Obesity and the number overweight of children are currently major global issues. According to the Regional Office for Europe (2006) obesity has risen three times over the last two decades worldwide. The attention is currently focused on health promotion and disease prevention among the population through comprehensive health education starting in the early age of individuals, aimed to slow down the increasing incidence of obesity and related health issues. This thesis discusses the pedagogical aspects of health, specifically the options on how to shape nutritional habits of elementary and middle school students and how to systematically deepen the required knowledge about healthy nutrition by implementation of nutrition education programs. The purpose of this study was to determine the relationships between dietary habits and healthy nutrition knowledge of grade nine students in elementary schools from the South Bohemian region in Czech Republic. A validated Nutritional survey and Nutritional knowledge quiz were designed to determine the relationship between knowledge and behavior of grade nine students from South Bohemia elementary schools. The validity of the Nutritional survey and the Nutritional knowledge quiz were tested using analytical analysis of all survey and test items and examining...

This dissertation is focused on currently one of the most burning social problem - childhood obesity in Czech Republic. We have tried to find out a childhood prevalence obesity, its causes, social risks and expected dangers and we evaluated possible solutions for the prevention of obesity. A research problem of the thesis is the growing prevalence of childhood obesity in the Czech Republic in the context of developing its ineffectively controlled determinant. Our research targets on children, more precisely said on pupils of four primary schools (in the Bílina city). Among the objectives of the thesis belongs a pupil categorization according to BMI (body mass index). A principal goal is an evaluation of level of support for children to a healthy lifestyle by primary schools. Data have been collected from the children themselves, as well as from the school management and the respective school founder (city or region). The results of the research point out that a prevalence of childhood obesity (for a sample of the pupils of bílina's primary schools) corresponds to the current development and proportional representation of overweight and obesity in our country. The case studies which are output as research section aimed at encouraging children to a healthy lifestyle from the school and the research...

Idrottande ungdomar gör inte alltid hälsosamma matval och rätt näring är en förutsättning för att orka de fysiska kraven som ställs på fotbollsspelare. Syftet med studien var att kartlägga kostvanor hos ungdomar på fotbollsgymnasium och jämföra resultaten med Svenska Olympiska Kommitténs kostrekommendationer. Studien var kvantitativ och en webbenkät användes som datainsamlingsmetod. Enkäten omfattade kostvanor, livsmedelsval samt kost i samband med prestation och besvarades av 132 deltagare varav 100 svar analyserades. Data analyserades med deskriptiv statistik. Studiens resultat visade att majoriteten av ungdomarna har en regelbunden måltidsordning avseende frukost, lunch, middag och mellanmål, däremot har de mindre kännedom om måltidsplanering och vad som bör intas efter träning. Resultatet visar också att mättat fett är det dominerande intaget av fettkälla hos deltagarna och en stor önskan om minskat intag av mättat fett, sötsaker och snabbmat finns. Resultatet av denna studie utgör ett underlag av råd och riktlinjer kring kost för unga fotbollsspelare och kan vara ett användbart verktyg och stöd för hälsovägledare, lärare, tränare och föräldrar. / Athletes do not always make healthy food choices meanwhile the right nutrition is prerequisite to meet the physiological commands of a soccer player. The purpose of the study was to investigate dietary habits of young people at soccer gymnasiums and compare the results with the Swedish Olympic Committee's dietary recommendations. The study was quantitative and a web survey was used as a data collection method. The questionnaire was made to collect information regarding the respondents' dietary habits, food choices, and diet in connection with performance and was answered by 132 participants, of whom 100 responses could be analyzed. Data was analyzed with descriptive statistics. The results of the study show that the majority of young people have a regular meal arrangement for breakfast, lunch, dinner and snacks. However, they have less control over timing and what should be taken after training. In addition, the study also showed that saturated fat is popular among the participants and that they have a great desire for reduced intake of saturated fat, sweets and fast food. In conclusion, the result of this study is a basis for advice and guidelines on diet for soccer youths and can be a useful tool and support for health counselors, teachers, trainers, and parents.

Due to the fact that there has been a dramatic increase in the number of adolescents with unhealthy eating habits there is a growing recognition on the part of professionals, educators and parents for the development and implementation of an intervention programme for the facilitation of healthy eating habits. Relevant literature on eating behaviour indicated that low self-concept is associated with health compromising behaviours such as unhealthy eating habits. The nature of self-concept and eating habits was explained in order to determine important exogenous and endogenous factors as well as perspectives to use as a background for the development of a Psychoeducational intervention programme. Theoretical principles and practical applications of cognitive-behaviour therapy and hypnotherapy were analysed and used as a foundation for the development of the intervention programme. The researcher developed an Interactionism Model of Self-concept and Eating habits and a Psycho-educational programme involving cognitive-behaviour therapy and hypnotherapy to improve eating habits of adolescents. Valid and reliable measuring instruments were used in order to measure self-concept and eating habits. A pre-test post-test design was implemented to nine participants using the Adolescent Self-concept Scale (ASCS), Eating Habits Questionnaire for Adolescents (EHQA) developed by the researcher (2001) and Body Mass Index (BMI). Diagnostic measuring instruments also included the Emotions Profile Index (EPI), Draw A Person (DAP), Sentence Completion, Dietary Record and interview. Results from the empirical study indicated that adolescents with low self-concept and unhealthy eating habits responded positively to the Psycho-educational programme involving cognitive-behaviour and hypnotherapy. Specifically, there was a significant increase in selfconcept and a satisfactory improvement in eating habits. Recommendations for psychotherapy practice, educators and parents were made, based on the current research results. The contribution of the study lies in the fact that a hands-on practical implementation of the Psycho-educational programme was developed to facilitate the improvement of eating habits and it further contributes to the psychological well-being and healthy life-style of adolescents having positive implications for society. / Educational Studies / D.Ed. (Psychology of Education)

L’hypoglycémie est une barrière au traitement du diabète de type 1 (DbT1). La collation au coucher est recommandée pour prévenir l’hypoglycémie nocturne (HN), mais son efficacité n’est pas démontrée. Objectif : Déterminer si une prise alimentaire en soirée est associée à la survenue d’HN. Étude observationnelle : 100 DbT1 ont porté un lecteur de glucose en continu et complété un journal alimentaire pendant 72 heures. L’HN est survenue durant 28 % des nuits. Une prise alimentaire en soirée n’était pas associée à l’HN. Toutefois, dans un modèle ajusté, l’apport en glucides en soirée était positivement associé aux HN (avec injection d’insuline rapide) et l’apport en protéines inversement associé aux HN (sans injection d’insuline rapide). Manger en soirée ne semble pas associé à moins d’HN. Des études contrôlées sont nécessaires pour comprendre l’effet de la collation au coucher sur le contrôle glycémique et le rôle de l’insuline rapide injectée en soirée. / Hypoglycemia remains a limiting factor of type 1 diabetes (T1D) treatment. Bedtime snack is often suggested to reduce nocturnal hypoglycemia (NH), but its effectiveness is not supported by evidence-based data. Objective: To determine the association between post-dinner dietary intake and NH occurrence. This is an observational study during which 100 T1D wore a blinded continuous glucose monitoring system and completed a food diary for 72 hours. NH occurred on 28 % of the 282 nights studied. Post-dinner dietary intake was not associated with NH. However, in multivariate models, carbohydrate intake was positively associated with NH (when rapid insulin was injected) and protein intake was inversely associated with NH (without rapid insulin injected). Post-dinner dietary intake does not seem to be associated with a reduce occurrence of NH. Further studies are needed to better understand the impact of bedtime snack on glycemic control and the role of the injection of rapid insulin in the evening.

In recent years, there is an apparent renaissance of the Czech cuisine, the "First Republic era" (1918 - 1938, CSR I) especially. Both chefs and journalists writing about cooking and dining are referring to the gastronomy of this time period more and more often and they are praising its quality and taste. However, there is no comprehensive publication about Czech gastronomy in 1918 - 1938 period, sparse references and notes can be found in witnesses commemorative volumes, from history of folklore and from the historical press, respectively. Based on the last especially, the image of "first republic" gastronomy is gradually puzzled out. Using a content analysis method, the four biggest newspapers (Lidové noviny, Národní listy, Český deník and Venkov) and eight women journals (Žena, Ženské listy, Ženské noviny, Ženský list, Rozsévačka, Česká Žena, Ženský svět and a "Československá žena" calendar) being published in examined period are investigated. For further findings of completive and linking facts, the historical analysis method is being used as well. Aim of this work was to answer questions about the first republic journals topics and titles, and in what fashion the first republic press thought about gastronomy. Further, this work explores the possible tendency, and development and attention is...

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Due to the fact that there has been a dramatic increase in the number of adolescents with unhealthy eating habits there is a growing recognition on the part of professionals, educators and parents for the development and implementation of an intervention programme for the facilitation of healthy eating habits. Relevant literature on eating behaviour indicated that low self-concept is associated with health compromising behaviours such as unhealthy eating habits. The nature of self-concept and eating habits was explained in order to determine important exogenous and endogenous factors as well as perspectives to use as a background for the development of a Psychoeducational intervention programme. Theoretical principles and practical applications of cognitive-behaviour therapy and hypnotherapy were analysed and used as a foundation for the development of the intervention programme. The researcher developed an Interactionism Model of Self-concept and Eating habits and a Psycho-educational programme involving cognitive-behaviour therapy and hypnotherapy to improve eating habits of adolescents. Valid and reliable measuring instruments were used in order to measure self-concept and eating habits. A pre-test post-test design was implemented to nine participants using the Adolescent Self-concept Scale (ASCS), Eating Habits Questionnaire for Adolescents (EHQA) developed by the researcher (2001) and Body Mass Index (BMI). Diagnostic measuring instruments also included the Emotions Profile Index (EPI), Draw A Person (DAP), Sentence Completion, Dietary Record and interview. Results from the empirical study indicated that adolescents with low self-concept and unhealthy eating habits responded positively to the Psycho-educational programme involving cognitive-behaviour and hypnotherapy. Specifically, there was a significant increase in selfconcept and a satisfactory improvement in eating habits. Recommendations for psychotherapy practice, educators and parents were made, based on the current research results. The contribution of the study lies in the fact that a hands-on practical implementation of the Psycho-educational programme was developed to facilitate the improvement of eating habits and it further contributes to the psychological well-being and healthy life-style of adolescents having positive implications for society. / Educational Studies / D.Ed. (Psychology of Education)

Text in English / Rhythmic gymnastics is a demanding sport that requires the athlete to not only execute the moves and elements required with perfection, but also demands a very specific lean body type in order to compete and be successful within the sport. This study explores retired gymnasts’ experiences of competing in rhythmic gymnastics at an elite level, as well as, exploring their experiences in relation to personal body image satisfaction and eating habits when they enter into retirement from the sport. The aim of this study is to provide an understanding of the athlete’s experiences as a rhythmic gymnast, as well as aspects of body image satisfaction and eating habits, following retirement from rhythmic gymnastics. The study provided a semi-structured interview to seven retired elite rhythmic gymnasts from Canada that had competed at provincial, national, and international levels. The data for this in-depth phenomenological study was obtained through the means of the semi-structured interviews to allow for the researcher to obtain an understanding of each of the gymnasts own personal experiences in their retired years. The transcription of each interview was then analysed and coded, first manually and then electronically using the qualitative coding software program ATLAS.ti, into various categories as well as themes found within the data. Findings were interpreted utilising the method of phenomenology explored themes relating to negative body image and poor eating habits both during their athletic career and after they had transitioned out of the sport and into retirement. In addition, the themes suggested that most of the former athletes still related to their elite rhythmic gymnastics identity with respect to their body image even after years of being in retirement. Participants seemed to highlight difficulties with lower self-confidence and self-esteem, as well as struggles regarding the acceptance of their body type and body image, themes also spoke to some participants’ dissatisfaction towards their new body post gymnastics. Ethical approval was obtained and all ethical standards were maintained throughout the duration of the research. / Psychology / M.A. (Psychology)

Background: Lifestyle habits like tobacco use, hazardous use of alcohol, unhealthy eating habits and insufficient physical activity are risk factors for developing non-communicable diseases, which are the leading, global causes of death. Furthermore, ill health and chronic diseases are costly and put an increased burden on societies and health systems.  In order to address this situation, governmental bodies and organizations’ have encouraged healthcare providers to reorient the focus of healthcare and undertake effective interventions that support patients to engage in healthy lifestyle habits. In Sweden, national clinical practice guidelines (CPGs) on lifestyle interventions were released in 2011. However, the challenges of changing clinical practice and introducing guidelines are well documented, and health interventions face particular difficulties. The overall purpose of this thesis is to contribute towards a better understanding of the complexities of shifting primary health care to become more health oriented, and to explore the implementation environment and its effect on lifestyle intervention CPGs. The specific aims are to investigate how implementation challenges were addressed during the guideline development process (Study I), to investigate several dimensions of readiness for implementing lifestyle intervention guidelines, including aspects of the intervention and the intervention context (Study II), to explore the extent to which health care professionals are working with lifestyle interventions in primary health care, and to describe and develop a baseline measure of professional knowledge, attitudes and perceived organizational support for lifestyle interventions (Study III), and to assess the progress of implementing lifestyle interventions in primary care settings, as  well as investigate the uptake and usage of the CPGs in clinical practice (Study IV).   Methods and results: Interviews were conducted with national guideline-developers (n=7). They were aware of numerous implementation challenges, and applied strategies and ways to address them during the guideline development process. The strategies adhered to four themes: (a) broad agreements and consensus about scope and purpose, (b) systematic and active involvement of stakeholders, (c) formalized and structured development procedures, and (d) openness and transparent development procedures. At the same time, the CPGs for lifestyle interventions challenged the development-model at the National Board of Health and Welfare (NBHW) because of their preventive and non-disease specific focus (I). A multiple case study was also conducted, using a mixed methods approach to gather data from key organizational individuals that were accountable for planning the implementation of CPGs (n=10), as well as health professionals and managers (n=340). Analysis of this data revealed that conditions for change were favorable in the two organizations that served as case studies, especially concerning change focus (health orientation) and the specific intervention (national guidelines on lifestyle interventions). Somewhat limited support was found for change and learning, and change format (national guidelines in general). Furthermore, factors in the outer context were found to influence the priority and timing of the intervention, as well as considerable inconsistencies across the professional groups (II). A cross-sectional study among physicians and nurses (n=315) in Swedish primary healthcare showed that healthcare professionals have a largely positive attitude and thorough overall knowledge of lifestyle intervention methods. However, both the level of knowledge and the involvement in patients’ lifestyle change, differed between professional groups. Organizational support like CPGs and the development of primary health care (PHC) collaborations with other stakeholders were identified as potential strategies for enhancing the implementation of lifestyle interventions in PHC (III). In addition to interviews and case studies, a longitudinal survey among health professionals (n=150; n=73) demonstrated that their use of methods to encourage patients to reduce or eliminate tobacco or alcohol use, had increased. The survey also indicated that nurses had increased the extent to which they addressed all four lifestyle habits. The progress of the implementation of CPGs on lifestyle interventions in PHC was somewhat limited, and important differences in physicians and nurses’ attitudes, as well as their use of the guidelines, were found (IV). Conclusions: Health orientation differs in many ways from more traditional fields in medicine. To strengthen the implementation of this very important (but not “urgent”) field in health care, it needs, first of all, to be prioritized at all levels! The results of the studies demonstrate relatively slow adoption of lifestyle intervention CPGs in clinical practice, and indicate room for improvement. The findings of this thesis can inform healthcare policy and research on further development of the health orientation perspective, as well as on the challenges of implementing CPGs on lifestyle interventions in primary care. In summary, this thesis presents important lessons learned regarding health orientation - from the development of CPGs in the field, via assessing healthcare organizations’ readiness to change and health professionals’ attitudes to methods to support patients with lifestyle changes. / Bakgrund: Levnadsvanor som tobaksbruk, riskbruk av alkohol, ohälsosamma matvanor och otillräcklig fysisk aktivitet är riskfaktorer för att utveckla kroniska sjukdomar, vilka orsakar de flesta dödsfallen i världen. Ohälsa och dess följdsjukdomar utmanar också samhällen och hälsosystem världen över p.g.a. de höga kostnader som de medför. För att förbättra situationen så försöker regeringar och organisationer förändra hälso- och sjukvårdens perspektiv till att fokusera mer på hälsa och att arbeta med effektiva interventioner för att förebygga och att förändra människors ohälsosamma vanor. År 2011 i Sverige, publicerades nationella kliniska riktlinjer för vårdens arbete med att förebygga sjukdom genom att stödja förändring av patienters ohälsosamma levnadsvanor. Det är dock välkänt hur svårt det är att förändra klinisk praxis och att introducera riktlinjer, och interventioner på området hälsa i sjukvården brottas med specifika utmaningar. Det övergripande syftet med den här avhandlingen har varit att bidra till en bättre förståelse av komplexiteten i att hälsoorientera primärvården, och att utforska förutsättningarna till att implementera kliniska riktlinjer för att stödja förändring av patienters levnadsvanor. De mer specifika syftena var: att (I) utforska hur implementeringsutmaningarna behandlades i utvecklingsprocessen av riktlinjerna ; att (II) undersöka dimensioner av beredskapen för förändring i primärvården för att implementera riktlinjerna om levnadsvanor inkluderande aspekter av interventionen själv samt kontexten ; att (III) utforska i vilken utsträckning hälsoprofessionerna arbetar med levnadsvanor i primärvården, och att beskriva deras kunskap, attityder och uppfattat organisatoriskt stöd för livsstilsinterventioner ; att (IV) i en två-årig uppföljning utvärdera utvecklingen av arbetet med levnadsvanor i primärvården, och användningen av de specifika nationella riktlinjerna för levnadsvanor. Metod och resultat: En intervjustudie med riktlinjeutvecklare på nationell nivå (n = 7) visade att många utmaningar för implementeringen av riktlinjerna identifierades och bemöttes under utvecklingsprocessen i fyra teman av strategier: breda överenskommelser och konsensus om inriktning och syfte, systematiskt och aktivt inkluderande av stakeholders, formaliserad och strukturerad utvecklingsprocess, öppenhet och insyn utvecklingsprocess. Samtidigt utmanade dock riktlinjerna om livsstilsinterventioner Socialstyrelsens utvecklingmodell p.g.a. deras förebyggande och icke sjukdomsspecifika fokus (I). En multipel fallstudie med nyckelpersoner ansvariga för implementeringen av riktlinjerna i sjukvårdsorganisationerna (n = 10) samt vårdpersonal och chefer (n = 340), visade på gynnsamma villkor för förändring i båda organisationerna rörande förändringsfokus (d.v.s. hälsoorientering) och den specifika interventionen (d.v.s. riktlinjer om metoder för att stödja förändring av ohälsosamma levnadsvanor). Stödet för förändring och lärande visade på något svagare resultat, likaså formen för förändringen d.v.s. nationella riktlinjer i allmänhet. Faktorer i den yttre kontexten visade sig kunna påverka prioritering av och optimalt val av tidpunkt för interventionen, likaså betydande skillnader i uppfattningar mellan yrkesgrupperna (II). En tvärsnittsstudie bland läkare och sjuksköterskor (n = 315) i primärvården visade att de har en positiv attityd och en god kunskapsnivå om metoder för livsstilsförändring. Både kunskapsnivå och i vilken utsträckning man arbetar med patienters livsstil skiljer sig mellan yrkesgrupper. Organisatoriskt stöd som nationella riktlinjer och utvecklandet av primärvårdens samarbete med intressenter i närområdet identifierades som viktigt för att förbättra arbetet med livsstil interventioner (III). En longitudinell undersökning bland vårdpersonal visade att användning av metoder för att förändra patientens vanor beträffande tobaksbruk och riskbruk av alkohol har ökat över tid, och att sjuksköterskorna arbetar i högre utsträckning med alla fyra levnadsvanorna än i tidigare. Implementeringen av de nationella riktlinjerna för levnadsvanor hade inte kommit så långt vid det andra mättillfället, och stora skillnader visade sig i hur läkare och sköterskor ser på riktlinjer och i vilken utsträckning de använder dem (IV). Slutsats: Hälsofrämjande och prevention skiljer sig på många sätt från mer traditionella fält inom medicinen. För att stärka implementeringen av det här viktiga (men ej akuta) fältet i hälso- och sjukvården, så måste det först av allt prioriteras på alla nivåer! Resultatet visar på ett svagt upptag av riktlinjerna för livsstilsinterventioner i klinisk praxis, och lämnar utrymme till förbättring. Aspekter av resultatet som presenteras i avhandlingen kan vägleda fortsatt utveckling och implementering av hälsoorientering och riktlinjer för livsstilsinterventioner inom primärvården, samt användas för att påverka policy, praxis och framtida forskning. Det gäller framför allt aspekter av utveckling av nationella riktlinjer på området; hälso- och sjukvårdsorganisationernas beredskap till förändring; hälsoprofessionernas attityder, kunskap och i vilken utsträckning de arbetar med livsstilsinterventioner och riktlinjer.