Yeung Fai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 125-138). / Abstracts in English and Chinese; questionnaires also in Chinese. / Acknowledgement --- p.iii / Declaration --- p.iv / List of Tables --- p.v / List of Figures --- p.viii / Abstract --- p.ix / Abbreviation --- p.xiv / Chapter Chapter One --- Introduction / Background --- p.1 / Chapter 1.1 --- Definition / Chapter 1.2 --- Disease Prevalence / Chapter 1.3 --- Associated Disability / Chapter 1.4 --- Treatment-effectiveness / Chapter 1.5 --- Rehabilitation / Chapter Chapter Two --- Hong Kong Situation --- p.56 / Chapter 2.1 --- What is known --- Hong Kong elderly population database / Chapter 2.2 --- Service provision for the elderly in Hong Kong / Chapter Chapter Three --- Methodology --- p.68 / Chapter 3.1 --- Aims / Chapter 3.2 --- Subject and methodology / Chapter Chapter Four --- Results --- p.93 / Chapter 4.1 --- Results at baseline / Chapter 4.2 --- "Trend with time (0,12,48 weeks) between the exercise group and the control group" / Chapter 4.3 --- Results at first follow up (12 weeks) / Chapter 4.4 --- Results at second follow up (48 weeks) / Chapter 4.5 --- Results from baseline to second follow up within the exercise group or within the control group / Chapter Chapter Five --- Discussion --- p.113 / Chapter 5.1 --- Short-term efficacy of pulmonary program / Chapter 5.2 --- Long-term efficacy of pulmonary program / Chapter 5.3 --- The characteristics of pulmonary program / Chapter Chapter Six --- Conclusion --- p.124 / Reference --- p.125 / Appendix The Questionnaire Used in Interviews --- p.139

Chung Mei-lan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 118-124). / Abstracts in English and Chinese. / Abstract --- p.i / Declaration --- p.v / Acknowledgment --- p.vi / Abbreviations --- p.viii / List of Figures --- p.x / List of Tables & Graphs --- p.xi / Chapter 1. --- Background --- p.1 / Chapter Chapter 1: --- Age-Associated Changes in Nutritional Status in the Elderly --- p.1 / Chapter 1.1. --- Body Composition --- p.1 / Chapter 1.2. --- Nutritional Requirements --- p.2 / Chapter 1.2.1. --- Energy requirement in the elderly --- p.3 / Chapter 1.2.2. --- Protein requirement in the elderly --- p.3 / Chapter 1.2.3. --- Vitamin and minerals requirement in the elderly --- p.4 / Chapter 1.3. --- Food Intake --- p.4 / Chapter 1.3.1. --- Biobehavioral factors --- p.5 / Chapter 1.3.2. --- Social factors --- p.9 / Chapter 1.3.3. --- Psychological factors --- p.9 / Chapter 1.3.4. --- Physical factors --- p.10 / Chapter 1.3.5. --- Medical factors --- p.10 / Chapter 1.4. --- Age-Related Changes in Gastrointestinal Tract --- p.10 / Chapter Chapter 2: --- Energy Expenditure in the Elderly --- p.12 / Chapter 2.1. --- Total Daily Energy Expenditure (TEE) --- p.13 / Chapter 2.2. --- Basal Metabolic Rate (BMR) --- p.14 / Chapter 2.2.1. --- Mechanisms Leading to a Decrease in FFM Adjusted BMR --- p.15 / Chapter (i) --- Sex --- p.15 / Chapter (ii) --- Sympathetic Nervous System (SNS) Activity --- p.16 / Chapter (iii) --- Physical Activity --- p.17 / Chapter (iv) --- Body Weight --- p.17 / Chapter (v) --- Hormones --- p.18 / Chapter 2.3. --- Diet-Induced Thermogenesis (DIT) --- p.18 / Chapter 2.4. --- Energy Costs of Physical Activity --- p.20 / Chapter Chapter 3: --- Methods for the Measurements of Energy Expenditure --- p.22 / Chapter 3.1. --- Direct Calorimetry --- p.22 / Chapter 3.1.1. --- Principle of Direct Calorimetry --- p.22 / Chapter 3.1.2. --- Isothermal calorimetry --- p.23 / Chapter 3.1.3. --- Gradient-layer direct calorimetry --- p.23 / Chapter 3.1.4. --- Advantages and Disadvantages of Direct Calorimetry --- p.24 / Chapter 3.2. --- Indirect Calorimetry --- p.25 / Chapter 3.2.1. --- Principle of Indirect Calorimetry --- p.25 / Chapter 3.2.2. --- Whole body indirect calorimetry --- p.25 / Chapter 3.2.3. --- "Indirect calorimetry: ventilated hood system, a face mask, or mouthpiece" --- p.26 / Chapter 3.2.4. --- Advantages and Disadvantages of Indirect Calorimetry --- p.27 / Chapter 3.3. --- The Doubly-Labeled Water Method --- p.27 / Chapter 3.3.1. --- Principle --- p.27 / Chapter 3.3.2. --- Advantages and Disadvantages --- p.28 / Chapter 3.4. --- The Labeled Bicarbonate Method --- p.29 / Chapter 3.4.1. --- Principle of Isotope Dilution Method --- p.29 / Chapter 3.4.2. --- Principle of Traditional Labeled HC03 Method --- p.32 / Chapter 3.4.3. --- Labeled Bicarbonate-Urea Method --- p.34 / Chapter I. --- Calculations --- p.35 / Chapter A. --- Determination of energy equivalent of CO2 --- p.35 / Chapter B. --- Relationship between specific activity of urea and specific activity of CO2 --- p.35 / Chapter C. --- Fixation of infused label in the body --- p.36 / Chapter D. --- Calculation of CO2 production from the specific 3 activity of urinary urea --- p.6 / Chapter E. --- Two assumptions in labeled bicarbonate-urea method --- p.36 / Chapter 3.4.4. --- Advantages and Disadvantages of Labeled Bicarbonate-Urea Method --- p.37 / Chapter 3.5. --- Heart Rate Monitoring --- p.37 / Chapter 3.5.1. --- Principle --- p.37 / Chapter 3.5.2. --- Advantages and Disadvantages --- p.38 / Chapter 3.6. --- Activity Monitoring --- p.39 / Chapter 3.6.1. --- Principle --- p.39 / Chapter 3.6.2. --- Advantages and Disadvantages --- p.39 / Chapter 3.7. --- Activity Diaries --- p.40 / Chapter 3.7.1. --- Retrospective activity questionnaires --- p.40 / Chapter I. --- Principle --- p.40 / Chapter II. --- Advantages and Disadvantages --- p.40 / Chapter 3.7.2. --- Current diary method --- p.41 / Chapter I. --- Principle --- p.41 / Chapter II. --- Advantages and Disadvantages --- p.42 / Chapter 3.7.3. --- Time-and-motion study --- p.42 / Chapter I. --- Principle --- p.42 / Chapter II. --- Advantages and Disadvantages --- p.43 / Chapter Chapter 4: --- Nutritional Status and Energy Expenditure in Chronic Obstructive Pulmonary Disease (COPD) Patients --- p.44 / Chapter 4.1. --- Nutritional Status --- p.44 / Chapter 4.1.1. --- Body weight --- p.44 / Chapter 4.1.2. --- Fat-free mass (FFM) --- p.44 / Chapter 4.2. --- REE --- p.46 / Chapter 4.3. --- DIT --- p.47 / Chapter 4.4. --- TEE --- p.47 / Chapter 4.5. --- Nutrition Repletion by Caloric Supplement --- p.48 / Chapter 2. --- Objectives --- p.50 / Chapter 3. --- Subject and Method --- p.51 / Chapter 3.1. --- Part A: Subject and Methods I --- p.51 / Chapter 3.1.1. --- Subjects --- p.51 / Chapter 3.1.2. --- Methods --- p.51 / Chapter I. --- Anthropometric Assessment --- p.51 / Chapter II. --- Nutrient Intake --- p.52 / Chapter III. --- Clinical Assessment --- p.52 / Chapter IV. --- Energy Expenditure --- p.53 / Chapter V. --- Mini Nutritional Assessment Questionnaire --- p.53 / Chapter VI. --- Statistical Analysis --- p.54 / Chapter 3.2. --- Part B: Subject and Methods II --- p.55 / Chapter 3.2. --- Subjects --- p.55 / Chapter I. --- Patients --- p.55 / Chapter II. --- Control subjects --- p.55 / Chapter 3.2.2. --- Methods --- p.56 / Measurement of TEE by Labeled Bicarbonate-Urea Method --- p.56 / Chapter I. --- Study Protocol --- p.56 / Chapter Figure 6: --- Study protocol in Hospital --- p.57 / Chapter II. --- Clinical Protocol --- p.58 / Chapter A. --- Preparing the infusion --- p.58 / Chapter B. --- "Inserting the subcutaneous cannula, and starting the infusion" --- p.58 / Chapter C. --- Urine collection --- p.59 / Chapter D. --- Blood sample --- p.59 / Chapter III. --- Laboratory Procedures --- p.60 / Chapter A. --- Measuring the radioactivity of the infused bicarbonate solution --- p.60 / Chapter B. --- Measuring of specific activity of urea --- p.60 / Chapter (i) --- Titration of hyamine hydroxide solution --- p.60 / Chapter (ii) --- Urine radioactivity quantification --- p.61 / Chapter (1) --- Removal of dissolved CO2 from urine --- p.61 / Chapter (2) --- Determination of specific activity of C02 --- p.62 / Chapter (a) --- Principle --- p.62 / Chapter (b) --- Laboratory procedures for the determination of specific activity of urea --- p.62 / Chapter IV. --- Measurement in Hospital --- p.63 / Chapter A. --- Anthropometry --- p.63 / Chapter B. --- Indirect calorimetry --- p.63 / Chapter (i) --- Principle --- p.63 / Chapter (ii) --- Measurement of REE --- p.64 / Chapter (iii) --- Measurement of DIT --- p.65 / Chapter C. --- Food supply and dietary record during the study --- p.65 / Chapter D. --- Record of physical activity in rehabilitation program --- p.66 / Chapter E. --- Mini Nutritional Assessment Questionnaire --- p.67 / Chapter V. --- Statistical Analysis --- p.67 / Chapter 4. --- Results --- p.68 / Chapter 4.1. --- Results of Part A Study --- p.68 / Chapter 4.1.1. --- Anthropometry --- p.68 / Chapter 4.1.2. --- Nutrient Intake --- p.69 / Chapter 4.1.3. --- Caloric Balance --- p.71 / Chapter 4.1.4. --- Mini Nutritional Assessment Questionnaire --- p.72 / Chapter 4.2. --- Results of Part B Study --- p.73 / Chapter 4.2.1. --- Anthropometric Data --- p.73 / Chapter 4.2.2. --- REE --- p.74 / Chapter 4.2.3. --- DIT --- p.75 / Chapter 4.2.4. --- Nutrient Intake --- p.75 / Chapter 4.2.5. --- TEE --- p.76 / Chapter 4.2.6. --- Caloric Balance --- p.77 / Chapter 4.2.7. --- Mini Nutritional Assessment Questionnaire --- p.77 / Chapter 4.3. --- Table 1-1 --- p.78 / Chapter 4.4. --- Table 2-1 --- p.89 / Chapter 4.5. --- Graph1 --- p.100 / Chapter 5. --- Discussion --- p.103 / Chapter 5.1. --- Anthropometry in COPD patients --- p.103 / Chapter 5.2. --- Caloric and Nutrient intake in COPD patients --- p.105 / Chapter 5.3. --- Resting Energy Expenditure (REE) --- p.107 / Chapter 5.4. --- Diet-Induced Thermogenesis (DIT) --- p.108 / Chapter 5.5. --- Total Daily Energy Expenditure (TEE) --- p.108 / Chapter 5.6. --- Caloric Balance --- p.109 / Chapter 5.7. --- Limitation of this Study --- p.112 / Chapter 5.7.1. --- 24-hrs dietary recall --- p.112 / Chapter 5.7.2. --- Bicarbonate-urea method --- p.113 / Chapter 5.7.3. --- Anthropometry of community healthy elderly --- p.113 / Chapter 5.8. --- Recommendations --- p.114 / Chapter 5.8.1. --- Anthropometry monitoring in COPD patients --- p.114 / Chapter 5.8.2. --- Caloric supplements --- p.114 / Chapter 5.8.3. --- Physical activity in COPD patients --- p.115 / Chapter 6. --- Conclusions --- p.117 / Chapter 7. --- References --- p.118 / Chapter 8. --- Appendix I --- p.125 / Chapter A. --- Calculation of Total Energy Expenditure (TEE) --- p.125 / Chapter B. --- Sample of Calculation of Total Energy Expenditure (TEE) in Part B of the Study --- p.129 / Chapter 9. --- Appendix II - Equations --- p.133 / Chapter 10. --- Appendix III - Flow Calibration --- p.136