No description available.

No description available.

No description available.

No description available.

No description available.

No description available.

No description available.

The study was conducted for the purpose of designing and evaluating an educational program for undereducated diabetes mellitus patients. The program as designed integrated recommended emphases found in the literature for the development of educational programs for low literacy levels and accounted for cultural relevancy. Developed program components were the diabetic diet guide and an audiotape-slide presentation entitled, "How to Follow the Diabetic Diet Guide." Concentrated efforts were made to develop understandable and applicable dietary education materials. Educator and professional dietitian expertise were utilized in the formation and completion of the program design. Patients similar to potential study participants voluntarily served as trial learners provided input relative to realistic content transmission, application to the daily dietary regimen, and comprehensibility. The program components are clear, concise, colorful, visually-oriented, and interesting. The provision of an easy-to-follow guide for regular home use allows for repetitive application of required dietary principles. The content emphasis was on the necessary concepts for dietary control of the disease. Knowledge areas included nutritional knowledge basic to the disease, the foods in food groups, the measurement of serving sizes of foods using standard methods, unrestricted foods, restricted foods, the use of fat in food preparation, and the advocacy of an established eating routine throughout the day from day-to-day. In the diabetic diet guide, the aforementioned concepts were clearly and colorfully presented so that literacy was not required. The same concepts utilizing portions of the guide were reinforced by a unisex cartoon character explaining use of the guide. Evaluation instruments were designed to test program effectiveness with an undereducated diabetes mellitus patient population. The instruments (developed by the researcher) were a 70-item knowledge test, a 24-hour recall record, and a medical chart information sheet. A field test trial was conducted with 50 participants who are served on an outpatient basis. The site was the High Point Memorial Hospital Outpatient Clinic, funded by the health department. Fifty consenting participants were randomly assigned to experimental and control groups by a ratio of two to one by race and sex. Thirty-two experimental and 18 control subjects completed the study. All data collection was orally solicited initially, at two months, and at four months. The educational intervention was presented only to experimental subjects. Evaluation of increments in knowledge, decreases in weight, blood glucose values, and minimal acute complications indicated the newly designed program was successful. The data was subjected to statistical analysis using analysis of covariance. The initial scores or readings were used as covariates to control for initial variances. Knowledge scores improved significantly from the beginning to the end of the study (p ≤ 0.0001). Knowledge attainment must occur for subsequent application as reflected by clinical measurements. The desirable clinical measurements were generated during the four-month study as shown by statistically significant decreases in blood glucose values (p < 0.05) and a pronounced trend in weight loss. A further indication of success was that the experimental population had fewer acute complications than the control subjects. / Ph. D.

Obese, female Spraque-Dawley rats were assigned, on a weight basis, to one of three dietary treatments: ad lib, 15% caloric restriction, and 30% caloric restriction. All other nutrients were fed at levels to meet dietary requirements. Each treatment groups was further sub-divided into pregnant and non-pregnant animals. Rats were sacrificed on Day 20 of gestation and fetuses were taken by Caesearean section. Maternal and fetal body composition, maternal serum protein concentrations were examined. Weight change for pregnant rats was +85 gms in the ad lib-fed group, +82 gms in the 15% calorie restricted group, and +56 gms in the 30% calorie restricted group. Weight changes for the non-pregnant rats for 20 days of dietary treatment were +53 gms, +18 gms, and -7 gms respectively. Fetal body nitrogen and average pup weight did not differ between treatment groups. Total maternal body nitrogen was not decreased during pregnancy in ad lib-fed and 15% calorically restricted animals. It did decrease in 30% calorically restricted animals. Ad lib-fed animals showed no changes in total body fat. Animals on the 15% calorie restriction diet showed no change in total body fat percentages. Animals on the 30% calorie restriction showed a 10% decrease in total body fat content as compared to the ad lib and 15% restricted pregnant group. Serum protein levels decreased in pregnant animals as caloric restriction increased. Serum protein levels in nonpregnant animals increased as dietary restriction increased. The fetal compartment was not affected by maternal caloric restriction up to 30% provided that all other nutrients were adequate. Maternal stores were affected at a level of 30% caloric restriction. / Master of Science

The relationships between stress, ascorbic acid status, and the adequacy of nutrient intake during the third trimester of pregnancy were studied. Adequacy of nutrient and ascorbic acid intake were measured by diet histories and 24 hour recalls. Plasma ascorbic acid and cortisol levels were determined. Stress was assessed by Spielberger State-Trait Anxiety Inventories (STAI) and Symptom Checklists (SCL). Factors which may affect stress were assessed by a General Background Information Questionnaire. All subjects had acceptable plasma ascorbic acid levels (0.48 - 1.64). A-State and A-Trait scores, X̄ = 1.55 and X̄ = 1.63 respectively, indicated the majority of subjects to be little stressed. There were positive significant correlations between age and cortisol, A-State and A-Trait measures of STAI, nutritional scores from diet histories and plasma cortisol. Significant negative correlations were obtained between month of pregnancy and plasma ascorbic acid levels, total ascorbic acid intake and A-State measurements of STAI, A-State measurements and income, A-State measurements and education, and A-State measurements and ascorbic intake as calculated from diet histories. There was no significant correlations between STAI, measurements and cortisol, plasma ascorbic acid and cortisol, and STAI measurements and plasma ascorbic acid. This study showed no conclusive evidence that ascorbic acid status or nutrient intake were affected by psychological stress. / Master of Science