Master of Regional and Community Planning / Department of Landscape Architecture/Regional and Community Planning / Claude A. Keithley / This report examines what planners can do to increase healthy lifestyles within their communities by presenting development recommendations. In the beginning of the twentieth century the discipline of city planning was dedicated to stopping the spread of infectious diseases through improved sanitation and housing. Over the years planning separated from its origins in public health. Mobility and increased technology began to drive community development and planning, and our society created environments that devalue healthy lifestyles. A wide array of activities contribute to healthy lifestyles. Five characteristics have been shown to be the most promising in promoting health. They are regular physical activity, maintaining a healthy weight, moderate alcohol consumption, not smoking, and a prudent diet. To achieve its purpose this report will explore the prevalence of adhering to healthy lifestyle characteristics and recount a brief history of community development that has contributed to decreased healthy lifestyle adherence. Through the review of past destructive practices and current initiatives to create healthy communities, a guide to community development for healthy lifestyles is laid out. This guide will allow communities to determine their location in the process of becoming a health conscious community and give them recommendations about what they can do to promote health.

Background: Xerostomia is the subjective feeling of dry mouth and the state is because of its multifactorial character often limited to treating the symptoms that occurs instead of the causal factors. Xerostomia is a state which may affect both the oral and general health and can therefore have a negative impact on the individuals quality of life. Xerostomia was earlier defined as a state that affected old or sick people but investigations have lately showed that xerostomia also is prevalent in young healthy subjects. Aim: The aim of this study was to investigate the prevalence of xerostomia and potential risk factors in students at School of Health Sciences in Jönköping. Methods: Students from four education programs at School of Health Sciences was asked to participate and fill out a questionnaire including background variables, standard questions of dry mouth and Xerostomia Inventory. Result: Xerostomia was found in 20% of the subjects. These had higher scores on Xerostomia Inventory compared to the subjects without xerostomia. The difference was statistically significant (p≤0,05). Conclusion: Xerostomia is a state that is prevalent in young, healthy subjects and though the state is idiopathic further investigation about its prevalence and the causal factors are needed. / Bakgrund: Xerostomi innebär subjektiv muntorrhet och då tillståndet är av multifaktoriell karaktär begränsas behandling ofta till att lindra individens besvär och symtom. Xerostomi är ett tillstånd som påverkar både individens orala och generella hälsa negativt vilket även kan leda till en nedsatt livskvalitet. Xerostomi betraktades tidigare som ett tillstånd som drabbar äldre och sjuka men senare studier har funnit en förekomst även hos unga friska individer. Syfte: Syftet var att kartlägga prevalens samt möjliga orsaksfaktorer till xerostomi hos studenter på Hälsohögskolan i Jönköping. Metod: Individer som studerade fjärde terminen vid fyra av Hälsohögskolans totalt åtta utbildningsprogram tillfrågades om att besvara en enkät som omfattade bakgrundsvariabler, standardfrågor om muntorrhet samt Xerostomia Inventory. Resultat: Studien påvisade en förekomst av xerostomi hos 20 % av studenterna. Individer med xerostomi uppvisade högre poäng på Xerostomia Inventory än individer utan xerostomi Skillnaden var statistiskt signifikant (p≤0,05). Slutsats: Xerostomi är ett tillstånd som förekommer hos unga friska individer och då tillståndet är idiopatiskt är det angeläget att fortsätta utreda dess förekomst samt potentiella orsaksfaktorer.

Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The quest for enhancement has been part of human culture for thousands of years. Progress in scientific developments and especially in the field of medical science has allowed for previously unthinkable advances to be employed in the endeavours to improve human functioning in its various forms. Whereas in the past, enhancement has been focused on aspects such as prolonging life, improving the immune system or cosmetic enhancements, cognitive enhancement is receiving substantial attention at the moment. Recent reports have commented on the use of stimulants such as methylphenidate, especially amongst students at tertiary institutions with the aim of enhancing cognitive abilities. This raises various concerns, ranging from safety issues and the risk of drug abuse to the moral issues relating to enhancement in the broader context. Enhancement therapies are easily justified where the required enhancement is needed to improve functioning where a specific deficit is present or where such enhancement could prevent illness. But where no illness or disorder is present, these issues cause marked ambivalence amongst medical practitioners. The legal restrictions placed on the access to stimulants require the participation of a doctor as these drugs may not be sold across the counter and a prescription is needed to acquire them. The doctor is then put in the position where a request is made for medication where illness or a disorder is not present. Medical paternalism could easily dictate that the decision does lie with the doctor because of statutory rules, but this would be at the risk of ignoring the possible rights of students to enhance. This thesis examines the concerns mentioned related to safety risks as well as the abuse potential of methylphenidate. Although there are precautions that need to be taken into account when prescribing methylphenidate, this is not sufficient to warrant a blanket refusal by medical practitioners to prescribe it to healthy students. The arguments used to debate both the promotion of enhancement therapies as well as the reasons for restricting and possibly even preventing any use thereof, are discussed. There are various reasons why enhancement may be needed in current and future society and to ignore these would raise moral issues in itself. There are various arguments used to disapprove of enhancement, but this thesis concludes that although the concerns raised should be considered on an ongoing basis, as enhancement is an ongoing process, enhancement should be allowed to continue to be explored and employed where appropriate. Finally, potential guidelines for the individual and also for tertiary institutions relating to enhancement, especially relating to cognitive enhancement with stimulants such as methylphenidate, are proposed. / AFRIKAANSE OPSOMMING: Die soeke na verbetering is reeds vir duisende jare deel van die menslike kultuur. Vordering in wetenskaplike ontwikkelings en veral op die gebied van die mediese wetenskap het toegelaat dat voorheen ondenkbare vooruitgang toegepas kan word in die pogings om menslike funksionering in sy verskillende vorme te verbeter. In die verlede het verbeteringstegnieke merendeels gefokus op aspekte soos verlenging van lewe, die verbetering van die immuunstelsel of kosmetiese verbeterings, maar tans geniet kognitiewe verbetering aansienlike aandag. Onlangse verslae lewer veral kommentaar oor die gebruik van stimulante soos metielfenidaat, veral onder studente by tersiêre instellings, met die doel om die verbetering van kognitiewe vermoëns teweeg te bring. Dit lei tot verskeie bekommernisse, wat wissel van veiligheidskwessies en die risiko van dwelmmisbruik tot die morele kwessies met betrekking tot verbeteringstegnieke in die breër konteks. Terapieë gemik op verbetering is maklik geregverdig waar die verbetering nodig is om funksionering te verbeter, waar 'n spesifieke tekort teenwoordig is of waar so' n verbetering 'n siekte kan voorkom. Maar waar daar geen siekte of afwyking teenwoordig is nie, veroorsaak hierdie terapieë beduidende ambivalensie onder mediese praktisyns. Die wetlike beperkings wat geplaas is op die beskikbaarheid van stimulante vereis die betrokkenheid van 'n dokter aangesien hierdie middels nie oor die toonbank verkoop mag word nie en 'n voorskrif nodig is om dit te bekom. Die dokter word dan in die posisie geplaas waar daar 'n versoek is vir medikasie waar siekte of 'n versteuring nie teenwoordig is nie. Mediese paternalisme kan maklik dikteer dat die besluit suiwer as gevolg van statutêre reëls wel alleen by die dokter lê, maar die risiko bestaan dan dat die regte van studente om hulself te verbeter ignoreer word. Hierdie tesis ondersoek die potensiële probleme met betrekking tot die veiligheidsrisiko's sowel as die misbruikpotensiaal van metielfenidaat. Alhoewel daar voorsorgmaatreëls in ag geneem moet word wanneer die voorskryf van metielfenidaat oorweeg word, is dit nie voldoende om 'n totale weiering deur geneeshere om dit voor te skryf aan gesonde studente te regverdig nie. Die argumente wat gebruik word om sowel die bevordering van die verbeteringsterapieë as die redes vir die beperking en moontlik selfs die voorkoming van enige gebruik daarvan te debatteer, word bespreek. Daar is verskeie redes waarom verbetering in die huidige en toekomstige samelewing nodig is en om dit te ignoreer sou op sigself morele beswarte opper. Daar is wel verskeie argumente wat gebruik kan word om verbetering af te keur, maar hierdie tesis wys daarop dat hoewel die kommer wat geopper word in ag geneem moet word op 'n deurlopende basis, aangesien verbeteringstegnieke ‘n voortdurende proses is, bevordering van hierdie terapieë toegelaat moet word en waar toepaslik in diens geneem moet word. Ten slotte word moontlike riglyne vir die individu en ook vir tersiêre instellings met betrekking tot verbetering, veral met betrekking tot kognitiewe verbetering met stimulante soos metielfenidaat, voorgestel.

Ohälsosamma levnadsvanor så som dålig kost och brist på fysisk aktivitet leder till övervikt och fetma hos barn och ungdomar idag. För att inte de ohälsosamma levnadsvanorna ska ge framtida komplikationer är det viktigt att se till att barn och ungdomar får den hjälp de behöver för att motiveras till en beteendeförändring så tidigt som möjligt. Motiverande samtal (MI) är en samtalsmetod för att få individer motiverade till en förändring. Denna studie kommer att fokusera på just hälsosamma levnadsvanor. Olika hälso- och sjukvårds professioners använder motiverande samtal som metod för att stödja en beteendeförändring hos överviktiga ungdomar. Därutifrån har syftet till denna studie skapats vilket är att undersöka professionernas upplevelser av hur metoden fungerar på barn och ungdomar med övervikt. Studien har en kvalitativ insats som inkluderade intervjuer med sex stycken professioner. Intervjuerna spelades in och analyserades. Resultatet av studien visade att professionerna upplevde MI som en mycket positiv och användbar samtalsmetod och att kontinuitet behövdes för att upprätthålla kunskapen. Möjligheterna med att använda MI menar de professionella är att de ofta kan se en positiv förändring hos patientens beteende samt att de ser positivt på användningen av MI i framtiden. Författaren anser att det är viktigt att fortsätta utbilda personal som jobbar med människor inom MI då samhället troligtvis kan “spara” både pengar och tid hos personalen genom att använda MI i exempelvis primärvården. / The unhealthy lifestyles such as poor diets and lack of physical activity can lead to overweight and obesity for children and adolescents today. To not have the unhealthy lifestyles lead to future complications it’s important to give them the help and support they need to get motivated to change theirs behavior. Motivational interviewing (MI) is a method to help people change their behavior, this study will focus on a healthy lifestyle changes. A profession in healthcare uses the MI as a method to support the lifestyle change for children and adolescents with obesity. The purpose of this study is to examine what the professions experiences is concerning how the method works with children and adolescents with overweight. This study has used a qualitative method with six interviews. The interviews were recorded and analyzed. The result of this study showed that professions experiences MI as a very positive and useful method, also that the professions needed to use the method continuity to maintain the knowledge. The potential of MI as a method was that the professions often could see a positive change in the patient and the respondent had a positive view in using MI in the future. The author of this study believes that it’s incredibly important to keep working with MI as it probably can "save" money both for society and the work hours for professions in healthcare.

Cathepsin S is a protease important in major histocompatibility complex (MHC) class II antigen presentation and also in degrading the extracellular matrix. Studies, most of them experimental, have shown that cathepsin S is involved in different pathological conditions such as obesity, inflammation, atherosclerosis, diabetes, and cancer.    The overall hypothesis of this report is that high levels of circulating cathepsin S, is a biomarker that reflects pathology induced by inflammation and obesity. The overall aim of this report was to investigate possible associations between circulating cathepsin S, inflammation, glucometabolic disturbance, and its associated diseases in the community. As cathepsin S appears to be a novel risk marker for several pathological conditions, we also wanted to examine the effect of dietary intervention on circulating cathepsin S concentrations.    This thesis is based on data from three community-based cohorts, the Uppsala longitudinal study of adult men (ULSAM), the prospective investigation of the vasculature in Uppsala seniors (PIVUS), and a post-hoc study from the randomized controlled NORDIET trial.    In the first study, we identified a cross-sectional positive association between serum cathepsin S and two markers of cytokine-mediated inflammation, CRP and IL-6. These associations were similar in non-obese individuals. In longitudinal analyses, higher cathepsin S at baseline was associated with higher CRP and IL-6 levels after six years of follow-up. In the second study, we identified a cross-sectional association between increased serum levels of cathepsin S and reduced insulin sensitivity. These associations were similar in non-obese individuals. No significant association was observed between cathepsin S and insulin secretion. In longitudinal analysis, higher cathepsin S levels were associated with an increased risk of developing diabetes during the six-year follow-up. In the third study, we found that higher serum levels of cathepsin S were associated with increased mortality risk. Moreover, in the ULSAM cohort, serum cathepsin S was independently associated with cause-specific mortality from cardiovascular disease and cancer. In the fourth study, we identified that adherence to an ad libitum healthy Nordic diet for 6 weeks slightly decreased the levels of plasma cathepsin S in normal or marginally overweight individuals, relative to the control group. Changes in circulating cathepsin S concentrations were correlated with changes in body weight, LDL-C, and total cholesterol.    Conclusion: This thesis shows that circulating cathepsin S is a biomarker that independently reflects inflammation, insulin resistance, the risk of developing diabetes, and mortality risk. Furthermore, a Nordic diet moderately reduced cathepsin S levels in normal-weight and overweight men and women. This effect may be partially mediated by diet-induced weight loss and possibly by reduced LDL-C concentrations.

2 pp. / This publication provides active children and their parents information about the role protein plays in their sports nutrition diet and how to choose healthy foods to meet the protein needs of growing active children.

2 pp. / This publication gives active children and their parents ideas on how to choose everyday healthy snack choices to fuel them during sports.

2 pp. / [Healthy Fats -- Guide for Improving the Quality of Fat Intake] / The fact sheet reviews healthy fats and how to incorporate a healthy amount of fat into our diet. Fats are necessary for our bodies to function properly. In fact, fats are an important part of a healthy diet and we can't live without them. Fats can be grouped into two groups: saturated and unsaturated. Unsaturated fats include polyunsaturated and monounsaturated fats. Both these fats, when eaten in moderation and used in place of saturated and trans fats, can help lower cholesterol levels and decrease the risk of heart disease. We provide a list of "Do's" and "Tips" which gives examples of how to select fats wisely and incorporate healthy changes into our diet. We also provide a guide for selecting an appropriate portion size of fat.

2 pp. / The fact sheet reviews healthy fats and how to incorporate a healthy amount of fat into our diet. Fats are necessary for our bodies to function properly. In fact, fats are an important part of a healthy diet and we can't live without them. Fats can be grouped into two groups: saturated and unsaturated. Unsaturated fats include polyunsaturated and monounsaturated fats. Both these fats, when eaten in moderation and used in place of saturated and trans fats, can help lower cholesterol levels and decrease the risk of heart disease. We provide a list of "Do's" and "Tips" which gives examples of how to select fats wisely and incorporate healthy changes into our diet. We also provide a guide for selecting an appropriate portion size of fat.

8 pp. / "Turning Points" is a video production written and acted by teen youth in Flagstaff, many of whom were involved with an educational promotions program on healthy dating. The program portrays teen dating relationship scenarios to prompt thinking and discussion among teens about dating. An accompanying discussion guide to be used in conjunction with the DVD is written for in-class and informal teen groups.