Despite a worsening obesity epidemic and despite the American Medical Association (AMA) declaring Obesity a disease (2013), few assessment tools exist that assist practitioners who are charged with identifying risk for development of OW/OB in children. The Center for Health Statistics (2017) reported a 40% rate in obesity in the adult population and 18.5% in children in the U.S. Successful weight loss maintenance after 1 to 2 years of non-invasive treatment is less than 1%, indicating obesity is nearly incurable, making prevention imperative. Assessing risk for OW/OB in children has proven difficult given the lack of validated tools. The purposes of this study were to evaluate the predictive validity and estimate the reliability of the Electronic Kids Dietary Index (E-KINDEX) to measure risk for development of overweight and obesity OW/OB in children aged 10 to 18. In addition, the relationship between quality of life perceptions and OW/OB in children was assessed. Methods. E-KINDEX, a 30-item questionnaire encompassing three dietary domains of food quality, dietary behaviors (attitudes), and dietary habits (Lazarou et al., 2011), was administered to 50 child participants who, with their parents’ consent, agreed to participate. The children also completed the quality of life questionnaire. The range for E-KINDEX scores was 1 (worst) to 87 (best) for assessment of the obesogenic environment that encompasses the immediate environment of the individual, factors that influence food quality, choices, and behaviors. Predictive validity was evaluated using multiple regression, factor analysis, and receiver operating curve statistics in SPSS; reliability was analyzed using Cronbach’s alpha. Pearson product-moment correlations were used to measure strength of relationships among OW/OB, E-KINDEX scores, and quality of life perceptions in the sample. Results. E-KINDEX overall score was significantly correlated with OW/OB (r = -340, n = 50, p = .008), as was Dietary Behaviors (r = -.593, n = 50, p = Discussion. Predictive validity of E-KINDEX subscales and overall were supported through achievement of aims of the study. Correlations between both E-KINDEX scores and child weights were significant and reliability supported by Cronbach’s alpha. Limitations included small sample size of 50 and accuracy of children self-report data in the presence of parents. Parental weight did not correlate with E-KINDEX, but should be studied further relative to the Obesogenic Environment. Physical activity was high in both OW/OB and lean groups. Validated Physical Activity tools are needed. Implications. Although refinement and further study are needed, E-KINDEX is a useful tool for clinicians to identify children at risk for the chronic disease of OW/OB before it develops, perhaps before risk factors become difficult to modify.

No description available.

The purpose of this research was to investigate the role of social support in helping adolescent Māori mothers cope with pregnancy, birth and motherhood, with a particular emphasis on its role in enabling them to continue at school. The aim of this research is to understand and make sense of these experiences and to perhaps identify gaps within an individual's social network. The analysis and methodology of the research was underpinned by a community psychology framework. Nine interviews were conducted with young Māori women who had become pregnant and continued with their pregnancy, all before the age of 20. The in depth interviews included questions focusing on the young women learning of pregnancy, the pregnancy, birth, caring for their child and their experiences with education and future plans. Negative experiences were usually those which involved unsupportive people. Positive interactions were those where support, of all types, was offered and useful to my participants and their children. Education was highlighted as the most effective way of providing a better life for adolescent mothers and their children. The research highlights the importance of social support and the continuation of education. Combining the efforts of positive social networks and social support services can improve the lives of adolescent Māori mothers and their children.

Adolescent depression is highly prevalent, associated with negative effects and likely to recur, this provides a cogent argument for finding sustainable, cost-effective, developmentally appropriate approaches to preventing depression. Although there is good evidence to support efficacy, there is no evidence of the effectiveness of programs preventing adolescent depression. Thus the primary aim of this thesis is to evaluate the effectiveness of a universal, school-based, adolescent depression prevention program when implemented by teachers and local mental health professionals. Participants were 1003 secondary school students drawn from three pairs of matched Year 9 cohorts. The three pairs were assigned to either: (a) Resourceful Adolescent Program (RAP), an 11-session school-based resilience program delivered as part of the school curriculum (n = 522) or (b) a comparison condition (n = 481). All students completed measures of depressive symptoms and hopelessness at pre-intervention, post-intervention and 6-month follow-up. The intervention group completed quantitative and qualitative evaluations of perceived program benefit. Small program effects on depressive symptoms for the RAP group were evident for the whole group at post-intervention (ES = 0.30) and for girls only at follow-up (ES = 0.35). However, both boys' and girls' self-reports indicated very positive overall benefits from the RAP intervention. Teachers were not less effective as group leaders than mental health professionals in terms of outcomes on depression measures, perceived program benefits or acceptability to students. Public health implications of this population-based approach are discussed in the light of small effects, high recruitment rates and potential use of sustainable school resources.

This qualitative study was designed to gain an insight into the ways in which adolescents and young adults managed ?self? in their day - to - day diabetes management. It also examined the effect that illness self representations had on that management. A grounded theory approach using a symbolic interactionist framework was adopted based on 27 in- depth semi structured interviews with adolescents and young adults with diabetes. Respondents described the effects of diabetes management on the physical, emotional, social and related selves. They also described their various illness self representations. It often took an inordinate amount of work for the respondents to manage their diabetes. This ?management? work could be related to problems with their physiological control, emotional stressors, the need to be socially interactive, differing priorities or relational issues. Certainly even the most resilient respondents experienced periods of vulnerability and needed to nurture the ?self? The study generates new knowledge which builds upon the existing body of knowledge relating to the management of self in adolescents and young adults in the context of T1DM. The study established that whilst some health professionals are sensitive and cognizant of the needs of adolescents and young adults with diabetes, there is room for improvement in the way in which health professionals understand the complexities involved in diabetes management for adolescents and young adults / Doctor of Philosophy (PhD)

The major focus of this study was to investigate the association between adolescent attachment styles and types of parent-adolescent conflict and anger. The study used adolescent respondents (n=214, females=136, males=78), 95% of whom were aged 14 or 15. The methodology was a one-off survey design. An adapted adult attachment scale with two dimensions, anxiety and avoidance, measured attachment. This scale was used to form four adolescent attachment styles, secure, preoccupied, fearful and dismissive. Family conflict was assessed in a range of ways, including general measures of self-reported family conflict and abuse at home. Also measured were general anger-proneness and depression-proneness. As well, adolescents responded to four specific, hypothetical parent-adolescent conflict scenarios. The responses to these vignettes included their reported emotions, conflict resolution strategies, expected endings and post-conflict coping/risk behaviours. Results indicated the presence of one major healthy and functional conflict-anger pattern associated with a secure attachment style, and two major types of harmful and dysfunctional conflict-anger patterns. Healthy conflict and anger involved secure adolescents reporting they would experience negative emotions in conflict but would still expect the conflict to be resolved well for everyone. Secure adolescents were also less anger-prone and depression-prone generally than other adolescents, possibly indicating their ability to regulate their negative emotions. The first harmful conflict pattern, associated with preoccupied and fearful attachment styles, included relatively higher levels of family conflict involving poor conflict endings, and even moderate levels of violence. Preoccupied and fearful adolescents may have poor emotional regulation, as indicated by their higher levels of general anger-proneness and depression-proneness. The second harmful conflict-anger pattern was associated with a dismissive attachment style and involved conflict with emotional distance and coolness in the family, as well as lower levels of reported problem solving strategies and good conflict endings. Results are discussed in terms of adolescent attachment style profiles and the need to distinguish and assess attachment styles in families in order to devise appropriate and effective interventions. Examples of primary, secondary and tertiary preventative interventions are described to assist mildly to severely conflicted, distressed or disengaged families.

<p>The objective of this master thesis was to study the relation between public green open space and health among adolescents in Uppsala municipality, Sweden. The aim of the study was to investigate if there is an association between the access to green open space in the living environment and adolescent´s health, in terms of fysical activity, self- reported health and overweight. The public health questionnaire ”Liv och Hälsa Ung 2009” provided data together with a map over public green space, where the measure taken into account is the proportion of public green space in the living environment. The study includes 3423 adolescents, 12-19 years old. The statistical results indicate that access to public green space in the living environment is genrally not correlated to the health variables studied in this thesis. The author´s interpretation is that other health determinants are more crucial to adolescent´s health than green space, parents educationlevel is sugested as one. Further research is needed to support the findings of this study.</p> / <p>Syftet med föreliggande studie var att undersöka om det finns samband mellan tillgång till grönområden i boendeområdet och ungas hälsa (med avseende på fysisk aktivitet, självskattad hälsa och övervikt) i Uppsala kommun. Studien utgår i från redan befintliga data genom frågeformuläret ”Liv och Hälsa Ung 2009” som riktar sig till elever i årskurs 7 och 9 i högstadiet samt årskurs 2 i gymnasiet i Uppsala län. Studien omfattar 3423 elever i åldern 12-19 år. Med utgångspunkt i enkäten samt med hjälp av en karta över Uppsala kommuns grönområden undersöks måttet andel offentlig grönyta i boendeområden i förhållande till de valda hälsovariablerna. Sammanfattningsvis uppvisar resultatet få uppmätta samband mellan tillgång till grönområden i boendeområdet och de hälsovariabler som studerats. Författarens slutsats är att andra faktorer verkar vara viktigare för ungas hälsa, som exempelvis föräldrarnas utbildningsnivå. Det behövs dock fler studier genomföras för att bekräfta studiens fynd.</p>

In recent years, dietary calcium intake among children and adolescents has fallen sharply. This trend is alarming because childhood and adolescence are the primary ages for building bone mass. Therefore, an interactive website, Clueless in the Mall (http://calcium.tamu.edu) was developed targeting youth to increase knowledge, improve attitudes, and equip them to incorporate calcium-rich foods into their diets. This website was created with the help of adolescents at every stage of development and has been pilot tested with adolescents at home and in school, showing improvements in knowledge and attitudes. However, the website has not been tested for effectiveness in changing behaviors, specifically for increasing calcium intake. The present study was conducted to measure the effectiveness of the website for changing knowledge, attitudes, and behaviors. The hypothesis of this investigation was that the website intervention would significantly improve attitudes and knowledge about calcium and increase dietary calcium intake among adolescents and pre-adolescents who took part in the study. After the group-administered Food Frequency Questionnaire (FFQ) was validated among a local church youth group, a total of 126 middle school and high school students were recruited from 12 local public school classes to participate. Each student took three questionnaires during class time to measure baseline knowledge, attitudes, and behaviors (including calcium intake using the FFQ). Then each student took one class period to view the calcium website. Four to six weeks later, the investigators returned to administer the same three tests to each student. Demographic information was collected, and data were analyzed using paired samples t-tests and analyses of variance (ANOVA). Results demonstrated that the website alone was sufficient to improve knowledge scores; however, it was not enough to change attitudes and behaviors significantly. In conclusion, the website should be used to promote and reinforce health behaviors, but should not be expected to stand alone as an intervention.

Exposure to traumatic events has deleterious effect resulting in considerable psychological (cognitive and affective/emotional), physical and social impairments. In contrast to natural disasters, victims of man-made disasters have been reported to be vulnerable to severe psychological and psychiatric disorders affecting a large number of abilities and lasting for many years. Among the most common psychiatric diagnosis associated with violence exposure is the Posttraumatic Stress Disorder (PTSD). Like adults, children and adolescents are not exempt from this situation. In 1994, Rwanda experienced an unprecedented genocide in which about 800.000 Tutsi, for their majority, were atrociously murdered (UN). This genocide generated multiple and massive stressors that may lead to severe and long-lasting PTSD among its survivors, including children and adolescents. Report on traumas exposure and psychological reactions to genocide among young survivors in Rwanda (Dyregrov et al., 2000) unanimously indicate a precarious situation. At the social level, children and adolescents heading household (CHH) are presumably the most vulnerable given their social deprivation. Moreover, the increased number of significant losses (parents, siblings, relatives, family and community cohesion) and the traumatic nature of the death predict traumatic grief among the young orphans of the genocide in Rwanda. The embedment of traumas and bereavement in this population is postulated to increase the likelihood of severe and persistent posttraumatic distress. With regard to the genocide in Rwanda, especially the extent of its damages; it is hypothesized that psychological consequences from such disaster are crucial. Considering social categories of young survivors, CHH are hypothesized to be vulnerable to several psychological sequels given their social and economic living conditions. The trauma exposure history, traumatic bereavement of key caretakers and attachment figures (parents and other relatives), lack of adult guardianship, insecure family structures and precarious social support are risk factors predicting poor outcomes. About the structure, this thesis consists of seven chapters, the general introduction and conclusion excluded. The two first chapters are theoretical and overview the literature related to PTSD (Chapter 1) and the association of trauma and bereavement (Chapter 2) resulting in a conjunction of PTSD and grief. They clarify issues related to symptoms and semiotic concepts, diagnostic and assessment protocols, and demonstrate how PTSD and grief can be embedded on certain aspects but not on others. At the empirical level, findings from PTSD prevalence (chapter 3) and the association of PTSD and grief (chapter 4) among young people survivors of the 1994 genocide in Rwanda are presented. Furthermore, continuous exposure to post-genocide trauma reminders, deleterious socio-economic life conditions, coping strategies and PTSD comorbidity are presented as major risk factors to persistent and complex post-traumatic distress (Chapter 5). Finally, given our findings, a rumination focused cognitive and behavioural therapeutic (RFCBT) protocol is tested in a pilot sample (Chapters 6) and in a Randomized Controlled Trial (RCT) (chapter 7).

The objective of this master thesis was to study the relation between public green open space and health among adolescents in Uppsala municipality, Sweden. The aim of the study was to investigate if there is an association between the access to green open space in the living environment and adolescent´s health, in terms of fysical activity, self- reported health and overweight. The public health questionnaire ”Liv och Hälsa Ung 2009” provided data together with a map over public green space, where the measure taken into account is the proportion of public green space in the living environment. The study includes 3423 adolescents, 12-19 years old. The statistical results indicate that access to public green space in the living environment is genrally not correlated to the health variables studied in this thesis. The author´s interpretation is that other health determinants are more crucial to adolescent´s health than green space, parents educationlevel is sugested as one. Further research is needed to support the findings of this study. / Syftet med föreliggande studie var att undersöka om det finns samband mellan tillgång till grönområden i boendeområdet och ungas hälsa (med avseende på fysisk aktivitet, självskattad hälsa och övervikt) i Uppsala kommun. Studien utgår i från redan befintliga data genom frågeformuläret ”Liv och Hälsa Ung 2009” som riktar sig till elever i årskurs 7 och 9 i högstadiet samt årskurs 2 i gymnasiet i Uppsala län. Studien omfattar 3423 elever i åldern 12-19 år. Med utgångspunkt i enkäten samt med hjälp av en karta över Uppsala kommuns grönområden undersöks måttet andel offentlig grönyta i boendeområden i förhållande till de valda hälsovariablerna. Sammanfattningsvis uppvisar resultatet få uppmätta samband mellan tillgång till grönområden i boendeområdet och de hälsovariabler som studerats. Författarens slutsats är att andra faktorer verkar vara viktigare för ungas hälsa, som exempelvis föräldrarnas utbildningsnivå. Det behövs dock fler studier genomföras för att bekräfta studiens fynd.