Doctor of Philosophy / School of Family Studies and Human Services / Jared A. Durtschi / Despite previous literature illustrating strong links between social relations, mental health, and health outcomes, much remains unknown regarding the associations among adult romantic attachment, depression, and reports of physical health within those diagnosed with a chronic disease. Using a sample of 197 individuals who reported a diagnosed chronic disease and in a cohabiting or romantic relationship from the Flourishing Families Project, a mediated latent growth curve analysis was used to test to what extent trajectories of reported physical health across two years were a function of attachment and depression. Specifically, trajectories of physical health were modeled to examine changes over two years with time-invariant covariates of depressive symptoms and adult attachment predicting initial levels of physical health and changes in physical health over time. Results indicated that as depressive symptoms increased, initial levels of physical health were worse. Higher reports of attachment anxiety were linked with better initial reports of physical health. Further, higher reports of depressive symptoms and attachment anxiety predicted a significant upward shift in the expected trajectory of improved physical health. These results expand current research and theory by examining how adult attachment and depression are linked with expected trajectories in physical health over time.

Construction of a tool to assist nurses to assess the abilities of patients, with chronic conditions, to feed themselves was based upon twenty-one identified feeding behaviors derived from observations of a random sample of fifty such patients from two urban hospitals. Observations were also made of the nurses who cared for these patients. Identifying specific behavior items was concurrent with defining five categories along the dependence-independence continuum during analysis of the data. A 3:1:1 ratio for weighting behavioral components was established arbitrarily. The Kenny Self-care five point numerical rating scale was adapted to provide a method of determining the amount of help a patient would require to feed himself. Experts in the field agreed, with minor modifications, that the tool could determine a measure of independent feeding. A reliability test, using eight pairs of registered nurses to assess thirty-two patients produced a reliability coefficient of .849; evidence that this tool is dependable and consistent in measuring the relative state of feeding dependence-independence of patients with chronic conditions. Rating behaviors provides written evidence of the degree to which the patient is able to feed himself. The difference between what a patient can do and the criteria for independent feeding provides a measure of the help a patient will require to feed himself. Further research is indicated in the areas of usefulness of the tool for registered nurses, identifying psychosocial behaviors more precisely, testing the tool in different feeding situations and expansion of the tool to include the other activities of daily living. / Applied Science, Faculty of / Nursing, School of / Graduate

Accurate assessment is the foundation on which effective nursing interventions rest. However, it is not known how accurately nurses identify and prioritize the needs of parents whose children have chronic conditions. When nurses proceed with interventions based on inaccurate assessments, the results can be unsuccessful interventions that neither meet parental needs nor provide optimal health care for this population of children. This descriptive comparative study was conducted to 1) examine parental needs identified and prioritized by parents of children with chronic conditions and their respective nurse care-givers, and 2) identify similarities and differences between the two groups. Patterns that evolved from these similarities and differences provide us with information related to where nurses have expertise or difficulty identifying and prioritizing the needs of parents. Kleinman's (1978) health care systems theory, which supports the premise that health care professionals and clients perceive health care episodes differently, provided the conceptual framework for this study. Study participants included 38 parents and 13 nurses who were affiliated with ten ambulatory programs in a Western Canadian pediatric hospital. Both groups completed the modified Family Needs Survey (Bailey & Simeonsson, 1988b) and socio-demographic tool developed by this investigator. Responses to the 35-item scale of the Family Needs Survey were described and ranked, in addition to being analyzed using inferential parametric statistics to determine differences between parents' and nurses' identification of parental needs. Responses to the open-ended question on the Survey were described and ranked. Research findings revealed some similarities and a number of striking differences between the responses of parents and nurses. On the 35-item scale, parents and nurses agreed that five parental needs were 1) information about current research, future services and treatments, 2) help locating competent regular or respite care providers, 3) reading material about other parents with a similar child, 4) opportunity to meet and talk with other parents, with a similar child, and 5) more time for self, spouse and other children. Both groups were consistent in their ranking of the first two needs as the most important needs in the information and community services subscales, respectively. However, nurses had generally higher responses on all subscales and identified eight more parental needs than did parents which were related to information, support, and family functioning. Parents and nurses repeated most of the above needs on the open-ended question, although nurses indicated that parents also had a number of needs related to psychosocial issues and family functioning. Nurses ranked counselling (child's condition, treatment, stress management) as the primary support need. Further, both groups differed in their prioritization of parental needs on the open-ended question. Where parents ranked information, community services, and support needs as the most important, nurses ranked support, information, and community services. The implications of these research findings for nursing practice and education are discussed and recommendations for future research are presented. / Applied Science, Faculty of / Nursing, School of / Graduate

Nutrition education programs in the prevention of chronic diseases has flourished over the last 15 years. Investigators continue to demonstrate that soy consumption plays a role in decreasing chronic diseases such as cardiovascular disease, cancer, osteoporosis and problems regarding menopause. Although research focuses on soy benefits regarding chronic disease, to date, no program exists focusing on soy consumption.164 surveys distributed to 18-65 year-olds in Southwest Virginia assessed the population's chronic disease knowledge and information sources regarding soy foods and three nutrition education programs. Purchases of and opinions on soy products along with 62 single-blind taste evaluations comparing soy and non-soy taste preferences were assessed. 73.4% of the population sample knew at least one of three nutrition programs while 37.1% knew soy's relationship to chronic disease. Information sources for both were significantly (p<.006) higher for magazines and newspapers. Health and belief of not liking the taste of soy were significant (p<.017) reasons influencing purchase of soy foods. Tofu and soy burgers were consumed significantly (p<.001) more than other soy foods. No significant (p>.05) difference in preference was found between all cookies and muffins. Women knew significantly (p<.04) more about soy than men. Knowledge about soy was significantly (p<.03) correlated with soy consumption.Results indicate a need for soy education and consumption in preventing chronic diseases. Target populations should focus on non-Asians, males, 18-24 years, with less than a college education level. Implementing a soy education program in preventing chronic diseases is feasible, necessary, and cost-effective. / Master of Science

No description available.

In order to prevent the onset of several chronic diseases, populations that exhibit poor dietary practices must be identified and educated on proper nutritional habits. This study used the pre-validated Rapid Eating Assessment for Participants – Shortened version (REAP-S) survey and a four-question demographic questionnaire to identify these populations among undergraduate students at the University of Central Florida. The participants were 171 students of at least 18 years of age who completed the 17-question online survey. The data collected indicated that significant differences in diet quality regarding consumption of fats and saturated fats exist between ages, class standings, and sexes within an undergraduate population. Additionally, significant differences in diet quality regarding whole grain consumption were observed between sexes within an undergraduate population. More extensive dietary surveys and thorough demographic questionnaires should be utilized in future research to verify the existence and extent of these variations in diet quality to determine the groups of undergraduate students most at risk for chronic diseases.

No description available.

No description available.

Children with chronic inflammatory disease (CID) are at an increased risk for health complications including mental health issues, cancer, and cardiovascular disease. These complications have been linked to elevated levels of pro-inflammatory cytokines and lifestyle behaviours including low physical activity, and high sedentary time. Physical activity may represent a simple and effective strategy to modulate inflammation and subsequently improve health outcomes. However, the link between cytokines and movement behaviours in children with a CID remains poorly understood. Indeed, no studies to date have examined the link between a broad complement of inflammatory markers and patterns of movement behaviours in children with a CID. Therefore, the objectives of this study were to: (1) examine movement behaviours and inflammation in children with either cystic fibrosis (CF), juvenile idiopathic arthritis (JIA), inflammatory bowel disease (IBD), and type 1 diabetes (T1DM), (2) examine movement behaviours and inflammation in children with a CID compared with healthy controls and (3) examine the association between movement behaviours and inflammation profiles in children with a CID. We hypothesized that (1) children with a CID will have comparable movement profiles and inflammation, (2) children with a CID will have lower physical activity levels and higher levels of pro-inflammatory cytokines relative to healthy counterparts, and (3) children with a CID who are more physically active and engage in less sedentary time will have less inflammation. Boys and girls with a CID and controls wore an ActiGraph GT3X accelerometer around the waist during waking hours for 7 days. Outcomes of interest included, sedentary time, time spent in light physical activity (LPA), moderate-to-vigorous PA (MVPA), and total PA (TPA), determined using Evenson cut-points. After one week a fasted blood sample was collected to determine serum cytokines (TNFα, IL-23, IL-1β, IL-12, IL-6, IL- 17, TGFβ, IL-10) by multiplex assays and C-reactive protein by enzyme linked immunosorbent assay. A total of 132 participants (47% girls; age: 13.3±2.8 years), including JIA (N=27), IBD (N=21), CF (N=14), T1DM (N=18) and healthy controls (N=52), completed the study. Physical activity and inflammatory profiles were comparable between CF, JIA, IBD and T1DM groups. Children with a CID participated in 13.3 fewer mins/day [95% confidence interval 6.9, 101.2] (MVPA (F(1,113)=11.015, p=0.001) of MVPA relative to healthy controls and had comparable cytokine profiles. Physical activity did not predict inflammation in children with a CID. However, we know that physical activity has many beneficial cardiorespiratory and mental health effects. As such, it is still of interest to uncover any potential effects movement behaviours may have on our immune system. / Thesis / Master of Science (MSc) / The purpose of this study was to assess how physical activity, sedentary time, and inflammation are associated. Inflammation is an important part of our immune system that protects us from infection and disease; however, when inflammation goes unchecked, it can cause serious chronic inflammatory disease. We were interested in understanding if children with a chronic inflammatory disease had different levels of physical activity and sedentary time, or different levels of inflammation than healthy children with no medical conditions. We were also interested in understanding if physical activity or sedentary time were related to levels of inflammation in children with a chronic disease. We asked boys and girls between 7 and 17 years old to visit our lab twice. Some of our participants had a medical condition, including chronic kidney disease, cystic fibrosis, juvenile idiopathic arthritis, or inflammatory bowel disease and type 1 diabetes. We also invited a group of children who had no medical condition to participate. During their first visit, we measured their weight, height, pubertal status and gave them a physical activity monitor to wear for 7 days before coming back for their second visit. At their second visit we took a small blood sample that we used to measure immune proteins called cytokines, these proteins act like messengers to tell the immune system what to do. Some of them make inflammation worse, and others help to bring down levels of inflammation. We found that children who had a chronic inflammatory disease participated in less physical activity but had similar levels of sedentary time compared with healthy children. We also found that there were no differences in inflammation between children with a chronic disease and healthy children. Lastly, we found that physical activity and sedentary time were not related to inflammation levels. Although we did not find a relationship between physical activity and inflammation, we know that physical activity has many beneficial cardiorespiratory and mental health effects. As such, it is still of interest to uncover any potential effects movement behaviours may have on health outcomes.

O envelhecimento populacional vem sendo alvo de atenção no Brasil, uma vez que está ocorrendo um aumento significativo do número de idosos na população. Observa-se que juntamente com essa transição demográfica, ocorre a transição epidemiológica. A preocupação com doenças infecto-contagiosas perde lugar para a alta prevalência das doenças crônicas não-transmissíveis, e a população idosa é a mais acometida por essas doenças. Nesta situação, a família desempenha um papel fundamental na manutenção e controle da doença de seus membros, pois cabe a ela arcar com a continuidade do cuidado ao indivíduo no seu processo de viver. Assim, o estudo tem como objetivo construir um modelo conceitual de cuidado familiar ao idoso com condição crônica, com base nos significados construídos nas interações sociais, identificando, deste modo, como a família vivencia o processo de cuidar do idoso com condição crônica e interpretando os significados do cuidado familiar à este idoso. Utilizou-se como referencial metodológico a Teoria Fundamentada nos Dados e o referencial teórico do Interacionismo Simbólico. Participaram da pesquisa oito famílias de idosos com doença crônica não-transmissível. As famílias foram selecionadas a partir da Equipe de Saúde da Família 15 do município de Maringá-PR, sendo as mesmas acompanhadas no período de agosto de 2005 a maio de 2006. Para o desenvolvimento da pesquisa, utilizou-se como técnica de coleta de dados a observação participante, entrevistas e análise de documentos, realizadas nos domicílios das famílias. A participação em diferentes momentos da vida das famílias e seus membros idosos, bem como os depoimentos permitiram compreender a vivência do cuidado ao idoso com doença crônica, expressa através de conceitos desenvolvidos em três processos: A identificação da doença crônica do idoso, A convivência com a cronicidade da doença do idoso e Os serviços de saúde na vida das famílias. O primeiro processo é constituído por quatro categorias analíticas, sendo estas: A vivência das dificuldades na fase aguda da doença; O processo de adaptação; O reconhecimento da cronicidade da doença; e A perspectiva do futuro incerto. O segundo processo também é composto por quatro categorias: A presença do idoso independente na família; A vivência do cuidado ao idoso dependente; Estratégias utilizadas no cuidado do idoso; e Perceber-se vulnerável. O terceiro processo é formado por uma categoria analítica: O serviço público de saúde no cuidado ao idoso. A organização desse modelo teórico revelou que, na construção de significados sobre o viver e envelhecer com a presença da doença crônica, a capacidade funcional do idoso é um fator significativo e determinante no processo de cuidar e ser cuidado. / The population aging has turned into the target of attention in Brazil, since a significant increase of the number of the senior citizens is going on. It is observed that while the demographic transition happens, there is also the epidemiological transition. The concern with contagious diseases loses its position to the high prevalence of non-transmissible chronic diseases, and the elderly population is the most affected by those diseases. In this situation, the family has a fundamental role in the maintenance and control of the disease of its members, for it is the family duty to continue caring for the individual in the living process. Therefore, the present study aims to build a conceptual model of the care of the family towards the aged person in chronic condition, based on the meanings built in the social interactions, identifying, this way, how the family lives the process of caring for the elderly with chronic condition and interpreting the meanings of care of the family towards the elder. As a methodological reference the Grounded Theory and the theoretical reference of the Symbolic Interactionism were used. Eight families of senior people with non-transmissible chronic disease participated of the research. The families were selected through the Family Health Team 15 in Maringá, and they were followed from August 2005 through May 2006. For the evolution of the investigation, participant observation, interviews and documents analysis in the families\' residences were used as data gathering. The participation in different moments of the families and their seniors\' life, and also their testimonies permitted to understand the experience of caring for the elder with chronic disease, expressed through developed concepts in three processes: Identifying the chronic disease, Living with the chronicity of the disease and the Health services in the families\' life. The first process is constituted by four analytical categories. They are: Living the difficulties in the acute phase of the disease; The adjustment process; The recognition of the chronicity of the disease; and The perspective of an uncertain future. The second process is also formed by four categories: The presence of the independent aged in the family; The living of the care towards the dependent aged; Strategies used on the caring of the elder; and Perceiving oneself as vulnerable. The third process is formed by an analytical category: The health public service towards the caring for the elder. The organization of this theoretical model revealed that, in the construction of meanings about living and aging with the presence of a chronic disease, the capacity of the elder is a significant factor and it is determinant in the caring and being cared process.