An Exploratory Center for Biobehavioral Studies of Fatigue Management at the University of Kansas School of Nursing is proposed. The Exploratory Center is intended to foster and support multi-disciplinary pilot and feasibility studies on the complex problem of fatigue in a variety of health and illness conditions. The overall goal in supporting these studies is to lay the groundwork for, and obtain the necessary data to support, independent extra-mural grants to study fatigue assessment and intervention strategies for managing this debilitating symptom from an integrated biobehavioral perspective. The Center will be comprised of: 1) a core Administrative structure to ensure the institutional commitment to the Center and to oversee, support, and facilitate the scientific integrity of the studies, 2) an Advisory Committee of senior investigators with diverse expertise in areas central to this Center, 3) a Data Management and Statistical Service to provide on-site methodological and statistical consultation and collaboration for the individual studies and to coordinate central processing and exploration of common data from across studies, 4) a Center library and fatigue literature database, and 5) a Panel of Consultants. The concepts of Self-Monitoring and Self-Regulation provide a common organizing framework for the studies of the proposed Exploratory Center. As applied to Fatigue, this framework conceptualizes Energy, a generic term to represent biopsychosocial resources, as the system input, and Activity as the system output. The processes that link Energy and Activity, and that are the subject of self-monitoring and self-regulation are Utilization and Restoration. As a dynamic system, these processes are in constant interaction with the internal (biological and psychological) and external (physical and social) environments of the individual. Each of the proposed pilot/feasibility studies is designed to be consistent with this common organizing framework and the overall Center objectives. Study 1 focuses on fatigue and metabolic control in older, obese, women with non-insulin dependent diabetes mellitus and will examine whether participation in a low-intensity exercise regimen of non-sedentary activities of daily living lessens fatigue and improves metabolic control. Study 2 focuses on the biological, physical and psychosocial correlates of fatigue in patients with rheumatoid arthritis and will examine the effects of a low-impact aerobic exercise program on the fatigue of these patients. Study 3 uses an animal model of diaphragmatic fatigue to test and validate the use of a miniaturized ultrasound device to directly monitor diaphragm contractions for possible development as an assessment tool to aid in ventilator weaning of patients, And, Study 4 focuses on fatigue among two groups of caregivers of preterm infants (one with infants sent home on an Apnea monitor, the other with no monitor) and will examine differences in fatigue between these two groups, changes in fatigue over time in both groups, methods of coping with fatigue, and effects of fatigue on caregiving tasks.
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