<p> The purpose of this study was to examine why diabetes is persistent in Native Americans using demographic characteristics, physical activity, self-reported health status, socio-economic status, and race. This study used secondary data from the California Health Interview Survey. There were 47,614 adults who participated in the survey, of which 1,369 participants identified themselves as American Indians. </p><p> Chi square analysis was used to substantiate the association between diabetes in Native Americans with diet, exercise, obesity, self-reported health status, and socioeconomic status. Statistical test results found that there was an association between all independent variables suggesting that diabetes in Native Americans is more complex than other races. There were limitations to the study. due to the small number of Native Americans participating in the survey. A further study is recommended at a national level to look more closely at underlying causes of the persistence of diabetes in Native Americans. </p>

Le but de cette étude consiste à démontrer l’impact positif d’une supplémentation en glutamine chez des nageurs élites, afin d’améliorer le statut immunitaire et d’évaluer si les changements plasmatiques de la glutamine peuvent expliquer l’incidence d’infections des voies respiratoires (IVRS). En parallèle, ce projet évalue si les apports alimentaires influencent la glutamine plasmatique et l’incidence d’IVRS. L’étude s’est effectuée auprès de 14 athlètes élites (8 hommes, 6 femmes). Chaque athlète a participé aux deux conditions expérimentales : un supplément de glutamine et une solution placebo isocalorique. Les périodes de supplémentation se déroulaient sur sept jours, incluant trois journées consécutives de compétition. Le profil hématologique, après les compétitions, montre qu’un supplément de glutamine n’améliore pas significativement la concentration plasmatique en glutamine ni les niveaux de cytokines comparativement à une solution placebo. Bien que les résultats soient semblables sous les deux conditions, les niveaux post-compétition ont tendance à être supérieurs aux valeurs pré-supplémentation, lorsqu’un apport exogène en glutamine est fourni à l’organisme alors que les concentrations plasmatiques de glutamine tendent à diminuer lorsqu’une solution placebo est administrée (p=0.067). L'incidence d’IVRS ne peut être expliquée par une faible concentration plasmatique de glutamine ni par un apport exogène de glutamine. On observe cependant une augmentation d’IVRS suite aux compétitions, soient de 8 athlètes pour le groupe placebo contre 3 au groupe glutamine. Les athlètes atteints d'IVRS semblent consommer moins d'énergie totale (kcal) et de protéines que les athlètes sains (p=0.060). Les résultats obtenus ne démontrent pas qu’une supplémentation en glutamine améliore le profil immunitaire et ne prévienne l’incidence d’IVRS, mais ils soulèvent l’hypothèse qu’un apport exogène en glutamine stabilise les niveaux plasmatiques de glutamine, permettant aux athlètes de poursuivre leurs entraînements et de récupérer efficacement. / The purposes of this study were to determine the positive impacts of glutamine supplementation upon immune system status and to determine whether changes in plasma glutamine relate to the appearance of upper respiratory tract infections (URTI) in elite swimmers. Furthermore, this study evaluated dietary intakes and its influence on immune parameters and URTI incidence. Fourteen athletes (8 men, 6 women) took part of the study. Each athlete participated in both experimental conditions: glutamine supplement and an isocaloric solution placebo. The supplementation period lasted seven day, including three consecutive competing days. Post competing hematologic profils of swimmers show that glutamine supplement does not significantly improve plasma glutamine neither cytokines levels, compared to a placebo solution. Even if plasma glutamine concentrations are similar with both conditions, the post competiting levels tend to be higher than pre competing values, when glutamine is supplemented. Futhermore, plasma glutamine levels show a decreasing trend under control conditions (p=0.060). In this study, URTI can not be explained by low plasma glutamine or supplemented glutamine. However, URTI incidence is higher after competitions, where 8 athletes showed symptoms (control group) and 3 only in the experimental group. Athletes with URTI seem to consume less energy and proteins than healthy athletes (p=0.060). These data does not suggest that glutamine supplementation improves immune function or prevents URTI in highly trained swimmers during competition. However, results support the hypothesis that exogenous glutamine stabilizes plasma glutamine levels, allowing athletes to tolerate training workload and recover properly.

<p> Healthy nutrition is essential for everyone but in some periods, including pregnancy, people are more susceptible and demand attention for nutrition. According to the United States Food and Drug Administration (FDA), approximately 300 extra calories are needed daily to maintain a healthy pregnancy for women. This study analyzes the effects of health education that is provided to pregnant women who are either seeking an office visit for routine or high-risk pregnancy. This study predicted there is no difference in being referred for any type of health education offered to pregnant women between those who received routine pregnancy care and those with high-risk care. It also predicted there is no difference in whether pregnant women are offered nutrition health education/exercise for receiving routine prenatal care and high-risk care. The Statistical Package for Social Services (SPSS) was applied to analyze the 2010 National Ambulatory Medical Care Survey (NAMCS) data using Chi Square statistics. The results from this study indicated no significant relationship between pregnant women who are either seeking an office visit for routine or high-risk pregnancy, as it relates to health education. These results reassure the importance of health education.</p>

<p> The purpose of this research was to examine the link between obesity and stroke rates among African Americans and Hispanics/Latinos. Secondary data set was utilized to test the hypotheses of this study. Previous studies have indicated that the link between obesity and stroke is environment, poor nutrition, and socioeconomic status. Increasing health awareness about obesity and stroke prevention by having health fairs can promote a healthier lifestyle in the community. The study aimed to determine the causes of obesity and stroke among African Americans and Hispanics/Latinos in the underserved population. This research was intended to examine the risk factors that can lead to obesity and stroke among this population. The findings of this research concluded the acceptance of both hypotheses that in the underserved population, obesity and stroke rates are higher in the rural areas; and African American and Hispanic/Latino men have a higher risk of being obese and having higher risk of stroke. </p>

<p> The need for an adjunctive and alternative program at Alternative, Community, and Correctional Schools and Services (ACCESS) schools is critical to better serve the youth of Orange County. The purpose of this project was to write a grant proposal seeking funds to develop a program that will explore the use of active treatment approaches: healthy diet and exercise as an alternative or adjunct to the use of psychotropic medications among adolescents identified at risk for mental health problems. The proposed program if funded will introduce active approaches to improve the student's self-regulation and level of mental health functioning. The program will involve a nutritional, well balanced diet integrated into their daily life along with daily exercise and a weekly outdoor engagement outing. If funded, this program would result in the adolescent's ability to overcome their mental health challenges holistically, attaining self-sufficiency without pharmacotherapeutic treatment. Submission of this grant is not required for this thesis project.</p>

<p> The purpose of this study was to examine the association of demographic factors, serum Vitamin D levels, hypertension (HTN) (by HTN diagnosis, systolic blood pressure [SBP] and diastolic blood pressure [DBP]), serum (hs-CRP) and endothelial measures of inflammation upon the prevalence of depression in adults with coronary artery disease (CAD) from central North Carolina. A literature derived theory, the Puglisi Model of Vitamin D Levels' Associations with Depression, guided this study. Vitamin D levels, measures of blood pressure, and serum and endothelial measures of inflammation, were theorized as being associated with depression. </p><p> A cross-sectional, associational design was employed in the parent study from which previously frozen alliquoted blood of subjects with CAD was further analyzed to assess the serum Vitamin D levels and liver function. This convenience sample of 101 persons with CAD who presented between 2007 and 2010 at the University of North Carolina Hospital's Cardiac Catheterization lab was utilized. The majority of the sample of well-controlled persons with CAD was male (66%), White (81%), had hypertension (81%), and low serum Vitamin D levels (82%). Depression, found as a diagnosis in 27%, was not significantly associated with Vitamin D levels (<i>p</i> = 0.17), even when controlling for demographic factors (AOR 0.96; <i>p</i> = 0.13; 95% CI [.90 - 1.01]). There were no differences between brachial artery flow mediated dilation (BAFMD), augmentation index, and high sensitivity C-reactive protein (hs-CRP) by depression group, but there was for reactive hyperemia index (RHI) [<i>t</i> = 1.97; <i>df</i> = 99; <i>p</i> = 0.05]. Vitamin D levels were inversely associated with both SBP (<i>p</i> &lt; 0.001) and DBP (<i>p</i> &lt; 0.001), but Vitamin D levels were not associated with a diagnosis of HTN (AOR 0.97; <i>p</i> = 0.28; 95% CI [.92, 1.02]. Controlling for the potential confounders of age, sex, race, body mass index, liver and kidney functions did not alter the significant association between Vitamin D levels and SBP and DBP (<i>p</i> = 0.05). Vitamin D levels were significantly associated with two inflammatory measures&mdash;hs-CRP and augmentation index, but not with BAFMD and RHI. When controlling for age, sex, race, BMI and Vitamin D levels, only hs-CRP but none of the three endothelial measures of inflammation (RHI, BAFMD nor augmentation index [AI]), were associated with depression (AOR 0.956; <i>p</i> = 0.13; 95% CI [.90, 1.01]). </p><p> Nurses should be aware that most of the adults with CAD herein had low or insufficient Vitamin D levels, and that Vitamin D levels may significantly affect SBP and DBP in persons with CAD and perhaps other populations as well. Many persons have depression around the time of their cardiac event or thereafter. Because increased morbidity and mortality occur in individuals with decreased Vitamin D levels, and depression, even when identified and treated in persons with CAD is associated with worsened outcomes, appropriate screening for and treatment of low serum Vitamin D levels is needed. Thus, advanced practice clinicians caring for persons with CAD should encourage screening of Vitamin D levels, and treatment of low levels with appropriate supplementation. </p><p> Further studies are needed to explore why some endothelial measures are associated with Vitamin D levels and depression, and others are not. Additional studies should seek to confirm the inverse association of Vitamin D levels with SBP and DBP while accounting for season of the year and other potential confounders. Finally, studies should utilize a depression screening tool to test the Puglisi model's proposed association between low Vitamin D levels with an increased occurrence of depression in both persons with CAD and other populations.</p>

<p> Obesity and substance abuse are two major public health issues in the United States, especially among low-income individuals. The United States Department of Health and Human Services has set forth the <i>Dietary Guidelines,</i> which encourage a diet rich in fresh fruits, vegetables, whole grains, legumes, lean meat, and low-fat dairy to help Americans obtain a healthy body weight. Substance abusers in recovery are at increased risk of weight gain, as their previous addiction may continue with the substance shifting from drugs or alcohol to sugary or high fat food. Nutrition interventions have been beneficial in recovery by improving outcomes and preventing relapse, however, possible barriers to obtaining fresh, healthy food items have been noted. There is limited research investigating females, especially mothers, in recovery and their access to healthy food items. The current study utilized a demographic survey and multiple Household Food Inventories (HFI) to assess the amount and variety of food items of mothers and their children in a residential substance abuse recovery facility. A sample of 11 mothers in rural, eastern North Carolina completed the survey and two separate HFI, two weeks apart to account for intra-monthly variability. Demographic information was entered into Statistical Package for the Social Sciences [SPSS] while HFI data were coded and categorized in Microsoft Excel. Results included all 11 mothers participated in at least two different federal food assistance programs, stated they face challenges grocery shopping, and seven households were food insecure. Fresh vegetables were slightly more common in households than fresh fruits, and canned, frozen, and packaged fruits (especially fruit juice), vegetables, and legumes, were more prevalent than fresh forms. Cheese was the most popular form of dairy, and most was full fat. The majority of protein was red meat or breakfast meat including bacon and sausage. Whole grain was less common than white, refined grain products. There was an abundance of pre-packaged, convenience food including chips, ice cream, cookies, and cakes. The results indicated that the HFI on two separate occasions was beneficial to explain variability among types and amounts of food items from one assessment to the next, especially among fresh fruits, fresh vegetables, and chicken. The lack of fresh fruits, vegetables, low-fat dairy options, lean meats, and whole grains in combination with copious sweetened, pre-packaged, high-fat food items form a diet associated with obesity and contradictive of the <i> Dietary Guidelines.</i> Possible barriers to obtaining healthier food options may include low or fluctuating income and federal assistance benefits, limited transportation, decreased storage space, infrequent grocery trips, or a lack of nutritional knowledge. Mothers and children in recovery could benefit from nutrition education and improved access to healthier food items. Future research should further investigate the barriers to obtaining fresh, healthy food items, as well as shifts in addiction from substance to food, food choice, disordered eating patterns, and subsequent weight and health issues to guide nutrition interventions for mothers and children in substance abuse recovery facilities.</p>

<p> The Unimak Island caribou herd is in the midst of a population decline associated with low birth rates and calf survival. I evaluated the spatial and temporal complexity of caribou landscape use and the availability and nutritional quality of key forage species. First, I examined seasonal landscape use and movement using GPS collar data. Second, I determined seasonal diets to the species-level for spring, summer, and fall using a novel n-alkane and long-chain fatty acid (LCOH) method. Finally, I compared diet quality with needs for maintenance and to the quality of available plant species. Caribou home ranges were largest and movements least in the winter, and movements appeared dependent on plant phenology and weather conditions. Diets were complex and seasonally variable but generally contained higher proportions of forbs than other caribou herds likely due to their higher relative availability as compared to other preferred forages. Finally, animals foraged selectively each season, obtaining a diet that was higher in digestible dry matter and nitrogen than the average of plants available. Nutritional quality appeared to be well above requirements during the three seasons investigated. Overall, I concluded that spring, summer, and fall forage quality and availability do not impose strong constraints on Unimak Island caribou. However, I recommend that diet composition and quality be determined in the winter, the time when forage often limits the productivity of caribou herds.</p>

<p> The number and variety of study tools available to those eligible to take the Commission on Dietetic Registration Exam (CDR RD Exam) and to prepare dietetic interns (DIs) for dietetic internship (IDNP) rotations are limited.</p><p> The purpose of this project was to develop a planner that included material reviews and supplements for the different domains of the CDR RD Exam as well as a calendar with the goal of preparing Dis for IDNP rotations, preparing Dis for the Registration Examination for Dietitians, and improving time management during the IDNP.</p><p> The tool was developed after a comprehensive review of dietetics-related literature and current examples of CDR RD Exam preparation materials and evaluated by a panel of2 Registered Dietitians (RDs) and 2 Dis. More research is needed to evaluate the content of the tool and its efficacy in achieving its intended purpose.</p>

<p> The purpose of the current study was to address the relationship between Body Mass Index (BMI) status and psychological distress within the adolescent population. Data was acquired from the California Health Interview Survey (CHIS) 2011-2012, a state-wide phone survey which addresses health issues among the resident population. The present study used data from 2,1 04 California adolescents, utilizing variables relating to demographics, general health condition, and mental health.</p><p> Results indicated a statistically significant relationship between BMI and psychological distress, with overweight adolescents experiencing more distress and depression than their underweight/healthy weight counterparts. Gender and perceived general health condition were both significantly related to distress, with females and those of poor perceived general health condition experiencing greater psychological distress, regardless of weight status. This study has implications for social work policy and practice, especially in work with youth and families.</p>