by Hung Chi-Wai, Pang Kin-Wah. / Thesis (M.B.A.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 51-52). / ABSTRACT --- p.ii / TABLE OF CONTENTS --- p.iii / ACKNOWLEDGEMENTS --- p.vi / Chapter CHAPTER I --- INTRODUCTION --- p.1 / Chapter CHAPTER II --- METHODOLOGY --- p.4 / Chapter CHAPTER III --- TARGET USERS --- p.6 / Chapter CHAPTER IV --- OBJECTIVES --- p.7 / Aim at Fitness --- p.7 / Build a Healthy Base --- p.7 / Plan a Diet Sensibly --- p.8 / Chapter CHAPTER V --- HEALTHY WEIGHT & OVERWEIGHT --- p.10 / Chapter CHAPTER VI --- BODY MASS INDEX --- p.12 / General Guideline of BMI --- p.13 / BMI is a Diagnostic Tool --- p.14 / BMI Measures Body Fat --- p.14 / Chapter CHAPTER VII --- DAILY CALORIE REQUIREMENT --- p.16 / Basal Metabolic Rate --- p.17 / Activity Level --- p.17 / Losing Weight and Increasing Weight --- p.18 / Limitation of Basal Metabolic Rate Calculation --- p.18 / Chapter CHAPTER VIII --- PHYSICALLY ACTIVE --- p.20 / Physical Activity and Nutrition --- p.22 / Chapter CHAPTER IX --- FOOD PYRAMID --- p.23 / Grains --- p.25 / Fruits and Vegetables --- p.25 / Know More About Fat --- p.25 / Chapter CHAPTER X --- CORRECTING OR AVOIDING BAD EATING HABITS --- p.28 / Skip Breakfast --- p.28 / Eat Too Fast --- p.29 / Eat Too Much Fast Food --- p.29 / Have Unhealthy Snacks and Drinks --- p.29 / Chapter CHAPTER XI --- DESCRIPTION OF PERSONAL HEALTH PLANNING MODEL --- p.30 / Personal Health Planning Model flow --- p.32 / Data Input --- p.33 / Database --- p.34 / Calculation --- p.34 / Optimization --- p.35 / Constraints --- p.35 / Report --- p.35 / Chapter CHAPTER XII --- LIMITATIONS OF OUR MODEL --- p.35 / Chapter CHAPTER XIII --- CONCLUSION --- p.35 / APPENDIX 1 --- p.35 / APPENDIX II --- p.35 / APPENDIX III --- p.35 / APPENDIX IV --- p.35 / APPENDIX V --- p.35 / REFERENCES --- p.35

RESUMO: Trata-se de uma pesquisa social realizada a partir de pressupostos da sociologia compreensiva em diálogo com autores das áreas da antropologia, psicanálise e psicologia social em que doze sujeitos apresentaram suas trajetórias e respectivos sentidos para o consumo de drogas lícitas e ilícitas em contextos privados. A partir de suas narrativas pôde-se compreender que o consumo de drogas relaciona-se diretamente com o contexto social na qual vivem os sujeitos, trazendo à tona aspectos morais, estéticos e sociais em seus usos. É possível afirmar como resultados da investigação: que a problemática do consumo de drogas envolve a excessiva medicalização e psiquiatrização de comportamentos, além de uma demasiada testagem entre os usuários de fármacos prescritos; a relação entre vulnerabilidade social e pobreza é um indicador superficial para a compreensão do consumo de drogas, em que a vulnerabilidade não está e não deve ser circunscrita à pobreza, e pessoas de camadas sociais mais favorecidas também fazem uso de drogas das mais diversas e por razões semelhantes àqueles que vivem em situação economicamente desfavorecida; a narrativa oriunda da comunidade científica no tratamento das drogas como um problema de saúde pública legitima o saber biomédico; o consumo do uso de drogas faz parte de um modo e estilo de vida contemporâneos para o alívio, anestesia e recreação de nosso tempo social; a produção de categorias científicas referentes aos usuários de drogas e aos seus estilos de vida acaba por transformar esse saber-poder em mercado para a comunidade científica e médico-jurídica; e, por fim, que o consumo de drogas não é um problema de saúde pública, a priori, principalmente, no que diz respeito ao uso das chamadas ilícitas, mas faz parte de um regime de moralidades. Nesse contexto, é o uso excessivo de fármacos prescritos e sua testagem em consumidores que devem ser olhados como problema de saúde pública, já o consumo de drogas ilícitas torna-se uma questão de saúde pública apenas na medida em que o usuário e/ou seu entorno justificam seu consumo como problemático a partir de uma construção social em que os saberes da medicina e da justiça tratam-no como sendo / ABSTRACT: This is a social research study based on the assumptions of interpretative sociology (Verstehen), in dialogue with authors from the areas of anthropology, psychoanalysis and social psychology, in which twelve subjects presented their personal histories and respective meanings in relation to the consumption of licit and illicit drugs in private contexts. From these narratives it was possible to comprehend that the consumption of drugs is directly related to the social context in which the subjects live, thereby bringing to light the moral, aesthetic and social aspects of their uses. It is possible to affirm the following results from the research: that the issue of drug consumption includes the excessive medicalization and psychiatrization of behaviors, in addition to excessive testing among users of prescribed drugs; the relationship between social vulnerability and poverty is a superficial indicator in the understanding of drug use, considering that vulnerability is not and should not be circumscribed to poverty since people from the most favored social strata also use a wide range of drugs for reasons similar to those of individuals in economically disadvantaged situations; the scientific community´s narrative in the treatment of drugs as a public health problem legitimizes biomedical knowledge; drug use exists as part of contemporary lifestyles and ways of life to provide relief, anesthesia and recreation during our social time; the production of scientific categories for drug users and their lifestyles ends up transforming this know-how into a market for the scientific and medical-legal community; and, finally, that drug use is not a public health problem a priori, especially with regard to the use of so-called illicit drugs, but exists within the context of a set of moral codes. In this context, it is the excessive use of prescription drugs and their testing on consumers that should be regarded as a public health problem, while the consumption of illicit drugs becomes a public health issue only to the extent that the user and/or his/her environment justify their consumption as \'problematic\' as a result of the social construction in which medical and legal knowledge considers them as such

Este estudo apresenta uma análise compreensiva das experiências e modos de levar a vida de mulheres entre 50 e 59 anos, no intuito de refletir sobre a vivência do processo de envelhecer e adoecer diante da invisibilidade sintomática da osteoporose, apresentando como referência contextual um momento específico do curso de vida destas mulheres. A abordagem teórica e metodológica apóia-se na articulação entre a sociologia do cotidiano e das emoções para exploração e interpretação de trajetórias, marcadores sociais e modos de vida que se processam na dinâmica da vida cotidiana deste grupo sociocultural. Através de histórias pessoais, das socialidades nos contextos interativos e do significado do corpo como processo narrativo e simbólico, desvelam-se categorias subjetivas que ordenam a vida e as práticas sociais destas mulheres em seu processo de envelhecimento, apresentando-as como sujeitos além da sua doença (osteoporose). Utiliza-se a conceitualização sobre curso da vida a partir dos sistemas produtivo, social e político para orientar a compreensão das experiências e trajetórias de vida de mulheres nesta faixa etária. O corpo é apresentado como uma tradução de formas de comer, de cuidar e de outras atividades de vida diárias, mostrando valores simbólicos e de referência conceitual sobre formas de ser, estar e fazer, onde as emoções pautam-se em processos intersubjetivos e contextos sociais diversos. No campo investigativo e analítico, utilizou-se como instrumento empírico a sala de espera de um posto de saúde em Fortaleza e entrevistas individuais para coleta e análise de informações, no intuito de apresentar singularidades e similaridades que compõem suas experiências e modos de vida. As falas retrataram a experiência de um corpo doloroso não vinculado à osteoporose, mas a situações afetivas, sociais e financeiras precárias que circunscrevem o dia a dia / This study presents a comprehensive analysis of the experiences and ways of taking the lives of women between 50 and 59 years in order to reflect on the experience of the process of aging and sicken against osteoporosis symptomatic invisibility,presenting as a contextual reference specific time course of life of these women. The theoretical and methodological approach is based on the relationship between the sociology of everyday life and emotions, for exploration and interpretation of trajectories, social bookmarks and lifestyles that are processed in the dynamics of everyday life of this socio and cultural group. Through personal stories, the sociabilities in interactive contexts and meaning of the body as symbolic and narrative process, give us a subjective categories ordering the life and social practices of these women in their aging process, presenting them as subjects beyond their disease (osteoporosis). It is used on the conceptualization of the life course viewed from the production, social and political systems to guide the understanding of the experiences and life trajectories of women in this age group. The body is presented as a translation of ways of eating, caring and other activities of daily living, showing symbolic values and conceptual framework on ways of being, being and doing, where emotions are driven in intersubjective processes, and various social contexts. In the investigative and analytical field, as an empirical instrument, we used the waiting room of a health center in Fortaleza, and individual interviews to collect and analyze information in order to provide uniqueness and similarities that make up their experiences and ways of life. The reports portrayed the experience of a painful body not linked to osteoporosis, but the precarious emotional, social and financial situations that encompass the day to day

Esta investigação tem por objetivo compreender como mulheres imigrantes constróem no espaço da cidade formas de convívio e negociações, conseguem acolhimento e respostas às suas necessidades e investem no pertencimento de redes sociais de apoio configurando novas formas de levar suas vidas. A partir de contato inicial realizado em uma instituição religiosa na cidade de São Paulo que recebe mulheres estrangeiras selecionaram-se cinco dessas mulheres: três solicitantes de refúgio, uma imigrante e uma egressa de sistema prisional propondo-se a pesquisadora a acompanhá-las, em diferentes períodos e situações, nas suas atividades cotidianas. A proposta possibilitou a realização de uma etnografia e observação participante em profundidade de seus itinerários na cidade. Os itinerários percorridos e acompanhados pela pesquisa mostraram diversas formas de construção de sociabilidade e de novas estratégias na vida dessas mulheres bem como diferentes modos de relação com as instituições às quais elas recorriam para apoio. De modo geral, percebe-se que, sendo mulheres, e estrangeiras, a transitoriedade de suas estadas na cidade é atravessada por interações com outras pessoas, com um trabalho ou uma atividade de lazer ou mesmo com as instituições de ajuda. Dentre estas interações percebe-se que as relações de ajuda efetiva se dão, principalmente, nos espaços fora das instituições, ou seja, nas redes de sociabilidade criadas e nos espaços acessados e acessíveis da cidade. / This study aims to comprehend how immigrant women build, in the space of the city of São Paulo, their interpersonal relationships, their negotiations with the institutions they have to deal with, their support and social networks, resulting in a new way of living their lives. Starting from a contact with one of the religious institutions that offers shelter to foreign women in São Paulo, five inhabitants of this house were met and followed on their routine activities around the city. Those women were three asylum seekers, one economic migrant and one ex-prisoner. This proposal made possible the construction of an ethnography and a participant observation of the itineraries undertaken by them in the city. Those itineraries undertaken by them and followed by this study showed different strategies and social relationships made by those women in the city. In general, the itineraries showed that, by being women and foreigners, their transitional relationship with the city was crossed by the people they meet, their work, their leisure activities and the institutions that were willing to help them. In spite of those interactions, the ones that seem to be more able to offer a significant help to them are the relationships outside the scope of those institutions, meaning the social networks built and the interactions with the accessible and accessed spaces in the city.

Cette thèse porte sur la mesure et la compréhension des inégalités des chances en santé c'est-à-dire aux inégalités attribuables à des facteurs ne relevant pas de la responsabilité individuelle, tel que le milieu d'origine. Nous portons un intérêt spécifique à la contribution des comportements de santé dans la construction de ces inégalités. Nous développons notre analyse à travers trois axes : (i) la mesure de l'importance respective des conditions de vie dans l'enfance, du niveau d'éducation et des comportements de santé dans l'explication des inégalités de santé ; (ii) l'analyse des mécanismes en jeu dans la transmission intergénérationnelle des comportements de santé avec l'exemple du tabagisme et des habitudes de soins ; (iii) la mesure des différences entre pays européens dans les inégalités des chances en santé. Les analyses empiriques combinent des données prospectives d'une cohorte britannique ainsi que des données rétrospectives issues d'une enquête française et d'une enquête européenne. Les résultats soulignent la contribution aux inégalités de santé des conditions de vie dans l'enfance et du niveau d'éducation de façon directe et de façon indirecte par les comportements de santé. / This thesis focuses on the measurement and the understanding of inequality of opportunity in health which are inequalities related to factors beyond the individual responsability, such as the individual's social background. We focus on the contribution of health-related behaviors in the construction of these inequalities. Our analysis is based on three topics: (i) the measure of the respective contribution of early-life conditions, education and lifestyles to health inequality ; (ii) the analysis of the intergenerational transmission of health-related behaviors with the example of smoking and health care habits ; (iii) the measure of cross-country differences in inequality of opportunity in health with a European perspective. Empirical analysis are conducted with both prospective data using a British cohort and retrospective data using a French study and a European study. The results emphasize the contribution of early-life conditions and education to health inequality both directly and indirectly through lifestyles.

The adoption of health behaviours is essential if coronary heart disease patients are to optimise their chance of survival and reduce the likelihood of recurrent coronary events. However, this behavioural change may not ensue following an acute myocardial infarction(AMI). This study on first AMI subjects sought firstly to examine the psychometric properties of five scaled instruments used for assessing health behaviours. Secondly, the study assessed the prevalence of health-enhancing behaviours at the time of the first AMI and 6 months after this event.Thirdly, the magnitude of health behavioural change was then examined. Fourthly, sociodemographic, clinical and psychosocial predictors of health-enhancing behaviours were explored.These health-enhancing behaviours included non-smoking behaviours, normal body mass index (BMI), adequate physical activity, medication adherence and low dietary fat intake. Finally, the study examined relationships between sociodemographic , psychosocial and modifiable lifestyle factors, based on Antonovsky's hypothesis on sense of coherence(SOC), stress and adaptive coping. The study highlights that some modifiable risk factors, for example, being overweight or obese and physical inactivity were more resistant to change following an AMI.This finding, and the relationship between stress and increased dietary fat suggest a need for individualised programs to support the specific needs of AMI patients to change their modifiable cardiac risk factors. / Doctor of Philosophy (PhD)(Health)

Lifestyle diseases such as cardiovascular diseases, hypertension, cancer, type 2 diabetes are the major causes of mortality and morbidity worldwide. The prevalence of these diseases is high in New Zealand as well. It is believed that promoting a healthy diet and increased physical activity can make beneficial changes and extend the healthy life expectancy. This twelve week study with follow-up at 52 weeks was designed to demonstrate if a diet and physical activity group intervention in the workplace would result in changes in risk factors for antioxidant damage and therefore reduce the risk for lifestyle diseases. The effect of the addition of kiwifruit to the diet on markers of oxidative stress was also measured in a crossover sub study within this study. Fifty two healthy subjects (male 24, female 28, mean age 46), completed the 12 week study with measurements points being at 0, 3, 6, 9 and 12 weeks. Thirty eight subjects presented for another set of measurements at 52 weeks. The intervention started at week 3 and the kiwifruit crossover treatment was launched between weeks 6 and 12.Ferric reducing ability of plasma (FRAP) assay was utilized to measure the changes in plasma antioxidant activity(AOA) and thiobarbituric acid reactive substances (TBARS) assay to measure the changes in plasma malondialdehyde (MDA), as a marker of lipid peroxidation (LP) at each measurement point. Since almost all participants had a normal range of baseline measurements of plasma AOA and LP (plasma MDA), they were categorized as relatively low and high AOA (1200micromol/L cut off point) and LP groups (1.70mmol/L cut off point), as well as divided into male and female groups. The effect of changed diet and increased physical activity during the 12 week study period resulted in a significant increase (P<0.05) in plasma AOA. The changes were much higher in low AOA group (P=0.005) and in male subjects (P<0.005), while no changes were observed in subjects with already high AOA at baseline. The increased plasma AOA level was maintained and increased even more over the year. No changes were observed in LP (plasma MDA). The effect of kiwifruit on the markers of oxidative stress was modest, the 3-week daily kiwifruit consumption (2-3 kiwifruit per day) resulted in significant increase (P=0.01) in plasma AOA only in female subjects within the low AOA group. However, the precision and validity of the measurements were limited by a possible loss of vitamin C due to storage of the plasma samples rather than analysis when fresh. Given that kiwifruit is particularly high in vitamin C the effect of the addition of kiwifruit to the diet might not have been detected. In this study it was shown that a group diet and physical activity intervention within the workplace can increase the level of plasma antioxidant activity and thereby reduce the risk for oxidative stress and related lifestyle diseases.

Cardiovascular disease is a major cause of death in most Westernised countries. The prevalence of obesity, type 2 diabetes mellitus and cancers is rapidly increasing. Older people with elevated blood lipids, obesity and DNA damage are at high risk of developing these diseases. There is a plethora of research to support the claim that a healthy diet and increased physical activity can reduce the risk of increased body fatness, diabetes and generally improve health. However, most interventions require intensive one to one advice. The aim of this study was to measure the effect of a group approach to advising on changes in lifestyle with particular attention to foods high in fibre. The study spanned a period of 12 weeks with a follow up session at 52 weeks to ascertain sustainability. The study: This study was a 12 week longitudinal intervention study with a follow up after 52 weeks. Measurements of anthropometry (skin folds, girths, weight and height), blood pressure, body fat by bio impedance and fasting blood (lipids, glucose and insulin) were made at weeks 0, 3, 6, 9,1 2 and 52. The participants were asked to complete a food frequency questionnaire and a physical activity questionnaire at each of the 6 measuring sessions and to provide an indication of what the goals that they had set and if they had accomplished them after 9,12 and 52 weeks. Between measurements at weeks 0 and 3 the volunteers were left to follow their usual food and activity pattern. Then as a group they were given a diet and exercise talk and provided with written material and pedometers to increase motivation. After measurement at week 6 they were randomly divided into two groups. The first group (A) were prescribed and provided with kiwifruit at a dose of 100g/30 kg body weight for three weeks while the second group (B) continued with the changes in diet and physical activity. Following measurement at week 9 group A abstained from kiwifruit while Group B added the kiwifruit to their diet and the measurements repeated. After 52 weeks, with only emails as ongoing communication, they were remeasured. Results For this multicultural, relatively middle aged group of 53 staff (28 women, 25 men) of mean age 46 years, measurable and statistically significant metabolic gains were made in the lipid profile over 12 weeks. Total cholesterol, LDL cholesterol, triglycerides and the ratio of total cholesterol to HDL all decreased and HDL increased significantly. Total cholesterol decreased from 5.6(±1.1) mean (±SD) mmol/L at baseline to 5.3(±1.1) mmol/L at week 12 (p<0.001); LDL cholesterol decreased from 3.5(±0.97) mmol/L at baseline to 3.3(±0.94) mmol/L at week 12 (p<0.001); and total cholesterol to HDL ratio decreased from 4.0(±1.1) to 3.7(±0.9) (p<0.001). In the 36 who were measured at 52- week follow- up these changes persisted. With the other outcome measures glucose showed a statistically but not biologically significant decrease over the 12 week period and body composition, blood pressure and insulin showed no significant change. The kiwifruit crossover had no apparent affect on the measures of any of the measurements reported. The participants reported that they increased fruit and vegetable and oily fish consumption and increased physical activity. These increases took place over the initial 12 week period and were maintained over 52 weeks. Conclusion: This study has shown that changes in diet and physical activity can favourably influence blood biochemistry even without accompanying changes in percentage body fat and weight. Furthermore, small, manageable lifestyle changes can result in biochemical changes persisting over 52 weeks.

Title from title screen (viewed on 15 Apr. 2004) Text and graphics. Web site contains the complete thesis submitted in total fulfilment of the requirements for the Degree of Doctor of Philosophy, School of Sociology, Politics and Anthropology, Faculty of Humanities and Social Sciences, La Trobe University, Melbourne, Australia. Also includes photographs and links to related web sites. System requirements: Adobe Acrobat reader for viewing files in PDF format. Mode of access: Internet via World Wide Web. Available at: http://www.confest.org/thesis/index.html Selected for archivingANL

Three studies were designed to investigate the effects of exercise-based lifestyle interventions including diet change and exercise training on cardiovascular and autonomic responses to various physical and mental challenges in untrained premenopausal women. In Study 1, the effects of different tasks designed to activate the sympathetic nervous system on autonomic control of cardiovascular functioning such as the Stroop colour-word task (Stroop) and lower body negative pressure (LBNP) in 20 untrained premenopausal women (22.6??0.7 years) were determined. In Study 2, a longitudinal exercise intervention strategy was used with 18 untrained premenopausal women (22.5??0.7 years) in order to investigate the effect of 15 weeks of high intensity intermittent exercise (HIIE) training on cardiac autonomic responses to mental challenge (Stroop) and LBNP. In Study 3, the effects of HIIE training combined with a Mediterranean-style eating plan and fish oil supplement (Fish oil, Exercise, Mediterranean diet; FEM) on cardiovascular function during mental challenge (Stroop) and physical tasks (handgrip and reactive hyperaemia) were examined in 32 overweight untrained premenopausal women (22.0??0.6 years). In these studies, forearm blood flow (FBF) was assessed using Hokanson Plethysmography with the venous occlusion technique. The surface electrocardiogram and continuous beat-to-beat arterial blood pressure were also monitored. Peak oxygen uptake was assessed using open-circuit spirometry (True Max 2400, ParvoMedics). In addition, body composition was measured using DEXA (dual energy X-ray absorptiometry; DPX-IQ, Lunar Radiation). Results from Study 1 indicate that FBF response to mental challenge in young females was smaller compared to previously obtained data from age-matched males. Furthermore, this FBF response to mental challenge was negatively correlated to insulin resistance estimated by the homeostasis model assessment (HOMA-IR) (r = - .52, p < .05). In addition, when cardiopulmonary baroreceptors were unloaded by a mild level of LBNP (-20 mmHg) during Stoop, FBF response to mental challenge (vasodilation) was abolished suggesting a large dependency of vasodilation response during mental challenge on cardiopulmonary baroreflex. After 15 weeks of supervised HIIE training, aerobic fitness improved (p < .05) whereas percent of body fat was significantly decreased (p < .05). In addition, recovery BP following Stroop was significantly reduced. Insulin resistance (HOMA-IR) was marginally decreased (p = .056). Women who had higher insulin resistance (HOMA-IR) lost less fat than women with lower HOMA-IR (r = .60, p = .088). In addition, change in FBF during Stroop after training was directly related to pretest insulin resistance levels (r = .68, p < .05). Therefore, HIIE training had a normalising effect on FBF response to mental challenge. PEP/LVET ratio at rest and during LBNP was also significantly increased in women with higher HOMA-IR suggesting a reduction in cardiac contractility via a decrease in sympathetic stimulation (r = .62, p = .076, r = .62, p = .75 respectively). In Study 3 results indicated that 12 weeks of the FEM trial significantly reduced percent of body fat (p < .001), fasting insulin (p < .05), interleukin-6 (p < .05) and cortisol (p < .05), and significantly improved aerobic fitness ( ; p < .001). With respect to cardiovascular and cardiac autonomic measures, rate pressure product (RPP) was significantly reduced at rest (p < .05) and during recovery after Stoop (p < .05), suggesting decreased myocardial oxygen consumption. In addition, baseline heart rate determined in the sitting position was significantly reduced (p < .05), while both baseline high frequency power (HF) determined in supine (p < .01) and cardiac baroreflex sensitivity (BRS) determined in the sitting position (p < .05) were increased after the FEM trial. In addition, BRS determined during mental challenge also marginally increased (p = .051). In summary, lifestyle intervention including HIIE training, Mediterranean-style eating plan, and a fish oil supplement significantly enhanced parasympathetic influence of the heart and improved fitness, blood profiles, and body composition.