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    Cytokine gene associations with self-report ratings of morning and evening fatigue in oncology patients and their family caregivers.
    Biol Res Nurs 2015 Mar 27;17(2):175-84. Epub 2014 May 27.
    School of Nursing, University of California, San Francisco, CA, USA
    The purpose of this study was to evaluate for differences in variations in pro- and anti-inflammatory cytokine genes between participants who were classified as having low and high levels of morning and evening fatigue and to evaluate for differences in phenotypic characteristics between these two groups. In a sample of 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their family caregivers, growth mixture modeling was used to identify latent classes of individuals based on ratings of morning and evening fatigue obtained prior to, during, and for 4 months following completion of radiation therapy. Differences in single nucleotide polymorphisms and haplotypes in 15 cytokine genes were evaluated between the latent classes. Multiple logistic regression was used to assess the effect of phenotypic and genotypic characteristics on morning and evening fatigue class membership. Associations were found between morning fatigue and number of comorbidities as well as variations in tumor necrosis factor alpha (TNFA) rs1800629 and rs3093662. Evening fatigue was associated with caring for children at home and variations in interleukin 4 (IL4) rs2243248 and TNFA rs2229094. Younger age and lower performance status were associated with both morning and evening fatigue. These findings suggest that inflammatory mediators are associated with the development of morning and evening fatigue. However, because different phenotypic characteristics and genomic markers are associated with diurnal variations in fatigue, morning and evening fatigue may be distinct but related symptoms.

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    J Pain Symptom Manage 2015 Nov 29;50(5):599-614.e3. Epub 2015 May 29.
    School of Nursing, University of California, San Francisco, California, USA. Electronic address:
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    Methods: Energy subscale scores from the Lee Fatigue Scale were used to determine latent class membership. Read More
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    School of Nursing at UCSF.
    Purpose/objectives: To identify latent classes of individuals with distinct quality-of-life (QOL) trajectories, to evaluate for differences in demographic characteristics between the latent classes, and to evaluate for variations in pro- and anti-inflammatory cytokine genes between the latent classes.

    Design: Descriptive, longitudinal study.

    Setting: Two radiation therapy departments located in a comprehensive cancer center and a community-based oncology program in northern California. Read More
    Differences in morning and evening fatigue in oncology patients and their family caregivers.
    Eur J Oncol Nurs 2013 Dec 5;17(6):841-8. Epub 2013 Sep 5.
    School of Medicine, University of California, San Francisco, CA, USA.
    Purpose Of The Research: To identify distinct latent classes of individuals based on ratings of morning and evening fatigue; evaluate for differences in phenotypic characteristics, as well as symptom and quality of life scores, among these latent classes; and evaluate for an overlap in morning and evening fatigue class membership.

    Patients And Methods: In a sample of 167 oncology outpatients and 85 of their FCs, growth mixture modeling was used to identify distinct latent classes based on ratings of morning and evening fatigue obtained before, during, and after radiation therapy. Analyses of variance and Chi Square analyses were used to evaluate for differences among the morning and evening fatigue latent classes. Read More
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    Eur J Oncol Nurs 2013 Jun 24;17(3):346-53. Epub 2012 Nov 24.
    School of Medicine, University of California, San Francisco, CA, USA.
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