Objective: Utilizing a conceptual model of the impact of disasters on children╒s functioning, the current study examined unhealthy diet and sedentary activity levels of children exposed to Hurricane Ike. Exposure stressors (perceived and actual life threat) and recovery stressors (hurricane-related stressors and major life events), were hypothesized to be associated with unhealthy diet and sedentary activity. Exposure stressors, recovery stressors, and child demographic characteristics were also expected to be associated with posttraumatic stress (PTS) symptoms. It also was predicted that physical activity would attenuate the relationship between recovery stressors and children╒s PTS symptoms. Finally, the feasibility of collecting health behavior information from children was examined. Method: Utilizing a cross-sectional design, 204 children (51% girls; M age = 9.23, SD = .79; grades 3 and 4) from Galveston, Texas were evaluated 8 months after Hurricane Ike (Time 1). At Time 1, children completed self-report measures of traumatic experiences, major life events, PTS symptoms, height and weight, and health behaviors. 53 children were reevaluated two weeks later (Time 2) to examine the stability and validity of health-related measures. Children completed a second measure of their height, weight, and health behavior measures, and actual measurements of height and weight were also taken. Results: Consistent with expectations, exposure and recovery stressors were associated with sedentary activity and PTS symptoms. Exposure stressors were indirectly related to sedentary activity and PTS symptoms through recovery stressors. However, contrary to expectations, stressors were not associated with unhealthy diet. African American ethnicity, Hispanic ethnicity, and female gender were related to PTS symptoms through recovery stressors. Physical activity did not attenuate the relationship between recovery stressors and children╒s PTS symptoms. In terms of health behaviors, children╒s self-reported weight was both stable and valid from Time 1 to Time 2. Self-reported height was stable but invalid. Measures of children╒s unhealthy diet and sedentary activity showed moderate stability. The measure of physical activity exhibited low stability and low validity. Conclusions: Sedentary activity may be a particularly important health behavior to examine after disasters. Implications for schools, families, and future research are discussed. Alternative measures of physical activity should be considered.

Thesis (M. Ed.)--University of Hong Kong, 2005. / Title proper from title frame. Also available in printed format.

Parkinsons sjukdom är en neurologisk sjukdom, som främst drabbar motorik, men även kan påverka psykosociala och kognitiva funktioner. Studiens syfte var att kartlägga aktiviteter och upplevd delaktighet hos en grupp personer med Parkinsons sjukdom (n = 10). En semistrukturerad intervju gjordes med genomgång av aktiviteter under ett dygn. Data analyserades utifrån aktivitets- och delaktighetsdomänerna i ICF. Jämförelse med tidigare forskningsresultat visade att personerna i den aktuella undersökningsgruppen ägnade mer tid åt personlig vård, men mindre tid åt vila och TV-tittande. Upplevd delaktighet i aktiviteterna skattades generellt som hög, men en negativ korrelation sågs mellan tid sedan diagnos och delaktighet inom domänen Viktiga livsområden. En stor spridning i materialet indikerar att exempelvis rehabiliteringsinsatser bör baseras på individuell aktivitetsanalys.

Introduction Physical inactivity is a major cause of reduced quality of life, as well as many common diseases and even premature death. Most people, globally, are scarcely or rarely physically active. Consequently, physical inactivity influences the burden of disease, and increases its societal costs. In view of this, it is necessary to ask how health care should respond when the population and the patients are either inactive or rarely physically active. Cost-effectiveness analyses of the promotion of physical activity in health care can contribute substantially to health care policy. Aims The overall aim of this thesis was to investigate the cost-effectiveness of physical activity promotion in the health care system. The specific aims were: (I) to provide a model for analyzing cost-effectiveness and equity in health for community-promoted physical activity, (II) to review current knowledge about the cost-effectiveness of health care based interventions aimed at improving physical activity, (III) to evaluate the cost effectiveness of physical activity promotion as a treatment method in primary health care, (IV) to illustrate the importance of enjoyment of exercise in interventions aimed at promoting physical activity, and (V) to describe a method of valuing the time spent on exercise. Methods Standard methods for economic evaluation were studied and adapted to create a model for the evaluation of physical activity promotion (I). Relevant databases were searched for published articles, and the articles found were analyzed using this economic evaluation model (II). A trial in primary health care was evaluated in a cost-utility analysis based on the model (III). In the same trial, the association between time spent on exercise and enjoyment of exercise was analyzed (IV). A model for valuing the time spent on exercise was developed based on existing approaches to the valuation of time, and used in two different groups of exercisers; experienced and inexperienced (V). Results An economic evaluation model was developed, as was a model to calculate an intervention’s effect on equity in health (I). In total, 26 articles were found regarding the cost-effectiveness of physical activity promotion in health care, and 20 of these described interventions, which the authors considered to be cost-effective (II). The treatment of patients in primary health care by the promotion of physical activity was shown to be cost-effective (III). For the same group of patients, time spent on exercise was associated with enjoyment of exercise (IV). A model for valuing the time spent on exercise was developed and used. Time costs were significantly higher among inexperienced exercisers (V). Conclusions There are many examples of interventions promoting physical activity that may be regarded as cost-effective. In general, it seems to be cost effective to promote physical activity among patients with increased risk, or who manifest poor health associated with physical inactivity. Unfortunately, there is still little evidence of when physical activity should be used, or what the best design of such an intervention might be. Although there is still a need for stronger evidence, the Swedish health care system should use the promotion of physical activity as a standard method among the following patients: • those who manifest increased risk (such as high blood pressure) of ill health due to a physically inactive lifestyle; • frail older people, especially those with increased risk of fall injuries; • those requiring rehabilitation after heart failure.

Age, male sex, hypertension, smoking, diabetes, dyslipidaemia, and obesity are considered as established risk factors for cardiovascular diseases. Several of these established cardiovascular risk factors are strongly influenced by lifestyle. Novel biomarkers from different mechanistic pathways have been associated with cardiovascular risk, but their clinical utility is still uncertain. The overall objective of the thesis was to evaluate the associations between certain lifestyle factors (physical activity and snuff use), biomarkers reflecting the haemostatic and the inflammatory systems and risk of a future first-ever myocardial infarction.  A prospective incident nested case-control study design was used with a total of 651 cases of myocardial infarction and 2238 matched controls from the population-based Northern Sweden Health and Disease Study.  The effects of commuting activity, occupational and leisure time physical activity on risk of myocardial infarction were studied. A clearly increased risk of myocardial infarction was found for car commuting compared to active commuting (walking, cycling or going by bus). High versus low leisure time physical activity was associated with decreased risk of myocardial infarction. Low occupational physical activity was associated with risk of myocardial infarction in men.  The risk of myocardial infarction or sudden cardiac death was studied in male snuff users compared to non-tobacco users. No increased risk was found for myocardial infarction or sudden cardiac death among snuff users without a previous history of smoking. However, for sudden cardiac death the study did not have statistical power to detect small differences in risk.  Plasma levels of haemostatic markers have previously shown to be associated with risk of myocardial infarction, but as haemostatic markers are also acute-phase reactants, it is not clear if their association with myocardial infarction is independent of inflammatory markers. In the present study, the haemostatic markers D-dimer, von Willebrand factor (VWF), tissue plasminogen activator (t-PA), and tissue plasminogen activator/plasminogen activator inhibitor-1 complex (t-PA/PAI-1 complex) were associated with risk of myocardial infarction after adjustment for established risk factors and the inflammatory markers C-reactive protein (CRP) and interleukin 6 (IL-6). Furthermore, the addition of eight haemostatic and inflammatory markers could improve the predictive ability for future myocardial infarction beyond that of a model utilizing only established risk factors.  Established risk factors and novel biomarkers were explored as potential mediators of the reduced risk of myocardial infarction related to active commuting. A combination of established risk factors, haemostatic and inflammatory markers appeared to explain a substantial proportion (40%) of the difference in risk for myocardial infarction between active commuters and car commuters. IL-6, t-PA, t-PA/PAI-1 complex, apo B/apo A-1 ratio, and BMI seemed to be the largest potential mediators when tested individually. In conclusion, regular physical activity such as active commuting is associated with reduced risk of a first-ever myocardial infarction. This effect could in part be mediated through a beneficial influence on haemostasis and inflammation, as well as a positive impact on established risk factors. Several haemostatic markers are associated with risk of myocardial infarction independent of established risk factors and inflammatory markers. The combination of haemostatic and inflammatory markers may enhance predictive ability beyond established risk factors. Our findings do not support the hypothesis that snuff use increases the risk of myocardial infarction.

Graduation date: 1991

Two key proteins, LexA and RecA, are involved in regulation of the SOS expression system in bacteria. LexA and RecA act as the transcriptional repressor and inducer of the SOS operon, respectively. LexA downregulates the expression of at least 43 unlinked genes and activated RecA interacts with the repressor LexA and therefore, LexA undergoes self-cleavage. The ability of the LexA protein to dimerize is critical for its ability to repress SOS-regulated genes in vivo, as the N-terminal domain (NTD) alone has a lower DNA-binding affinity without the C-terminal domain (CTD) and the components for the dimerization of LexA are located in the CTD. Two antiparallel β-strands (termed β-11) in the CTD at the dimer interface of LexA are involved in the dimerization. LexA interacts with the active form of RecA in vivo during the SOS response. It was determined experimentally that monomeric and non-cleavable LexA binds more tightly to RecA and is resistant to self-cleavage. Therefore, we reasoned that if we can produce such LexA mutants we would be able to stabilize the LexA and active RecA complex for crystallization. Therefore, in this experiment, we attempted to make a non-cleavable and predominantly monomeric LexA that interacts intimately with RecA. We produced four single mutations at the dimer interface of the non-cleavable and NTD-truncated mutant of LexA (∆68LexAK156A) in order to weaken the interactions at the interface. The predominant forms of LexA mutants and the affinities of interaction between the mutant LexA proteins and RecA were examined. ∆68LexAK156AR197P mutant was found as predominantly monomeric at a concentration of 33.3 μM both by gel filtration chromatography and dynamic light scattering (DLS) experiments. It also bound RecA more tightly than wild-type LexA. Another mutant, ∆68LexAK156AI196Y, was also found as predominantly monomeric at a concentration of 33.3 μM by DLS. Both these proteins were subjected to crystallization with wild-type RecA protein. We were able to produce some predominantly monomeric LexA with good binding affinity for RecA; however, we were unsuccessful in co-crystallization.

The objective of this research was to study relationship(s) of ethnicity, physical activity and diet with adiposity development in Aboriginal youth. To meet this objective, three separate, yet inter-related studies were undertaken: 1) to comprehensively assess adiposity in Aboriginal youth and their age, sex and maturity matched Caucasian peers; 2) to assess the role of ethnicity and sex on physical activity (PA) levels and identify the proportion of Aboriginal youth meeting international recommendations; and 3) to explore relationships of ethnicity, physical activity and diet with adiposity. In study one, it was hypothesized that Aboriginal youth would have greater adiposity than their Caucasian peers. While much of the research to date has focused on body mass index, this investigation used DXA and waist circumference to show that Aboriginal youth had greater total and central adiposity in comparison to their Caucasian counterparts.<p> Study two examined physical activity behaviors of Canadian Aboriginal youth in relation to ethnicity and sex. It was hypothesized that the physical activity levels of Aboriginal youth would be lower than their Caucasian peers; that the majority of Aboriginal youth would not meet PA and T.V. viewing recommendations; and that Aboriginal boys would have higher adjusted physical activity energy expenditures than girls. Findings indicated that physical activity levels of the two ethnic groups were generally comparable, that Aboriginal boys had greater activity energy expenditures than girls, and that a greater percentage of boys were meeting the international recommendations for physical activity and T.V. viewing. Study three built upon the first two investigations, to explore relationships of physical activity and diet with adiposity in Aboriginal youth. It was hypothesized that when age, size and maturity, and their interactions were accounted for, diet and physical activity variables would be related to adiposity (waist circumference, total body and trunk fatness). Results indicated physical activity was inversely related to adiposity level, independent of biological factors. Although energy intake was the sole dietary variable related to the adiposity measures, descriptives showed the eating behaviors (i.e., consumption of fruits and vegetables, sugar sweetened beverages and other foods) of the Aboriginal youth were sub-optimal when compared to current recommendations. This research project is unique because it comprehensively assessed adiposity, diet and physical activity, and the relationships between these variables, in a relatively large sample of Aboriginal boys and girls. Furthermore, these relationships were established using a variety of measures (i.e., DXA, waist circumference, height and weight) while controlling for biological confounders. Overall, the results highlight the urgent need to promote physical activity and healthy eating in Aboriginal youth and set the stage for future research.

Objective: To examine the workplace challenges of lupus patients. Methods: A cross sectional study surveyed lupus patients seen at the Toronto Lupus Clinic in the last 2 years. We included questions on health, work context and psychosocial perceptions. Descriptive statistics described the sociodemographic and clinical characteristics of the sample; multivariable analysis examined factors associated with workplace activity limitations, job strain, and job accommodations. Results: 362 respondents completed the questionnaire (60% response). 49.7% were currently employed. Participants who recently left work had higher disease activity and workplace activity limitations. Employed participants had low to moderate job strain. Seventy percent of employed participants used job accommodations. Health, work context, and psychological factors were significantly associated with workplace activity limitations, job strain and job accommodations. Conclusion: Persons living with lupus are faced by different challenges at the workplace. Workplace difficulties and needs of individuals with lupus should be assessed by health professionals.

Objective: To examine the workplace challenges of lupus patients. Methods: A cross sectional study surveyed lupus patients seen at the Toronto Lupus Clinic in the last 2 years. We included questions on health, work context and psychosocial perceptions. Descriptive statistics described the sociodemographic and clinical characteristics of the sample; multivariable analysis examined factors associated with workplace activity limitations, job strain, and job accommodations. Results: 362 respondents completed the questionnaire (60% response). 49.7% were currently employed. Participants who recently left work had higher disease activity and workplace activity limitations. Employed participants had low to moderate job strain. Seventy percent of employed participants used job accommodations. Health, work context, and psychological factors were significantly associated with workplace activity limitations, job strain and job accommodations. Conclusion: Persons living with lupus are faced by different challenges at the workplace. Workplace difficulties and needs of individuals with lupus should be assessed by health professionals.