Failure to comply with prescribed regimens is a major reason for the failure of treatment programs. This study investigated factors which are related to compliance with prescribed diet revision therapy for food allergies in school-aged children. Forty-five children, aged 6 to 12 years, who were under a physician's care for food allergies, formed the sample. The Health Belief Model was used as the basis for a questionnaire devised to measure these factors. The development of the Diet Revision Therapy Parent Questionnaire involved a pilot test and revisions; the resulting instrument consists of 38 items organized into 4 subtests, of which one 7-item subtest is to be considered optional. The 38-item DRTPQ has a full scale internal consistency reliability of .87, and a composite reliability of .61 for the four subscales. The canonical correlation between 3 types of subjective ratings of compliance and the 4 subtests is .80, with 64% shared variance between these sets of variables. A discriminant function of 3 subtests of the DRTPQ proved capable of discriminating diet therapy dropouts from continuing subjects with 88.9% accuracy. These three subtests measured: 1. Parent and family life factors, such as the amount of perceived interference in normal routines, 2. Child's attitudes to the treatment and his/her normal behavior with respect to cooperation with parental demands, and 3. Belief in the benefits to be derived from the treatment. A fourth category of items measured perceived severity of the condition and perceived susceptibility to illness but proved not to predict compliance in this sample, although it may be useful in clinical practice. Suggestions for interventions to aid compliance are outlined. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

by Annie Chi Kwan Lam. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves 112-119). / Abstracts in English and Chinese ; questionnaires also in Chinese. / Acknowledgements --- p.i / Abstract --- p.ii-vi / List of Figures --- p.vii / List of Tables --- p.vii-x / List of Abbreviations --- p.xi / Table of Contents --- p.xii-xvi / Chapter Chapter One: --- Background / Chapter 1.1 --- Diabetes Mellitus: A public health burden / Chapter 1.1.1 --- Definition and Health Consequences --- p.2 / Chapter 1.1.2 --- Prevalence of Type 2 Diabetes Mellitus in Asia --- p.3 / Chapter 1.1.3 --- Prevalence of Type 2 Diabetes Mellitus in the Hong Kong Chinese Population --- p.4 / Chapter 1.1.4 --- Medical Burden of Diabetes Mellitus in Hong Kong --- p.7 / Chapter 1.2 --- Clinical Intervention To Improve Glycemic Control / Chapter 1.2.1 --- The United Kingdom Prospective Studies (UKPDS) --- p.8 / Chapter 1.2.2 --- The Diabetes and Complications Trial (DCCT) --- p.9 / Chapter 1.2.3 --- Another Clinical Trial of Lifestyle Intervention --- p.10 / Chapter 1.2.4 --- Physical Activity in Diabetes Management --- p.12 / Chapter 1.3 --- Dietetic Situation in Hong Kong / Chapter 1.3.1 --- Survey of the Hong Kong Dietetics Situation --- p.15 / Chapter 1.3.2 --- Current Situation of Prince of Wales Hospital --- p.17 / Chapter 1.3.3 --- Diabetes Knowledge and Compliance Level in Hong Kong Patients --- p.22 / Chapter 1.4 --- Medical Nutrition Therapy and Practice Guidelines / Chapter 1.4.1 --- Definition --- p.24 / Chapter 1.4.2 --- Development of the Practice Guidelines --- p.24 / Chapter 1.4.3 --- Recommended Procedure for the Practice Guidelines in Type 2 Diabetic Patients --- p.28 / Chapter 1.5 --- Study Purpose and Objectives --- p.32 / Chapter Chapter Two: --- Study Design and Method / Chapter 2.1 --- Research Design --- p.34 / Chapter 2.2 --- Sample Selection --- p.34 / Chapter 2.2.1 --- Method of Randomization --- p.35 / Chapter 2.2.2 --- Sample Size Calculation --- p.36 / Chapter 2.2.3 --- Inclusion Criteria --- p.37 / Chapter 2.2.4 --- Exclusion Criteria --- p.38 / Chapter 2.3 --- Summary of Patient Procedure --- p.38 / Chapter 2.3.1 --- Definition Of The Two Treatments --- p.41 / Chapter 2.3.2 --- Research Procedure For PGC Group --- p.43 / Chapter 2.3.3 --- Research Procedure For CC Group --- p.49 / Chapter 2.4 --- Outcome Measures / Chapter 2.4.1 --- Anthropometrics Variable --- p.50 / Chapter 2.4.2 --- Laboratory Data --- p.51 / Chapter 2.4.3 --- Pre-testing For Questionnaires --- p.51 / Chapter 2.4.4 --- Dietary Variables --- p.52 / Chapter 2.4.5 --- Measurement of Diabetes Knowledge --- p.53 / Chapter 2.4.6 --- Measurement of Barriers To Diet Compliance --- p.54 / Chapter 2.4.7 --- Measurement of Physical Activity --- p.54 / Chapter 2.4.8 --- Measurement of Barriers To Exercise Compliance --- p.54 / Chapter 2.4.9 --- Measurement of Overall Compliance in MNT --- p.55 / Chapter 2.5 --- Statistical Analysis --- p.57 / Chapter 2.6 --- Ethics --- p.58 / Chapter Chapter Three: --- Results / Chapter 3.1 --- Subjects and Response Rate --- p.60 / Chapter 3.1.1 --- Baseline Characteristics of the PGC and CC Group --- p.61 / Chapter 3.2 --- Results of Intervention Process Between PGC and CC Group / Chapter 3.2.1 --- Attendance Rate --- p.67 / Chapter 3.2.2 --- Total Patient-Dietitian Contact Time --- p.67 / Chapter 3.2.3 --- Satisfaction With Dietetic Services --- p.68 / Chapter 3.2.4 --- Other Alternatives Treatment --- p.69 / Chapter 3.2.5 --- Changes In Medical Therapy After Intervention --- p.69 / Chapter 3.2.6 --- Hospital Admission --- p.71 / Chapter 3.3 --- Outcomes - Questionnaires Results Between PGC and CC Group / Chapter 3.3.1 --- Food Frequency Questionnaire --- p.72 / Chapter 3.3.2 --- Physical Activity Questionnaire --- p.72 / Chapter 3.3.3 --- Diabetes Knowledge --- p.72 / Chapter 3.3.4 --- Barrier To Diet Compliance --- p.72 / Chapter 3.3.5 --- Barrier To Exercise Compliance --- p.73 / Chapter 3.3.6 --- Overall Medical Nutrition Therapy Compliance --- p.78 / Chapter 3.4 --- Outcomes - Anthropometry Results Between PGC and CC Group --- p.79 / Chapter 3.5 --- Outcomes - Laboratory Results Between PGC and CC Group / Chapter 3.5.1 --- Glycemic Control --- p.83 / Chapter 3.5.2 --- Lipid --- p.84 / Chapter Chapter four: --- Discussion and Conclusion / Chapter 4.1 --- Enrollment / Chapter 4.1.1 --- Response Rates --- p.91 / Chapter 4.1.2 --- Behavior Change Model --- p.92 / Chapter 4.1.3 --- Participation of Subjects --- p.93 / Chapter 4.1.4 --- Randomization --- p.93 / Chapter 4.2 --- Measurements / Chapter 4.2.1 --- Questionnaire --- p.94 / Chapter 4.2.2 --- Blinding Process --- p.94 / Chapter 4.2.3 --- Laboratory --- p.94 / Chapter 4.3 --- Outcomes / Chapter 4.3.1 --- Questionnaire Outcomes --- p.95 / Chapter 4.3.2 --- Anthropometry Outcomes --- p.100 / Chapter 4.3.3 --- Glycemic Outcomes --- p.102 / Chapter 4.3.4 --- MNT Process Outcomes --- p.103 / Chapter 4.3.5 --- Limitations --- p.104 / Chapter 4.4 --- Clinical Significance and Implications --- p.104 / Chapter 4.5 --- Conclusions and Recommendations --- p.110 / References --- p.112 / Appendices --- p.120

Dietetic professionals integrate knowledge and expertise in food, nutrition, management and people and apply their skills in a variety of settings. As the changing scene in health care has necessitated enhanced management of resources, the clinical nutrition manager (CNM) has emerged as a dietetic professional in hospitals applying sound management practices to the area of clinical nutrition services. The purpose of this study was to provide information about the position of clinical nutrition manager and about the professional development strategies used by incumbents. The research design had two phases. The purpose of the first phase was to develop a job description for the position of clinical nutrition manager, including duties/activities and job specifications for education, experience and professional credentialing. The purpose of the second phase was to verify the accuracy of the job description, determine educational and experiential resources used to develop the required skills and knowledge for performing the duties/activities, and collect other descriptive data about the position. The result was a job description for a Clinical Nutrition Manager with 46 duties/activities assigned to the position and job specifications for work experience and academic preparation. Chi square analysis was used to test the association of the performance of a duty/activity with amount of time allotted to the position; number of personnel supervised; and type of personnel supervised. Results indicated that type of personnel supervised had the most significant association. One sample chi square analysis indicated that entry-level education and entry-level experience were the less likely resources to be used for development of skills and knowledge. For more than 50% of the duties/activities, the number of resources used was significantly related to the perceived level of importance. There was no significant finding for an association between timing of career decision to become a CNM and career development strategies intentionally selected. Findings also indicated that perceived competence improves with increasing number of years in the position and is not affected by having an advanced degree. / Graduation date: 1992

A new, Internet-based Food Recall Checklist (FoRC) was developed to assess students diet; a checklist of 121 foods consumed on the previous day which was completed on multiple days.  FoRC was validated against a non-weighted diet record in two studies (n=94).  Novel feedback messages for students were created and software was developed to link these messages to results from individual dietary assessment in FoRC.  An intervention trial was planned to measure students’ diet and to deliver tailored nutrition messages via the Internet, to assess whether tailored dietary feedback could help to promote healthy diet change. General dietary intake of the sample was analysed using one-day diet records from 459 undergraduate students.  The dietary intake of the sample of students was found to be healthier than participants aged 19-24 years in the UK-wide National Diet and Nutrition Survey.  However, there was evidence of poor dietary habits; Non-Milk Extrinsic Sugars (NMES) intake exceeded the maximum daily guideline intake and fruit and vegetable and Non-Starch Polysaccharide intakes did not meet recommendations. There was also evidence of excessive consumption of unhealthy foods, such as alcohol, crisps and confectionary. Change in dietary intake was assessed in an <i>intervention </i>group and <i>control </i>group.  The <i>intervention </i>group received feedback after baseline, three and six month completion of four days of FoRC.  The retention rate was very low, but in participants who completed the protocol NMES intake significantly decreased in the <i>intervention </i>group at six  months compared to the <i>control </i>group (p=0.017). It was concluded that monitoring diet in students may still be an important public health objective; students may be relatively healthy, but may still benefit from nutrition surveillance and advice.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

A dissertation submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg for the degree of Master of Science. / In this dissertation I examine the effects of a long term (one month) and a short term (two week) very low energy diet of 3347 kl/d (800 kcal/d) on body weight, body composition, cardiac function, nutritional and hormonal status, psychological variables and sleep and temperature variables. In both investigations, data were collected 28 days apart to control for menstrual cycle differences. (Abbreviation abstract). / Andrew Chakane 2018

Two hundred non-insulin dependent diabetic patients, predominantly from three health facilities in Lahore, Pakistan were assessed for metabolic control, weight status, diabetes knowledge, and six areas of diabetes self-care activities as well as dietary intake. A questionnaire was administered in an interview format followed by a 24-hour recall of dietary intake. Glycosylated haemoglobin status were determined on ninety subjects. The care levels appear to be inadequate for satisfactory diabetes control. Only 5 subjects had HbA1c levels within the normal range, while 21 showed extremely high levels. Complications and associated medical conditions were present in more than half of the sample. Diabetes knowledge averaged 4 correct responses out of a total of 11. Considerable variation was noted in the reported care regimens including the dietary regimen. Analysis revealed a number of areas of concern including high fat intake and a low intake of leafy vegetables, pulses and fruit which along with nutrient analysis results suggests a low fibre intake. The data points towards the need for improved diabetes education at all levels and identifies several areas of concern to be address / Master of Science (Hons)

Title from PDF of title page (University of Missouri--Columbia, viewed on Feb 16, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Dissertation advisor: Dr. Kent S. Gates. Vita. Includes bibliographical references.

Second only to lung cancer, breast is the leading type of cancer among women in the US. Despite all the medical advances over the past few decades, toxicity and increased resistance to standard drug therapy still remains a significant problem. The heterogeneic nature of all cancers has led to a shift in treatment approaches, in that more research is being carried out with combination treatments in the hope that a multidirectional targeting of cancer will be far more effective than the current single treatment options. Our goal was to gain a better understanding of the molecular mechanisms of a nonhydrolyzable ether analog of RRR-[alpha]-tocopherol, 2, 5, 7, 8-tetramethyl-2R-(4R, 8R, 12-trimethyltridecyl)chroman-6-yloxyacetic acid (abbreviated [alpha] -TEA), and to investigate its efficacy when used in combination with known chemotherapeutics 9-nitro-camptothecin (9NC), and Paclitaxel (Taxol). The data presented here looks encouraging as it shows a clinically relevant delivery method using [alpha]-TEA and 9NC has the unique ability to reduce primary tumor burden as well as macro and micrometastatic lung and lymph node lesions in an aggressive syngeneic mouse mammary model, while displaying no obvious toxic side effects. The effect of combination treatments on tumor volume appears in part to be moderated by an increase in tumor cell apoptosis and a decrease in tumor cellular proliferation. Next, the intricate molecular mechanism of how [alpha]-TEA alone and in combination with 9NC is able to induce apoptosis in 66cl-4-GFP murine mammary cancer was investigated. The data suggest that the signaling pathway that ultimately leads to apoptosis is caspase dependent, is able to upregulate pro-death players while at the same time downregulate pro-survival proteins such as c-Flip and survivin. Finally, we investigated the efficacy of [alpha]-TEA used in an allograft mouse model following treatment with Taxol. Combination treatments were able to significantly reduce primary tumor burden, decrease lung and lymph node micrometastases, tumor cell proliferation, tumor blood vessel density as well as increase tumor cell apoptosis. Based on the results presented, we propose that [alpha]-TEA when used alone and in combination is an effective, non-toxic option for cancer treatment which warrants further investigation. / text

Background: Despite growing utilization of mobile phones and websites for consumers seeking health care advice, the area is largely understudied. A niche market for these applications is in diabetes care. Since diabetes is a chronic condition requiring daily monitoring it is a good candidate for consumer health informatics and especially interactive websites and mobile phone applications. As the obesity epidemic continues, so too the prevalence of type 2 diabetes continues to rise. This chronic condition can lead to major complications and high medical cost. It is on the rise in countries all over the world, and beginning to impact people at younger ages. Low cost interventions are being explored to mitigate these complications and cost. Objective: To examine the effectiveness of consumer health informatics, such as websites, personal digital assistants, and mobile phone applications that claim to help people with diabetes self-monitor diet and exercise behaviours to lose weight. Methods: A search for relevant literature was conducted using PUBMED, Cochrane, and IEEE Xplore, with the search terms: (mhealth OR mobile health OR phone OR web* OR ehealth OR internet OR ICT) AND diabetes AND (diet* OR exercise OR physical activity). Also, a bibliographic search was done to identify any studies that were missed in the initial search. The search was not limited to any date range, but articles were identified from the time period of September 2000 through April 2012. Only articles in English were included. Studies were included if the program included an interactive logging feature for diet and/or physical activity. Studies that looked at type 1 disbetes were excluded. Results: A total of 10 original studies were found that met the inclusion criteria. Including 2 qualitative design, 1 randomized trial, and 7 randomized control trials. There was a great deal of heterogeneity among the studies. Delivery methods varies, studies including the following are: *  Mobile device only: 3 *  Website only: 6 *  Website plus mobile device: 1 Many different outcome measures were used across the studies including: behavioural, physiological, psychosocial, as well as usability and satisfaction. Overall, adherence and follow up were low. Dietary tracking generally appears not to be as effective as broad goals such as, “each more fruits and vegetables”. Exercise tracking was more effective at increasing physical activity. Message boards and peer support did not show an increase in effectiveness, but personal online coaches and personalized emails showed promising results. Usability and satisfaction was high in those that reported it, but the large number of dropouts are not considered in this. Conclusions: At this time, consumer health informatics does not seem to be an effective solution in facilitating significant behavior change for people who have type 2 diabetes. Future programs should look at ways to increase adherence and usage of the programs because the people who did use the programs daily benefited more than sporadic users. Components that showed promising results are access to a personal online coach, personalized weekly emails, integration with a pedometer that automatically uploads to a tracking program, and broader food related goals. Further testing is necessary to determine if this type of intervention is effective. / published_or_final_version / Public Health / Master / Master of Public Health