Background: The study of circulating biomarkers and their association with disease outcomes has become progressively complex due to advances in the measurement of these biomarkers through multiplex technologies. The Least Absolute Shrinkage and Selection Operator (LASSO) is a data analysis method that may be utilized for biomarker selection in these high dimensional data. However, it is unclear which LASSO-type method is preferable when considering data scenarios that may be present in serum biomarker research, such as high correlation between biomarkers, weak associations with the outcome, and sparse number of true signals. The goal of this study was to compare the LASSO to five LASSO-type methods given these scenarios. Methods: A simulation study was performed to compare the LASSO, Adaptive LASSO, Elastic Net, Iterated LASSO, Bootstrap-Enhanced LASSO, and Weighted Fusion for the binary logistic regression model. The simulation study was designed to reflect the data structure of the population-based Tucson Epidemiological Study of Airway Obstructive Disease (TESAOD), specifically the sample size (N = 1000 for total population, 500 for sub-analyses), correlation of biomarkers (0.20, 0.50, 0.80), prevalence of overweight (40%) and obese (12%) outcomes, and the association of outcomes with standardized serum biomarker concentrations (log-odds ratio = 0.05-1.75). Each LASSO-type method was then applied to the TESAOD data of 306 overweight, 66 obese, and 463 normal-weight subjects with a panel of 86 serum biomarkers. Results: Based on the simulation study, no method had an overall superior performance. The Weighted Fusion correctly identified more true signals, but incorrectly included more noise variables. The LASSO and Elastic Net correctly identified many true signals and excluded more noise variables. In the application study, biomarkers of overweight and obesity selected by all methods were Adiponectin, Apolipoprotein H, Calcitonin, CD14, Complement 3, C-reactive protein, Ferritin, Growth Hormone, Immunoglobulin M, Interleukin-18, Leptin, Monocyte Chemotactic Protein-1, Myoglobin, Sex Hormone Binding Globulin, Surfactant Protein D, and YKL-40. Conclusions: For the data scenarios examined, choice of optimal LASSO-type method was data structure dependent and should be guided by the research objective. The LASSO-type methods identified biomarkers that have known associations with obesity and obesity related conditions.

No description available.

En av de största utmaningarna, inom folkhälsan, under 2000-talet beskrivs vara, övervikt och fetma hos barn. Sen år 1990 är ökningen alarmerande och detta främst i låg- och medelinkomstländerna. I Sverige har det främst varit en ökning av övervikt och fetma bland barn i en mer utsatt socioekonomisk bakgrund. Familjen och de levnadsvanor som följer barnet i uppväxten beskrivs vara avgörande, för om barnet utvecklar övervikt eller fetma. Sjuksköterskor har goda möjligheter, att komma i kontakt med hela familjen för att rådgöra samt stötta. Syftet med studien är att beskriva sjuksköterskors erfarenheter av att möta barn med övervikt samt deras familjer. En litteraturstudie genomfördes. Elva vetenskapliga artiklar, varav 9 med kvalitativ forskningsansats och 2 med kvantitativ forskningsansats, granskades och analyserades. Fyra teman och nio subteman identifierades. Resultatet visar att yrkesverksamma sjuksköterskor möter svårigheter, till dessa hör att övervikt tolereras och accepteras på ett annat sätt än tidigare, liksom livsstilsförändringar som innebär att vi idag är mer stillasittande. De ansåg sig väl positionerade för att ta hand om barnen med övervikt och fetma, men upplevde en osäkerhet för samtalet kring och med barnet, samt dess familj. Bristande riktlinjer på arbetsplatsen bidrog till färre antal samtal, med berörda föräldrar. Sjuksköterskorna upplevde en osäkerhet i den egna professionen, där mer utbildning önskades, dels i hur kommunikationen med barn och deras föräldrar kunde förbättras men även i ämnet övervikt. För att öka tryggheten hos sjuksköterskorna behövs tydlig arbetsbeskrivning och riktlinjer, mer utbildning, främst i kommunikation med barn och familj, men även ett förbättrat samarbete med andra yrkeskategorier.

O excesso de peso é um grave problema de saúde pública na atualidade e vem sendo considerado uma epidemia nos países desenvolvidos. Este quadro predispõe os indivíduos a risco de desenvolvimento de doenças crônicas não-transmissíveis e quando instaladas na adolescência, são agravantes para perpetuação na idade adulta. O presente estudo teve como objetivo estimar a prevalência de excesso de peso em 386 adolescentes de ambos os sexos, com idade entre 10 e 14 anos, de duas escolas públicas e duas escolas privadas da cidade de Guarapuava-PR. A análise foi realizada com dados de peso e altura e cálculo do Índice de Massa Corporal, levando em consideração a idade, sexo, rede de ensino e a presença de maturação sexual. Como resultados, encontrou-se prevalência de sobrepeso de 13,0% e obesidade de 3,4% com níveis mais elevados em meninos do que em meninas. Praticamente a metade dos adolescentes apresentava sinais de maturação sexual e desses, 70,0% tinham sobrepeso. Porém, naqueles com obesidade, a distribuição em relação à maturação sexual foi igual. Analisando-se pela origem da escola, os alunos da rede privada apresentaram índices mais elevados (16,2% de sobrepeso e 3,8% de obesidade) em relação aos da rede pública (10,0% de sobrepeso e 3,0% de obesidade). Concluiu-se que a alta prevalência de sobrepeso encontrada pode evoluir para obesidade justificando assim, a necessidade de políticas públicas que incentivem mudanças de hábitos de vida envolvendo a prática de atividade física e alimentação mais saudável. / Nowadays, overweight is a serious public health problem, which has been considered as an epidemic in developed countries. This situation predisposes individuals to the risk of non-transmissible chronic diseases which, when developed during adolescence, constitute aggravating circumstances for perpetuation into adulthood. This study aimed to estimate the prevalence of overweight in 386 male and female adolescents between 10 and 14 years old from two public and two private schools in Guarapuava-PR, Brazil. The analysis was based on weight, height and Body Mass Index data, considering age, gender, education network and sexual maturity. Prevalence rates amounted to 13.0% for overweight and 3.4% for obesity, with higher levels among boys than among girls. Practically half of the adolescents displayed signs of sexual maturity, 70.0% of whom suffered from overweight. However, overweight students were equally distributed in terms of sexual maturity. As to the origin of the school, students from the private network presented higher levels (16.2% for overweight and 3.8% for obesity) in comparison with those from the public network (10.0% overweight and 3.0% obesity). The high prevalence rates for overweight found in this study can evolve to obesity, which justifies the need for public policies that encourage changes in life habits involving physical exercise and healthier food habits.

O excesso de peso é um grave problema de saúde pública na atualidade e vem sendo considerado uma epidemia nos países desenvolvidos. Este quadro predispõe os indivíduos a risco de desenvolvimento de doenças crônicas não-transmissíveis e quando instaladas na adolescência, são agravantes para perpetuação na idade adulta. O presente estudo teve como objetivo estimar a prevalência de excesso de peso em 386 adolescentes de ambos os sexos, com idade entre 10 e 14 anos, de duas escolas públicas e duas escolas privadas da cidade de Guarapuava-PR. A análise foi realizada com dados de peso e altura e cálculo do Índice de Massa Corporal, levando em consideração a idade, sexo, rede de ensino e a presença de maturação sexual. Como resultados, encontrou-se prevalência de sobrepeso de 13,0% e obesidade de 3,4% com níveis mais elevados em meninos do que em meninas. Praticamente a metade dos adolescentes apresentava sinais de maturação sexual e desses, 70,0% tinham sobrepeso. Porém, naqueles com obesidade, a distribuição em relação à maturação sexual foi igual. Analisando-se pela origem da escola, os alunos da rede privada apresentaram índices mais elevados (16,2% de sobrepeso e 3,8% de obesidade) em relação aos da rede pública (10,0% de sobrepeso e 3,0% de obesidade). Concluiu-se que a alta prevalência de sobrepeso encontrada pode evoluir para obesidade justificando assim, a necessidade de políticas públicas que incentivem mudanças de hábitos de vida envolvendo a prática de atividade física e alimentação mais saudável. / Nowadays, overweight is a serious public health problem, which has been considered as an epidemic in developed countries. This situation predisposes individuals to the risk of non-transmissible chronic diseases which, when developed during adolescence, constitute aggravating circumstances for perpetuation into adulthood. This study aimed to estimate the prevalence of overweight in 386 male and female adolescents between 10 and 14 years old from two public and two private schools in Guarapuava-PR, Brazil. The analysis was based on weight, height and Body Mass Index data, considering age, gender, education network and sexual maturity. Prevalence rates amounted to 13.0% for overweight and 3.4% for obesity, with higher levels among boys than among girls. Practically half of the adolescents displayed signs of sexual maturity, 70.0% of whom suffered from overweight. However, overweight students were equally distributed in terms of sexual maturity. As to the origin of the school, students from the private network presented higher levels (16.2% for overweight and 3.8% for obesity) in comparison with those from the public network (10.0% overweight and 3.0% obesity). The high prevalence rates for overweight found in this study can evolve to obesity, which justifies the need for public policies that encourage changes in life habits involving physical exercise and healthier food habits.

This thesis investigated the effect of high intensity, intermittent exercise (HIIE) on fat loss in young, sedentary women. It attempted also to identify possible mechanisms underpinning exercise-induced changes in adiposity. Study 1 investigated some of the metabolic and hormonal responses to two variations of HIIE. Sixteen female subjects were tested. The first session involved a cycle ergometer VO2peak test. The next two sessions were completed in random order. After baseline measures the women did 20 min of HIIE. There was a short bout exercise of 8 s work, followed by 12 s relative rest and a long bout exercise of 24 s work followed by 36 s relative rest. Seven subjects had excess postexercise oxygen consumption (EPOC) and resting metabolic rate determined. Both exercise modalities made significant demands on the participants??? oxygen delivery systems. RER diminished over the 20 min of exercise and plasma glycerol concentrations increased. Lactate concentrations rose. Catecholamine concentrations were elevated postexercise. There was an elevated EPOC associated with above baseline fat utilisation. Study 2, a 15-week training study, was a randomised controlled trial comparing the effects of short bout HIIE and steady state (SS) exercise on fat loss. Forty-five women were randomly assigned to one of three groups: HIIE, SS, or control. Preliminary and posttraining testing included a DEXA scan and a VO2peak test including blood collection. All participants completed 3-d diet diaries and maintained their current diet for the course of the study. Participants exercised three times a week for the next 15 weeks under supervision. The HIIE group did 20 min of HIIE (8 s work:12 s rest) at a workload determined from the VO2peak test. The SS group cycled at 60%VO2peak , building to a maximum of 40 min exercise. Both exercise groups increased VO2peak . The HIIE group had a significant loss of total body mass (TBM) and fat mass (FM) when compared to the other groups. There was no change in dietary intake. There have been a number of studies examining the acute effects of HIIE but, to our knowledge, this is the first study examining the chronic effects of this particular exercise protocol.

<p>Overweight and obesity in children is an extensive and accelerating </p><p> problem in the western world. The risk factors for overweight are well-</p><p> known and well-documented. Focus should lie in the prophylactic work </p><p> in order to prevent overweight and obesity in preschool children.</p><p> The aim of our study has been to highlight the role of the district</p><p> nurse in her/his work to prevent overweight and obesity in preschool </p><p> children. The study was carried out through studies as a literature </p><p> review. In order to support the parents and taking their circumstances </p><p> and conditions into consideration, it was considered very important that </p><p> the district nurse paid attention to the view of the parents on the weight </p><p> of their child. Parents were considered to have an important role in </p><p> giving their children healthy eating habits. The attitude of the district </p><p> nurse was relevant as to how she/he treated the overweight and how </p><p> she/he tackled the preventive work. Professional practice and training </p><p> within the field were important factors in making the district nurse </p><p> succeed in her/his work to prevent overweight and obesity in children. </p><p> Lack of time and lack of parental commitment and attitude were the </p><p> main reasons for limiting the district nurse in her work to prevent </p><p> overweight and obesity in children. Personnel within the primary care </p><p> should supervise and coordinate health promoting measures in order to </p><p> prevent overweight and obesity in children. The district nurse plays a </p><p> unique part in influencing the parents very early on in their children’s </p><p> life by arranging regular and repeated visits to the child welfare center. </p><p> The basis for a successful work by the district nurse is training and the </p><p> fact that she is made aware of her own attitudes towards overweight. </p><p> More research is imperative to support and develop guidelines for </p><p> preventing overweight and obesity in children.</p>

<p>Overweight and obesity among children and adolescents is increasing. Diseases which earlier occurred exclusively among adults are now also observed among children. There is an urgent need for new treatments that can change this negative trend. The aim of this study was to describe existing treatments for obesity among children in the age of 6-12 and the effect of those treatments. This descriptive literature study is based on 17 research articles published between 2000 and 2007 from different parts in the world. The treatments found in the studies could be categorised as follows: treatment with only physical activity, multidisciplinary treatment, multidisciplinary treatment with family participation, behavioural program with support from parents and alternative medicine treatments. No significant pattern could be observed for the effects of the different treatments. Similar treatments showed different effects, which makes the data difficult to interpret. Good results among the studied treatments were however, often obtained using multidisciplinary programs. Moreover it was shown that support from parents had a positive effect. It is of major importance to adjust the treatment to each individual and to construct the program in such a way that the effect reside also after completion of the treatment.</p>

Purpose &lt;br&gt;The purpose of this focused ethnography is to understand the meaning and cultural influences of healthy eating and the role of nursing in the promotion of healthy eating practices from the Mexican American child's point of view. &lt;br&gt;Background &lt;br&gt;No current studies directly measure the meaning of healthy eating from the Mexican American child's perspective. Mexican American children have a unique perspective and understanding of the meaning of healthy eating and can help identify cultural norms and other factors that may be vital in directing culturally appropriate health promotion interventions. &lt;br&gt;Research Design &lt;br&gt;A focused ethnography method using Leininger's four phases of data analysis was utilized. &lt;br&gt;Informants &lt;br&gt;The researcher interviewed twenty-one children aged eleven to thirteen for the study. Fifteen individual interviews and two group interviews were completed. &lt;br&gt;Data Collection and Analysis &lt;br&gt;Data gathering and data analysis occurred simultaneously. Leininger's four phases of qualitative data analysis and utilized NVivo9 qualitative data management software. &lt;br&gt;Results &lt;br&gt;The data emerged into three themes within the culture. Theme one: Mexican American children connect healthy eating with familiar foods in the context of their Mexican American culture. Theme two: Foods that provide feelings of happiness and well being are essential for healthy eating. Theme three: Sources of food and health information education are valued when provided by familiar and trusted sources. &lt;br&gt;Conclusions and Implications &lt;br&gt;For the informants of this study the meaning of healthy eating is closely tied to the cultural life ways learned and valued by the Mexican American culture. Culture cannot be separated from the child when considering the meaning of healthy eating. Mexican American children view healthy eating within the context of culture, associating familiar foods that provide a feeling of happiness and well being with healthy foods. Mexican American children view eating habits as healthy when taught by familiar and trusted sources. &lt;br&gt;This study provides nurses an enhanced understanding of the meaning of healthy eating and valuable information to improve nutritional health education and promotion activities, better assists children and their families to improve and maintain health and provides culturally congruent care that is valued by the population. / School of Nursing; / Nursing / PhD; / Dissertation;

Overweight and obesity among children and adolescents is increasing. Diseases which earlier occurred exclusively among adults are now also observed among children. There is an urgent need for new treatments that can change this negative trend. The aim of this study was to describe existing treatments for obesity among children in the age of 6-12 and the effect of those treatments. This descriptive literature study is based on 17 research articles published between 2000 and 2007 from different parts in the world. The treatments found in the studies could be categorised as follows: treatment with only physical activity, multidisciplinary treatment, multidisciplinary treatment with family participation, behavioural program with support from parents and alternative medicine treatments. No significant pattern could be observed for the effects of the different treatments. Similar treatments showed different effects, which makes the data difficult to interpret. Good results among the studied treatments were however, often obtained using multidisciplinary programs. Moreover it was shown that support from parents had a positive effect. It is of major importance to adjust the treatment to each individual and to construct the program in such a way that the effect reside also after completion of the treatment.