Individuals with chronic liver disease experience progressive muscle wasting, weakness, fatigue, and decreased quality of life. Liver transplantation is the only treatment for end-stage liver disease with cirrhosis; however, muscle wasting, strength impairments, activity limitations, and health related quality of life do not return to the level of healthy adults. Currently there is no plan of care for rehabilitation of individuals post-liver transplantation. These individuals are only instructed to gradually increase walking and activity. Walking may increase lower extremity muscle strength; however, walking at a self-selected pace is less effective than resistance exercise. The purpose of this dissertation was to compare the benefits of a home exercise program of targeted lower extremity resistance exercise with benefits of progressive walking in individuals who have undergone liver transplantation. In Chapter 2 we performed a study to validate the ability of several outcome measures to detect changes in strength and activity performance in the population with liver disease and post-liver transplantation. The strength impairment measures of Grip Strength, Heel Rising, and Bridging along with activity limitation measures 30 Second Chair Stand and Six Minute Walk Test (6MWT) were able to differentiate strength and activity performance across levels of liver disease severity including post liver transplantation. Liver disease severity was moderately correlated with the strength impairment measures Bridging and Heel Rising but was not correlated with Grip strength. Liver disease severity was moderately correlated with 6MWT and 30-Second Chair-Stand but was not correlated with the SF-36 physical function scale. Strength impairment measures were strongly correlated with the activity limitation measures. Heel Rising and Bridging were strongly correlated with 30-Second Chair-Standing and 6MWT. Grip strength was moderately correlated with 30-Second Chair-Standing. In Chapter 3 we conducted a randomized controlled trial to assess the benefits of resistance exercise to progressive walking as a treatment plan for improving strength and activity performance in individuals post liver transplantation. We also examined the relationships of the change in muscle strength to the change in activity performance. Both the exercise and walking groups improved in strength and activity performance; however, the group performing the resistance exercise improved more. Bridging, 30 Second Chair Standing, Heel Rising, and 6MWT increased more for the exercise group than the walking group. Additionally, changes in strength were related to the changes in activity performance and health related quality of life. Bridging was correlated with Heel Rising, 30 Second Chair Standing, 6MWT, and the Chronic Liver Disease Questionnaire. In Chapter 4 we discuss the clinical relevance of the results of the studies described in the above chapters. We conclude Bridging, Heel Rising, 30 Second Chair Standing, and 6MWT are valid outcome measures to measure changes in strength and activity performance in the population with liver disease. Individuals post liver transplantation improve in strength and activity performance through progressive walking; however, the addition of resistance exercise to the current treatment plan is necessary for greater improvement. Additionally it is clinically relevant that this population was adherent to a home exercise program. Subjects adherent to the exercise program increased in strength and activity performance greater than subjects who were non-adherent.

Thesis (M.S.)--Oregon State University, 1982. / Typescript (photocopy). Some maps folded in pocket. Includes bibliographical references (leaves 156-169). Also available via the World Wide Web.

Increased demand for animal disease surveillance information has led to the development and refinement of methodologies for qualitative and quantitative surveillance system evaluations to maximize efficiency and efficaciousness. The impetus for this surveillance evaluation project was chronic wasting disease (CWD) and the objectives were to apply both qualitative and quantitative methodologies to examine the components of CWD surveillance in Saskatchewan.<p> A retrospective review of deer pathology and hunter-harvest submissions in Saskatchewan was conducted through the Canadian Cooperative Wildlife Health Centre. Qualitative evaluation methods outlined by Klauke et al (1988) were used and included key stakeholder interviews. A quantitative evaluation, with specific focus on disease detection, was conducted to examine system sensitivity, confidence of disease freedom and to compare system components using methods described by Martin et al (2007). The analysis was conducted using a scenario tree and Monte Carlo simulation.<p> Sampling rates of dead and clinically ill deer were low with a high degree of variability by season, year, location and nature of submissions. Ultimately, variability of submission patterns likely affected when and where diseases were detected. Poor data quality reduced the amount of available data for analysis but quality dramatically improved over time.<p> The surveillance evaluation demonstrated that the current surveillance system places more emphasis on monitoring trends in CWD-positive areas, at the expense of early detection. This is explained mostly by the coupling of disease control efforts and surveillance, in that harvests are heavily focused in CWD-positive areas. The system is not sufficient to detect disease in new areas where the disease prevalence is low, primarily due to low submission rates.<p> The quantitative evaluation found that overall sensitivity of the surveillance system and confidence of disease freedom was highly dependent on detection prevalence and the ongoing risk of disease introduction. Surveillance in the eastern part of Saskatchewan was not adequate from 1997-2006 to detect CWD at 0.5-1% prevalence. However, if risk of CWD introduction over this time period was assumed to be low, it can be concluded that the prevalence in this region was not 5% or higher.<p> A detection goal of 0.5-1% prevalence is an ambitious surveillance goal, especially in areas where the risk of disease introduction is high. The use of more targeted surveillance strategies should be further explored to help better meet surveillance these surveillance objectives.

Increased demand for animal disease surveillance information has led to the development and refinement of methodologies for qualitative and quantitative surveillance system evaluations to maximize efficiency and efficaciousness. The impetus for this surveillance evaluation project was chronic wasting disease (CWD) and the objectives were to apply both qualitative and quantitative methodologies to examine the components of CWD surveillance in Saskatchewan.<p> A retrospective review of deer pathology and hunter-harvest submissions in Saskatchewan was conducted through the Canadian Cooperative Wildlife Health Centre. Qualitative evaluation methods outlined by Klauke et al (1988) were used and included key stakeholder interviews. A quantitative evaluation, with specific focus on disease detection, was conducted to examine system sensitivity, confidence of disease freedom and to compare system components using methods described by Martin et al (2007). The analysis was conducted using a scenario tree and Monte Carlo simulation.<p> Sampling rates of dead and clinically ill deer were low with a high degree of variability by season, year, location and nature of submissions. Ultimately, variability of submission patterns likely affected when and where diseases were detected. Poor data quality reduced the amount of available data for analysis but quality dramatically improved over time.<p> The surveillance evaluation demonstrated that the current surveillance system places more emphasis on monitoring trends in CWD-positive areas, at the expense of early detection. This is explained mostly by the coupling of disease control efforts and surveillance, in that harvests are heavily focused in CWD-positive areas. The system is not sufficient to detect disease in new areas where the disease prevalence is low, primarily due to low submission rates.<p> The quantitative evaluation found that overall sensitivity of the surveillance system and confidence of disease freedom was highly dependent on detection prevalence and the ongoing risk of disease introduction. Surveillance in the eastern part of Saskatchewan was not adequate from 1997-2006 to detect CWD at 0.5-1% prevalence. However, if risk of CWD introduction over this time period was assumed to be low, it can be concluded that the prevalence in this region was not 5% or higher.<p> A detection goal of 0.5-1% prevalence is an ambitious surveillance goal, especially in areas where the risk of disease introduction is high. The use of more targeted surveillance strategies should be further explored to help better meet surveillance these surveillance objectives.

Thesis (M.S.)--University of Wyoming, 2008. / Title from PDF title page (viewed on Jan. 19, 2010). Includes bibliographical references.

Thesis (M.S.)--Brigham Young University. Dept. of Geology, 2003. / Includes bibliographical references (p. 38-40).

No description available.

Body composition profiles including stunting, wasting and underweight, overweight and obesity, can all affect the health, motor development and academic achievements of children. South Africa (SA), a developing, middle-income country, with large socio-economic inequalities, is one of the most complex nations with regard to race and ethnicity. It therefor results in different body composition profiles of children and adolescents, where undernutrition and obesity can occur among children and adolescents in the same socio-geographic population in disadvantaged communities, as well as in the same household. The aim of this study was firstly, to determine the incidence of overweight and obesity among Grade 1-learners in the North West Province of SA and to determine whether this incidence is related to gender, race and the socio-economic circumstances in which these learners live. Secondly, the study aimed to determine the incidence of stunting, wasting and underweight among this group of Grade 1-learners and to determine whether these incidences are related to gender, race and the socio-economic circumstances in which these learners live. The anthropometric measurements that were used in the study were height (cm), body mass (kg), 3 skinfolds [(sub-scapular, triceps and medial calf)] (mm) and waist circumference (cm). These measurements were taken by trained researchers according to the guidelines International Society for the Advancement of Kinanthropometry (ISAK). Body mass index (BMI) [(body mass (kg)/height (m)2)] was calculated and international age-specific cut-off points for BMI was used to determine whether a learner was overweight or obese. Z-scores of less than -2 standard deviation (SD) for height-for-age and weight-for-age were calculated to determine the prevalence of stunting and underweight, while the Z-scores for wasting was determined using BMI-for-age, under the 5th percentile from an international reference population. The Statistica-computer programme (Statsoft, 2011) and AntroPlus software (version 1.0.2) in SAS (Statistical Analysis System) were used to analyse the data. Data were descriptively analysed by using percentages, means (), minimum and maximum values and standard deviations (SD). Two-way frequency tables were used to analyse the incidence for overweight, obesity, stunting, wasting and underweight. Pearson Chi Square analysis p≤0,05 was used to determine statistical significance of differences in stunting, wasting and underweight between school types, race and genders. Practical significance of differences was determined using effect sizes (d≥0,1 which indicates a small effect, d≥0,3 indicating a medium effect and d≥0,5 indicating a large effect). Tukey’s Post Hoc tests were used to determine the significance of differences between the groups and genders. The results revealed an incidence of 11,6% of overweight and obesity in the group (N=816) of Grade 1-learners. Overweight in the group was 7,8% and overweight was more prevalent in 7 year old learners with 10,5%, compared to 6 year old learners with 6,3%. Obesity (3,8%) showed a lower incidence compared to overweight, were 2,5% learners at 6 years and 0,7% learners at 7 years were obese. The boys showed the highest prevalence for severe obesity at 6 and 7 years (2,4%). White learners showed the highest prevalence for overweight, obesity and severe obesity at 6 and 7 years. The group of Grade 1-learners furthermore showed lower percentages of stunting (4,3%), wasting (7,4%) and underweight (4,3%) compared to overweight and obesity incidences. A higher prevalence of wasting and underweight were found among the boys (8,4%; 6,0%) compared to the girls (6,3%; 2,5%), although the difference was only significant for underweight (p=0,02), while stunting was similar among girls (4,5%) and boys (4,1%; p>0,05). Black learners showed the highest incidence for underweight (5,5%; p<0,01), while small percentages of underweight were found in the white learners. Only the black learners showed stunting (p<0,01), while wasting occurred in black (n=39) and white (n=15) learners. Quintile 1-3 schools had the highest prevalence of underweight (5,1% – 8,2%) and stunting (3,9% – 10,7%), which was significantly higher than in Quintile 4 and 5 schools (p<0,01), and agreed with higher prevalences found in rural areas in other South African studies. Knowledge about the body composition profiles of young school beginners is important since extremes such as obesity, stunting and wasting play an important role in the further development and health of children. The results of this study make a valuable contribution to knowledge that can be used in this regard for preventative purposes. / Thesis (MSc (Kinderkinetics))--North-West University, Potchefstroom Campus, 2013.

Body composition profiles including stunting, wasting and underweight, overweight and obesity, can all affect the health, motor development and academic achievements of children. South Africa (SA), a developing, middle-income country, with large socio-economic inequalities, is one of the most complex nations with regard to race and ethnicity. It therefor results in different body composition profiles of children and adolescents, where undernutrition and obesity can occur among children and adolescents in the same socio-geographic population in disadvantaged communities, as well as in the same household. The aim of this study was firstly, to determine the incidence of overweight and obesity among Grade 1-learners in the North West Province of SA and to determine whether this incidence is related to gender, race and the socio-economic circumstances in which these learners live. Secondly, the study aimed to determine the incidence of stunting, wasting and underweight among this group of Grade 1-learners and to determine whether these incidences are related to gender, race and the socio-economic circumstances in which these learners live. The anthropometric measurements that were used in the study were height (cm), body mass (kg), 3 skinfolds [(sub-scapular, triceps and medial calf)] (mm) and waist circumference (cm). These measurements were taken by trained researchers according to the guidelines International Society for the Advancement of Kinanthropometry (ISAK). Body mass index (BMI) [(body mass (kg)/height (m)2)] was calculated and international age-specific cut-off points for BMI was used to determine whether a learner was overweight or obese. Z-scores of less than -2 standard deviation (SD) for height-for-age and weight-for-age were calculated to determine the prevalence of stunting and underweight, while the Z-scores for wasting was determined using BMI-for-age, under the 5th percentile from an international reference population. The Statistica-computer programme (Statsoft, 2011) and AntroPlus software (version 1.0.2) in SAS (Statistical Analysis System) were used to analyse the data. Data were descriptively analysed by using percentages, means (), minimum and maximum values and standard deviations (SD). Two-way frequency tables were used to analyse the incidence for overweight, obesity, stunting, wasting and underweight. Pearson Chi Square analysis p≤0,05 was used to determine statistical significance of differences in stunting, wasting and underweight between school types, race and genders. Practical significance of differences was determined using effect sizes (d≥0,1 which indicates a small effect, d≥0,3 indicating a medium effect and d≥0,5 indicating a large effect). Tukey’s Post Hoc tests were used to determine the significance of differences between the groups and genders. The results revealed an incidence of 11,6% of overweight and obesity in the group (N=816) of Grade 1-learners. Overweight in the group was 7,8% and overweight was more prevalent in 7 year old learners with 10,5%, compared to 6 year old learners with 6,3%. Obesity (3,8%) showed a lower incidence compared to overweight, were 2,5% learners at 6 years and 0,7% learners at 7 years were obese. The boys showed the highest prevalence for severe obesity at 6 and 7 years (2,4%). White learners showed the highest prevalence for overweight, obesity and severe obesity at 6 and 7 years. The group of Grade 1-learners furthermore showed lower percentages of stunting (4,3%), wasting (7,4%) and underweight (4,3%) compared to overweight and obesity incidences. A higher prevalence of wasting and underweight were found among the boys (8,4%; 6,0%) compared to the girls (6,3%; 2,5%), although the difference was only significant for underweight (p=0,02), while stunting was similar among girls (4,5%) and boys (4,1%; p>0,05). Black learners showed the highest incidence for underweight (5,5%; p<0,01), while small percentages of underweight were found in the white learners. Only the black learners showed stunting (p<0,01), while wasting occurred in black (n=39) and white (n=15) learners. Quintile 1-3 schools had the highest prevalence of underweight (5,1% – 8,2%) and stunting (3,9% – 10,7%), which was significantly higher than in Quintile 4 and 5 schools (p<0,01), and agreed with higher prevalences found in rural areas in other South African studies. Knowledge about the body composition profiles of young school beginners is important since extremes such as obesity, stunting and wasting play an important role in the further development and health of children. The results of this study make a valuable contribution to knowledge that can be used in this regard for preventative purposes. / Thesis (MSc (Kinderkinetics))--North-West University, Potchefstroom Campus, 2013.

Indianapolis / By the traditional definition of unintended weight loss, cachexia develops in ~80% of patients with pancreatic ductal adenocarcinoma (PDAC). Here we measure the longitudinal body composition changes in patients with advanced PDAC undergoing FOLFIRINOX therapy. We performed a retrospective review of 53 patients with advanced PDAC on FOLFIRINOX as first line therapy at Indiana University Hospital from July 2010 to August 2015. Demographic, clinical, and survival data were collected. Body composition measurement, trend, univariate and multivariate analysis were performed. Three cachexia phenotypes were identified. The majority of patients, 64%, had Muscle-and-Fat Wasting (MFW), while 17% had Fat-Only Wasting (FW) and 19% had No Wasting (NW). NW had significantly improved overall median survival (OMS) of 22.6 months vs. 13.0 months for FW and 12.2 months for MFW (p=0.02). FW (HR=5.2; 95%CI=1.5-17.3) and MFW (HR=1.8; 95%CI=1.1-2.9) were associated with an increased risk of mortality compared to NW. OMS and risk of mortality did not differ between FW and MFW. Progression of disease, sarcopenic obesity at diagnosis, and primary tail tumors were also associated with decreased OMS. On multivariate analysis cachexia phenotype and chemotherapy response were independently associated with survival. Three phenotypes of cachexia were observed. Moreover, three phenotypes suggests molecular or genetic heterogeneity of host or tumor. Identifying these differences will be vital to defining optimal treatment for cachexia. Survival among FW was as poor as MFW suggesting adipose tissue plays a crucial role in cachexia. Blunting or possibly preventing cachexia may confer a significant survival advantage in patients with advanced PDAC.