INTRODUÇÃO: a introdução de esquemas antirretrovirais altamente potentes, no tratamento da Aids pode estar associada ao aparecimento de alterações metabólicas em pacientes com HIV/Aids. Além da terapia antirretroviral, outros fatores, como a dieta podem contribuir para o aparecimento dessas alterações em adolescentes com HIV/Aids. Assim, faz-se necessária a avaliação da qualidade da dieta de indivíduos dessa população. OBJETIVO: analisar a qualidade da dieta de adolescentes com HIV/Aids. MÉTODOS: Trata-se de um estudo transversal aninhado a uma coorte de pacientes com HIV/Aids atendidos pela Unidade de Infectologia do Instituto da Criança (ICr-São Paulo). Foram avaliados 88 adolescentes (10 a 19 anos). Informações sobre o histórico da doença e uso de medicamentos foram obtidas a partir de prontuários médicos. Os adolescentes responderam a dois recordatórios de 24 horas e um questionário sobre atividade física habitual. Peso, altura e circunferência da cintura foram medidos em duplicata. A qualidade da dieta foi avaliada por meio do Índice de Qualidade da Dieta (IQD-R). O IQD-R é composto de 12 itens e a pontuação final varia de 0 a 100 pontos. Foram calculados os coeficientes de correlação de Pearson entre o IQD-R e as variáveis independentes. Também foram feitas as comparações das médias do IQD-R segundo as variáveis independentes pelo teste t-Student ou Mann-Whitney. RESULTADOS: a média para o IQD-R foi 51,90 pontos (EP=0,90 pontos). Os componentes que apresentaram menores médias foram cereais integrais e sódio. Os componentes que tiveram maiores médias foram cereais totais e óleos. Adolescentes moradores de casas de apoio tiveram média maior para fruta total e menor para carnes e leguminosas, quando comparados aos adolescentes que moravam com a família. Meninas apresentaram média maior para leite e derivados e menor para calorias provenientes de gorduras sólidas, bebidas alcoólicas e açúcares adicionados quando comparadas com meninos. CONCLUSÃO: os adolescentes com HIV/Aids avaliados apresentaram padrão de consumo alimentar semelhante ao de adolescentes da população geral: alto consumo de açúcar, gordura saturada e sódio e consumo insuficiente de cereais integrais e frutas. Atenção especial deve ser dada à dieta de adolescentes com HIV/Aids, pois eles estão em maior risco de desenvolver doenças cardiovasculares ou outras doenças crônicas. / INTRODUCTION: the introduction of the highly active antiretroviral therapy in the treatment of AIDS might be associated with the emergence of metabolic disturbances in patients with HIV/AIDS. Apart from the antiretroviral therapy, other factors, such as diet may contribute to the emergence of these disturbances in adolescents with HIV/Aids. Therefore, it is necessary to evaluate diet quality of individuals from this population. OBJECTIVE: to assess diet quality among adolescents with HIV/AIDS. METHODS: in a cross-sectional study nested in a cohort of patients with HIV/AIDS treated at the Infectious Disease Unity of the Instituto da Criança (ICr-São Paulo) 88 adolescents (10 to 19 years old) were assessed. Information on disease history and use of medication were obtained from medical records. Adolescents responded to two 24-hour recalls and one questionnaire on habitual physical activity. Weight, height and waist circumference were measured twice. Diet quality was assessed by means of the Healthy Eating Index-2005 (HEI-2005). The HEI-2005 is composed of 12 items and the final score ranges from 0 to 100 points. Pearson´s correlation coefficients between the HEI-2005 and the independent variables were calculated. HEI-2005 means were also compared according to the independent variables by means of Student´s t-test or Mann-Whitney test. RESULTS: The mean for the HEI-2005 was 51.90 points (SE=0.90 points). The components with the lowest means were whole grains and sodium. The components with highest means were total grains and oils. Adolescents living in foster homes had higher mean for total fruit and lower mean for meats and beans when compared to adolescents living with their families. Girls had higher mean for milk and dairy products and lower for calories from solid fats, alcoholic beverages, and added sugars when compared to boys. CONCLUSION: Adolescents with HIV/Aids showed an eating pattern similar to the adolescents from the general population: high consumption of added sugar, saturated fat and sodium and inadequate ingestion of whole grains and fruits. Special attention should be paid to the diet of adolescents with HIV/AIDS, because they are at higher risk of developing cardiovascular and other chronic diseases.

Background: Overweight and obesity affects almost 30% of Canadian children and adolescents aged 2-17 years old which can lead to chronic disease later on in life. Research shows that healthy weight programs are effective at reducing BMI but have issues regarding recruitment and retention. One way to address these problems is by using a Social Marketing framework to determine what adolescents need in a community-based healthy weight program. Methods: Open-ended and closed-ended question surveys were conducted with multiple perspectives including youth aged 13-17 years, parents, and youth workers in Fall 2018. Open-ended question answers were a priori categorized by the ‘4Ps’ of the SM framework (Product, Price, Place, and Promotion) while frequency count data was generated for closed-ended question answers. Open-ended answer data were managed using NVivo 12 and were analyzed using Braun and Clarke’s six-step approach to thematic analysis (Braun & Clarke, 2006). Results: A ‘marketing mix’ was thematically generated to identify elements of a healthy weight program that adolescents need in order to participate from all three perspectives. Based on the findings, programs should include physical activity, nutrition, and emotional/social health components that are relevant and fun (Product). They should also emphasize benefits to participating such as improvement to physical and mental health, having fun, receiving incentives, and building relationships (Product) while minimizing barriers including emotional health concerns, lack of time, financial cost, transportation, boring programs (Price). Differences were found amongst perspectives in terms of types of incentives, transportation, and cost of program. Programs should take place in convenient, appealing, and safe locations that may already exist including schools or recreation centres (Place) and should also be promoted using social media and peer word-of-mouth or create partnerships with youth-relevant organizations and use body positive language (Promotion). Conclusion: Using this foundational work of a ‘marketing mix’ can help program developers design programs that will help recruit and retain youth in community-based healthy weight programs. Elements of social marketing were not considered in this study including competition, segmentation, and branding which further highlights the need for exploring competing behaviours in youths’ lives, different priority audience segments of BC, and brands that can be used to recruit and retain youth. / Graduate

Recent research demonstrates that new verbal memories are retained better if learning is followed by a brief period of wakeful rest. This effect is hypothesised to be the result of wakeful rest providing a state that is conducive for early-stage cellular consolidation (i.e. strengthening of specific memory traces) by protecting this process from interfering sensory input and associated encoding. The aims of this PhD project were to (i) examine whether the benefit of wakeful rest extends to the retention of complex spatial memories, and (ii) explore the effects of different cognitive states on memory consolidation. In order to address the first aim, three virtual reality spatial memory experiments were conducted. In young and older adults, wakeful rest not only enhanced the retention of complex spatial memories, but it also promoted the systems-level integration of spatial memories into accurate cognitive maps, a function, hitherto, assumed to be specific to sleep (Chapters 2-4). Pilot work also tentatively suggested that wakeful rest enhances the retention of complex spatial memories (i.e. a recently travelled route) in patients with amnestic Mild Cognitive Impairment (Chapter 4). In order to address the second aim, five experiments were run in young adults. The first experiment directly compared the effects of wakeful rest and sleep, two states that are positively associated with consolidation. Wakeful rest enhanced the retention of a list of known words, whereas a similar-length period of sleep enhanced the acquisition of novel linguistic constraints (Chapter 5). The final four experiments revealed that, similar to continuous external sensory input, internally generated autobiographical thinking activities (recalling the past and imagining the future) interfere with consolidation (Chapter 6). Together, the findings reported in this thesis reveal that wakeful rest promotes the strengthening (cellular consolidation) and wider integration (systems consolidation) of basic and complex declarative memories, and that this effect is contingent on a reduction in external sensory input as well as rich autobiographical thought.

abstract: Background: Higher intake of carbohydrates in the evening and later eating times has been associated with higher total energy intake (TEI)1-3 and higher risk of being overweight or obese.1,4 Though existing evidence indicates a link between added sugars intake and increased body mass index (BMI), the effect of daily patterns of added sugars intake on TEI and BMI is unknown. Research on added sugars has relied on self-report dietary assessments with limited days of dietary data, resulting in unreliable estimates. The purpose of this thesis was to describe patterns of added sugars consumption, and to investigate the relationship between dietary sugars, eating patterns, TEI, and BMI using 15-days of dietary data from a feeding study. Methods: 40 participants age 18 to 70 years completed a 15-d highly controlled feeding study which imitated their normal diet, while recording meal times. Meals and snacks were coded based on participant identified, time-of-day, and meal content specific criteria. All consumed foods and beverages were carefully weighed and entered into the Nutrition Data System for Research (NDSR) for analysis. Pearson correlation, independent t-test, one-way repeated measures analysis of variance (ANOVA) with post hoc tests, and multiple linear regressions were used to investigate the association between patterns of added sugars and energy intake, as well as eating frequency (EF), with TEI and BMI. Results: 15-d median added sugars intake was 9.7% of total calories. The highest contribution to added sugars intake (% of g/d) came from snacks (44%) in women and from afternoon (39%) consumption in men. The highest contribution to TEI came from dinner (30%) and afternoon (34%) consumption in women, and from lunch (31%) or dinner (30%) and afternoon (35%) consumption in men. Total eating occasion (EO) frequency had a negative association with TEI (r = -0.31) and no association with % energy from added sugars. In multivariate regression models, besides sex, % energy from beverages only (Adjusted R2 = 0.41) and % added sugars from dinner (Adjusted R2 = 0.39) were significant predictors of TEI, while none of the variables were associated with BMI. Conclusion: Changing one’s pattern of eating, (EF and % energy from beverages only and % added sugars from dinner), may reduce TEI, potentially reducing BMI. / Dissertation/Thesis / Masters Thesis Nutrition 2019

Many factors detrimental to healthy aging have been proposed including depression, stress, cognitive decline, and telomere shortening. Of specific interest are the genetic factors that may contribute to these factors and subsequently lead to accelerated telomere shortening and aging, namely the Bcl1, 5-HT, DRD2, and ApoE polymorphisms. We sought to: 1) further clarify the role of depression, stress tolerance, and cognitive decline in aging by examining the effect of associated polymorphisms (Bcl1, 5-HT, DRD2, and ApoE) on telomere length in two samples of older adults and 2) determine the difference in absolute telomere length between the two groups. We examined two samples of older adults: participants in a competitive, athletic event (N=220; mean age=66.8 years) and a sample of community-dwelling older adults (N=208; mean age=69.1 years). Participants completed a questionnaire with demographic information and provided a saliva sample. The Bcl1, 5-HT, DRD2, and ApoE polymorphisms were determined using PCR and Taqman assays. Telomere length was determined using qPCR analysis. The community-dwelling group had significantly shorter telomere lengths than the athletic group (t=-4.82, p< .0001). Additionally, for males in the athletic group, the L/S genotype of the 5-HT polymorphism was associated with longer telomere length. In males in the community-dwelling group, the GC genotype of the Bcl1 polymorphism was associated with shorter telomere length. In females in the athletic group, the GC and GG genotypes of the Bcl1 polymorphism were associated with shorter telomere length with the opposite being true for females in the community-dwelling group: the GC genotype of the Bcl1 polymorphism predicted longer telomere length. Exercising nearly everyday and the length of exercise were associated with telomere length in both groups. Our results indicate that competitive athletic activity in older age is associated with increased telomere length, longer periods of exercise at one time may contribute to longer telomere length, and the Bcl1 and 5-HT polymorphisms are associated with telomere length in older adults.

No description available.

Purpose To describe outcomes of community partnerships for promoting healthy active living among families with young children in the ReadNPlay for a Bright Future Project. Methods ReadNPlay for a Bright Future was developed through grant support from the American Academy of Pediatrics (AAP) and Metlife Foundation awarded to the East Tennessee State University Department of Pediatrics and Tennessee AAP Chapter. ReadNPlay is a coordinated, multi-level, multi-component initiative promoting healthy active living among families with young children during infant-toddler health supervision visits and in childcare and other community settings. The project site is located in rural southern Appalachia, an area of the country with a high prevalence of obesity. Materials and messages developed by the project team were finalized during a community forum with stakeholders held in Northeast Tennessee in fall 2012. Four themes emerged as a focus for the initiative: Play More: Shut off the Screen, Play Together: Be Active as a Family, Fuel to Play: Eat Healthy, and Play Safely. Partnerships with the regional children's hospital, childcare providers, health department, public libraries, and farmers' markets were supported through on-going communication via email, social media, and individual meetings. Availability of two $750 pediatric resident mini-grants and structure afforded by the residency program's existing community pediatrics rotation facilitated development and implementation of community initiatives for this project. Results Project posters displayed in community settings, use of social media, and periodic community events are reinforcing efforts to promote healthy active living in the clinical setting. A new event for families with infants/toddlers was added to the children's hospital annual Kids Run, involving over 120 families during the first year. Walk N' Rollers received free Reach Out and Read books and were surprised at the sugar content of juice and other beverages displayed in sippy cups as part of a “Sugar Quiz.” Information disseminated through regional child care centers will promote participation in a summer Walk N' Roll program in addition to this annual event. At a regional childcare provider conference, ReadNPlay workshops with over 100 infant-toddler teachers and 40 families were conducted and information on Tennessee's “Gold Sneaker” designation for compliance with state nutrition and physical activity policies was shared (only 6% of local centers are designated). During summer 2013, 75 families are being provided with $10 farmers' market vouchers at their 12-15 month well child visit to encourage consumption of fruits and vegetables. 18-month statistics on social media reach, walking program participation, new Gold Sneaker designations, and farmers' market program participation will be presented. Conclusion This presentation will illustrate how pediatric residency programs and practitioners may partner with existing community organizations and initiatives to promote healthy active living in families with young children.

Purpose To describe: (1) development of ReadNPlay for a Bright Future with community stakeholders, (2) integration of a novel communicative tool, the ReadNPlay Baby Book, into infant-toddler well child visits, and (3) use of a quality improvement approach to monitor progress in promoting healthy active living in families with young children. Methods ReadNPlay for a Bright Future is funded by a grant from the American Academy of Pediatrics (AAP) and Metlife Foundation awarded to the East Tennessee State University Department of Pediatrics and Tennessee Chapter of the AAP. The setting for this project is in rural southern Appalachia, a U.S. region with a disproportionately high prevalence of obesity. During a community forum held in Northeast Tennessee in fall 2012, community stakeholders provided feedback to help finalize project materials and messages developed by the project team around four themes: Play More: Shut off the Screen, Play Together: Be Active as a Family, Fuel to Play: Eat Healthy, and Play Safely. A behavioral health consultant (BHC) assisted with provider training in brief motivational interviewing and behavioral counseling and project implementation in the clinic. An anonymous mothers' survey was designed to identify opportunities for improving behaviors and monitor progress in promoting healthy active living during well child visits. Process measures and feedback will be obtained from provider surveys and focus groups with parents and providers. Results As of February 2013, the ReadNPlay Baby Book is being provided to families starting at the newborn visit. The book contains age-appropriate guidance and areas for parents to record their baby's growth, milestones, eating habits, favorite books, and activities between birth and 18 months. Families are receiving small incentives for bringing it to each well child visit. A companion Healthy Active Living Tips booklet encourages healthy behaviors in the whole family. Use of social media, posters, and periodic community events provide reinforcement. A total of 80 mothers with infants 9-24 months of age are completing anonymous surveys during well child visits every 4-6 months (mostly Caucasian, 70% WIC recipients). Baseline surveys with mothers of younger infants (9-12 months of age) suggest: 60% of mothers are reading or looking at books with their infants on most days of the week; 80% of infants watch at least 30 minutes of television and 48.7% drink juice on a typical day; 82% of infants were ever-breastfed; 20% of mothers had sought care for their infants due to an injury; and 13.2% of infants routinely bed-share. Over 80% of all mothers wished that they themselves could get more exercise. Conclusion ReadNPlay for a Bright Future is using novel communication tools, community partnerships, and quality improvement methodology to encourage healthy active living during infant-toddler well child visits

The purpose of this project was to identify the standards for the American Association of Critical Care Nurses (AACN). The employees of a 39-bed medical surgical unit within a 697-bed metropolitan medical center were selected through collaboration with the practicum site. Out of 68 allocated positions for this unit, only permanent employees were selected to participate. An employee presented the purpose of the project, the survey process, and inferred consent represented by online login to complete the survey. Following the online assessment, the employee explained the AACN healthy work environment standards in a subsequent presentation. The online healthy work environment assessment measured the AACN healthy work environment standards, which included skilled communication, collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership. A mean score was generated by the healthy work environment online assessment tool on a scale ranging from 1 (Needs Improvement) to 5 (Excellent). Data from the online assessment were analyzed by comparing mean pre- (3.03) and post- (2.17) project results, which revealed a need for greater understanding of AACN healthy work environment standards. Increased education of the AACN healthy work environment standards and implementation of a formal program would impact nursing turnover rates, improve employee engagement, and ultimately improve the care and outcome of patients, thereby promoting positive social change.

Hoy en día, el gobierno peruano establece normas de protección saludable para los niños con el fin de proteger su salud. Por ese motivo, la industria alimenticia y el consumidor peruano vienen cambiando sus hábitos de compras y consumo saludable, de cara a estos cambios, se ha detectado la oportunidad de ofrecer un producto alimenticio saludable y nutritivo contribuyendo a la salud de los niños peruanos. “Power Eggs” busca posicionarse en el mercado peruano en los segmentos A, B y C como un complemento nutricional, brindando a las madres de familia una alternativa de nutrición para el consumo diario de los niños. El mercado al que se apunta está conformado por 9, 485,406 de mujeres con hijos entre las edades de 2 a 12 años en la ciudad de Lima, para el cual se ha calculado un mercado target de 1,171,437 personas. Uno de los principales objetivos es alcanzar un 20% de participación sobre el target de 39,420 personas, como un crecimiento anual de 10% en los próximos 5 años. Como principal estrategia se busca posicionar un producto diferencial de apoyo a la alimentación saludable en el mercado peruano. / Today, Peruvian government establishes healthy protection norms for children in order to protect their health. For that reason, the food industry and Peruvian consumer have been changing their shopping habits and healthy consumption. Faced with these changes, it has been detected the opportunity to offer a healthy and nutritious food product contributing to the health of Peruvian children. “Power Eggs” seeks to position itself on the Peruvian market in segments A, B and C as a nutritional supplement, providing mothers with an alternative nutrition for the daily consumption of children. The market we aim for is made up of 9, 485,406 women with children between the ages of 0 to 12 years in the city of Lima, for which we have a target market of 1, 171,437 people. One of the main objectives is to reach a 20% of participation on the target, as an annual growth of 10% in the next 5 years. It main strategy is to position a differential product to support healthy eating in the peruvian market. / Trabajo de investigación