Obesity rates among adults have steadily grown in recent decades all the way up to 42.4% in 2018. This is a 12% increase from the turn of the century (Center for Disease Control and Prevention, 2021). A major reason for this rise is increased consumption of processed, high-calorie foods. People eat these foods at a young age and develop bad eating habits that can last for the rest of their lives. It is essential to intervene early and help adolescents form balanced, healthy eating habits before bad habits are already formed. Our solution to this problem is Green Gamers. Green Gamers combines adolescent’s passion for gaming with healthy eating via in-game rewards for healthy eating. People will be able to purchase healthy food items, such as a bag of carrots, and on the packaging there will be a QR code. They will then be able to scan the code on our website, and earn points which will unlock in-game items and other rewards. Video game rewards act as effective motivators for you people to eat more healthy foods. After the solution was formulated, a preliminary survey was conducted to confirm that video game related rewards would inspire children to eat more healthy foods. Based on those results, we are currently in the process of running a secondary market research campaign to learn if gift card rewards are a stronger motivator. Our end goal for Green Gamers would be to partner with large gaming studios and food producers. This would allow us access to many gaming franchises, so that rewards are available from a wide variety of games: making the platform appealing to a diverse audience of gamers. Similarly, a relationship with large food producers would give us the ability to place QR codes on a greater assortment of healthy food items. Although no relationships with large companies have been forged yet, we plan to utilize funding to test our concept on small focus groups in schools.

Introduction. Human papillomavirus (HPV) is the most common sexually transmitted infections globally. HPV is responsible for several health concerns including genital warts, cancer of the cervix, vulva, penis, anus, and oropharynx. In China, HPV infection accounts for 69.1% of invasive cervical cancer. Currently, there is no treatment for HPV infection, but HPV vaccination has been proven to be effective against HPV-related diseases. Given the highest rate of contracting HPV and suboptimal vaccination rate in college students including international students in the U.S., it is important to investigate key factors associated with vaccine uptake among Chinese international students. Purpose. This study aimed to investigate knowledge and awareness of HPV and the vaccine, attitudes, and vaccination intention in this population. We conducted a cross-sectional online survey via REDCap. Methods. Participants who were (1) Chinese international student at Arizona State University; (2) 18 and older; (3) able to read, speak and write in Chinese or English were recruited from Arizona State University. Descriptive statistics (mean, standard deviation, frequency) and inferential statistics (Chi-square test, independent t-test) were conducted using SPSS 26.0. Results. One hundred and ten participants were included in this study (56.4% female, mean age = 24, SD = 3.7). Female students had significantly higher HPV vaccination rate than males (p = 0.000). The mean knowledge score was 8.09 (SD = 1.35); female students were more likely to receive HPV education than males (p = 0.001). The most common source of education was friends (50.7%). Three most common perceived risks were not being sexually active, being male, and not having any physical signs and symptoms. The three most common facilitators were infection prevention, access to vaccination, and ability to afford vaccination. The three most common barriers were the cost, safety, and efficacy of HPV vaccine. In conclusion, gender disparities exist among Chinese<br/>international students’ HPV vaccine uptake and HPV related education. Implication. Although Chinese international students possess moderate to high level of knowledge about HPV and HPV vaccines, they lack education from credible sources. Culturally and gender appropriate education is needed in order to address barriers of getting HPV vaccination.

Minority mental health patients face many health inequities and inequalities that may stem from implicit bias and a lack of cultural awareness from their healthcare providers. I analyzed the current literature evaluating implicit bias among healthcare providers and culturally specific life traumas that Latinos and African Americans face that can impact their mental health. Additionally, I researched a current mental health assessments tool, the Child and Adolescent Trauma Survey (CATS), and evaluated it for the use on Latino and African American patients. Face-to-face interviews with two healthcare providers were also used to analyze the CATS for its’ applicability to Latino and African American patients. Results showed that these assessments were not sufficient in capturing culturally specific life traumas of minority patients. Based on the literature review and analysis of the interviews with healthcare providers, a novel assessment tool, the Culturally Traumatic Events Questionnaire (CTEQ), was created to address the gaps that currently make up other mental health assessment tools used on minority patients.

For those living lives devoted to taking care of others, it can be difficult to remember to take care of themselves. This thesis project is a review of quantitative and qualitative literature pertaining to self-care for the caregivers of Alzheimer's and dementia patients. Three nursing diagnoses and related nursing interventions were created using data from the evidence-based literature. With the proper knowledge and assistance, caregivers can better prepare for the future and participate in health-promoting self-care activities which may improve their quality of life.

This study examines the effectiveness of two modes of exercise on inhibitory control in adults with Down Syndrome (DS). Thirteen participants attended four sessions: a baseline assessment, an Assisted Cycling Therapy (ACT) session, a Resistance Training (RT) session, and a session of No Training (NT). In the baseline assessment, 1-repetition max (1RM) measurements and voluntary pedal rate measurements were taken. In the resistance training session, the leg press, chest press, seated row, leg curl, shoulder press, and latissimus pulldown were performed. In the cycling intervention, the participant completed 30 minutes of cycling. The Erikson Flanker task was administered prior to each session (i.e., pretest) and after the intervention (i.e., post-test). The results were somewhat consistent with the hypothesis that inhibition time improved more following RT and ACT than NT. there was also a significant difference between ACT and NT. Additionally, it was hypothesized that all measures would improve following each acute exercise intervention, but the most significant improvements were seen following ACT. In conclusion, an acute session of ACT demonstrated a significant trend towards improvements in inhibitory control in adults with DS which we interpreted using a model of neural changes.

The following paper explores the various effects of stress on the endocrine system. Many understand that being stressed can jeopardize maintaining adequate health, but what specifically happens when humans are stressed? Why does stress affect human health? This paper delves into background information, previous research, and the depths to which stress negatively affects the body. The effects stress has on the endocrine system, specifically on the hypothalamic-pituitary-thyroid axis (HPT) and hypothalamic-pituitary-adrenal axis (HPA), is discussed, and additionally, at home de-stressing methods are researched. The study included a set of participants at Arizona State University. The method took place over the course of 2 weeks: one normal week, and the other with the implementation of a de-stressing method. The normal week involved the participants living their daily lives with the addition of a stress-measuring survey, while the second week involved implementing a de-stressing method and stress-measuring survey. The purpose of this study was to discover if there was a correlation between performing these relaxation activities and decreasing stress levels in ASU students. The results found that students reported they felt more relaxed and calm after the activities. Overall, this thesis provides information and first hand research on the effects of stress and stress-reducing activities and discusses the importance of maintaining lower stress levels throughout everyday life.

Circadian misalignments in terms of eat and sleep cycles, common occurrences among college students, are linked to adverse health outcomes. Time-restricted feeding, a form of intermittent fasting, may offer an exciting, non-pharmacologic approach to improve the health of this population by restricting eating to feeding windows that align with circadian biology. This study aims to fill a gap in the literature regarding the effect of early time-restricted feeding (eTRF) on college students, particularly in regard to diet quality, diet self-efficacy, and sleep quality. To test the hypothesis that eTRF would lead to an increase in all three variables, a 4-wk randomized-controlled, parallel arm trial was conducted. Thirty-five healthy college students were randomly assigned to one of two groups: the intervention group (TRF) was instructed to adhere to an 8-h feeding window aligned with the light cycle (9 am to 5 pm), and the control group (CON) was instructed to adhere to a 12-h feeding window typical of college students (10 am to 10pm). The eTRF diet was consumed ad libitum, and the participants were not instructed to avoid compensatory hyperphagia. The results showed a strong, reverse effect of eTRF on diet quality: fasting had a highly significant association with decreased diet quality. The results suggest that, under free-living conditions, college students practicing eTRF are more likely to compensate for prolonged fasting with unhealthy eating and snacking.

The purpose of this pilot study is to explore the coping mechanisms utilized by school nurses in response to stress encountered working in the high school setting. One aim of this research is to identify both positive and negative coping strategies by school nurses. A secondary objective is to determine some of the stressors these nurses experience in the workplace. This paper also seeks to find missing information in school nursing literature in order to identify areas of research that could be further explored as a result of this pilot study. This study consisted of five singular, phone interviews to a total of five high school nurses working in a singular school district in the state of Arizona. These interviews consisted of qualitative questions focused on stressful experiences and actions taken by the nurse as a response. Demographic data was also collected in an additional survey after the interviews. Additional literature was reviewed and patterns between literature and interview data were analyzed, as it was determined the data collected from interviews was not enough to reach data saturation. Thematic analysis was performed on the collected data to determine key concepts relating to coping by school nurses. The results of this analysis indicated number of factors relating to stress levels in the school healthcare setting and different coping methods. Themes often used in coping mechanisms included learning from experience, preventative teaching, communication, faith & self- reflection, sense of purpose, positivity, self-care versus neglect, and depersonalization. Due to the limited setting and results of this pilot study, additional research is indicated in the area of coping and stress in school nursing literature.

Exercise has many physical and mental health benefits, but there are several common barriers to
physical activity that the general population faces. Furthermore, it has been shown that
transgender individuals do not participate in physical activity as much as nontransgender
individuals do. This suggests that the transgender population may face additional or unique
barriers to physical activity. The purpose of this study was to further examine and identify these
barriers for adult transgender individuals regardless of whether they decided to, were in the
process of, or completed medical transition. Five categories of physical activity barriers were
analyzed within a survey: time, motivation, accessibility, emotions, and social factors. This
online physical activity questionnaire was distributed to transgender adults 18 years or older over
a course of two months. Twelve responses were received but only nine of those met the inclusion
criteria and were used in the study (n=9). Three questions were asked for each barrier category
and were formatted as a Likert scale. Each question and barrier category was given a score based
on if the responses indicated that particular instance as a barrier to physical activity or not. The
results of the survey responses showed that social factors was the highest reported barrier to
physical activity for transgender adults. Emotions was the second highest reported barrier, while
accessibility was the lowest reported barrier. The responses from this study indicate that
transgender adults do experience different or additional barriers to physical activity when
compared to the general population.

Sepsis is a global health problem, and millions of people die annually from sepsis around the world (Centers for Disease Control and Prevention, 2018). The purpose of this literature review is to discuss the prevention, recognition, and treatment of sepsis as well as the need for more public health education to raise awareness of the significant burden of sepsis. It is difficult to recognize because there are several nonspecific symptoms, and there is not a comprehensive diagnostic tool. Diagnosis is based on evidence of infection, organ dysfunction, and clinical judgment (Fay et al., 2020). The definition of sepsis has evolved over the last three decades, though the most recent update is not widely accepted by all healthcare systems. There remains debate about treatment practices as well, including the following: whether one or multiple antibiotics should be used, which type of fluids should be used for rapid resuscitation, and the number of fluids that should be given to the patient. However, evidence agrees that treatment should be started within the first hour of symptom onset for the best chance of survival (Gyawali, Ramakrishna, & Dhamoon, 2019). Despite the significant burden that sepsis places on families, healthcare team members, and hospitals, there is not enough public awareness of the issue (Jabaley et al., 2018). There should be a greater push for public education using technology, social media, and mass media campaigns to increase awareness and prevention of infection.