Thesis (PH.D.) -- Syracuse University, 2006 / "Publication number AAT 3251799."

<p> The purpose of this study was to conduct a secondary analysis to examine the association between the change from baseline to follow-up in Latino mothers&rsquo; self-reported nutrition knowledge, self-efficacy, intentions, food label use, and role modeling from baseline to follow-up with their reports of children&rsquo;s dietary intake measured at follow-up. Data were obtained from from Sanos y Fuertes, a culturally-tailored community-based nutrition education intervention. The participants were Latino mothers and their children ages 2 to 8 years old. A dietary quality scoring system was created using food frequency data. To account for reported frequencies, five set points were created to define criteria for high dietary quality. Logistic regression tests were conducted for the five set points. The change in nutrition knowledge (<i>p</i> = .019) and role modeling (<i>p</i> = .034) of the mothers significantly predicted probability of higher child dietary quality at follow-up. Findings suggest the need for interventions that focus on increasing parental dietary knowledge while emphasizing the importance of role modeling. Further research is needed to explore cultural-related dietary differences between Latinos and non-Latinos.</p><p>

<p> In the United States, type 2 diabetes mellitus (T2DM) has been categorized as a major health-threatening problem affecting a wide cross section of people. About one third of the population is unaware that they have the disease; however, early recognition of symptoms would lead to prevention, diagnosis for a better prognosis, and, in some cases, the reversal of the disease. Researchers have shown that late diagnosis leads to high mortality, morbidity, disability, loss of productivity, and high costs of health care to individuals, families, and the government. The main purpose of this study was to establish a new model mechanism for the detection and prevention of T2DM using the lived experiences of the primary care physicians. This qualitative study investigated the lived experiences of seven primary care physicians from the Northern California Bay area community. The primary data collection method was by interview through e-mail correspondences and the data were organized, coded, and analyzed on the responses to the interview questions and research questions. The research study resulted in four major themes: (a) lifestyle choices to reduce T2DM, (b) desire to improve the lives of patients, (c) government involvement, and (d) shared perception of T2DM. Recommendations were developed based on the compiled data from this study and future studies could involve health-care accessibility and treatment interventions of T2DM for patients with low socioeconomic status and use of the new model mechanism to improve early detection and prevention of T2DM.</p><p>

<p>The purpose of this study was to examine the influence of age, marital status, household size, and number of years residing in the United States on knowledge of nutrition and health topics, confidence, and intent for lifestyle change among Latinos. Specifically, the population being studied was from the Long Beach area in southern California. </p><p> Data were obtained from a larger, childhood obesity prevention intervention, Sanos y Fuertes, which collected demographic and behavioral surveys from Latino families with children between the ages of 2 and 8 years old. Significant differences for knowledge, confidence, and intent were detected between different age groups. Further research needs to be conducted to expand on the understanding of the variables researched in this thesis in order to further understand the complexity of the multiple influences on healthy behaviors. This will serve as a stepping-stone towards alleviating health disparities, and creating health equity among minority groups. </p>

Este estudo teve por objetivo analisar a acurÃcia das caracterÃsticas definidoras do diagnÃstico de enfermagem âNutriÃÃo Desequilibrada: menos que as necessidades corporaisâ em crianÃas na primeira infÃncia. Trata-se de um estudo de acurÃcia diagnÃstica, com corte transversal. O estudo foi desenvolvido em uma organizaÃÃo nÃo governamental, situada na cidade de Fortaleza, referÃncia no combate à desnutriÃÃo infantil. A populaÃÃo foi constituÃda por crianÃas na primeira infÃncia, de ambos os sexos, totalizando uma amostra de 123 crianÃas. Para a coleta de dados foi desenvolvido um instrumento baseado nas caracterÃsticas definidoras do diagnÃstico em questÃo, alÃm de dados sÃcio demogrÃficos do paciente e outros sinais e sintomas de desnutriÃÃo que nÃo compunham a lista de caracterÃsticas definidoras da NANDA Internacional. Os dados foram analisados estatisticamente com o apoio do pacote estatÃstico SPSS versÃo 19.0 for Windows e do software R versÃo 2.12.1. Para verificar a sensibilidade e especificidade de cada caracterÃstica definidora foi utilizado o mÃtodo de anÃlise de classes latentes. Os dados sÃcio demogrÃficos mostraram leve predominÃncia do sexo masculino. Setenta e oito por cento era proveniente da capital Fortaleza, 63,4% das crianÃas avaliadas ainda nÃo frequentavam a escola e pelo menos metade das crianÃas tinham atà 35 meses de idade. O diagnÃstico nutricional predominante foi desnutriÃÃo leve. As caracterÃsticas mais frequentes no estudo foram Relato de ingestÃo inadequada de alimentos, menor que PDR (porÃÃo diÃria recomendada) (48,8%), Irritabilidade (48%) e Saciedade imediatamente apÃs a ingestÃo (37,4%). A prevalÃncia do diagnÃstico foi estimada pelo modelo de classe latente em 27,6%. As caracterÃsticas que apresentaram as melhores medidas de acurÃcia para inferÃncia de espectros iniciais do diagnÃstico em estudo foram Falta de interesse na comida e Saciedade imediatamente apÃs a ingestÃo. Assim como, as caracterÃsticas definidoras AversÃo ao ato de comer, Fraqueza dos mÃsculos necessÃrios à deglutiÃÃo, Incapacidade percebida de ingerir comida e Relato de sensaÃÃo de sabor alterada se apresentaram bons indicadores de confirmaÃÃo da presenÃa do diagnÃstico de enfermagem em questÃo. Por fim, entende-se a importÃncia deste estudo para aprimoramento dos elementos do diagnÃstico de enfermagem, bem como para auxiliar os enfermeiros na prÃtica clÃnica, visto que possibilita reduzir a ocorrÃncia de vieses nas inferÃncias realizadas sem base em evidÃncias clÃnicas, contribuindo com a melhoria da qualidade da assistÃncia. / This study aimed to analyze the accuracy of the defining characteristics of the nursing diagnosis "Imbalanced Nutrition: less than body requirements" in children of early childhood. This is a cross-sectional study of diagnostic accuracy. The study was conducted in a non-governmental organization located in the city of Fortaleza, reference center in childcare malnutrition. The population consisted of children in early childhood, from both genders, with sample of 123 children. For data collection, an instrument was developed based on the defining characteristics of the diagnosis in question, as well as socio-demographic patient data and other signs and symptoms of malnutrition not included in the list of defining characteristics of NANDA International. Data were statistically analyzed with the support of statistical package SPSS version 19.0 for Windows  and R software version 2.12.1. To check the sensitivity and specificity of each defining characteristic the method of latent class analysis was used. The sociodemographic data showed slight predominance of males. Seventy-eight percent were from the capital Fortaleza, 63.4% of the children not attending school and at least half of the children were less than 35 months old. The predominant nutritional diagnosis was mild malnutrition. The most common characteristics in the study were Reports inadequate food intake less than RDA (recommended daily allowance) (48.8%), irritability (48%) and Satiety immediately after ingesting food (37.4%).The latent class model estimated the prevalence of diagnosis in 27.6%. The characteristics that showed the best measures of accuracy for inferring initial spectra of the diagnosis in the study were lack of interest in food and satiety immediately after ingesting food. Just as the defining characteristics Aversion to eating, weakness of muscles required for swallowing, perceived inability to ingest food, and reports altered taste sensation presenting as good indicators for confirmation of nursing diagnosis in question. Finally, understand the importance of this study for enhancing the elements of nursing diagnosis and to assist nurses in clinical practice, as it allows reducing the biases in inferences made not based on clinical evidence, contributing to improving quality of care.

<p> This dissertation consists of two substudies. The objectives of Substudy 1 were as follows: 1) to examine changes in obesity rates throughout elementary school in a large sample of children with respect to socioecological factors, especially trends in body mass index (BMI) and the prevalence of &ldquo;severe high obesity&rdquo; during elementary school, and 2) to explore the longitudinal effect of socioecological obesogenic factors (including individual, parental, familial, and environmental factors) on the transition from a normal/healthy weight to being overweight or obese among children aged three to 13 years old. This longitudinal panel study used the Early Childhood Longitudinal Study Program (ECLS-K). A modified socioecological model was used as a conceptual framework to guide the investigation of this study&rsquo;s research questions. Two longitudinal ordered regressions were performed to determine the associations between socioecological obesogenic variables (e.g., family activity and parental involvement) and changes in obesity rates, as well as the transition from a normal/healthy weight to being overweight, obese, or severely obese. A total of 1,264 children (representing 379,297 at the population level) were identified for this study (mean age: 5.24 years; female: 48.7% at baseline). Hispanics and other nonwhite children, children with less socioeconomic and environmental support, and children living in households with fewer family members were more likely than their counterparts to gain weight (all <i>p</i>s &lt; 0.05). This study revealed multiple dimensions of how sociological obesogenic factors influence children&rsquo;s weight increases and transitions in a longitudinal setting. Unhealthy BMI status among children was affected not only by individual factors but also by parents, family, and environments. Parents and family play a crucial role in children&rsquo;s physical activity and nutrition, and obtaining family and environmental support is critically important for maintaining a healthy BMI status. The findings suggest that a greater focus on family and social support is necessary to help children maintain a healthy weight over time. </p><p> Substudy 2 aimed to investigate the association between the Head Start Program and children&rsquo;s BMI status, as well as their quality of life with respect to socioecological obesogenic factors. This cross-sectional study employed the ECLS-K as well. A propensity-score matching analysis was performed to examine the association between the Head Start Program and children&rsquo;s BMI status, as well as the quality of life, controlling for socioecological obesogenic factors. A total of 3,753 children (representing 1,284,209 at the population level) were recruited for this study (mean age: 13.69 years; female: 49.42%). In the final matched model, the Head Start Program did not have a statistically significant effect on children&rsquo;s obesity. Children who were African American, had less participation in school-sponsored activities, perceived themselves as overweight, lived in a household with fewer family members, and had less strict TV regulations were more likely to be overweight than their counterparts (all <i>p</i>s &lt; 0.05). Evidence suggests that multiple dimensions of sociological obesogenic factors&mdash;including individual as well as parental, familial, and community support factors&mdash;affect the weight of children from low-income families and should be considered when establishing behavioral and policy interventions to thwart the childhood obesity epidemic.</p><p>

Energy restriction has a high failure rate, which may be related to energy regulating hormones (acylated ghrelin, insulin, etc.) that stimulates energy intake (EI) and suppresses energy expenditure (EE). An alternative is to maintain EI and raise EE through exercise. The impact of short-term exercise training on energy regulating hormones has not been systematically studied. In addition, women do not lose body fat with exercise training, whereas men do lose body fat. The sex difference may be related to energy regulating hormones. The purposes of this proposal were, (1) to determine the independent effects of exercise with and without energy replaced on energy regulating hormones (acylated ghrelin, insulin, etc.) and appetite responses, and (2) to determine whether sex differences exists. Concentrations and area under the curve (AUC) of these hormones were measured in overweight/obese individuals (9M, 9W) during a meal tolerance test after a 1-day baseline. Using a counter-balanced, crossover design, measurements were repeated after 4 consecutive days of exercise (EE = ∼750 kcal/d-1 for men, ∼600 kcal/d-1 for women) with exercise energy added back to maintain energy balance (BAL) and, 4 consecutive days of the exercise without energy added back to maintain energy deficit (DEF). In men, acylated ghrelin AUC was not different between baseline, DEF, and BAL. In men, compared to baseline insulin AUC was lower after DEF (p<0.05), but not BAL. In women, compared to baseline acylated ghrelin AUC was higher after DEF and BAL (p<0.05). Women vs. men had a greater change from in acylated ghrelin after DEF and BAL. In women, compared to baseline insulin AUC was lower after DEF and lower after BAL (p<0.05). Appetite ratings were lower after BAL compared to baseline or DEF in men. In women, there was no change in appetite ratings. In women short-term exercise training regardless of energy state affects energy regulating hormones and appetite in the directions expected to stimulate energy intake and suppress energy expenditure. In men however, exercise alone has no impact on energy regulating hormones or appetite when energy balance was maintained and the effect of energy deficit was less pronounced than in women.

<p> Substance use disorders (SUD) can lead to many adverse health effects including nutritional deficiencies and malnutrition. Research shows that proper nutrition can have a positive effect on recovery outcomes; however, nutrition services and education are often undervalued and not adequately utilized in substance abuse treatment centers. Previous research indicates that barriers to healthy eating are often due to ones lack of self-confidence in preparing and purchasing healthy foods. The purpose of this study was to investigate the effectiveness of a "hands-on" nutrition and culinary intervention in a SUD treatment center. Specifically, this study measured the participants' positive and negative attitudes towards cooking, as well as their perceived self-efficacy in relation to purchasing and preparing healthy foods. </p><p> There was a significant difference in the participants' overall self-efficacy related to food preparations skills, specifically in their ability to prepare whole grains. Participants also became more confident in purchasing whole grain products by the end of intervention. Further review of the study revealed that the participants' enjoyment of cooking increased significantly after completion of the cooking classes.</p>

Thesis (M.S.P.H.)--University of Michigan, 1941.

Thesis (M.S.P.H.)--University of Michigan, 1941.