Providing adequate nutrition to children with severe neurological disabilities is extremely difficult due to the high prevalence of oral-motor dysfunction in this group. Short stature and light weight for height are common in disabled children and undernutrition is believed to play a role in this poor growth. This programme of study investigated the effect of gastrostomy-tube feeding in disabled children with oral-motor dysfunction and evaluated the energy balance and body composition of disabled children fed both orally and via gastrostomy-tube over twelve months. The Quality of Life of the children and their carers was also evaluated. Energy intake was measured using three-day dietary diaries and energy expenditure with indirect calorimetry and doubly labelled water. Total body water using oxygen-18 dilution was used to evaluate body composition along with standard anthropometry. Improved growth, nutritional status and general health were seen at six and twelve months after gastrostomy-tube placement. The Quality of Life of the children and their carers also significantly increased. Both energy intake and energy expenditure were found to be lower than reference standards, but energy balance was positive indicating that inadequate nutrition was not the sole cause of poor growth. Body composition was also found to be significantly different from reference. Fat-free mass was significantly low for age and for height. Fat mass was higher in gastrostomy-tube fed children, but lower or normal in disabled children fed orally. Physical activity levels were low for the entire group of disabled children yet the gastrostomy-tube fed children displayed much higher levels of disability. Gastrostomy-tube feeding has a positive impact upon the growth, health and Quality of Life of disabled children and their carers. Careful follow-up is critical in order to optimize health and body composition.

Bakgrund: Ätstörningar är den tredje vanligaste sjukdomen i västvärlden bland unga kvinnor efter astma och fetma. Av de personer som drabbas utav Anorexia Nervosa avlider drygt 10 % till följd av sjukdomen. Syfte: Studiens syfte var att beskriva kvinnors upplevelser av att vårdas för sjukdomen Anorexia Nervosa. Metod: Denna studie genomfördes med en kvalitativ metod och en narrativ analys. Datainsamlingen grundades på fyra självbiografier, skrivna av kvinnor som hade drabbats av och vårdats för Anorexia Nervosa. Resultat: I resultatet kunde olika upplevelser av att vårdas för Anorexia Nervosa plockas ut. Upplevelserna delades upp i olika teman och förtydligades med citat. De teman som uppkom var Att tävla, Att släppa kontrollen, Att bli kränkt, Att förlora sin integritet, Att bli sedd, Att få insikt och Att känna en rädsla för att bli frisk. Dessa teman avspeglade kvinnors upplevelser av att vårdas för anorexia nervosa. Slutsats: Denna studie kan bidra till att vårdpersonal kan erhålla en ökad förståelse om kvinnors upplevelser av att vårdas för anorexia nervosa. Det kan innebära att vårdpersonalen kan främja kvinnornas behov av omvårdnad, för ett ökad hälsa och välbefinnande. / Background: Amongst young female adults in the western society, eating disorder is the third most common disease after asthma and obesity. About 10 % of the people who suffers from anorexia nervosa die due to the disease. Aim: This studies aim is to describe women’s experiences of being cared for Anorexia Nervosa. Method: This study was completed with a qualitative method and a narrative analysis. The gathering of data was founded on four autobiographies, written by women who has suffered from, and been cared for Anorexia Nervosa. Result: In the results, different experiences from the treatment for anorexia nervosa could be pointed out. The experience was divided into different themes and was clarified with quotations. The themes were To compete, To let go of the control, To be offended, To be seen, To get insight and To feel fear of being healthy. These themes reflected the women’s experiences from being cared for anorexia nervosa. Conclusion: This study can contribute so that health professionals receive a greater understanding about women’s experiences from being cared for Anorexia Nervosa. It could help the health professionals to promote these women’s need of care, it can also increase the women’s experience of health and well-being.

Ätstörningar i samband med graviditet är ett växande, dolt problem. Kvinnor som lider av en ätstörning väljer i många fall att dölja sina symtom, inte minst under en graviditet. Tecken kan vara svåra att se, vilket ställer stora krav på att sjuksköterskan är väl insatt i de tecken och symtom som tyder på att en ätstörning förekommer. Syftet med studien var att beskriva tecken och symtom på att en ätstörning förekommer i samband med en graviditet. Metoden som användes var en litteraturstudie, där resultatdelen baserades på elva vetenskapliga artiklar. Analysen mynnade ut i fyra kategorier: kontrollerad kosthållning och vikt, utsatta livssituationer, förvrängd självbild samt depression och ångest. Resultatet påvisade en oro, starkt kopplad till den egna vikten, samt kroppens form. Smalhetsidealet i dagens samhälle sätter stor press på kvinnor och deras utseende. Kvinnor i sårbara livsituationer och med låg självkänsla, var mer benägna att utveckla en ätstörning i samband med en graviditet än kvinnor med stabil livsituation och god självkänsla. Sjuksköterskan behöver vara lyhörd för tecken och symtom på att en ätstörning förekommer i samband med graviditet. God kommunikation är av stor vikt för att nå fram till patientgruppen. Ytterligare forskning kring hur sjuksköterkor skall arbeta med gravida kvinnor, efter upptäckten av att en ätstörning förekommer, är av intresse. / Eating disorders in pregnancy is a growing, yet hidden problem. Women who suffer from an eating disorder often choose to hide their symptoms, especially during a pregnancy. Signs which indicate that an eating disorder occurs during the pregnancy may be difficult to detect. This is a dilemma and therefore the nurse has to be familiar with signs and symptoms which may occur. The aim of the study was to describe signs and symptoms of eating disorder during a pregnancy. A literature study was accomplished as a method, where the result was based on eleven scholarly articles. The analysis of the study culminated into four categories: controlled diet and weight control, tough circumstances in life, distorted self-image and depression and anxiety. The result demonstrates a concern, strongly related to the perception of an individual’s weight and body shape. The idea of being slim in today’s society puts a lot of pressure on women and their appearance. Women in vulnerable circumstances of life and with low self-esteem, were more likely to develop an eating disorder during pregnancy. Therefore the nurse has to be alert to detect symptoms and signs of eating disorders during pregnancy. Good communication is of importance to reach out to the patient group. Additional research about nursing of pregnant women after discovering that an eating disorder occurs, is of interest.

The purpose of this study was to explore protective factors that help women resist societal pressures for thinness. The present study used a qualitative life history methodology to examine the experiences of women who identified themselves as resilient to pressures to be thin and as liking their bodies regardless of size. In-depth semi-structured interviews were conducted with 14 women, ages 18 to 25, representing diverse social and ethno-cultural backgrounds and body physiques. In the interviews, the participants were inquired about their experiences related to anything they felt was helpful for them in developing a positive body image from childhood, adolescence, and to present day. The interviews were transcribed and analyzed for themes using constructivist grounded theory methodology. Data analysis was informed by the feminist theoretical approach, with attention paid to social and contextual factors. Three core categories emerged from the analysis, which included protective factors associated with participants’ experiences of identity, ways of inhabiting their bodies, and the nature of social influences in their lives. This research highlighted the women’s active role in maintaining a resilient stance in the face of pressures for thinness as well as the importance of social factors that assist them in this process.

Dietary habits which seriously erode health and quality of life are widespread. Effective clinical strategies for overweight, obese and eating disordered individuals are needed. Such treatment options are usually based on constructs generated by theoretical models of causation and maintenance. Underpinning the current enquiry, the Hypno-socio-cultural model hypothesises links between the aetiology of dysfunctional eating behaviours and higher levels of hypnotic susceptibility, fantasy ability and dissociative capacity, as well as acknowledging the social genesis of the self-defeating approach to diet. Empirical evidence has supported the socio-cognitive theory of causation and remediation, on which this research is based. The literature has suggested that hypnotic, imaginative and dissociative strategies have contributed to clinical efficacy, and that aetiology and maintenance of such self-defeating eating might be linked to higher than average hypnotic susceptibility, imaginative ability and dissociative capacity. Generalization of research findings across studies is limited by the uncertainty introduced by the variety of measuring instruments utilized, and gender and age differences which have emerged. As well, possible individual preferences for specificity of hypnotic suggestions, which may affect responsivity levels, could dictate a need for reinterpretation of the results of relevant research. As an initial step in exploration of these issues, a group of University students responded to a number of assessment instruments, designed to tap self-perceptions in relation to weight, shape and size concerns, eating behaviours, and use of imaginative, dissociative and hypnotic capacities, as well as responding to hypnotic suggestions embedded in a formal assessment thereof. In this current research, expected relationships between elements of the Hypno-socio-cultural model were probably affected by a complex array of factors, which are difficult to measure using current instruments. Case studies drawn from the participants in this study have further elucidated the possible connections underlying the proposed Hypno-Socio-Cultural model, as well as highlighting the complexity of the relationships of all the factors involved. The Phenomenology of Consciousness Inventory, which was used to access the subjective experience of the individual’s responsivity to hypnotic suggestion, and which also tapped imaginative and dissociative experiences in relation to same, appears to have unique potential for further exploration of issues related to the connections highlighted in this study Findings in the current study suggested that some widely used assessments were not measuring the same constructs. Because of such factors, results which suggested links between weight, shape and eating measures, and those assessing hypnotic susceptibility, fantasy-proneness and dissociative capacity, although in the expected direction, were not as strong as was expected. In light of the anecdotal evidence of effective clinical use of imaginative, dissociative and hypnotic techniques with self-defeating eaters, the results were reassessed. It seemed feasible to interpret these results as suggesting that higher reliance on self-protective and defensive modes of using imaginative and dissociative capacities may mark the self-defeating eater. A modified Hypno-Socio-Cultural model, incorporating such a possibility, has been proposed as the basis for further study. It is recommended that such research be undertaken, employing a variety of relevant measures, with a larger group of participants of both genders with DSM-IV criterion diagnosed self-defeating eating. The importance to clincial work of investigating the proposed model as a basis for treatment remains paramount in this field of self-defeating eating.

This study investigated the intrapersonal and interpersonal context of female dieting and partner support for dieting in 44 heterosexual couples. Participants completed questionnaires assessing self and relationship functioning, dieting levels and eating disordered attitudes, and weight-loss support frequency and helpfulness, in both a cross-sectional and longitudinal study. As predicted, a) higher levels of unhealthy dieting were significantly related to more negative views of the self (e.g., lower self-esteem), and b) lower perceived levels of support from the partner were significantly related to higher levels of eating-disordered attitudes, anxious attachment, and lower relationship satisfaction. However, testing more complex causal models showed that self-esteem played a pivotal role. First, tests confirmed that the impact of self-esteem on unhealthy dieting was mediated by more disordered attitudes to eating. Second, those with low-self-esteem were much less likely to diet in an unhealthy fashion with more frequent and positive partner support, whereas high self-esteem women were not influenced by the support offered by their partners. These findings did not apply to the frequency of healthy dieting, with the important exception that more frequent partner support encouraged healthier dieting, and they held up when plausible third variables were statistically controlled. The findings suggest that dieting behaviour is influenced both by individual differences and the nature of support in intimate relationship contexts.

Doctor of Philosophy (PhD) / University students are known to have a high prevalence of body dissatisfaction, dieting and disordered eating and exercise behaviours. Those enrolled in food and exercise related degree areas have been found to be particularly vulnerable. Part 1 of this study compared the body image, body dissatisfaction, dieting, disordered eating and exercise behaviours of first year male and female trainee physical education [PE; N = 295] teachers and undergraduates enrolled in non food and exercise related degree areas [Non PE; N = 207]. Male and female PE participants had a lower body image and higher body dissatisfaction and were significantly more likely to be dieting and engaging in disordered eating behaviours than Non PE participants. These findings provide empirical evidence of anecdotal suspicions that trainee physical education teachers are susceptible to body image problems and eating disorders; and create a demand for for intervention programs to improve the body image, body dissatisfaction, dieting and disordered eating and exercise behaviours of this population. Part 2 of this study involved the development of a dissonance and self esteem based (Intervention 1) and a dissonance, and media literacy based intervention that built self esteem and used computer technologies (Intervention 2) to be implemented into trainee physical education teachers’ [N= 170] undergraduate training. Both interventions were successful in improving the body image, and disordered eating behaviours of trainee PE teachers compared to a control group; which suggests that the inclusion of intervention programs in trainee teacher’s undergraduate training is both feasible and effective. Further research should investigate the effects of intervention programs to improve body image and eating behaviours among trainee physical education teachers; and male university students. The development of standardised measures and approaches toward the improvement of body image, body dissatisfaction and disordered eating and exercise behaviours that are specifically designed for males is also encouraged.

Dissertation (Ph. D.)--University of Akron, Dept. of Counselor Education and Supervision, 2007. / "December, 2007." Title from electronic dissertation title page (viewed 02/27/2008) Advisor, Robert C. Schwartz; Committee members, Karyn Bobkoff Katz, Cynthia A. Reynolds, Sandra Spickard-Prettyman, Fred H. Ziegler; Department Chair, Karin B. Jordan; Dean of the College, Cynthia F. Capers; Dean of the Graduate School, George R. Newkome. Includes bibliographical references.

Thesis (Ph. D.)--University of Wyoming, 2005. / Title from PDF title page (viewed on Nov. 5, 2007). Includes bibliographical references (p. 60-70).

Thesis (M.A.)--State University of New York at Binghamton, Psychology Department, 2006. / Includes bibliographical references.