No description available.

Bakgrund: Antalet personer med fetma har fördubblats sedan 1980-talet. Fetma har visat sig öka risken för flertalet sjukdomar. Samhället är präglat av normer om hur en kropp bör se ut och stigmatiseringen av personer med fetma kan leda till att personer blir lidande. Även inom vården riskerar personer med fetma att mötas av negativa attityder, trots att alla har rätt till vård på lika villkor. Syfte: Att beskriva hur personer med fetma upplever mötet med vården. Metod: Litteraturöversikt med induktiv ansats där nio artiklar med kvalitativ metod inkluderats. Artiklarna har analyserats med stöd av Fribergs femstegsmodell. Resultat: Tre kategorier framkom i resultatet. Att mötas av okunskap, att vara utsatt samt stöd i mötet. Personer med fetma upplever att de blir bemötta på ett annorlunda sätt i vården på grund av sin vikt. Negativa kommentarer och icke anpassad utrustning bidrog till känslor av utsatthet och att vara annorlunda. Slutsats: Resultatet visar att personer med fetma upplevde att de blir bemötta annorlunda på grund av sin vikt när de söker vård. Genom att medvetandegöra mötets betydelse kan förhoppningsvis det öka kunskapen hos vårdpersonal kring vilka attityder och värderingar som påverkar hur de bemöter personer med fetma. / Background: The number of obese people has doubled since the 1980s. Obesity has been shown to increase the risk of other diseases. The community is characterized by standards of how the body should look and the stigmatization of people with obesity can cause people to suffer. These norms and images are perpetuated in health care, even though everyone is entitled to health care on equal terms. Aim: To describe how obese individuals experience health care. Method: A literature review has been made with an inductive approach. Nine articles were included, all with a qualitative approach. All articles have been analyzed according to Friberg’s five-step. Results: The results emerged in three categories: Being met with ignorance, being exposed and feeling of support. People with obesity felt that they were being treated differently because of their weight. Negative comments and inappropriate equipment contributed to feelings of being exposed and being different. Conclusion: The results show that obese people feel that they are treated differently because of their weight when they seek health care. By raising these issues health professional may become more aware of how their attitudes and values affect how they treat people with obesity.

Objective: New Mexico nurse practitioners contribute to the prevention and management of pediatric obesity. This study aimed to assess nurse practitioners' knowledge, attitudes, and behaviors, which were unknown in New Mexico, to counseling frequency in the assessment and management of overweight and obese pediatric patients. This was done using clinical practice guidelines (CPG). The study also sought to learn nurse practitioners' insights on needed resources for clinical practice. Rural and urban nurse practitioners' responses were then compared to the study aims. Methods: This descriptive pilot study surveyed members of the New Mexico Nurse Practitioner Council (NMNPC) to evaluate their knowledge, attitudes, and behaviors, in addition to the counseling frequencies expected to result in patient change. The survey used the platform Qualtrics and measured answers using a four-point Likert scale. Rural and urban comparisons were evaluated for each variable (knowledge, attitudes, and behaviors) in order to investigate relationships. Despite the underpowered sample size, data were analyzed for feasibility of future studies using descriptive statistics, Spearman's Rho Correlation, and Mann-Whitney U testing. Results: Fifteen nurse practitioners were included in the statistical analysis. The data found the nurse practitioners' self-reported responses exhibited knowledge, positive attitudes, and confident behaviors using pediatric obesity CPGs. The increases in these parameters correlated reported needing a quick CPG tool that can be used in practice. In all, rural nurse practitioners reported a slightly higher usage of pediatric obesity CPGs than urban nurse practitioners. Conclusion: The feasibility of this study's assessment of nurse practitioners' knowledge, attitudes, and behaviors using CPGs will assist in developing interventions to impact patient outcomes. The study also found that resources needed by New Mexico nurse practitioners were similar to those desired by other providers throughout literature. Rural compared to urban nurse practitioners findings indicated the need for further research. Future studies should include all health care providers in New Mexico in order to further explore aims of this study and development of interventions on overweight and obese pediatric CPGs to positively impact practice.

Sympathetic overactivity (SO) is associated with obesity and cardiovascular disease (CVD) mortality. Black adolescents have an increased risk of obesity and CVD later in life, particularly females. PURPOSE: To evaluate differences in SO between black (BOA) and white obese female adolescents (WOA). METHODS: Sixty-one BOA (n=49, 13.7±1.6 yrs, 38.1±6.1 kg/m2) and WOA (n=12, 13.3±2.2 yrs, 34.3±4.9 kg/m2) completed a maximal graded treadmill test after which an exercise recovery index (ERI; heart rate/VO2 plateau) was calculated. RESULTS: The ERI was significantly greater in BOA compared to WOA (29.8 ± 6.4 vs. 24.1 ± 3.1, P = 0.004). Multiple linear regression modeling revealed a significant independent association between ERI and VO2FFM (r = -0.310, P = 0.027) and %FAT (r = 0.326, P = 0.020) in BOA only. CONCLUSIONS: These results suggest that BOA females have greater SO than WOA females.

Master of Science / Department of Kinesiology / Katie Heinrich / Background: The American College of Sports Medicine physical activity guidelines call for 150 minutes of moderate or 75 minutes of vigorous aerobic exercise plus two days of resistance training (A-RT) per week for health benefits. Yet, most adults do not achieve the recommended amount of physical activity per week frequently citing lack of time as a barrier. High-intensity exercise protocols have improved glucose control, insulin sensitivity, fitness, and body composition, in less total time than lower intensity protocols, but have been studied as singular modes of exercise. CrossFit (CF) temporally combines A-RT together utilizing constantly varied multi-joint, full range-of-motion movements in substantially less training time than lower-intensity protocols. The aim of this study was to compare the effects of CF versus A-RT on glucose control in overweight/obese, physically inactive individuals. Methods: Eighteen overweight/obese (BMI 30.3 ± 2.8) adults (28.5 ± 5.9 years) were randomized to one of two groups: CF (3 days/week for 60 minute sessions) or A-RT (3 days/week of aerobic exercise for 50 minutes, plus ~20 minutes resistance exercise on 2 of those days) over 8-weeks. Fasting plasma glucose and 1-hour oral glucose tolerance tests were taken at baseline and post-training along with Eurofit fitness measures, VO2 peak, and body composition via dual energy X-ray absorptiometry. Results: Glucose control and body composition did not change significantly within or between groups. Both groups significantly improved muscular endurance (pushups completed on knees, CF+39.5%, p < 0.05; A-RT+24.4%, p = 0.01). The CF group improved on number of situps (CF+6.8%, p = 0.01) and VO2 peak (CF+9.1%, p < 0.05). Time spent exercising was significantly different between groups with the CF group averaging 38.7 ± 15.6 minutes per week and 13.1 ± 0.9 minutes per workout, and the A-RT group averaging 190.0 ± 10.7 minutes per week and 63.3 ± 3.6 minutes per workout. Conclusion: Eight weeks of A-RT or CF did not produce significant changes in glucose control or body composition in overweight/obese adults. However, despite exercising significantly less time per week CF training demonstrated greater improvements in fitness measures than A-RT.

No description available.

The overall objective of this research was to investigate the status of tumor necrosis factor-α (TNF-α), and molecules associated with its signaling, in the pathological state of hepatic steatosis. The effect of NSAID piroxicam, a cancer preventive agent also known to affect TNF-α signaling on hepatic steatosis, was also investigated. The biological state of the tissue was assessed by examining the expression of TNF-α signaling molecule in whole tissue, as well as in hepatic lipid raft. Lipid rafts are dynamic assemblies of cholesterol and sphingolipids, microdomains that form in the exoplasmic leaflet of the biological membranes shown to play a role in compartmentalization, modulation and integration of the cell signaling. In the present research, Zucker obese rats were used as a model of human obesity and insulin resistant state. These rats exhibit hepatic steatosis in adulthood similar to those noted in obese individuals. Female Zucker obese and lean rats (5 weeks old) were fed a semisynthetic diet with or without piroxicam (150 ppm). Zucker lean counterparts served as control. After 8 weeks of feeding, rats were euthanized and liver from each animal was collected. Liver tissue from each animal was processed for histology and biochemical analysis which included lipids and proteins (COX-1 and 2, TNF-α, TNF-RI and RII, IKK-β, IκB-α and NF-κB). Liver histology and the level of total lipids confirmed that Zucker obese rats had hepatic steatosis, which was further augmented by piroxicam treatment. Whole tissue protein expression, using western blot, showed that the steatotic liver differed from non-steatotic livers by having lower levels of TNF-RII. TNF-RII showed a trend which was inversely proportional to the pathological state of the tissue. The obese-piroxicam liver had the lowest level of TNF-RII and lean livers had the highest (p<0.05). The total NF-κB level was higher in the obese and obese-piroxicam groups compared to the lean or lean-piroxicam groups (p<0.05). Piroxicam treatment lowered the level of NF-κB in obese and lean livers. IκB-α was higher in obese livers than in lean livers. The nuclear level of NF-κB by western blot analysis showed the same pattern as noted in the whole tissue homogenate. However, the difference in the level between obese and lean was marked. The obese nuclei contained two to three fold higher levels of NF-κB protein than the lean liver nuclei. IκB-α level was significantly higher in the obese liver tissues and nuclei than their lean counterparts. While transcriptionally active NF-κB was higher (p<0.05) in the obese livers than in the lean livers, the difference between obese and lean groups was not as significant as that noted for the level of NF-κB assessed by western blot. This suggests that the proportion of active NF-κB present in the nuclear fraction is much higher in the lean than in the obese nuclei. Lipid raft was extracted and identified successfully from obese and lean livers. The total caveolin and flotillin levels were significantly higher in the liver lipid rafts of the obese-piroxicam than that of the other groups. This is the group that also exhibited higher steatosis. Piroxicam treatment significantly decreased the level of caveolin in the lean liver and significantly increased the level of flotillin in the obese liver. While COX-1 was not detectable, however, the level of COX-2 and TNF-RII in lipid raft was opposite to the level noted in the whole tissue homogenate. TNFRII was highest in the obese-piroxicam lipid raft and lowest in the lean-piroxicam lipid raft. TNF-RII, COX-2, IκB-α and NF-κB proteins were the molecules profoundly affected by the pathological state of the tissue and piroxicam treatment. This research is the first to report the presence of IκB-α in the nuclear compartment with a higher level in the nuclei and whole tissue in the obese liver than in the lean liver. This research demonstrates that TNF-α to NF-κB axis is altered in steatotic liver, and analysis of lipid rafts in steatotic and non-steatotic liver demonstrates that lipid rafts play a distinct role in modifying the biological availability of key proteins in the pathological state of liver steatosis.

This study determined the effects of gestational obesity on the long-term metabolic status of the mother and if obesity management during or after pregnancy could attenuate these effects. At 120 days prior to estrus, 8 ewes received 100 percent of NRC nutrient requirements (control group) and 24 ewes had free access to feed (obesity induction). Beginning on day 42 of gestation, 8 obese ewes were restricted to 65 percent of NRC nutrient requirements. Following parturition, controls and all but one group of obese ewes were fed 100 percent of NRC nutrient requirements. At postpartum days (PPD) 1 and 150, glucose tolerance tests were administered to ewes. At both PPD1 and PPD150, obesity resulted in insulin resistance, impairment of whole-body glucose utilization, increased levels of circulating leptin, and altered profiles of amino acids in plasma; however, these effects were diminished in ewes receiving obesity management during or after gestation. Additionally at PPD150, obesity increased the circulating levels of ammonia and urea in ewes, which was prevented by realimentation to 100 percent NRC requirements. These results indicate that weight reduction in obese dams during pregnancy or after parturition can beneficially ameliorate the adverse effects of gestational obesity on the mother.

The purpose of this study was to examine the incidence of obesity and Developmental Coordination Disorder (DCD) of girls in the age group 10-12 years of different race groups in the North-West Province. A second purpose was to determine if DCD status can be predicted effectively among 10-12 year old girls with regard to race, age, percentage body fat, body mass, length, body mass index and bent aim hang. Obesity is the cause of health risks, psychological consequences and improper development (Chantell et al., 1994:116; Marshall & Bouffard, 1994:1997; Treuth et al., 1997:1738). Children with DCD have poor motor abilities and experience problems regarding concentration and social abilities, all of which are necessary for successful schooling (Geuze & Borger, 1993:14; Piek & Edwards, 1997:55; Sugden & Chambers, 1998:139) According to research, the incidence of obesity among children has doubled over the last 20 years, and 10-30% of all children and adolescents can be classified as obese. Causes of obesity may be genetic but a lack of physical activity and an unbalanced diet can also contribute to obesity. Health risks, psycho-social risks and developmental disorders are all indicated in the literature to be consequences of obesity. The incidence of DCD is documented in the literature to be between 5% and 16%. It is also shown that it may be the cause of problems in daily living and at school, and some racial differences with regard to motor differences are indicated. It is also indicated that overweight and obese children are less mobile and that their motor achievement is poorer in movements where the shifting of body weight is required. All the subjects for this study (N=346) completed the Movement ABC (MABC) (Henderson & Sugden, 1992) to determine their DCD status. Fat percentage was determined from the subscapular and triceps skin folds according to the formula of Boileau et al. (1985:17-27), while a body mass index (BMI) (l/w2)above the 85th percentile was used as a criterion for overweight, and a BMI of above the 95th percentile for obesity. The Statistics for Windows computer package was used to determine descriptive statistics and significant differences between the groups. The results showed that the incidence of obesity and DCD were 4,93% and 59,78% respectively. 50% of the white girls, 72,73% of blacks, 0% of coloureds and 100% of Indian girls in the total group who were classified as DCD were also obese. The results indicated a higher relationship between obesity and DCD among the Indian and black girls compared to the white and coloured girls in the DCD group. Indian girls showed the highest incidence of obesity and coloured girls the least. The Indian and black girls also showed the highest incidence of DCD, while the percentages of DCD among all the race groups were higher than the levels indicated in the literature. The percentage of obesity found in the study was lower than in the literature, but higher percentages were found among the Indian and white girls, while all the obese Indian girls were also classified as suffering from DCD. With regard to the second aim of the study, no significant predictors for DCD could be found among the different body composition variables of bent arm hang, race and age, although some tendencies emerged. Results showed that the percentage fat was not a good predictor of DCD status in the group, but in the different racial groups its predictive value became higher. However, none of the variables could be considered good predictors of DCD status among girls, although it can be concluded that there are tendencies towards a relationship between obesity, DCD and race. Thus it is important for children with DCD and obesity (separate and in combination) to be identified and treated with intervention programs as early as possible, and it is essential to include physical activities as part of the treatment (Dussart, 1994:81; LeMure et al., 2000:336). The results of the study indicated that it is important to analyse the needs and characteristics of the different race groups in order to ensure the success of such programs. Indian girls especially should be encouraged to participate in physical activity programmes because of the high percentages of obesity found in the DCD group. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2004.

The purpose of this study was to examine the incidence of obesity and Developmental Coordination Disorder (DCD) of girls in the age group 10-12 years of different race groups in the North-West Province. A second purpose was to determine if DCD status can be predicted effectively among 10-12 year old girls with regard to race, age, percentage body fat, body mass, length, body mass index and bent aim hang. Obesity is the cause of health risks, psychological consequences and improper development (Chantell et al., 1994:116; Marshall & Bouffard, 1994:1997; Treuth et al., 1997:1738). Children with DCD have poor motor abilities and experience problems regarding concentration and social abilities, all of which are necessary for successful schooling (Geuze & Borger, 1993:14; Piek & Edwards, 1997:55; Sugden & Chambers, 1998:139) According to research, the incidence of obesity among children has doubled over the last 20 years, and 10-30% of all children and adolescents can be classified as obese. Causes of obesity may be genetic but a lack of physical activity and an unbalanced diet can also contribute to obesity. Health risks, psycho-social risks and developmental disorders are all indicated in the literature to be consequences of obesity. The incidence of DCD is documented in the literature to be between 5% and 16%. It is also shown that it may be the cause of problems in daily living and at school, and some racial differences with regard to motor differences are indicated. It is also indicated that overweight and obese children are less mobile and that their motor achievement is poorer in movements where the shifting of body weight is required. All the subjects for this study (N=346) completed the Movement ABC (MABC) (Henderson & Sugden, 1992) to determine their DCD status. Fat percentage was determined from the subscapular and triceps skin folds according to the formula of Boileau et al. (1985:17-27), while a body mass index (BMI) (l/w2)above the 85th percentile was used as a criterion for overweight, and a BMI of above the 95th percentile for obesity. The Statistics for Windows computer package was used to determine descriptive statistics and significant differences between the groups. The results showed that the incidence of obesity and DCD were 4,93% and 59,78% respectively. 50% of the white girls, 72,73% of blacks, 0% of coloureds and 100% of Indian girls in the total group who were classified as DCD were also obese. The results indicated a higher relationship between obesity and DCD among the Indian and black girls compared to the white and coloured girls in the DCD group. Indian girls showed the highest incidence of obesity and coloured girls the least. The Indian and black girls also showed the highest incidence of DCD, while the percentages of DCD among all the race groups were higher than the levels indicated in the literature. The percentage of obesity found in the study was lower than in the literature, but higher percentages were found among the Indian and white girls, while all the obese Indian girls were also classified as suffering from DCD. With regard to the second aim of the study, no significant predictors for DCD could be found among the different body composition variables of bent arm hang, race and age, although some tendencies emerged. Results showed that the percentage fat was not a good predictor of DCD status in the group, but in the different racial groups its predictive value became higher. However, none of the variables could be considered good predictors of DCD status among girls, although it can be concluded that there are tendencies towards a relationship between obesity, DCD and race. Thus it is important for children with DCD and obesity (separate and in combination) to be identified and treated with intervention programs as early as possible, and it is essential to include physical activities as part of the treatment (Dussart, 1994:81; LeMure et al., 2000:336). The results of the study indicated that it is important to analyse the needs and characteristics of the different race groups in order to ensure the success of such programs. Indian girls especially should be encouraged to participate in physical activity programmes because of the high percentages of obesity found in the DCD group. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2004.