Obesity is one of the most important health problems in the UK and its prevalence is increasing. It is often neglected, despite it being associated with a range of serious diseases such as coronary heart disease, hypertension, diabetes, gall stones, peptic ulcer, gout and certain cancers. Most of these are reversed by weight loss but there are concerns that many treatments available to the obese are ineffective. The obese and overweight are the largest treatment group seen by dietetic departments and utilise a large proportion of clinic time. It is important that the best, most appropriate treatment is given to these patients based on their needs but, given the shortage of dietitians in the health service and the limited time available, the benefit/cost effectiveness of such work needs to be evaluated. The present study evaluated four methods of advising the obese and overweight including slimming groups and traditional individual counselling. The "multi-professional" approach to administering dietary advice was also reviewed using two groups in cardiac rehabilitation programmes. Dietary assessments by food records, nutrition knowledge by a questionnaire and body weight measurements were taken at the start of the study, at the end of the healthy eating programmes and 6 months after the programmes had finished. The groups advised on an individual basis were assessed at a corresponding time interval. The data obtained were compared statistically for the 6 groups. The attrition rate was highest for the subjects advised in slimming groups and lowest for the cardiac rehabilitation groups. The weight loss was highest for the subjects advised in individual consultations and lowest for the cardiac groups. The nutrition knowledge scores increased for all groups with no statistical differences between the groups. The results are reviewed and the future provision of dietetic services to the obese and overweight is discussed.

This document only includes an excerpt of the corresponding thesis or dissertation. To request a digital scan of the full text, please contact the Ruth Lilly Medical Library's Interlibrary Loan Department (rlmlill@iu.edu).

Kwan Shuk-ying. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 101-109). / Abstracts in English and Chinese. / ABSTRACT --- p.I / 摘要 --- p.III / ACKNOWLEDGEMENT --- p.V / TABLE OF CONTENTS --- p.VI / ABBREVIATION --- p.IX / LIST OF TABLES --- p.X / LIST OF FIGURES --- p.XI / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- Alzheimer's disease - a growing health problem in Hong Kong --- p.2 / Chapter 1.2 --- Pathology of Alzheimer's disease --- p.3 / Chapter 1.3 --- Clinical features of Alzheimer's disease --- p.6 / Chapter 1.4 --- Clinical diagnosis of Alzheimer's disease --- p.9 / Chapter 1.5 --- Background and objectives of study --- p.10 / Chapter 1.6 --- Outlines of the Thesis --- p.11 / Chapter CHAPTER 2 --- NUTRITIONAL ASPECTS OF ALZHEIMER'S DISEASE --- p.12 / Chapter 2.1 --- Introduction --- p.13 / Chapter 2.2 --- Weight loss in Alzheimer's disease patients --- p.14 / Chapter 2.3 --- "Weight loss, morbidity and mortality" --- p.15 / Chapter 2.4 --- Factors contribute to weight loss --- p.17 / Chapter 2.4.1 --- Progress of Alzheimer's disease --- p.17 / Chapter 2.4.2 --- Biological factors --- p.17 / Chapter 2.4.3 --- Biochemical factors --- p.21 / Chapter 2.4.4 --- Psychosocial factors --- p.26 / Chapter 2.5 --- Background of study --- p.28 / Chapter CHAPTER 3 --- METHODOLOGY --- p.30 / Chapter 3.1 --- Subject recruitment --- p.31 / Chapter 3.2 --- Ethical Approval --- p.31 / Chapter 3.3 --- Nutritional assessments --- p.32 / Chapter 3.4 --- Cognitive assessments --- p.39 / Chapter 3.5 --- Factors Associated with Nutritional Status --- p.42 / Chapter 3.5.1 --- Biological factors --- p.42 / Chapter 3.5.2 --- Biochemical factors --- p.52 / Chapter 3.5.3 --- Psychosocial factors --- p.57 / Chapter 3.6 --- Statistical Analysis --- p.59 / Chapter CHAPTER 4 --- RESULTS --- p.62 / Chapter 4.1 --- Demographic characteristics --- p.63 / Chapter 4.2 --- Nutritional assessments --- p.64 / Chapter 4.3 --- Factors associated with Nutritional Status --- p.66 / Chapter 4.3.1 --- Biological factors --- p.66 / Chapter 4.3.2 --- Biochemical factors --- p.68 / Chapter 4.3.3 --- Psychosocial factors --- p.68 / Chapter 4.4 --- Longitudinal observations --- p.70 / Chapter CHAPTER 5 --- DISCUSSION --- p.84 / Chapter 5.1 --- Nutritional Status --- p.85 / Chapter 5.1.1 --- Cross-sectional Study --- p.85 / Chapter 5.1.2 --- Longitudinal Observations --- p.86 / Chapter 5.2 --- Factors associated with Nutritional Status --- p.88 / Chapter 5.2.1 --- Biological factors --- p.88 / Chapter 5.2.2 --- Biochemical factors --- p.92 / Chapter 5.2.3 --- Psychosocial factors --- p.95 / Chapter CHAPTER 6 --- CONCLUSION --- p.98 / REFERENCES --- p.101 / Appendix 1 Clinical Diagnosis of Alzheimer's disease --- p.110 / Appendix 2 Consent Form --- p.111 / Appendix 3 Mini Nutritional Assessment --- p.115 / Appendix 4 Mini Mental State Examination --- p.118 / Appendix 5 Functional Assessment Staging (FAST) --- p.119 / Appendix 6 Physical Activity Questionnaire (PAQ) --- p.120 / Appendix 7 3-day Dietary Record --- p.129 / Appendix 8 Olfactory Function Test --- p.134 / Appendix 9 Neuropsychiatric Inventory (NPI) --- p.138 / Appendix 10 The Chinese version of Neuropsychiatric Inventory …… --- p.151

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 107-112).

In this participatory action research study, an Empowerment Process Model (EPM) was tested for the development of feasible action plans that addressed the priority concerns and the implicit food and nutrition problems of village families within their current socio-economic and political context. The Visual Verification Survey (VVS) was used to test the EPM results and its usefulness with similar participants. An EPM with 24 village women and a VVS with 68 village women were purposefully sampled in two locations in Dominica, West Indies, along with key informant interviews with eleven agency leaders to identify, prioritize, and describe their perceptions of villagers' life problems, the root causes of the problems, and solutions. This community-based approach used participatory non-written activities and locally developed visual aids to empower Dominican women to develop feasible action plans: a sewing workshop, how to start a business workshop, coffee house project, and women's group. Thematic content analysis and participatory activities were used to identify the themes and "give voice" to the participants' perceptions of top prioritized life problems: unemployment and economic issues, alcohol and drug abuse, lack of educational services, and teenage pregnancy. When specifically asked, the women identified basic health, food, and nutrition concerns, such as a steady income to buy food, a variety of foods to maintain health, and an accessible, clean water supply. The study revealed substantial differences in the rankings between the EPM and VVS women. The differences may have been influenced by the women's educational level, family situation, and previous involvement in community activities and leadership roles. Similar top prioritized root causes associated with many life problems by the women included lack of educational services, facilities and qualified teachers; and girls exchanging sexual favors for money or possessions. Overall, key informants and the Dominican women participants had similar perceptions of prioritized life problems of typical Dominican families. The results of the research demonstrated the need for site-specific programs and assessments using participatory non-written activities to engage a variety of women and to satisfy their diverse needs and locations. To become effective and sustainable, nutrition programming should be integrated into overall life problems. / Ph. D.

SAMMANFATTNING Bakgrund Malnutrition är ett globalt problem i både industri- och utvecklingsländer. Svenska studier genomförda under 2000-talet har påvisat att drygt var fjärde patient i slutenvården är malnutrierad. Vårdgivare är ansvariga att identifiera malnutrierade patienter och de som löper risk för malnutrition. Punktprevalensmätningen Dagen nutrition utförs årligen på Akademiska sjukhuset. Under ett dygn registreras inneliggande patienters nutritionsstatus för att utvärdera uppsatta nutritionsmål. År 2013 samt 2014 registrerades data på ca 60 % av patienterna. Orsaken till att registreringar inte genomfördes på alla aktuella patienter är inte kartlagt.   Syfte Att få fördjupad kunskap om involverad personals syn på varför alla aktuella patienter inte deltog i punktprevalensmätningen Dagen nutrition åren 2013 och 2014. Syftet var även att belysa förutsättningar som kan bidra till att öka patientdeltagandet i framtiden.   Design Kvalitativ metod. En deskriptiv studie med induktiv ansats. Datainsamlingen skedde genom semistrukturerade intervjuer.   Resultat Orsaker till att patienter inte deltog eller att resultatet från Dagen nutrition uteslöts var bristfälligt ifyllda registreringslistor, samt bristande kunskap och engagemang hos personalen. Respondenterna ansåg att delat ansvar, väl genomfört förarbete, personalengagemang samt avsatt tid skulle kunna öka patientdeltagandet. De belyste även vikten av utbildning och information. Det skriftliga informationsmaterialet ansågs vara svårtillgängligt. Respondenterna föredrog muntlig information framför webbaserad utbildning. De efterfrågade även återkoppling av resultatet från Dagen nutrition samt förbättringsförslag till avdelningarna.   Slutsats Ofullständiga registreringslistor samt bristande kunskap och engagemang hos personalen orsakade att alla aktuella patienter inte deltog eller uteslöts från Dagen nutrition. Respondenterna ansåg att det kan vara möjligt att öka patientdeltagandet om föreslagna åtgärder vidtas. / ABSTRACT   Background Malnutrition is a global health problem occurring in both industrialized and developing countries. Swedish studies conducted in the 21st century show that more than one in four inpatients are malnourished. Caregivers are responsible to identify the malnourished patients, and those at risk of malnutrition. The point prevalence survey Dagen nutrition, is performed annually at Uppsala university hospital. During one day inpatients' nutritional status is recorded in order to evaluate the set goals regarding nutrition. In 2013 and 2014 data was recorded on approximately 60 % of the patients. The reason why data wasn’t registered among all viable patients was not investigated.   Aim To gain in-depth knowledge in involved personnel´s views on why all viable patients did not participate in the point prevalence survey Dagen nutrition in the years 2013 and 2014. An additional aim was to highlight conditions which may contribute to increase patient participation in the future.   Design A qualitative design. A descriptive study with an inductive approach. Data was collected through semi-structured interviews.   Findings The reasons why patients did not participate or that the results from Dagen nutrition were excluded was inadequately completed forms and that the personnel lacked knowledge and engagement. According to the respondents a shared responsibility, well performed prepar-atory work, personnel engagement and dedicated time could improve the potential to increase patient participation. Moreover the respondents emphasised the importance of education and information. The written information was experienced as hard to understand. The respondents preferred oral information rather than web-based training. They also requested feedback on the results from Dagen nutrition along with suggestions for improvement to pass on to the wards.   Conclusions Inadequate filled out register forms and lack of knowledge and engagement among the personnel caused lack of participation and exclusion in Dagen nutrition among the viable patients. The respondents thought that it is possible to increase patient participation through suggested active measures.

Lic.-avh. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 2 uppsatser.

Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [110]-123).

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 195-208).

Thesis (Ph.D.)--University of Alabama at Birmingham, 2010. / Title from PDF title page (viewed on July 7, 2010). Includes bibliographical references.