Physical activity among breast and prostate cancer survivors: Barriers, facilitators and maintenance following the FRESH START trial

Research provides evidence of the positive health effects associated with regular physical activity participation in all populations. Activity may prove to be especially beneficial in those with chronic conditions such as cancer. However, the majority of cancer patients and survivors do not participate in the recommended amount of physical activity. The purpose of this dissertation was to identify factors associated with physical activity participation, describe how these factors change as result of a diet and exercise intervention, and to evaluate correlates of long term physical activity maintenance. ^ For this dissertation, I analyzed data from the FRESH START trial, a randomized, single-blind, phase II clinical trial focused on improving diet and physical activity among recently diagnosed breast and prostate cancer survivors. Analyses included both parametric and non-parametric statistical tests. Three separate studies were conducted, with sample sizes ranging from 400 to 486. ^ Common barriers to exercise, such as “no willpower,” “too busy,” and “I have pain,” were reported among breast and prostate cancer survivors; however, these barriers were not significantly associated with minutes of physical activity. Breast cancer survivors reported a greater number of total barriers to exercise as well as higher proportions reporting individual barriers, compared to prostate cancer survivors. Just less than half of participants reduced their total number of barriers to exercise from baseline to 1-year follow-up, and those who did reduce barriers reported greater increases in minutes of physical activity compared to those who reported no change in barriers to exercise. Participants in both the tailored and standardized intervention groups reported greater minutes of physical activity at 2-year follow-up compared to baseline. Overall, twelve percent of participants reached recommended levels of physical activity at both 1- and 2-year follow-up. Self-efficacy was positively associated with physical activity maintenance, and the number of total barriers to exercise was inversely associated with physical activity maintenance. ^ Results from this dissertation are novel and informative, and will help to guide future physical activity interventions among cancer survivors. Thoughtfully designed interventions may encourage greater participation in physical activity and ultimately improve overall quality of life in this population. ^

Ethnic differences in food availability at home among 3--5 year old preschoolers attending Head Start centers in 2008

Background. The childhood obesity epidemic has disproportionately impacted the lives of low-income, minority preschoolers and their families. Research shows that parents play a major role as "gatekeepers" who control what food is brought into the home and as role models for dietary practices. Currently, there is limited research regarding ethnic differences in families of low-income preschoolers. ^ Objective. The objective of this study was to look at ethnic differences in food availability at home among the low-income families of Hispanic and African American preschoolers attending Head Start centers in Harris County, Texas. ^ Design/Subjects. Descriptive data on food availability at home between Hispanic and African American families were used and analyzed for this study. Parents or primary caregivers (n = 718) of children enrolled at Head Start Centers in Houston, Texas completed the Healthy Home Survey. ^ Methods. In the Healthy Home Survey, participants were asked to answer open-ended questions regarding various types of foods currently available at home, such as fresh, canned or jarred, dried and frozen fruits; fresh, canned or jarred, and frozen vegetables; salty snacks, sweet snacks, candy, and soda. Descriptive analyses were conducted to identify significant differences between Hispanics and African Americans via a paired t-test to compare the means of variables between the study groups and a Pearson's chi-square or Fischer's exact (if cell size was <5) test calculated for food availability (food types) between ethnicities to determine differences in distributions. ^ Results. Although both Hispanics and African Americans reported having all categories of food types at home, there were statistically significant differences between ethnic groups. Hispanics were more likely to have fresh fruits and vegetables at home than African Americans. At the same time, more African American families reported having canned or jarred fruits and canned green/leafy vegetables than Hispanics. More Hispanic families reported having diet, regular, and both diet and regular sodas available compared to African American families. However, high percentages of unhealthy foods (including snacks and candy) were reported by both ethnicities. ^ Conclusions. The findings presented in this study indicate the implicit ethnic differences that exist in the food availability among low-income families of Hispanic and African American preschoolers. Future research should investigate the associations between food availability and children's weight status by ethnicity to identify additional differences that may exist.^

IMMUNOLOGICAL MECHANISMS OF EXTRACORPOREAL PHOTOPHERESIS IN CUTANEOUS T CELL LYMPHOMA AND GRAFT VERSUS HOST DISEASE

IMMUNOLOGICAL MECHANISMS OF EXTRACORPOREAL PHOTOPHERESIS IN CUTANEOUS T CELL LYMPHOMA AND GRAFT VERSUS HOST DISEASE Publication No.___________ Lisa Harn-Ging Shiue, B.S. Supervisory Professor: Madeleine Duvic, M.D. Extracorporeal photopheresis (ECP) is an effective, low-risk immunomodulating therapy for leukemic cutaneous T cell lymphoma (L-CTCL) and graft versus host disease (GVHD), but whether the mechanism(s) of action in these two diseases is (are) identical or different is unclear. To determine the effects of ECP in vivo, we studied regulatory T cells (T-regs), cytotoxic T lymphocytes (CTLs), and dendritic cells (DCs) by immunofluorescence flow cytometry in 18 L-CTCL and 11 GVHD patients before and after ECP at Day 2, 1 month, 3 months, and 6 months. In this study, ECP was effective in 12/18 L-CTCL patients with a 66.7% overall response rate (ORR) and 6/11 GVHD patients with a 54.5% ORR. Prior to ECP, the percentages of CD4+Foxp3+ T cells in 9 L-CTCL patients were either lower (L-CTCL-Low, n=2) or higher (L-CTCL-High, n=7) than normal. Five of the 7 GVHD patients had high percentages of CD4+Foxp3+ T cells (GVHD-High). Six of 7 L-CTCL-High patients had >80% CD4+Foxp3+ T cells which were correlated with tumor cells, and were responders. Both L-CTCL-High and GVHD-High patients had decreased percentages of CD4+Foxp3+ and CD4+Foxp3+CD25- T cells after 3 months of treatment. CD4+Foxp3+CD25+ T cells increased in GVHD-High patients but decreased in L-CTCL-High patients after 3 months of ECP. In addition, numbers of CTLs were abnormal. We confirmed that numbers of CTLs were low in L-CTCL patients, but high in GVHD patients prior to ECP. After ECP, CTLs increased after 1 month in 4/6 L-CTCL patients whereas CTLs decreased after 6 months in 3/3 GVHD patients. Myeloid (mDCs) and plasmacytoid DCs (pDCs) were also low at baseline in L-CTCL and GVHD patients confirming the DC defect. After 6 months of ECP, numbers and percentages of mDCs and pDCs increased in L-CTCL and GVHD. MDCs were favorably increased in 8/12 L-CTCL responders whereas pDCs were favorably increased in GVHD patients. These data suggest that ECP is favorably modulating the DC subsets. In L-CTCL patients, the mDCs may orchestrate Th1 cell responses to overcome immune suppression and facilitate disease regression. However, in GVHD patients, ECP is favorably down-regulating the immune system and may be facilitating immune tolerance to auto-or allo-antigens. In both L-CTCL and GVHD patients, DCs are modulated, but the T cell responses orchestrated by the DCs are different, suggesting that ECP modulates depending on the immune milieu. _______________

(Table 1) Geochemistry of realatively fresh rocks of ODP Sites 127-794 and 127-797

The flows and sills drilled at Sites 794 and 797 in the Yamato Basin of the Japan Sea are subalkalic, olivine, and/or plagioclase phyric basalts. Compositionally, the rocks can be divided into a depleted, low-K type and an enriched, relatively high-K type. In addition, two contrasting evolution trends are reflected in the rock compositions, which allow four different magmatic suites to be identified. It is suggested that the depleted or enriched nature of these suites represent primary characteristics, while the different evolution trends are related to fractionation processes in crustal magma chambers. A tholeiitic evolution trend, with increasing FeO and TiO2 and decreasing Al2O3, can be modelled by fractional crystallization of 40%-50% plagioclase, olivine, and augite. A mildly calc-alkalic evolution trend, with decreasing FeO, increasing Al2O3, and nearly constant TiO2, can be modelled by 8%-12% olivine fractionation. Mineralogical evidence suggests that these differences may be related to the effect of small amounts of water during crystallization of the calc-alkalic suites. The tholeiitic suites occur in the lower parts of the drill cores, while the calc-alkalic suites occur in the upper parts. This suggests a complex tectonic and magmatic evolution, perhaps reflecting a transition between calc-alkalic magmatism related to subduction zone activity and tholeiitic magmatism related to back-arc spreading. Furthermore, any magmatic model must be able to account for the range in parental magmas from depleted to enriched throughout the tectonic history of the Yamato Basin.

Descripción del subsistema estrictamente coordinado de exportación de mango fresco : Passion Fresh

El mango es una de las frutas tropicales cuya demanda mundial ha mostrado un crecimiento positivo y sostenido en el tiempo. El Perú ha logrado destacar como uno de los principales exportadores de mango fresco en el mundo, en este país la mayoría de empresas exportadoras tiene varios años en el mercado y comercializan el producto en verde enviándolo vía marítima. Ese no es el caso de Passion Fresh, que con pocos años en el mercado, ha logrado convertirse en uno de los principales exportadores de mango fresco, comercializándolo con el grado de madurez exacto para ser consumido. Por ello, el objetivo de este trabajo es identificar las innovaciones organizacionales de Passion Fresh a fin de comprender su creciente inserción en mercado internacional. La metodología utilizada fue la epistemología fenomenológica a través de un estudio de caso; sustentada teóricamente en la nueva economía institucional, utilizando el análisis estructural discreto, se hizo énfasis en el ambiente organizacional, analizando las transacciones de la empresa con cada uno de los actores del subsistema y su respectiva alineación. El subsistema se desarrolla en un ambiente institucional que no tiene una política específica para el mango, pero que se ha visto soportado por políticas para productos agrícolas en general. Respecto al ambiente tecnológico las innovaciones solo llegan a aquellos que están agrupados en asociaciones. Y en el ambiente organizacional coexisten dos subsistemas, uno orientado al mercado local y otro al externo, ambos con gran presencia de intermediarios. Los resultados obtenidos muestran a Passion Fresh como un subsistema estrictamente coordinado, con un activo altamente específico, lo que hace que se diferencie de sus competidores, ya que tiene que comercializar el mango vía aérea para que llegue listo para el consumo. Todo esto lo define como el coordinador del subsistema, disminuyendo así los costos de transacción y convirtiéndose en una referencia del sector.