitamin D group as compared to the Placebo group (p=.721). Additionally, there was no significant improvement in either plasma Vitamin D or TNF-alpha; in the Vitamin D group. There was however a significant improvement in predicted VO2max from the submaximal exercise test in the group receiving Vitamin D (p=.003). The results of these studies suggest that a single 100,000 IU dose of Vitamin D can enhance FMD within two week in older adults, but that a similar dose may not be sufficient to increase FMD or plasma Vitamin D levels in older adults with RA. A more aggressive supplementation regimen may be required in this patient population.
ContributorsRyan, Dana Meredith (Author) / Gaesser, Glenn A (Thesis advisor) / Rizzo, Warren (Committee member) / Martin, Keith (Committee member) / Larkey, Linda (Committee member) / Chisum, Jack (Committee member) / Arizona State University (Publisher)
Created2012
Description
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
A cost analysis was done on the participant recruitment for an ongoing research project to promote colon cancer screening in Phoenix, Arizona. The aim of the 5-year project is to navigate people, who do not regularly see primary care physicians, from the community to a nearby clinic to be screened, using an intervention strategy called tailored navigation. Through tailored navigation, participants' barriers to being screened are addressed by Community Health Navigators, who call the participant over the span of 8 weeks following an initial class at a community site and give them information on how to overcome his or her specific barrier. The objective of this cost analysis is to explore the costs of recruiting a participant from the community to the initial class to a potential program manager. The process of recruitment involved recruitment of a community site, project introduction, the sign-up of interested participants, eligibility, baseline, and consent tests, and the class itself. A Community Site Liaison recruits sites and schedules class times. The Community Health Navigator conducts eligibility, baseline, and consent surveys and teaches the class, a sixty minute presentation on colon cancer screening. The cost of recruitment per community site was $541.23, and the cost per participant attending class was estimated to be $1,594.41 per participant with variation between $1,379.97 and $1,770.71 in optimistic and conservative scenarios, respectively.
ContributorsMishra, Shovna (Author) / Koretz, Lora (Thesis director) / Larkey, Linda (Committee member) / Herman, Patricia M. (Committee member) / Barrett, The Honors College (Contributor) / W. P. Carey School of Business (Contributor) / Department of Management (Contributor)
Created2014-05
Description
This paper focuses on the current use of complementary medicine in Oncology. First, it reviews the general trends in the rise of complementary therapies in the United States and look at the organizations responsible for the advancement of research. Next reviewed is the specific use of complementary medicine in cancer prevention, during treatment, and post-treatment therapy for increased quality of life. There are many modalities used in the management of this disease including yoga, tai chi chuan, botanicals, probiotics and meditation practices. Each of these therapies has their own unique benefits and are used at different stages of disease prevention and treatment.
ContributorsBalcerzak, Erin Mary (Author) / Larkey, Linda (Thesis director) / Hosley, Brenda (Committee member) / Bucho-Gonzalez, Julie (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2013-05
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
Human trafficking is not only a social injustice, but also a major global health problem, that our communities cannot ignore. Despite the common misconception that trafficking is only seen in foreign countries or is only related to immigrants, the U.S. is known to be a major trafficking market and destination, with trafficking reported in all 50 states (Bladwin et al., 2011; Shandro et al., 2016; Dovydaitis, 2010). Although trafficking victims are unlikely to have appropriate access to health care, as much as 80% of sex trafficking victims have reported that they encountered a medical professional while under their traffickers' control and went unidentified at the time (Baldwin et al., 2011; Shandro et al., 2016). This exemplifies a serious missed opportunity for intervention. Health care providers should be prepared to identify and care for victims of trafficking as part of their routine clinical practice. This thesis aims to describe trafficking victims' encounters in U.S. health care settings, to assess health care professionals' and students' awareness, knowledge, and beliefs on trafficking, to examine the impact of an educational intervention on this populations' knowledge/belief changes, and to ultimately spread education about this issue to a wide array of communities.
ContributorsFelix, Kaitlyn Nicole (Author) / Larkey, Linda (Thesis director) / Calvin, Samantha (Committee member) / School of Nutrition and Health Promotion (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05