Introduction: Dementia refers to impairments of memory and other cognitive functions with consequent decline in activities of daily living. Besides cognitive symptoms, demented patients can also exhibit behavioral and psychological symptoms of dementia (BPSD), which are stressors leading to family caregivers’ burden. Physical activity may give rise to benefits in cognitive function, and may reduce behavioral symptoms and caregivers’ burden. However, most previous studies were reported from Caucasian populations. There was no previous report on the relationship of physical activity in dementia patients on family caregiver’s burden in Hong Kong Chinese older adults. Objectives: The objective of this study was to investigate the associations of physical activity level with cognitive function, behavioral and psychological symptoms and caregivers’ burden in dementia patients in Hong Kong Chinese population. Method: This was a cross-sectional study. 201 dementia patients who were screened by the inclusion and exclusion criteria were recruited from the Geriatric Clinic in Queen Mary Hospital, Hong Kong, from May 2013 to August 2013. Social demographic information and comorbid diseases information were collected from all subjects. Subjects were then assessed with the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL), Physical Activity Scale for the Elderly (PASE), as well as Neuropsychiatric Inventory (NPI). Subjects’ family caregivers were assessed with Zarit Burden Interview (ZBI). Main outcome measures: The outcome measures for the cognitive function were the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The outcome measures for BPSD and caregiver’s burden were the Neuropsychiatric Inventory (NPI) and Zarit Burden Interview (ZBI), respectively. Results: We screened a total of 239 subjects in the Geriatric Clinic of Queen Mary Hospital. 201 subjects (70 males and 131 females) were recruited. 38 participants were excluded according to the exclusion criteria. The score means (SD) of the recruited were: PASE =27.5 (23.9); ADCS-ADL=45.3 (14.5); MMSE=17.3 (5.4); MoCA=9.9 (5.3); NPI=9.5 (9.7); ZBI=33.3 (14.8). In bivariate analysis, the PASE score was significantly associated with the MMSE score (rho=0.259, p<0.001), the MoCA score (rho=0.311, p<0.001), the NPI score (rho=-0.225, p=0.001), and the ZBI score (rho=-0.253, p<0.001). In multivariate analyses, using general linear models, the PASE score was independently associated with the MMSE (F=5.57, p=0.001) and MoCA (F=7.10, p<0.001) scores, after adjusting for significant confounders in bivariate analyses (i.e. age, education and gender). The PASE was also independently associated with the NPI score (F=2.89, p=0.037). The PASE score was not an independent predictor of the ZBI score. However, the subjects’ ADCS-ADL score (F=15.65, p<0.001), and the NPI score (F=8.55, p=0.004) were independent predictors of the caregiver’s ZBI score. / published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Background: Unhealthy lifestyle are important contributors to chronic illness in Hong Kong and worldwide. Lifestyle modification, particularly improving healthy diet and physical activity, can prevent the development of various chronic illnesses, improve disease conditions, reduce the risk of complications and enhance the quality of life. Many behavioural models have been applied to achieve lifestyle modification, but the major limitation was that they mainly treated human behaviours as individual behaviours that were subsequent to rational thinking. Nudge theory, an advanced behavioral concept, proposed to change individual’s motivation, incentives and decision making through non-direct suggestion and non-forced reinforcement. However, the application of Nudge theory has been challenged on the lack of evidence to prove its effectiveness, and its controversial framework for ethical analysis. Objectives: This review was to synthesize the empirical findings about the effectiveness of using nudge theory for lifestyle modification including healthy diet and physical activity. Methodology: Interventional and experimental studies that were conducted based on Nudge theory to change diet or physical activity was identified from the published literature. The studies were divided into two large groups according to outcome measured: healthy diet and physical activity, and they were systematically synthesized. The “nudges” used in these studies were categorized as six types of “nudges” summarized by “nudge unit” as “MINDSPACE” for further discussion. The type of “nudges” that were used in the studies and their effectiveness on changing diet and physical activity was abstracted. Results: Totally, nine articles that met the inclusion criteria were included. Five nudges were identified from the included studies, including Priming (P), Default (D), Salience & Affect (SA), Incentives (I) and Messenger & Norms (MN). It is found that the strategies and methods applied on the same nudge may have different effectiveness. Seven studies applied Priming (P) as nudge to motivate change in diet, which used two major strategies: “availability” and “accessibility”. The evidence was strong that altering the availability of food presence could be effective to change food selection. The results of studies using accessibility were heterogeneous and contradictive with each other. Another three studies used different nudges including Default, Salience & Affect and Incentive. The effectiveness of Default (D) as nudge seemed to be blurry, and the sustainability remained questionable. The ethical consideration is always the primary pillar for applying nudging theory. As long as the applications are stick to necessary ethical concerns, the nudging model can be beneficial through mild “manipulation” rather than harmful. Conclusion: It has potential opportunity to carry out “libertarian paternalism” in Hong Kong. However, it is still a long way to take application of nudging model into regulation, legislation and daily practice. The evidences for each type of nudge were not consistent and enough. Besides, the monitoring and evaluation are not available yet. Future research can be focused on transferring these applications into real practice with an effective monitoring and evaluation system. / published_or_final_version / Public Health / Master / Master of Public Health

Southern Africa has the highest prevalence of Human Immunodeficiency Virus (HIV) infection in the world. With a high prevalence of HIV, as well as a rising incidence of chronic diseases of lifestyle (CDLs), South Africa is faced with the dual burden of infectious diseases and CDLs. Health promoting behaviours (HPBs), including physical activity (PA), maintaining good nutrition and taking responsibility for personal health, play an important role in managing the symptoms of HIV infection and the side effects of antiretroviral (ARV) use. Additionally HPBs improve health-related quality of life (HRQOL) in people living with HIV (PLWHIV). Furthermore, research indicates that HPBs should be encouraged among university students as they will become the future decision and policy makers in their places of employment. This study sought to determine the PA levels, HPBs and HRQOL of university students living with HIV, in order to better promote PA participation and HPBs in this population. Additionally, participants‘ perceptions of and attitudes towards exercise participation were investigated, as were barriers that mitigated against PA participation and HPBs. This study was exploratory-descriptive in nature and utilised a mixed methods design. The University Campus Health Clinic (CHC) staff recruited 29 HIV positive students (HIVPS) between the ages of 18 and 25 through purposive sampling. In the quantitative portion of the study the HIVPS completed a demographic questionnaire as well as three self-administered questionnaires, namely: the International Physical Activity Questionnaire (IPAQ), the Health-promoting Lifestyle Profile (version 2, HPLP-II) and the World Health Organisation Quality of Life Brief Questionnaire (WHOQOL-HIV-BREF) to determine PA levels, health-promoting lifestyle behaviours and HRQOL, respectively. Height and weight, as well as the most recent CD4 count were also recorded.

No description available.

The current obesity epidemic has intensified research on lifestyle interventions aimed at combating obesity and associated cardiovascular (CV) and metabolic risk. This clustering of risk factors with obesity is known as the “Metabolic Syndrome” (MS). There is now a large body of evidence detailing the ability of omega-3 fatty acids (n-3 FA) and regular moderate exercise to independently ameliorate several CV risk factors; however the combination of these interventions may be a more effective strategy in reducing CV risk than either treatment alone. This thesis describes the independent and combined effects of supplementation with docosahexaenoic acid (DHA) rich fish oil, and regular moderate exercise, on CV, metabolic and inflammatory biomarkers. Sedentary, overweight volunteers (BMI > 25kg/m2) with mild hypertension (140/90 – 160/100mmHg), elevated plasma triglycerides (TAG) (>1.6mmol/L) or elevated total cholesterol (TC) (>5.5mmol/L) were recruited in three cohorts for a 12-week intervention trial. Subjects were randomised to one of the following interventions: fish oil, fish oil and exercise, sunflower oil (placebo), sunflower oil and exercise. Subjects consumed 6 g/day of DHA-rich fish oil (26% DHA, 6% EPA; ~1.9g n-3 FA) or sunflower oil. The exercise groups walked 3 days/wk for 45 min, at 75% age-predicted maximal heart rate (HR). Outcome measures were assessed and compared across each intervention group at Weeks 0, 6 and 12, with the exception of body composition, heart rate variability (HRV) and immune functions, which were assessed at Weeks 0 and 12 only. Apart from the consumption of allocated capsules, all subjects were instructed to maintain their normal diet during the study. If not asked to exercise as part of the intervention subjects were also instructed to maintain their normal level of physical activity. Supplementation with DHA rich fish oil resulted in substantial increases in total long chain n-3 FA and DHA levels in erythrocyte membranes, accompanied by reduction of TAG, increase of high-density lipoprotein (HDL) cholesterol and reduction of superoxide production by stimulated neutrophils. Both the increase in HDL and the decrease in superoxide production were correlated with the change in erythrocyte DHA. Endothelium dependent arterial vasodilation (assessed by flow-mediated dilatation, FMD), HRV and HR response to exercise were also improved in subjects supplemented with the DHA-rich fish oil. Regular moderate intensity exercise, either alone or in addition to the DHA-rich fish oil supplementation, had no effect on these parameters, although it improved the compliance of small resistance arteries. Interestingly, however, both DHA-rich fish oil and regular exercise reduced body fat and these effects were additive when the interventions were combined. The change in fat mass was accompanied by an increase in fat oxidation during exercise, as measured by the respiratory exchange ratio. For the population as a whole, reductions in total and abdominal fat mass were associated with reductions in blood pressure. In summary, this study is the first to evaluate the metabolic and CV benefits that can be achieved by combining n-3 FA supplementation from fish oil and regular aerobic exercise in overweight/obese adults. While this combination did not produce any synergistic effects, several independent benefits were attained. The high compliance rate (>85%) within this study indicates that this intervention is well tolerated and may therefore be sustainable in the longer term. Future research should evaluate the mechanisms underlying the n-3 FA - mediated improvements in body composition. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1283720 / Thesis (PhD) -- School of Molecular and Biomedical Science, 2007

Adequate recovery from intense exercise is essential to optimise performance and reduce the associated symptoms of tiredness, fatigue and lethargy. The purpose of the study was to :- i. investigate the effects of massage and stretching in delaying the development of fatigue during repeated bouts of dynamic activity and, ii. to investigate the relative effects of massage and stretching on delayed onset muscle soreness (DOMS). Eighteen volunteer males participated in this study. They were randomly allocated into one of six groups of an Orthogonal Latin square design. Subjects performed five repetitions of as many heel raises as possible in 45 seconds. Each repetition was followed by a recovery technique of three minutes duration. This was repeated weekly until each group has had all three recovery techniques. A fatigue index % was calculated from the decline in the number of repetitions from stage 1 to stage 5. Muscle soreness ratings were retrospectively assessed at 12-36 hour after each session. An analysis of variance showed a significant difference in the fatigue indices. Post hoc intergroup comparison using paired T-tests with the Bonferroni adjustment showed a significant difference between rest and massage (p=0.0001) and rest and stretching (p=0.0006). The differences between massage and stretching were not significant. Fourteen (77.8%) and Fifteen (83.3%) subjects showed an improvement in performance following massage and stretching respectively. Massage is associated with significantly less muscle soreness than stretching (p<0,001). DOMS was most frequently found in the stretching group while the lowest incidence and lowest mean ratings of muscle soreness associated with DOMS was found in the massage group. The difference between massage and stretching was marginal (p=046I) and showed a trend that massage is associated with less DOMS than stretching. This suggests that rest is the least beneficial recovery technique, and that massage may be superior to stretching as there is less muscle soreness. / Thesis (M.Med.Sc.)-University of Natal, 1997.

The effects of pre-stroke exercise and levesl of brain-derived neurotrophic factor (BDNF) on behavioural and functional recovery were examined following focal cortical ischemic infarct. Intracortical microstimulation (ICMS) was used to derive topographical maps of forelimb representations within the motor cortex and ischemia was induced via bipolar coagulation of surface vasculature. One month of excerise prior to ischemia significantly increased the amount of peri-infarct movement represnetations and initiates vascular changes within motor cortex. Further, this exercise-induced preservation of peri-infarct movement representations is associated with behavioural recovery and is dependent on BDNF levels in the motor cortex. These results provide further support for the idea that endurance exercise prior to stroke may enhance functional and behavioural recovery. / 140 leaves : ill. (some col.) ; 29 cm.

The main goal of this study was to evaluate the utility of physical activity (PA) measurement in an Inuit population with a self-administered questionnaire. The objective was to validate a culturally relevant physical activity questionnaire that measures Inuit PA levels. To do this, the International Physical Activity Questionnaire (IPAQ) was evaluated against the Caltrac accelerometer and anthropometric/physiologic measurements. / There were a number of compliance problems encountered when implementing the Caltrac in the pilot community which resulted in too few Caltrac scores available for analyses. However, IPAQ PA score (N=44) was significantly inversely related to Body Mass Index (p≤0.05) and positively related to high-density lipoprotein cholesterol (p≤0.03). / The results indicate that the IPAQ has potential but needs further refinements to be acceptable to Inuit populations and needs re-evaluation in a larger sample. The participants found it very difficult to remember the time spent performing each activity and, in general, the IPAQ was not well received.

Thesis (MTech (Education))--Cape Peninsula University of Technology, 2010. / This research investigates the influence of a 12 week holistic fitness programme on learner attitudes in three multi-grade schools in the Wellington area of the Western Cape. A sample of 38 (N= 21 males and N=17 females), grade 4 multi-grade learners participated in the study. The study also tests whether an evaluation model as applied in this research: a) Can give insight into how to develop a fitness programme and assist to refine and improve such a program; b) Assists, through evaluation and attitudinal evaluation questionnaires to identify the various components of a fitness programme that can be modified to optimise the outcomes of the programme. It was found that the structure provided by the holistic fitness programme encouraged in significant positive attitudes toward all seven sub-domains of the CATPA inventory. It is concluded that the participation in a structured fitness programme is confidently associated with the development of more positive attitudes.

The association between increased participation in physical activity (PA) and improvements in health is so well established that the promotion of regular participation in PA is a key public health priority. However, much remains to be explored about the dose-response relationship between PA and the many health benefits. To address this issue, there is a need to accurately measure PA across all population sub-groups. Finding a valid, reliable and sensitive measure of PA is essential for improving our understanding of PA-related disorders, for more clearly defining the dose-response relationship between the volume, intensity and pattern of PA and the associated health benefits, and to examine the effectiveness of interventions and public health initiatives. We conducted three exercise studies aimed at examining the associations between a novel indexof exercise volume and selected physiological and psychological outcomes. The first and second studies were secondary analyses of studies in which the validity of this index was assessed in two different exercise interventions: 12-weeks of moderate-intensity aerobic exercise and a 6-week high intensity interval training intervention. The third study was a prospective randomized controlled trial testing the feasibility and practicality of this index as applied to a specific population in an at-home exercise intervention. Taken as a whole, the results from the three studies indicate that the novel method of measuring exercise volume is promising for tracking some of the biological and psychological benefits that are associated with exercise. In these studies, this novel index of exercise volume was significantly associated with specific markers of biological adaptation to exercise training that are clinically meaningful. Further research is needed to replicate these findings in larger, diverse samples, and to broaden our understanding of how applications of this novel index can expand our ability to illuminate mechanisms whereby exercise might improve physical and mental health in research and in practice.