Thesis (M.A.)--York University, 2009. Graduate Programme in Sociology. / Typescript. Includes bibliographical references (leaves 108-114). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR51505

Thesis (B.A.)--Haverford College, Dept. of English, 2009. / Includes bibliographical references.

Thesis (Ph.D.)--University of Waikato, 2007. / Title from PDF cover (viewed April 8, 2008) Includes bibliographical references (p. 404-445)

published_or_final_version / Social Work / Master / Master of Social Work

Context: Young women are at high risk of weight gain but there has been limited knowledge on weight management in this group. Hyperandrogenemia and menstrual abnormalities are common co-morbidities of obesity in young women but their associations with food cravings are not known. Metformin has been shown to reduce body weight and improve metabolic outcomes in older adults but its effects on healthy overweight and obese young women have not been investigated. Quantitative lifestyle advice has been shown to be effective in inducing weight loss but its psychological effects on young women have not been extensively studied. The overall objective of this study was to investigate the effectiveness of metformin, quantitative lifestyle advice and internet-based intervention on weight management in young. Methods: In the first 12-weeks, 203 overweight and obese young women (BMI 33.3±0.3 kg/m² , age 28±0.3 years; age range:17-37) were randomized to one of three treatment arms to receive metformin (Diabex XR 1500mg a day) plus qualitative lifestyle advice (M-QL), placebo plus qualitative lifestyle advice (P-QL) or a structured lifestyle program (L-QT). L-QT consisted of an energy restricted diet with quantitative lifestyle advice (6000KJ; 40% protein, 40% carbohydrate, 30% fat), structured exercise program, and behavioural therapy. From weeks 13 to 48, all participants were placed on the structured lifestyle program conducted through a website. Outcome measures include body weight, fasting lipids, insulin, glucose, psychological distress, self-esteem, food cravings, energy intake and physical activity. Primary analyses were conducted using linear mixed models. Results: At baseline, psychological distress and hyperandrogenemia were associated with increased food cravings (P<0.01). At 12-weeks, L-QT group had greater weight loss (-4.2±0.4 kg) compared to M-QL (-1.0±0.4 kg) and P-QL groups (-0.2±0.3 kg) (P<0.001). Attrition at week 12 was high particularly in L-QT group, ie 48% (28/59) for L-QT group, 34% (22/65) for M-QL group and 29% (23/79) for P-QL group (P=0.08). Baseline psychological distress and food cravings predicted attrition at week 12. At week 12, L-QT group had significantly greater improvements in psychological distress (-3.0+0.9 vs -0.84+0.52, P=0.013) and self-esteem (3.2±0.8 vs -0.04±0.4, P<0.001) compared to the M-QL and P-QL groups. At 48 weeks, both QT and QL groups maintained significant weight loss (-4.8±0.1 kg vs -1.3±0.4 kg respectively, P=0.0005). Weight changes from week 13 to 48 were similar between the groups (P>0.05). Attrition was similarly high in both groups by week 48 (78%; 159/203) (P=0.003). Being married or having children predicted attrition at week 48. Conclusions: A structured lifestyle intervention program was more effective than metformin in achieving weight loss in young women. Quantitative lifestyle advice produced greater improvements in psychological outcomes compared to qualitative lifestyle advice. Internet-based weight loss program was effective in maintaining weight loss in young women independent of initial weight loss. High attrition rates were seen throughout the study, particularly among those who had greater psychological distress or food cravings, and those who were married or had children. Strategies on managing issues relating to psychological distress, food cravings and family responsibilities may allow better tailoring of weight management programs for this group. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1523605 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2009

Thesis (Ph. D.)--University of Wisconsin--Madison, 2003. / Includes bibliographical references (p. 121-126). Also available on the Internet.

Thesis (M.S.W.)--University of Hong Kong, 1977.

Objective: To identify the physician-, patient- and health-system-related factors that influence gynecologists’ decision to recommend endometrial sampling in young women (less than 40 years) with abnormal uterine bleeding Study methods: A mail-based survey study was conducted using the Salant-Dillman method with 4 points of contact over 9 weeks. All Canadian obstetrician/gynecologists were initially surveyed (N=1746), receiving either French or English questionnaires. Eligible respondents were gynecologists practicing in Canada who treat these young women (N=834). Order response bias was taken into consideration by mailing two versions of the survey. Categorical data were analyzed using Pearson’s Chi-square statistics. A logistic regression with mixed effect model was performed to determine the odds of sampling the endometrium, using physician as random factor. Results: Overall response rate was 56.5%. The majority of respondents were generalists (83.6%). 70.3% of respondents have had young patients with malignant or pre-malignant endometrial conditions. Physicians ≤ 39 years have had less experience with these patients (59.6%, p=0.002) as have physicians practicing in communities without ob/gyn residents (35.2%, p=0.006). Sampling method was predominantly by office pipelle (79.7%), with younger physicians and female respondents employing this method most frequently (p=0.0001). In case scenarios which explored the importance of four patient-related risk factors (obesity, irregular cycles, nulliparity and older age), on the decision to sample, 98.8% of respondents would sample a young woman presenting with all four risk factors, as opposed to 8.8% who would sample if the patient did not have any of these characteristics. Obesity and irregular cycles was the next most important combination of risk factors prompting sampling in 87.3% of physicians. In the logistic regression, the odds ratio to proceed with endometrial sampling was 2.23 (95% CI 1.64-3.03) if a physician had previous experience with young women diagnosed with endometrial cancer or a pre-malignant condition, and was 1.45 (95% CI 1.05-2.01) if the physician was female. Conclusion: Patient and physician factors influenced the decision to proceed with sampling the endometrium of young women with abnormal uterine bleeding, whereas the health-system factors studied in this survey did not seem to play a strong role. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2010-07-14 15:06:07.786

Context: Young women are at high risk of weight gain but there has been limited knowledge on weight management in this group. Hyperandrogenemia and menstrual abnormalities are common co-morbidities of obesity in young women but their associations with food cravings are not known. Metformin has been shown to reduce body weight and improve metabolic outcomes in older adults but its effects on healthy overweight and obese young women have not been investigated. Quantitative lifestyle advice has been shown to be effective in inducing weight loss but its psychological effects on young women have not been extensively studied. The overall objective of this study was to investigate the effectiveness of metformin, quantitative lifestyle advice and internet-based intervention on weight management in young. Methods: In the first 12-weeks, 203 overweight and obese young women (BMI 33.3±0.3 kg/m² , age 28±0.3 years; age range:17-37) were randomized to one of three treatment arms to receive metformin (Diabex XR 1500mg a day) plus qualitative lifestyle advice (M-QL), placebo plus qualitative lifestyle advice (P-QL) or a structured lifestyle program (L-QT). L-QT consisted of an energy restricted diet with quantitative lifestyle advice (6000KJ; 40% protein, 40% carbohydrate, 30% fat), structured exercise program, and behavioural therapy. From weeks 13 to 48, all participants were placed on the structured lifestyle program conducted through a website. Outcome measures include body weight, fasting lipids, insulin, glucose, psychological distress, self-esteem, food cravings, energy intake and physical activity. Primary analyses were conducted using linear mixed models. Results: At baseline, psychological distress and hyperandrogenemia were associated with increased food cravings (P<0.01). At 12-weeks, L-QT group had greater weight loss (-4.2±0.4 kg) compared to M-QL (-1.0±0.4 kg) and P-QL groups (-0.2±0.3 kg) (P<0.001). Attrition at week 12 was high particularly in L-QT group, ie 48% (28/59) for L-QT group, 34% (22/65) for M-QL group and 29% (23/79) for P-QL group (P=0.08). Baseline psychological distress and food cravings predicted attrition at week 12. At week 12, L-QT group had significantly greater improvements in psychological distress (-3.0+0.9 vs -0.84+0.52, P=0.013) and self-esteem (3.2±0.8 vs -0.04±0.4, P<0.001) compared to the M-QL and P-QL groups. At 48 weeks, both QT and QL groups maintained significant weight loss (-4.8±0.1 kg vs -1.3±0.4 kg respectively, P=0.0005). Weight changes from week 13 to 48 were similar between the groups (P>0.05). Attrition was similarly high in both groups by week 48 (78%; 159/203) (P=0.003). Being married or having children predicted attrition at week 48. Conclusions: A structured lifestyle intervention program was more effective than metformin in achieving weight loss in young women. Quantitative lifestyle advice produced greater improvements in psychological outcomes compared to qualitative lifestyle advice. Internet-based weight loss program was effective in maintaining weight loss in young women independent of initial weight loss. High attrition rates were seen throughout the study, particularly among those who had greater psychological distress or food cravings, and those who were married or had children. Strategies on managing issues relating to psychological distress, food cravings and family responsibilities may allow better tailoring of weight management programs for this group. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1523605 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2009

Thesis (Ph. D.)--University of Wisconsin--Madison, 2003. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (p. 121-126).