Smoking cessation leads to weight gain but the reason for this gain is not clearly established. The objective of this study was to compare the mean change in dietary intake among quitters and non-quitters enrolled in a smoking cessation program. Mean dietary intake was measured using 24-hour recall over the telephone at baseline and 6 weeks after the scheduled 'quit date'. Baseline data were obtained from 177 subjects and 130 (73%) were recontacted with complete data. There were 47 quitters (27%). The mean self-reported weight gain among the quitters and non-quitters was 2.4 kg +/- 3.1 and 0.04 kg +/- 2.5 respectively (p = 0.001). Mean energy intake was the same at baseline between the quitters and non-quitters. There were statistically significant changes in dietary intake between quitters and non-quitters. Given the high within-individual variability (sd 832) this sample size was only sufficient to detect differences in the change in intake of approximately 460 kcals between quitters and non-quitters.

Thesis (M.S.)--Auburn University, 2007. / Abstract. Vita. Includes survey instruments. Includes bibliographic references (ℓ. 63-68)

Thesis (M.S.)--Auburn University, 2008. / Abstract. Vita. Includes bibliographical references (p. 71-80).

Thesis (Ph. D.)--University of Wyoming, 2007. / Title from PDF title page (viewed on Dec. 5, 2008). Includes bibliographical references (p. 33-42).

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed Oct. 10, 2007). PDF text: viii, 178 p. UMI publication number: AAT 3258407. Includes bibliographical references. Also available in microfilm and microfiche formats.

Philosophiae Doctor - PhD / Background: There is an increased interest in understanding the effects of severe tooth decay on the physical, anthropometric, psychosocial, functional, and oral health related quality of life (OHRQoL) among children. Children who have severe tooth decay are thought to have lower weight, height, Body Mass Index (BMI), Haemoglobin (Hb) levels and poorer OHRQoL compared to children who are caries free. Comprehensive dental treatment under general anaesthesia (GA) appears to significantly improve these variables to levels equivalent to healthy caries free children. However, there is a paucity of high quality evidence that has demonstrated these gains in the anthropometric (Height, Weight BMI), clinical and oral health related quality of life (OHRQoL) measures following extensive dental treatment under GA. This trial sought to determine the impact of the treatment of severe dental caries on weight, height, body mass index (BMI), Hb levels and oral health related quality of life (OHRQoL) among a group of young children who had access to immediate care compared to a control group of children who waited 6 months before treatment. Methodology: This was a Community based prospective, randomized controlled intervention trial conducted in the peri-urban town of Worcester in the Western Cape Region of South Africa. The study population consisted of crèche going children, aged 2-6 years old who had severe tooth decay with a pufa score ≥ 1and attended public dental facilitates in the town. Simple random sampling using an existing lottery draw system at the clinic was used to divide the children into an immediate treatment group and a delayed treatment group (6 months later). Baseline height, weight, BMI, Hb levels were compared between treatment and no treatment groups at 6 months. OHRQol was measured from both the child and parent/caregiver perspective at baseline, 6 months later (in delayed group) and 6 months post treatment in both groups. Anthropometric variables were reported as unadjusted means and z-scores which were determined by transforming the unadjusted means against a reference group to determine the weight-for-height (WAH), weight-for-age (WAZ) and BMI-for –age (BAZ) in both groups after treatment. OHRQoL scores were dichotomized and/or categorized into high, low and no impacts. Descriptive statistics (means), correlation analyses (by age, gender) and multilevel mixed regression model analysis was undertaken to determine the effect of the treatment on the outcome variables using SPSS version 23. Results: 126 children in the immediate group (mean age 4.4 years, SD 1.2) and 125 children (mean age 3.75 years, SD 1.3) completed this trial. Comparative baseline measures significantly favoured children in the immediate group for age, height, and weight. The average number of teeth extracted under GA was 7.4 (SD 3.53) in the immediate group and 8.55 (SD 3.94) in the delayed group. Unadjusted mean scores for height, weight, BMI and Hb showed significant improvements within the groups at 6 months follow-up. When the group were compared (treatment vs. no treatment) using unadjusted or z-scores, statistically significant gains were noted for height and weight but not for BMI or Hb. Multilevel Regression modelling confirmed these findings implying that the intervention alone was not a factor in the improved Hb or BMI levels. OHRQoL significantly improved from both the child and parent/caregivers' perspective after treatment was received. In the delayed group, there was no improvement in OHRQoL scores during the 6 month waiting period but these significantly improved to comparable levels seen in the immediate group 6 months after treatment. Conclusion: This randomised controlled trial found that children with severe tooth decay who received treatment under general anaesthesia had significantly better height and weight gains than those children who has no treatment. Although gains were also noted in the BMI and Hb levels, these gains were not statically significant and their improvements could not be explained by the intervention alone (dental treatment under general anaesthesia). OHRQoL outcomes showed significant improvement from both the child and parental/caregiver perspective when comparing children who received treatment against those who did not have treatment. Children who had to wait for treatment had similar negative impacts on OHRQoL at 6 months follow-up compared to baseline. However, once they received treatment (delayed group), similar significant improvements for OHRQoL as reported in the immediate group was also found in the delayed group.

Abstract Previous observations have indicated that reproductive endocrine disorders are common among patients with epilepsy. Valproate (VPA) treatment is associated with hyperandrogenism, polycystic ovaries, and obesity in women. Carbamazepine (CBZ) may also induce endocrine disorders, while the hormonal effects of oxcarbazepine (OXC) are poorly known. The aim of this study was to elucidate the effects of antiepileptic drugs on reproductive hormones, linear growth and pubertal maturation in patients with epilepsy. Altogether 223 patients taking VPA, CBZ, or OXC monotherapy for epilepsy and 103 healthy age- and sex-matched volunteers participated in the study. Seventy-eight girls and 90 men with epilepsy participated in the cross-sectional parts of the study. Thirty-nine adult patients with newly diagnosed epilepsy participated in a 3-month longitudinal study and VPA was replaced with lamotrigine (LTG) in 16 women with VPA-related endocrine disorders in a 1-year longitudinal study. The girls were between 8-18 years, the women 17-41 years and the men 17-51 years of age. None of the antiepileptic drugs studied significantly influenced linear growth or pubertal development in girls with epilepsy, but hyperandrogenemia, increased number of ovarian follicles, and weight gain were observed in prepubertal, pubertal and postpubertal girls taking VPA for epilepsy. Increased serum testosterone levels were observed in half of the women after the first 3 months of VPA medication, and high serum concentrations of androgens were common (prevalence 57 %, p < 0.001) in men taking long-term VPA treatment. The women with VPA-related hyperandrogenism and polycystic ovaries were also found to present other features of insulin resistance (i.e. hyperinsulinemia, centripetal obesity, and an unfavorable serum lipid profile). Reproductive endocrine disorders associated with VPA treatment in women began to normalize after VPA was replaced by LTG. CBZ reduced the bioactivity of androgens, whereas OXC did not have similar effects. Serum concentrations of sex hormone-binding globulin (SHBG) were increased and dehydroepiandrosterone sulfate decreased already during the first months of CBZ treatment. Serum hormone levels were normal in patients with low OXC doses (< 900 mg/d), but serum concentrations of testosterone, gonadotropins and SHBG were high in men with a daily OXC dose ≥ 900 mg. The adverse reproductive endocrine effects of antiepileptic drugs should be considered at the beginning of and during antiepileptic medication.

This thesis explores the role of mood in adherence to changes in behaviour required for weight maintenance following weight loss in an obese sample. Significant increases in physical activity are necessary for successful weight maintenance, yet this change in lifestyle remains challenging for many. Anecdotally, the importance of being in the 'right mood' to make lifestyle changes is frequently reported. A systematic review of the weight maintenance literature revealed that a number of behaviour change techniques were associated with effective weight maintenance interventions. Therefore, the current randomised control study employed relevant behaviour change techniques within two goal setting interventions to improve either daily steps walked or mood compared to a control group in a weight loss programme cohort. The number of daily steps walked and mood were evaluated and the following questions were addressed: 1) In an obese population enrolled in a weight loss programme, do goal-setting interventions increase the number of steps walked compared to those in a control group? 2) Does the mood score differ for those participants in the mood improvement intervention group compared to those in the steps-walked intervention or control groups? 3) Does weight change differ for those individuals who have shown mood improvement compared to those whose mood is unchanged/worsened? The primary outcomes of steps walked, mood and weight were recorded immediately after intervention and again after unsupervised follow up 6-months later. The results showed that all groups increased the number of steps walked but not significantly so. This increase was greatest for the steps-walked group during the active intervention period but greatest for the mood intervention group during the unsupervised follow-up period. Mood improved significantly for all groups and was associated with significantly increased weight loss at follow-up. A trend for increased steps walked being associated with improved mood was observed in the 6-month follow up period. These findings highlight the links between mood and continued participation in lifestyle behaviour changes required for weight maintenance. Future research priorities are outlined for this field.

Reports have linked atypical antipsychotics (AAPs) with weight gain. The polymorphic CYP2D6 involved in metabolism has been associated with medication morbidity. Eleven subjects receiving olanzapine were genotyped for CYP2D6 to examine the relationship between 2D6 and AAP weight gain. Using a linear regression, the dependent variable was percent change in body mass index (BMI). Genotype, dose and duration of treatment were independent. Genotype was significant (P < 0.0097) for those with a *1/*3 or *4 genotype experiencing a larger percent BMI change than those with a *1/*1 genotype. This may be due to increased olanzapine concentrations leading to increased exposure, which may trigger AAP weight gain.

This qualitative study included women who had gone through the menopausal transition and had experienced obesity, and it focused on their weight histories and experiences across the life course. The goal of this research was to add to the body of knowledge concerning weight gain by applying a novel middle range theory (story theory). Story theory was used to collect and interpret from women’s life course stories the critical themes and patterns of their weight gain. Oral accounts were elicited during personal interviews from a convenience sample of ten women recruited from a weight loss and exercise program in Central Florida. Literature focusing on the prevalence of obesity, contributing factors and associated complications, as well as treatment approaches is extensive. A variety of approaches have been proposed to identify factors that contribute to the development of obesity across the lifespan. Ultimately, the goal of these studies is to understand risk factors for weight gain along with corresponding prevention and management strategies. A particular life course approach focuses on critical periods across the life span that may be associated with risk for the development of obesity. For women, puberty, pregnancy and menopause are noted to be critical for weight change in the life course as they are associated with hormonal changes and changes in body composition including fat mass. Story theory was chosen to conceptualize and guide participants through a personal interview in order to share their weight experiences along their life course. Content analysis procedures were used to analyze the data in order to identify themes and corresponding verbatim exemplars. A re-constructed composite story was developed that included excerpts from the participants’ stories in order to reveal contextualized results. Themes that were identified relative to participants’ experiences with their weight included: changes associated with emotional and iv physical health; eating patterns associated with multiple and/or changing roles/relationships; and, changes in the environment. An interpretation of the predominant pattern of weight gain included: changes in eating and physical activity that occur during multiple and simultaneous transitional life experiences, primarily in adulthood. The findings suggest that transitional experiences in women's lives - physiological, developmental, relational or environmental - were critical in that they presented risk for behavior changes related to eating and physical activity. The results of this study and the use of story theory have implications for providing individualized, patient-centered lifestyle recommendations for the prevention of unhealthy weight gain