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Determining the Efficacy of a Nutrition Education Intervention on Improving Consumer Comprehension of the Nutrition Label
Full text linkNutrition-related health problems and diseases have become a major concern in recent years. Scientists have established associations between Nutrition Label use and positive dietary outcomes. Furthermore, they have determined that consumers may be unable to correctly comprehend the information provided on Nutrition Labels. Research has shown that, although many variables play a role in limited label use among consumers, nutrition knowledge and a lack of nutrition education appear to be major concerns. Therefore, conducting nutrition education programs may ameliorate health illiteracy rates among the American population, increase label use, and ultimately improve dietary outcomes. This research will conduct a gender-focused nutrition education intervention in reading Nutrition Labels to college students in Philadelphia, Pennsylvania. The aim of the study is to determine the efficacy of a nutrition education intervention in increasing comprehension of the Nutrition Label in college students. Participants will perform nutrition knowledge tests before and after the intervention. Baseline and post-intervention questionnaire scores will be compared by statistical analyses to determine the significance of the intervention.M.S., Human Nutrition -- Drexel University, 201
Effectiveness of Interval vs. Endurance Training to Minimize Asthmatic Symptoms in Recreationally Active Adults
Full text linkThe prevalence of asthma is on the rise, affecting the quality of life of those who suffer from this condition. There are several treatments for asthma, exercise being one of the most affordable, while also offering other physiologic benefits. High intensity interval training (HIIT) consists of short bouts of maximal intensity exercise, followed by short periods of recovery. Endurance training consists of continuous, steady-state aerobic exercise, usually around 70% to 80% of maximal heart rate for 30 to 60 minutes in duration. Improvements in asthmatic symptoms have been seen utilizing both training protocols; however, most of the participants in these studies have been children. The purpose of this study was to determine if exercise will improve asthmatic symptoms of recreationally active adults, and to determine if there is a difference in interval and endurance training protocols in terms of asthmatic symptoms. It was hypothesized that exercise will improve asthmatic symptoms; however, due to lack of recruitment, the second aim of this study was not addressed. One recreationally active adult, 26 years of age, with no other chronic diseases, was recruited through the use of flyers. The participant was informed of the risks and benefits before partaking in any training protocol. Due to the fact that only one participant was recruited and time constraints to conduct a crossover design study (as was originally intended), the participant was randomly assigned to a six-week endurance protocol. Biometric and pulmonary measurements were taken before and after the protocol. It may appear that there was a slight decrease in pulmonary functions following the six-week endurance protocol; however, the measurements are likely within normal variation. Because this was a case study, no statistical analyses could be performed to determine statistical significance.M.S., Human Nutrition -- Drexel University, 201
Attention and Executive Functioning Profiles in Children Following Perinatal Arterial Ischemic Stroke
Full text linkBackground: Despite its recognition as the most frequent form of stroke in children and being a major source of long-standing neurological sequelae, there is a dearth of research concerning the psychosocial and neuropsychological profile of perinatal arterial ischemic stroke (PAIS). Prior research has documented a high incidence of Attention Deficit Hyperactivity Disorder (ADHD)—a disorder characterized by prominent impairments in attention and executive functioning skills—among children with a history of PAIS, yet there are no prior studies comprehensively investigating this profile in these children. Moreover, medical and neurophysiological factors may contribute to outcomes in these domains are largely understudied in this population. A elevated understanding of the attention and executive functioning profile in PAIS will not only better inform clinicians of the cognitive outcomes, but may also lead to better interventions to address—or strategies for management of—the subsequent sequelae of PAIS. Objectives: The present study sought to: 1) investigate and describe the profile of attention and executive functioning in children following perinatal stroke; and 2) examine the influence of clinical and demographic factors on attention and executive functioning outcomes in children following perinatal stroke. Participants: Forty-one children aged 3-15 diagnosed with perinatal arterial ischemic stroke, recruited from the Children’s Hospital of Philadelphia (CHOP) in Philadelphia, Pennsylvania. Patients were identified through the CHOP Pediatric Stroke Program’s ambulatory patient care clinic and IRB-approved Stroke Registry. Method: Children underwent a single-session neuropsychological assessment focusing on attention and executive functioning domains at CHOP. Additionally, parents/legal guardians completed questionnaires regarding real-world functioning of attention and executive functioning during the visit as well, providing a functional measure of these domains. Demographic (age, sex, race, and family socioeconomic) and medical variables (lesion size, lesion location, presence of epilepsy) were collected for each participant. Results: Although intellectual performance was in the lower normative range (mean = 94.38; SD = 15.90), it was significantly lower than FSIQ in the normative sample. Additionally, measures of attention, verbal fluency, inhibitory control, flexibility/shifting, planning/organizing, and processing speed were significantly lower in children with PAIS than in the normative sample (all p<0.001); working memory was not significantly different. The presence of comorbid epilepsy, larger stroke volume, and older age at time of testing significantly influenced performance on several attention and executive functioning measures, whereas sex, stroke location (anatomical), and stroke laterality did not. Conclusions: Overall, children with PAIS evidenced significant attention and executive functioning impairment in comparison to typically developing peers in the normative population. Children with comorbid epilepsy, larger stroke volume, and/or older age were at increased risk for deficits in these cognitive domains.Ph.D., Psychology -- Drexel University, 201
An Exploration of My Experience as a Dance/Movement Therapy Intern who worked with Children who have Experienced Trauma: An Artistic Inquiry
Full text linkThis artistic inquiry asked, what is my experience as a DMT intern who worked with children who have experienced trauma? I was the only participant in the study. The data was collected using the practice of Authentic Movement, which is a codified expressive, improvisational movement process. Data was also collected using journaling. The data was analyzed using movement and identifying themes in the written data. The results can be summarized in three main themes: boundaries and limitations, polarities and balance and self-care.
The main implications of the study are to integrate the explicit use of movement in DMT supervision and self-care practices. Additionally, the practice of sharing one’s cohesive experienced is recommended. For future research, I propose the inclusion of more participants, both DMT interns and therapists and the use of a different artistic medium in the collection of data.M.A., Dance/Movement Therapy and Counseling -- Drexel University, 201
Gender, Reproductive, and Lifestyle Risk Factors Associated with Liver Disease Severity in Chronic Hepatitis B Infection
Full text linkHepatitis B is a common infectious disease worldwide. It is linked to a series of liver complications such as inflammation, fibrosis, cirrhosis, hepatocellular carcinoma, and liver-related death. It is well-established that males are more likely to develop severe forms of liver disease compared to female chronic hepatitis B (CHB) patients. The goal of this dissertation was to test three hypotheses that could potentially explain the gender difference between male and female liver disease severity in the hepatitis B infected population. The data in this dissertation is derived from the Haimen City cohort, established in 1992-93 in Haimen City, China. The goal of the first paper is to determine whether lifestyle and environmental related exposures could explain the gender differences in liver disease severity in the HBV infected population. The objective of the second paper is to better understand the impact of estrogen exposure by examining the effect of reproductive history on the severity of liver disease in CHB women. The third paper examines HBV viral load change over time among men and women and determines how this change may predict later liver disease.Ph.D., Epidemiology -- Drexel University, 201
An Examination of the Correlation between Never Married, Heterosexual Black Males’ Self-Reported Experiences of Racism and their Desire to Marry
Full text linkThe topics of love and intimate relationships maintain a constant presence in popular and empirical discourse. Romantic relationships in the Black community have been of particular interest in the last decade and several researchers have developed connections between the low rate of Black marriages to the historical enslavement of African people in the United States (Bryant, Taylor, Lincoln, Chatters, & Jackson, 2008; Cherlin, 1998; Cole & Omari, 2003; Dickson, 1993; Jones, 2006; Landrine & Klonoff, 1996; Lawrence-Webb, Littlefield & Okundaye, 2004; Raley, 1996). Despite the apparent interest in "Black love", Black men are repeatedly excluded from research studies as viable subjects (Jenkins, 2006; Hurt, 2012; Roberts, 1994). Experiences of racism are prevalent for Black men, as with all Black people, and have extensive ramifications (Bonilla-Silva, 2006; Byrd & Clayton, 2000, 2002; Feagin & Spikes, 1994; Jones, 1997; LaVeist, 2002; Pinderhughes, 2002; Utsey & Ponterotto, 1996; West, 2001). One area, which is significantly impacted by racism, is family formation and, more specifically, the formation and maintenance of healthy partner relationships. The purpose of this quantitative study was to examine whether experiences of racism impact desire to get married for never married, heterosexual Black men between age 18 and 45. A survey tool was used to administer two measurements: the Desire to Marry Scale (South, 1993), which measured marriage desirability, and the Schedule of Racist Events (Landrine & Klonoff, 1996), which measured perceived experiences of racism. Additionally, demographic information such as age, income, education, etc. was gathered.Ph.D., Couple and Family Therapy -- Drexel University, 201
Facilitators and Barriers to Healthy Eating and Disease Management Among Low-Income Seniors Residing in Subsidized Housing: A Case Study
Full text linkLow-income seniors residing in subsidized housing may develop unhealthy eating behaviors and experience poor health outcomes due to a lack of access to fresh produce in their local environment. Guild House West (GHW) is a Quaker-run subsidized housing facility for seniors and disabled individuals located in the West Poplar neighborhood of Philadelphia, Pennsylvania. GHW was established and is managed by Friends Rehabilitation Program, a Quaker-related non-profit, whose mission is to provide affordable housing and social services for seniors, low-income persons, and individuals with special needs. GHW is located in a neighborhood with low access to supermarkets but has the unique feature of a community garden implemented by the nonprofit organization Greener Partners. There is also a food pantry on site offering packaged goods to the residents once a week. Community-based participatory research was incorporated to establish a community partnership between Drexel University's Nutrition Sciences Department, Greener Partners, and GHW. Therefore, the purpose of this research was to incorporate formative research methods to gain a better understanding of the nutrition-related needs of the population living in a subsidized housing facility for future research. The researcher determined if community-driven nutrition education programing could be implemented to facilitate improvements in dietary intake and self-management of nutrition-related chronic conditions among low-income seniors. This manuscript describes the preliminary stage of the formative research process, as the researcher collected information using ethnographic and phenomenological approaches to help inform the rest of the research process. Following 12 months of interacting directly with the GHW population, common themes and behaviors were identified. The two aspects of the case study focus on themes seen in 1) food focus groups during cooking classes 2) food pantry use and barriers to access. Focus group questions were developed and residents were invited in-person and through a weekly newsletter to participate in food focus groups by GHW management and the researcher. Participation in the GHW community food pantry was pursued initially to better understand the needs of the residents for future research/programming. A thematic analysis was performed using NVivo 10, a software package that is used to organize and manage qualitative databases. Generalizable information was gathered on the beliefs and behaviors of the GHW residents. Seven major themes and sub-themes were derived from the NVivo 10 Software data analysis of the attitudes and behaviors of the residents at GHW during food focus groups and food pantry participation. Themes included negative dietary attitudes about diet quality, challenges of change around nutrition and healthy eating, external barriers in the food environment, negative influences in the internal environment, disconnect between disease state and nutrition recommendations, difficulties of disease self-management through dietary modifications, and interest for learning new recipes to improve nutrition knowledge base. The significance of understanding the attitudes, behaviors, and beliefs surrounding the internal and external challenges to healthful eating were classified in this case study. Acknowledging the impact that barriers had on the social and personal constructs of low-income seniors residing in subsidized housing was found to be a successful strategy in informing the research process for future nutrition programming. The themes are considered generalizable to similar populations indicating that community-driven nutrition education programming can be implemented within a subsidized living setting to facilitate improvements in dietary intake and self-management of disease among low-income seniors. This research uncovered two novel concepts; residents were not familiar with healthier food options that were not culturally relevant and community tensions existed among the residents due to lack of social cohesion. Future research must consider these novel concepts while developing nutrition programming within subsidized housing facilities.M.S., Human Nutrition -- Drexel University, 201
The Effect of Palliative Care Team-led Family Meetings on End-of-Life Decision-Making Among Medical Surrogates of Hospitalized, Incapacitated, Senior, African Americans with Life Limiting Illnesses
Full text linkCulture and ethnicity are known to influence end-of-life decision-making. The purpose of this study was to conduct a retrospective chart review to explore whether Palliative Care Team (PCT)-led family meetings influence end-of-life decisions made by medical surrogates of hospitalized, incapacitated, senior, African Americans suffering with life limiting illnesses. Using Imogene King’s nursing theory of Goal Attainment as the overarching framework in achieving effective caring, the electronic medical records (EMRs) of 96 African Americans, whose medical surrogates participated in a PCT-led family meeting on their behalf to discuss end-of-life care options from April 1, 2013 to March 31, 2014 were reviewed. Data extracted from EMRs identified end-of-life decisions made by the surrogates. The data were also examined to compare decisions made by surrogates with what the patients documented in their Living Wills (LW). Finally, the data were used to examine relationships between age, gender, and kinship, and end-of-life decisions made by surrogates on the patient’s behalf. Demographics and variables were examined using descriptive statistics. ANOVA and Pearson Chi-Square were utilized to evaluate relational significance. A significant relationship was noted between decreased length of hospital stay and those transitioned to comfort care. Additionally, a representative number (40%) of these patients were transitioned from restorative to comfort care following their surrogate’s participation in a PCT-led meeting. While few (13.5%) had a LW, of those LWs available, the medical surrogates generally upheld the patients’ wishes documented within their LW. Age, gender, and kinship played an insignificant role in the surrogate’s care pathway decision. Meetings were conducted by PCT physicians or nurse practitioners. Both obtained similar meeting outcomes, thus implying that family meeting facilitation skills are similar between these disciplines. This work suggests that the PCT-led family meeting can influence medical surrogate decision-making. Future efforts must focus on fostering the right of autonomy among African Americans, and providing education concerning the importance of the LW. Making PCTs available to those involved in end-of-life decision-making can further efforts to eliminate health care disparities which African Americans continue to face.Dr.N.P., Nursing Practice -- Drexel University, 201
The Experience of Wives/Female Companions of Aging Vietnam Veterans with Chronic Posttraumatic Stress Disorder: A Qualitative Replication Study
Full text linkA plethora of information exists regarding Posttraumatic Stress Disorder (PTSD) in Vietnam veterans. What has not been exclusively researched is the effect of this illness on the aging wives and female companions of these veterans. The purpose of this phenomenologic qualitative replication study was to describe the experiences of wives and female companions living with aging Vietnam veterans with chronic PTSD and to compare/contrast findings to the 2001 parent study conducted by Lyons. A purposive sample of wives/female companions living with aging Vietnam veterans with chronic PTSD was recruited from various geographical areas of the United States using snowball sampling, recruitment flyers and direct contact. The 10 participants ranged in age from mid-fifties to the late sixties and had been in a cohabitating relationship with aging Vietnam veterans diagnosed with PTSD for more than six months over the last fifteen years. The data collection approach for this phenomenological study used semi-structured interview questions, with four participants interviewed in person and the remaining six participants interviewed by telephone; all interviews were audio recorded. Participants were also asked to complete a demographic questionnaire and the Cohen perceived stress scale, which measured the level of perceived stress within the past month. Data was analyzed using Colaizzi’s systematic method and the qualitative analytical program Nvivo 10 was used to code data and extract themes. Themes that emerged were similar to the findings of Lyons and a fourth phase was added that was termed the epilogue.Dr.N.P., Nursing Practice -- Drexel University, 201
Experiential Avoidance and Distress in Breast Cancer Patients
No full textStrategies categorized as "avoidant coping" have been identified as important predictors of psychosocial outcomes (distress, anxiety, depression) among individuals with breast cancer. However, there are several different ways that researchers have defined this construct, resulting in the use of differing measures. As such, it is difficult to compare the results from various research studies in order to translate them into clear recommendations for screening and treatment. However, two clearly defined constructs, experiential avoidance and avoidant problem solving style, overlap significantly with avoidant coping and are associated with distress in other populations. The present study had two main aims. First, this study aimed to examine the relationships among several measures of avoidance and distress. Two hundred and thirtythree women with a current or past diagnosis of breast cancer completed measures to assess the outcome variables of generalized distress (NCCN Distress Thermometer), anxiety (HADS-A) and depression (HADS-D), and predictor variables including severity of cancer-related problems (CARES-SF), experiential avoidance (AAQ-II), avoidant problem solving style (SPSI-R-AS) and avoidant coping (COPE scales of Denial, Mental Disengagement and Behavioral Disengagement). When controlling for cancer-related problems, statistically significant positive partial correlations were found between experiential avoidance and distress, anxiety and depression. However, controlling for cancer-related problems significantly weakened, and in most cases completely eliminated, the relationships between traditional avoidant coping strategies and the outcome measures. This suggests that breast cancer patients' self-report of specific avoidant coping strategies may be highly dependent on the severity of cancer-related problems - and that experiential avoidance, which reflects the tendency to utilize these strategies inflexibly, might be a more reliable and useful predictor of distress in this population. The second aim of the study was to explore the underlying factor structure of the five avoidance measures. Principal axis factoring revealed a two-factor solution which explained 40.6% of the variance, and which was consistent with the proposed factor structure of the AAQ-II and the SPSI-R-AS. The solution did not support the structure of the avoidant coping scales as initially proposed by the authors of the COPE, suggesting that these measures should be reevaluated for use in the breast cancer population.Ph.D., Psychology -- Drexel University, 201