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突變生成(mutagenesis)的方式有許多種，其中insertional mutagenesis為果蠅上常使用建立突變株的方式，本篇論文利用p[GawB]隨機插入果蠅genome中產生大量突變株，並篩選出會影響壽命的突變果蠅M2。進一步的實驗發現M2果蠅為Vha16-1基因的突變，並造成其mRNA表現量的下降，且在低卡路里(5% yeast、5% dextrose)與高卡路里(15% yeast、15% dextrose)的環境下homozygous mutant果蠅皆有減少平均壽命的現象。 Vha16-1所表現的蛋白為Vacuolar-type H+-ATPase (V-ATPase)上的subunit c，V-ATPase主要的功能為藉由消耗ATP來運送氫離子，並可調節胞器或胞外腔室的酸鹼平衡。V-ATPase主要表現在果蠅腸道的copper cell上，此細胞的功能類似於哺乳動物的胃壁細胞(parietal cells)，與胃酸的分泌有關，我們發現M2 homozygous mutant果蠅因Vha16-1基因的缺失而有減少腸道酸化的情形發生，符合我們觀察到其在腸道上的表現。此一現象亦在另一株突變果蠅Vha16-1EP2372上加以證實。先前研究顯示果蠅腸道酸鹼平衡的破壞會影響到對養分的吸收，而Vha16-1的缺失亦導致M2果蠅體重與三酸甘油酯的上升，並增加對飢餓的耐受性，而這些代謝上的變化並不會改變M2果蠅對食物的攝取量或者生育能力。綜合這些實驗結果，我們推測Vha16-1基因的缺失會改變腸道功能，並影響果蠅體內代謝的狀態，表現出類似肥胖(obesity)的性狀，而終導致平均壽命的縮短。 / Mutagenesis can be induced by many ways and one of the most common approaches used in Drosophila is insertional mutagenesis. In this study, we screened pGawB insertion lines and identified M2 as a novel mutant with affected lifespan. The mutant allele of M2 carried a pGawB inseration at the 5’ end of the Vha16-1 gene, which caused a reduced Vha16-1 mRNA expression level and a shorten lifespan in homozygous mutants under both low calorie (5% yeast and 5% dextrose) and high calorie (15% yeast and 15% dextrose) foods. Vha16-1 encodes the c subunit of the Vacuolar-type H+-ATPase (V-ATPase) which is known to regulate pH homeostasis by pumping protons across organelle and plasma membranes. V-ATPase is highly expressed by the Copper cells which are located at the Drosophila middle midgut and functionally similar to the gastric acid producing parietal cells in mammals. Along the same line, we found that Vha16-1 pGawB drives GFP reporter was observed along the Drosophila gastrointestinal tract. M2 as well as the other Vha16-1 hypomorphic mutant line, EP2372, also showed reduced midgut acidification. This disrupted pH homeostasis in the Drosophila midgut region may be associated with increased body weight, triglyceride, and starvation resistance that observed in M2 mutants. The feeding behavior and reproductive function, however, were not affected in M2 mutant flies. In summary, our data suggested Vha16-1 deficits may alter normal intestinal function or internal metabolic status that ultimately induces obesity phenotypes with reduced lifespan.

因體重過重所導致的肥胖問題，在世界各經濟先進國家中逐漸成為重要的議題，其不僅關乎於因肥胖可能嚴重影響個人健康，亦包含整體國民健康素質下降及為了治療肥胖所引起的相關疾病，造成龐大的健康保險或是衛生資源等經費及預算的支出。鑑於我國國民肥胖比率的嚴重性，國民健康署推動肥胖防治政策，如相關體重管理與健康減重的活動。而本研究乃探討該肥胖防治政策的整體行銷架構及有何行銷阻力與問題，並檢視社會行銷理論與該政策實務之間有何差異，以及協力參與的機制在該政策的行銷過程如何建立及運作，並對於該政策的行銷推動有何影響與成效。 研究發現在該政策的整體行銷模式中，透過「產品、通路、定價、促銷」行銷要素的界定以及「市場區隔、訂定目標、市場定位」的行銷策略的討論，構成其行銷推動的模式。惟該政策的行銷阻力在於如何能維持民眾持續參與的意願、衛教資訊能成功被參與者所吸收以及如何能營造出共識的氛圍，而不生競爭的心態。此外在關於肥胖歧視部分，則在推行中未有明顯的出現，且以健康概念為主要的論述，使人不至於產生負面或排斥的想法。而在討論城鄉之間在推動該政策上的差異，則因客觀環境與人口地域特質的不同，在行銷管道與途徑、行銷的重點及客觀環境條件與資源方面有所差異。檢視實務與理論不同之處，則該個案較值得與理論討論部分有以全民性為主、提供客觀的環境條件、涉及生活習慣與健康知識、協力參與的運用以及重視媒體運用，包裝與故事性的發揮。而檢視個案推動上的問題，則有生活習慣改變不易、手段與目的混淆、經費配置的問題、其他事項的連結以及未能解決真正問題的情形。再來協力參與的建構部分，透過「產、官、學、民、媒」各方互相合作，由官方單位居中協調，使各方共同為該政策的推動與行銷做出貢獻，而在學校或醫療院所等場域中，也可見各方合作的情形，而此一協力參與關係對於該政策在政治制定、執政執行及化解阻力方面，帶來了傳播效果的增加、政策的擬定與推行、傳遞健康知識、跨領域與跨單位的合作以及塑造氛圍的效果與影響。然而在此協力過程之中，仍有些問題尚須改進及加強，如參與動機不足、為了執行，忽略目標以及參與團體內部意識分歧的現象。

University of Macau / Faculty of Education

This business plan aims to develop a premium holistic service for girls who suffer from obesity, overweight and/or eating disorders, using new approaches to these existing problems. Our mission is to provide an innovative approach that can make a difference for young women with obesity, overweight and/or eating disorders.

偏見不只影響遭受者的身心健康，也違背社會正義，為了改善這樣的狀況，研究者們致力於發展降低偏見的方案。不過這些降低偏見的方案通常針對種族或性別群體，卻甚少關心肥胖者與愛滋感染者。肥胖者、愛滋感染者不僅受研究社群忽視，他們在生活中亦不受重視（如醫療體系），因此本論文著眼降低人們對肥胖者、愛滋感染者的偏見。研究一發展降低偏見方案，透過撰寫支持肥胖者或愛滋感染者的短文，引發人們言行不一的認知失調感，可能進而改變其原本對肥胖者或愛滋感染者的偏見。研究一的結果顯示，只有撰寫愛滋主題的參與者其愛滋偏見分數低於其他組別，也就是說他們的行為違反本身對愛滋感染者的既有態度而產生認知失調，透過降低愛滋偏見來化解認知失調之不適感。不過，撰寫肥胖主題的參與者，其肥胖偏見分數則與各組無異，也就是說這種降低偏見的方案對肥胖者的偏見無影響。預試二發現，相對於愛滋感染者，肥胖者通常被視為較可控制自己身屬於該社會群體的命運（可控制性），且其較需為自己的遭遇負責。為了檢視人們認為肥胖者與愛滋感染者可控制性的差異，是否影響偏見方案的效果，研究二除了改良研究一的降低偏見方案外，更操弄可控制性的高低。研究二發現可控制性會調節降低偏見方案的效果－當人們認為成為愛滋感染者是自己可以控制時，降低偏見方案的效果較弱；反之，若人們認為成為愛滋感染者是自己不能控制的，則降低偏見的效果較強。不過，撰寫肥胖主題文章的參與者則無此效果。這樣的差異或許是因為人們對肥胖者與愛滋感染者的熟悉程度有所不同。相較於愛滋感染者，人們對肥胖者較為熟悉，對其態度不容易改變，不論是接受高可控或低可控的訊息操弄，都無法改變人們對肥胖者的想法。根據本論文結果，認知失調適合降低人們較不熟悉與視其較為不可控的社會群體，如愛滋感染者，不適合應用在人們較熟悉的社會群體，如肥胖者。本論文進一步討論降低偏見方案執行困難的原因，並提出可能的建議與後續的研究方向。 / Prejudice and discrimination may have negative consequences on subordinate group members’ physical and mental health, and prejudice and discrimination also violate social justice. To deal with these problems, researchers have dedicated to develop various interventions to counter prejudice and discrimination. However, most of these interventions focus on racial and gender minorities, and researchers largely ignore people with obesity and people with HIV/AIDS. The purpose of this thesis is to develop an intervention that could reduce prejudice against people with obesity, as well as to reduce prejudice against people with HIV/AIDS. According to cognitive dissonance theory, when people’s attitudes and behavior are inconsistent, they feel uncomfortable and in turn change their attitudes to eliminate the inconsistency (Festinger, 1957). Following the basic ideas in cognitive dissonance theory, in Study 1, I randomly assigned participants to write presumably counter-attitudinal essays, in which they write about people with obesity or people with HIV/AIDS (to advocate allocating more resources to them), or school policy change (a control group). The results showed that after writing about people with HIV/AIDS, participants displayed significantly lower prejudice against people with HIV/AIDS than participants in other conditions. However, after writing about people with obesity, participants’ prejudice against people with obesity remained at similar levels as participants in other conditions. According to findings in the second pilot study, the diverging findings in Study 1 may be due to that people with obesity were considered having more controllability and responsibility than people with HIV/AIDS. To further explore the effects of levels of controllability on intervention, I revised Study 1’s intervention and added a manipulation of controllability on people with obesity or on people with HIV/AIDS. The findings showed that controllability manipulation moderated the intervention effect on people with HIV/AIDS, but had no effect on people with obesity. Because participants were more familiar with people with obesity than with people with HIV/AIDS, it is possible that attitudes toward a familiar social group are more difficult to be changed than the attitudes toward an unfamiliar social group, The results suggested that interventions based on cognitive dissonance principle have effects on unfamiliar social groups, such as people with HIV/AIDS. Obstacles with prejudice reduction interventions were further discussed; suggestions and future research directions were offered.

在我國抑或是世界其他的國家，肥胖的問題日趨嚴重，根據世界衛生組織（World Health Organization， WHO）的研究，2008年全球約有15億以上的超重成年人，其中有2億的男性和將近3億的女性體重已經達到所謂的「肥胖」，另外2010年全世界約有4300萬5歲以下的兒童超重 。綜上所述，肥胖的問題正影響著每一個社會。 肥胖者在日常生活中的食衣住行可能會受到一定的歧視與不便，由於可以討論的範圍過廣，本文僅聚焦在「就業上的肥胖歧視」。為了探討此問題，本文第二章說明何謂就業歧視，闡述肥胖者在就業上可能會面臨的歧視有哪些、主流群體對於肥胖的態度與刻板印象，最後論證國家就業上肥胖歧視的正當性與必要性。 第三章介紹美國法就業上肥胖歧視之解決途徑。在美國關於肥胖者於就業上受到的歧視，可能有三種法律救濟途徑。第一、可以尋找聯邦或是州法律有沒有在保護基於「身心障礙」之就業歧視；第二、他可以思考目前所面臨的「肥胖歧視」，得否繫於其他法律保護的歧視類型，例如：種族或是性別；第三、他可以尋找他所居住的州或是城市是否有針對肥胖歧視的直接立法？本文就美國聯邦與各州禁止身心障礙歧視的相關立法做初步的分析，並且帶出相關之判決；另本文亦分析某些州或城市直接禁止「肥胖歧視」之反歧視法與相關案例分析。 第四章則回到我國，分析我國目前法制關於就業上肥胖歧視之議題該如何處理，主要區分私人企業與國家兩種途徑，私人企業上，我們將著重在《就業服務法》第5條之規範，提出本文對於此條文用以解決肥胖歧視之利與弊；國家方面則從我國公務人員考試涉及BMI值判斷的合憲性。 最後第五章結論的部分，綜合分析美國法制與我國法制之間的異與同，最後提出個人對於此議題之建議，以期達到消弭就業上肥胖歧視之長遠目標。 / Obesity discrimination is a serious problem affecting millions of workers. Fat people, and fat women in particular, experience job-related discrimination in hiring, wages, and the terms and conditions of their employment. Hence, this research focus on the problem of obesity discrimination in employment. Part II defines "what is obesity?",and describes mainstream attitudes towards fatness, considers the empirical and anecdotal evidence demonstrating that fat people experience employment discrimination because of their obesity. Then discusses medical information about weight and health as well as weight loss in order to debunk the myth that being fat is always unhealthy and that weight loss is a viable or desirable outcome, this part concludes that being fat is immutable and deserve legal protection. Part III introduces American legal remedies. In America have three legal avenues to explore. First, someone could pursue an action under federal and state laws that protect people from employment discrimination based on disability or perceived disability. Second, someone could consider whether the weight discrimination he (or she) experienced was tied to him(or her) sex, race, or some other protected class. Finally, someone could determine whether any state or local law where he (or she) lived specifically prohibited weight discrimination in employment , since a few jurisdictions have included weight as protected category in their antidiscrimination laws. This part will discuss federal and state disability antidiscrimination laws and cases, and reviews antidiscrimination law passed by three earlier jurisdictions that specifically include weight as a protected category. Part IV discusses how to solve obesity discrimination in employment? This part separate privately owned businesses and national measure. In privately owned businesses, this part will focus on Employment Service Act Article 5 and analyze how to use Employment Service Act solve obesity discrimination in employment. On the side, this part will discuss on some national examinations have qualification restricted are constitutionally.