Theses and Dissertations - Department of Human Nutrition and Hospitality Management
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Browsing Theses and Dissertations - Department of Human Nutrition and Hospitality Management by Author "Ellis, Amy C."
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Item Demographic correlates of patients with head-and-neck cancer receiving radiotherapy(University of Alabama Libraries, 2017) Willman, Alexis; Lawrence, Jeannine C.; University of Alabama TuscaloosaBackground: Patients with head-and-neck cancer (HNC) often require some form of enteral feeding during their treatment due either to the presence of the tumor or as a result of radiation treatment (RT). Because of the catabolic nature of the disease and severe consequences of the radiation treatment, many patients benefit from enteral nutrition (EN). This improves the nutritional status of the patient and allows the patient to continue with their treatments. Studies have identified clinical predictors associated with the decision to initiate EN, but there is a dearth of information regarding demographic correlates. Objective: The purpose of this study was to identify whether demographic variables, such as age, gender, religious affiliation, marital status, and ethnicity of patients with HNC are predictors of the decision to initiate EN feedings. Methods: A retrospective chart review of 123 patients with HNC was conducted. Patients were excluded if there was no information of RT, EN initiation prior to the start of RT, or no primary diagnosis of HNC. Demographic information, anthropometrics, and enteral feeding initiation date were recorded from the Registered Dietitian and oncologist’s notes. Percent body weight loss was calculated from the recorded weights at four points throughout the treatment. Results were analyzed with Spearman’s correlation, chi square tests, Mann-U Whitney Tests, and linear regression models. Results: Religious affiliation, weight change from diagnosis to RT completion, and weight change from the start to completion of RT were the only significant predictors of EN initiation (p=0.008; p=0.01; p=0.001). Age, ethnicity, and marital status were not related to EN initiation or the timing of EN initiation. Conclusions: Religious affiliation and weight loss were significant predictors of EN initiation. Because of an informal guideline internal to the cancer treatment center monitoring and recommending EN to patients with >5% weight loss, bias was reduced. Therefore, policies that are based on percent body weight loss may be helpful in reducing EN placement bias.Item Dietary Interviews and Survey of Habits in Parkinson Disease: the Dish Mixed Methods Study(University of Alabama Libraries, 2021) Ferguson, Christine C.; Ellis, Amy C.; University of Alabama TuscaloosaBackground: The pathophysiology of Parkinson disease (PD) may influence the ability of a person living with PD (PwP) to perform food-related activities (FRA) such as meal planning, food procurement, food preparation, eating and drinking. Their abilities may be further impacted by other internal and external factors, including the novel coronavirus disease 2019 (COVID-19) pandemic.Purpose: The purpose of this mixed methods study was to explore personal, behavioral, and environmental factors that are associated with the ability of people living with PD (PwPs) to perform FRA as well as the impact of the COVID-19 pandemic on their overall dietary patterns. Methods: Using a convergent parallel design, PwPs and their care-partners completed virtual dyadic qualitative interviews about their experiences with FRA during the COVID-19 pandemic. Semi-structured interviews were guided by the Social Cognitive Theory. PwPs completed a Food Frequency Questionnaire (FFQ) to quantify their dietary intake in the previous 12 months. Sociodemographic data, medical history, and symptom severity were also assessed among PwPs. Qualitative data were analyzed independently by two coders using both inductive and deductive techniques. Quantitative data from the FFQ were descriptively analyzed and utilized to calculate diet scores. Results: Eleven dyadic interviews were conducted to uncover the following subthemes by the personal, environmental, and behavioral levels of the SCT: perception of a healthy diet, perception of how nutrition influences PD symptoms and progression, confidence in following a healthy diet, barriers & perceived challenges to performing FRA, previous sources of nutrition information, willingness to changing their diet with a Registered Dietitian, modifications to FRA due to food-medication interactions, and skills necessary to maintain a healthy diet. Participants experienced changes in their typical FRA and routines due to COVID-19. Specifically, they cooked more at home, consumed fewer meals with non-household members, and altered their grocery shopping habits. These changes often led to an increase in the care-partners’ responsibilities and overall burden. The average diet scores among PwPs were 73.0+6.3 for the Healthy Eating Index 2015 (scale of 0-100), 29.2+6.6 for the Mediterranean diet (scale of 0-55), and 10.4+1.8 for the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet (scale 0-15). Conclusions/Implications: Although diet scores indicated healthy dietary patterns among PwPs, findings from this study highlight the need for tailored nutrition education for PwPs and care-partners, and the results provide talking points for healthcare providers to address with their PD patients. Results also point to the need for future nutrition intervention research to inform evidence-based guidelines for this patient population. Interviews with PwPs and their care-partners revealed the need for healthcare providers and researchers to address increases in caregiver burden that resulted from changes in FRA due to the COVID-19 pandemic.Item Prevalence of dietary supplement use of individuals with Parkinson’s disease(University of Alabama Libraries, 2018) Ferguson, Christine Cherie Childs; Ellis, Amy C.; University of Alabama TuscaloosaParkinson’s disease (PD) is an incurable, progressive neurological disease that appears with motor and non-motor symptoms such as tremors, muscle rigidity, impaired gait, mood disorders, constipation, and sleep disorders.1,2 Although its etiology is unknown, oxidative stress is believed to be involved in the development and progression of PD. This has prompted interest in dietary supplements with antioxidant functions as a potential strategy to mitigate these processes.2 However, individuals with PD may self-medicate with dietary supplements that are poorly regulated.3,4,7 The primary aims of this study were to explore the prevalence of dietary supplement use among individuals with PD and to identify the most common supplements being taken. This cross-sectional study utilized a questionnaire that was administered through Qualtrics to those with PD via support group websites. Dietary supplement users were also asked if they spoke with a healthcare professional about their supplement use. In addition to descriptive statistics, Mann-Whitney U, Fischer’s Exact, and chi-square tests were used to determine differences in demographic characteristics between supplement users and non-users. Spearman’s correlations were used to identify possible associations between demographic variables and dietary supplement use. The percentage of respondents who reported using at least one dietary supplement in the past thirty days was 83.4% (171/205). The most commonly used dietary supplements were vitamin D, multivitamins, vitamin B12, fish oil, melatonin, CoQ10, and calcium. However, 94 different supplements were identified. More than one in four respondents reported that they had not discussed their supplementation with a physician or other healthcare professional. These results demonstrate a high prevalence of dietary supplement use among individuals with PD as well as a wide variety of supplements being taken. This study’s findings also indicate the need for better dialogue between patients and healthcare providers regarding the use of dietary supplements.