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Factors Affecting Cervical Cancer Screening Among African Women Living In The United States, Mosunmola Adeyemi Jan 2011

Factors Affecting Cervical Cancer Screening Among African Women Living In The United States, Mosunmola Adeyemi

Walden Dissertations and Doctoral Studies

More than half of the incidents and mortality rates from cervical cancer occur among minority groups, including immigrant women from continental Africa living in the United States. Although researchers have examined cervical cancer screening practices among minority populations, including Black women in Africa and in the United States, there are few studies on cervical cancer screening and associated risk factors, specifically among African women living in the United States. The purpose of this study was to investigate the association between selected factors and cervical cancer screening practices among African immigrant women living in the United States. Using the behavioral model …


Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea Jan 2011

Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea

Walden Dissertations and Doctoral Studies

Effective recognition and proper treatment of cardiovascular diseases (CVDs) in Hispanic woman is a public health problem that needs further investigation. Guided by the stress and coping social support theory, the purpose of this cross-sectional survey study was to examine the relationship between attitudes, emotional support, and the perception of success in managing cardiovascular diseases (CVDs) in 335 Hispanic women living in Atlanta, Georgia. Correlations, independent-sample t tests, simple linear regression, and multiple linear regressions showed ethnicity as a moderating variable between the perception of success in handling CVD and emotional support, while emotional support was shown to be a …


The Relationship Between Overweight And Obesity And Acculturation Of 12- To 19-Year-Old Mexican American Children, Elsa Ramirez-Brisson Jan 2011

The Relationship Between Overweight And Obesity And Acculturation Of 12- To 19-Year-Old Mexican American Children, Elsa Ramirez-Brisson

Walden Dissertations and Doctoral Studies

Mexican Americans, one of the fastest growing segments of the population, have been identified as having above-average rates of obesity. Yet, among this group, obesity rates seem to differ by immigrant status: recent immigrants, immigrants who have lived in the United States more than 15 years, and U.S.-born Mexican Americans. Guided by the acculturation phenomenon and the social ecological model, the current study assessed all 1,732 Mexican American children 12-19 years old who participated in the National Health and Nutrition Examination Survey between 2003 and 2008 to determine the association between body mass index (BMI) and language, years living in …


The Relationship Of Provider Cultural Competence And Utilization Of Prenatal Care In The Hmong Of Minnesota, Cynthia J. Larson Jan 2011

The Relationship Of Provider Cultural Competence And Utilization Of Prenatal Care In The Hmong Of Minnesota, Cynthia J. Larson

Walden Dissertations and Doctoral Studies

Experts suggest that the cultural competence of healthcare providers is a critical factor impacting healthcare services to the ethnically diverse patient populations in the U.S. and that it may play a role in improving outcomes and reducing health disparities; however, the association between cultural competence and health outcomes remains unclear. This study used a cross-sectional quantitative design grounded by cultural competency constructs and the ethnic origins theory to explore the relationships between provider cultural competence, adequacy of prenatal care, and neonatal health outcomes in Hmong women, a population whose cultural beliefs affect their use of early and adequate prenatal care. …


Experiences And Perceptions Of Pregnant Unmarried Adolescent Girls In Nigeria, Priscilla N. Asonye Jan 2011

Experiences And Perceptions Of Pregnant Unmarried Adolescent Girls In Nigeria, Priscilla N. Asonye

Walden Dissertations and Doctoral Studies

Sexual activity among unmarried adolescents is a major public health problem in Nigeria, because unmarried pregnant girls are more likely to have multiple sex partners and are less likely to use contraceptives, putting them at greater risk for sexually transmitted diseases (STD), unplanned pregnancy, abortion, social isolation, and poverty. Teen pregnancy and STD rates are on the rise in Nigeria, yet few data exist on the experience of the adolescents themselves. This phenomenological study was designed to explore the in-depth experiences of 10 pregnant, unmarried adolescent girls aged 16-19, including the factors contributing to their sexual activity. An ecological model …


Occupational Stress In Veterinary Support Staff, Sandra Morales Foster Jan 2011

Occupational Stress In Veterinary Support Staff, Sandra Morales Foster

All ETDs from UAB

OCCUPATIONAL STRESS IN VETERINARY SUPPORT STAFF Sandra Morales Foster DOCTOR OF PUBLIC HEALTH ABSTRACT Limited information exists about veterinary support staff and the occupational stressors of this workforce. Concern for workers in occupations of high or prolonged stress such as caregivers in hospitals and emergency situations has been noted in many studies. Occupational stress can cause harmful physical and emotional outcomes when the homeostatic balance is upset. This study explored occupational stress, health status, and coping strategies of veterinary support staff. A mixed-method collected quantitative and qualitative data. Demographic information and three validated instruments were ad-ministered using a web-based survey; …


Investigation Of Numerical Approaches To Analyze Flapping Wings, Nitin Bhagat Jan 2011

Investigation Of Numerical Approaches To Analyze Flapping Wings, Nitin Bhagat

All ETDs from UAB

For centuries, the agility and maneuverability of flying insects have been an inspiration to fluid dynamists. A large number of research activities have been conducted within the biological, aerodynamics, and computational science communities to understand the complex flow fields around flapping insects and their capability for rapid maneuvers. However, the understanding of these natural phenomena is still in its infancy. Recent experimental flow visualizations have shown the complex vortical structures around flapping wings and vortex interactions. Even with the advent of faster and better computer processors and improved numerical algorithms, computational fluid dynamics (CFD) techniques to accurately predict flow features …


Hierarchical And Bayesian Approaches For Estimating Prevalence Based On Pool Screening, Thomas Birkner Jan 2011

Hierarchical And Bayesian Approaches For Estimating Prevalence Based On Pool Screening, Thomas Birkner

All ETDs from UAB

Pool screening is a method that combines individual items into pools. Each pool will either test positive (at least one of the items is positive) or negative (all items are negative). Pool screening is commonly applied to the study of tropical diseases where pools consist of vectors (e.g. black flies) that can transmit the disease. The goal is to estimate the proportion of infected vectors. In paper 1, we present a frequentist Bernoulli-Beta hierarchical model to relax the constant prevalence assumption underlying the traditional frequentist prevalence estimation approach. This assumption is called into question when sampling from a large geographic …


Three Topics In Eye Injury Research, Justin Blackburn Jan 2011

Three Topics In Eye Injury Research, Justin Blackburn

All ETDs from UAB

Eye injuries are a leading cause of monocular blindness, with approximately 2 million Americans sustaining an eye injury annually. Occupational eye injuries resulting in at least one missed day of work total nearly 28,000 each year. Eye injuries have many different etiologies, although most are "minor" injuries such as corneal abrasions and foreign bodies. Chemical-related eye injuries have not been described epidemiologically. The most widely advocated prevention method for eye injuries is protective eyewear, but evidence to support this is surprisingly absent. Furthermore, the use of eye protection among workers who have previously sustained an eye injury remains a question …


Bayesian Hierarchical Generalized Linear Models For Detecting (Rare) Haplotype-Haplotype And Haplotype-Environment Interactions In Genetic Association Analysis, Jun Li Jan 2011

Bayesian Hierarchical Generalized Linear Models For Detecting (Rare) Haplotype-Haplotype And Haplotype-Environment Interactions In Genetic Association Analysis, Jun Li

All ETDs from UAB

This dissertation research focuses on genetic association analysis based on haplotypes in the context of both population-based and family-based studies. Haplotype-based association analysis is powerful in the discovery and characterization of the genetic basis of complex human diseases. However, statistical models that fit haplotype-haplotype and haplotype-environment interactions have not yet been fully developed. Furthermore, statistical methods for detecting the association between rare haplotypes and disease have not kept pace with their counterpart of common haplotypes. For both population-based and family-based association analyses, we herein propose two efficient and robust methods to separately tackle these problems based on Bayesian hierarchical generalized …


Survival Analysis With Censored Outcomes, Henry T. Robertson Jan 2011

Survival Analysis With Censored Outcomes, Henry T. Robertson

All ETDs from UAB

This dissertation is arranged in the three-paper format. The unifying theme of the dissertation is estimating longevity in terms of years of life lost (YLL). The papers are presented in order of increasing methodological focus. The first paper, No compelling evidence that sibutramine prolongs life in rodents despite providing a dose-dependent reduction in body weight, was published in the International Journal of Obesity in 2010. Although sibutramine reduced food intake and body weight, it had no association with longevity. The conclusions were based on data from a 2-year toxicology trial required by the FDA. Although this paper was largely applied …


Characterization And Modeling Of Styrene Emission From A Thermoset Composite Material, Shaun Anthony Crawford Jan 2011

Characterization And Modeling Of Styrene Emission From A Thermoset Composite Material, Shaun Anthony Crawford

All ETDs from UAB

Diffusive emissions of volatile compounds from building materials have been well documented as a source of indoor air pollution. While laboratory testing can quantify these emissions and predict volatile concentrations in indoor air, the ability to precisely model emission rates from any given building material would provide a useful tool to air quality professionals to anticipate, identify and mitigate potential sources of indoor air pollution. Composite materials, some made with vinyl ester resins, are replacing metal in transportation applications (bus bodies, airplane fuselages) but contain volatile styrene. Here, a mass transfer model for predicting volatile emissions from a dry building …


Social Connectedness And Its Association With Violence Commission In Adolescents Living In Low-Income Inner-City Neighborhoods, Thomas Norton Creger Jan 2011

Social Connectedness And Its Association With Violence Commission In Adolescents Living In Low-Income Inner-City Neighborhoods, Thomas Norton Creger

All ETDs from UAB

ABSTRACT For nearly two decades, violence has been viewed as a major public health issue. According to the Centers for Disease Control and Prevention, 4,141 young people between the ages of 10 and 19 were murdered in 2008, and over 480,238 young people were treated for violence-related injuries in U.S. emergency rooms that same year. That translates to an average of 11 young people murdered each day, and a daily average of 1,315 young people who sustained violence-related injuries so severe that they required treatment at a hospital. The purpose of this study was to test a multilevel model linking …


Growing Up With Hiv: Disease Management Among Perinatally Infected Adolescents, Barbara J. Szelag Jan 2011

Growing Up With Hiv: Disease Management Among Perinatally Infected Adolescents, Barbara J. Szelag

USF Tampa Graduate Theses and Dissertations

Children born with HIV in the 1980s and 1990s are surviving into adolescence and adulthood, due to the availability of highly active antiretroviral therapy (HAART). Growing up with a chronic and stigmatized disease presents considerable challenges as young people explore their sexuality, develop relationships, and take steps to become independent and productive adults. Adherence to HAART is an essential and life-long practice for the maintenance of health and longevity. For adolescents born with HIV, a daily medication schedule is one aspect of disease management that also includes medical visits, HIV status acceptance, bouts of illness, and disclosure of HIV status …


Indicators Of Early Adult And Current Personality In Parkinson's Disease, Kelly Sullivan Jan 2011

Indicators Of Early Adult And Current Personality In Parkinson's Disease, Kelly Sullivan

USF Tampa Graduate Theses and Dissertations

Introduction: Previous epidemiologic studies suggest that the personality of Parkinson's disease (PD) patients differs from that of controls, and laboratory evidence supports a potential common pathophysiology of personality traits and PD. One nested case-control study found that PD cases were significantly more anxious than controls before the clinical onset of the disease, and additional data suggest that certain occupations may be risk factors for the disease. Additionally, the latent period that precedes the onset of motor symptoms of PD is unknown.

Objectives: The objectives of this study were to evaluate the association of PD with objective indicators of current and …


A Comparison Of Latina Women In Centeringpregnancy And Individual Prenatal Care, Tara E. Trudnak Jan 2011

A Comparison Of Latina Women In Centeringpregnancy And Individual Prenatal Care, Tara E. Trudnak

USF Tampa Graduate Theses and Dissertations

CenteringPregnancy is a model of group prenatal care that replaces routine, individual prenatal care. The program brings women together into small groups to receive their care and prenatal education, and is based on three components: risk assessment, education, and support. The model is client-centered, designed to empower pregnant women and support persons, and involves the woman in small group discussions of 8-10 other women of similar gestational age. The group discussions provide support, help women educate each other, and invoke self-monitoring. Currently, there have been few publications that closely examined maternal weight and obesity and associated outcomes in women involved …


A Mixed Method Study On The Peripartum Experience And Postpartum Effects Of Emergency Hysterectomy Due To Postpartum Hemorrhage, Cara De La Cruz Jan 2011

A Mixed Method Study On The Peripartum Experience And Postpartum Effects Of Emergency Hysterectomy Due To Postpartum Hemorrhage, Cara De La Cruz

USF Tampa Graduate Theses and Dissertations

Background: Little is known about the experience and psychological outcomes for women who experience emergency peripartum hysterectomy (EPH). The objective of this study was to explore women's experiences of EPH and to determine if women who experience EPH were more likely to experience mental health sequelae.

Methods: This mixed method design involved a quantitative and a qualitative phase. The quantitative phase used a retrospective cohort design. Women were sampled through on-line communities, including an EPH support group, and a larger website for mothers. Women completed on-line surveys covering sociodemographic, obstetric/gynecological/ and psychiatric information, including screens for depression and Post-Traumatic Stress …


Assessing The Relationship Of Monocytes With Primary And Secondary Dengue Infection Among Hospitalized Dengue Patients In Malaysia, 2010: A Cross-Sectional Study, Benjamin Glenn Klekamp Jan 2011

Assessing The Relationship Of Monocytes With Primary And Secondary Dengue Infection Among Hospitalized Dengue Patients In Malaysia, 2010: A Cross-Sectional Study, Benjamin Glenn Klekamp

USF Tampa Graduate Theses and Dissertations

Dengue, a group of four similar viruses transmitted through the bite of a mosquito, is estimated to infect upwards of 100 million annually in over 100 nations throughout the global equatorial belt. Distribution of global dengue is highly skewed as Southeast Asian and Western Pacific regions endure 75% of the global dengue burden. Similar to other regional countries, Malaysia has been rapidly urbanizing, which has supported a hyperendemic dengue state.

The biological pathway by which dengue infection causes a wide range of clinical manifestations, spanning asymptomatic to life-threatening severe complications, is not comprehensively understood. Historically, severe dengue complications have primarily …


Cathepsin B: A Potential Prognostic Marker For Inflammatory Breast Cancer, Mohamed A. Nouh, Mona M. Mohamed, Mohamed El-Shinawi, Mohamed A. Shaalan, Dora Cavallo-Medved, Hussein M. Khaled, Bonnie F. Sloane Jan 2011

Cathepsin B: A Potential Prognostic Marker For Inflammatory Breast Cancer, Mohamed A. Nouh, Mona M. Mohamed, Mohamed El-Shinawi, Mohamed A. Shaalan, Dora Cavallo-Medved, Hussein M. Khaled, Bonnie F. Sloane

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Inflammatory breast cancer (IBC) is the most aggressive form of breast cancer. In non-IBC, the cysteine protease cathepsin B (CTSB) is known to be involved in cancer progression and invasion; however, very little is known about its role in IBC.

Methods

In this study, we enrolled 23 IBC and 27 non-IBC patients. All patient tissues used for analysis were from untreated patients. Using immunohistochemistry and immunoblotting, we assessed the levels of expression of CTSB in IBC versus non-IBC patient tissues. Previously, we found that CTSB is localized to caveolar membrane microdomains in cancer cell lines including IBC, and …


Inhibition Of Cathepsin B Activity Attenuates Extracellular Matrix Degradation And Inflammatory Breast Cancer Invasion, Bernadette C. Victor, Arulselvi Anbalagan, Mona M. Mohamed, Bonnie F. Sloane, Dora Cavallo-Medved Jan 2011

Inhibition Of Cathepsin B Activity Attenuates Extracellular Matrix Degradation And Inflammatory Breast Cancer Invasion, Bernadette C. Victor, Arulselvi Anbalagan, Mona M. Mohamed, Bonnie F. Sloane, Dora Cavallo-Medved

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

Inflammatory breast cancer (IBC) is an aggressive, metastatic and highly angiogenic form of locally advanced breast cancer with a relatively poor three-year survival rate. Breast cancer invasion has been linked to proteolytic activity at the tumor cell surface. Here we explored a role for active cathepsin B on the cell surface in the invasiveness of IBC.

Methods

We examined expression of the cysteine protease cathepsin B and the serine protease urokinase plasminogen activator (uPA), its receptor uPAR and caveolin-1 in two IBC cell lines: SUM149 and SUM190. We utilized a live cell proteolysis assay to localize in real …


Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Heat Stress Levels, Brian Grace Jan 2011

Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Heat Stress Levels, Brian Grace

USF Tampa Graduate Theses and Dissertations

Clothing can influence heat stress depending on the design and its ability to act as a barrier. The progressive heat stress protocol permitted the collection of data to empirically estimate the apparent total evaporative resistance (Re,T,a). Five different clothing ensembles were evaluated, which included work clothes, cotton coveralls, and three limited-use protective clothing ensembles including a pthesis-barrier ensemble, (Tyvek® 1424), water-barrier, vapor-permeable ensemble (NexGen® LS 417), and a vapor-barrier ensemble (Tychem QC®). The study design called for three metabolic level's: low, moderate, and high (L, M, & H) and three heat stages: compensable, transitional, …


Gender Differences In Lung Cancer Treatment And Survival, Margaret Anne Kowski Jan 2011

Gender Differences In Lung Cancer Treatment And Survival, Margaret Anne Kowski

USF Tampa Graduate Theses and Dissertations

The objectives of this research were to test treatment and survival differences between women and men with lung cancer as there is minimal investigation in the literature. Three research questions were developed with statistical testing for gender differences based on similar cancer type, stage, treatment assignment and survival. Data for 44,863 primary lung cancer cases were collected from eight U.S. state-based cancer registries to investigate the research questions. The lung cancer incidence data included the morphological cell-types of adenocarcinoma (AC); squamous cell carcinoma (SCC); large cell carcinoma (LCC) and small cell carcinoma (SCC). Stage, grade, treatment type, as well as, …


Numeracy, Cancer Risk Perceptions, And Self-Protective Behaviors Among U.S. Adults, Teri Malo Jan 2011

Numeracy, Cancer Risk Perceptions, And Self-Protective Behaviors Among U.S. Adults, Teri Malo

USF Tampa Graduate Theses and Dissertations

Individuals have become more involved in health-related decisions, in part due to an unprecedented access to information that can be used to enhance both physical and mental health. Much of this health-related information is presented in a numerical format; unfortunately, research suggests many Americans may not possess the literacy skills necessary to comprehend numerical health-related information. More research needs to be conducted to examine numeracy and its role in cancer risk perceptions, and how those risk perceptions relate to cancer self-protective behaviors. The purpose of the current study was to: (a) examine socio-demographic variables associated with numeracy, (b) determine which …


Contextualizing Hiv/Aids Prevention And Treatment Programs In Zanzibar, Tanzania, Naheed Ahmed Jan 2011

Contextualizing Hiv/Aids Prevention And Treatment Programs In Zanzibar, Tanzania, Naheed Ahmed

USF Tampa Graduate Theses and Dissertations

International aid organizations and wealthy nations have contributed billions to combat the spread and treatment of HIV/AIDS in sub-Saharan Africa; however, these programs have been critiqued for not addressing the socioeconomic and cultural context of the epidemic, instead relying upon generalized approaches. The prevalence rate in Zanzibar, Tanzania is low in the general population, but high among vulnerable segments of Zanzibari society, resulting in interventions focusing on particular groups (e.g. sex workers, drug users, and men who have sex with men). Through interviews with government agencies, non-profit organizations, medical professionals, vulnerable populations, and HIV/AIDS patients, this paper examines how local …


An Examination Of The Impact Of Preconception Health On Adverse Pregnancy Outcomes Through The Theoretical Lens Of Reciprocal Determinism, Mary Elizabeth Buie Jan 2011

An Examination Of The Impact Of Preconception Health On Adverse Pregnancy Outcomes Through The Theoretical Lens Of Reciprocal Determinism, Mary Elizabeth Buie

USF Tampa Graduate Theses and Dissertations

Statement of Purpose

The purpose of this study is to examine the impact of preconception health on adverse pregnancy outcomes through the theoretical lens of reciprocal determinism. Thus, this study aims to develop a preconception health conceptual framework that accounts for the interactive relationships among behavior, the environment, and the person.

Rationale for the Study

Women may not recognize a pregnancy until the first or second missed menstrual cycle, a full four to eight weeks or more after conception. Once a woman realizes the possibility of a pregnancy, it takes further time to confirm the pregnancy with a home pregnancy …


Disparities In Survival And Mortality Among Infants With Congenital Aortic, Pulmonary, And Tricuspid Valve Defects By Maternal Race/Ethnicity And Infant Sex, Colleen Conklin Jan 2011

Disparities In Survival And Mortality Among Infants With Congenital Aortic, Pulmonary, And Tricuspid Valve Defects By Maternal Race/Ethnicity And Infant Sex, Colleen Conklin

USF Tampa Graduate Theses and Dissertations

Background: The etiology of congenital heart valve defects is not well understood; little is known about the risk factors that contribute to the survival and mortality outcomes of children with these defects.

Methods: Using data from the Texas Birth Defects Registry (TBDR) we conducted a retrospective cohort study of 2070 singleton infants with congenital aortic, pulmonary, or tricuspid valve atresia or stenosis born in Texas between January 1, 1996 and December 31, 2007 to Hispanic, Non-Hispanic (NH) black, and NH white women. TBDR data were death-to-birth matched by the Texas Vital Statistics Unit for deaths between January 1, 1996 and …


Adolescence Is An Ocean: A Biocultural Investigation Of Youth Food Consumption In Tanzania, Elizabeth J. Danforth Jan 2011

Adolescence Is An Ocean: A Biocultural Investigation Of Youth Food Consumption In Tanzania, Elizabeth J. Danforth

USF Tampa Graduate Theses and Dissertations

This study investigates adolescents' relationships with food and other community and household members' perceptions of youth and their food consumption to understand the multifactorial dynamic processes which create nutritional outcomes among urban and rural youth in central Tanzania. Youth are an important and demographically large population in developing countries. The identities created during this distinct stage of cultural production can be reflected in youths' food consumption and relationships with food. Nutrition likely affects how youth transition through a variety of states, including their growth and development stages, primary to secondary to higher education, child to parent, or unemployed to employed. …


Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Metabolic And Heat Stress Levels, Matthew David Dooris Jan 2011

Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Metabolic And Heat Stress Levels, Matthew David Dooris

USF Tampa Graduate Theses and Dissertations

Failure to maintain thermal equilibrium can cause uncontrollable increases in body core temperature beyond critical upper limits. In selecting clothing, consideration must be given to the heat transfer properties of clothing that may restrict the cooling capacity of the human body under heat stress conditions, most importantly, apparent total evaporative resistance (Re,T,a). This study calculated and compared Re,T,a for five clothing ensembles under varying heat stress conditions, including three relative humidity (RH) levels and three stages of heat stress to determine if Re,T,a values varied or remained the same with …


Literacy And Hazard Communication Comprehension Of Employees Presenting To An Occupational Health Clinic, Christine Bouchard Jan 2011

Literacy And Hazard Communication Comprehension Of Employees Presenting To An Occupational Health Clinic, Christine Bouchard

USF Tampa Graduate Theses and Dissertations

More than 100 million American workers, 7 million workplaces, and 945,000 hazardous chemical products are covered under the Hazard Communication Standard (HCS), regulated by the Occupational Safety and Health Administration. There were a total of 1,183,500 recordable non-fatal illnesses and injuries in private industry workplaces in 2006 resulting in days away from work. Of these, 19,480 were due to chemicals and chemical products. In addition, there were a total of 5,703 work-related fatalities in 2006. In 191 of these, chemicals and chemical products were listed as the primary source of injury and as the secondary source of injury in 104 …


Feedback Control For Exergames, Jeff Sinclair Jan 2011

Feedback Control For Exergames, Jeff Sinclair

Theses: Doctorates and Masters

The concept of merging exercise equipment with video games, known as exergaming, has the potential to be one of the main tools used in addressing the current rising obesity epidemic. Existing research shows that exergaming can help improve fitness and additionally motivate people to become more active. The two key elements of attractiveness - how much people want to play or use the exergaming system; and effectiveness – how effective the exergaming system is in actually increasing or maintaining physical fitness, need to be maximised to obtain the best outcomes from an exergaming system; we put this forward as the …