Obesity and its subsequent disease states are major health problems in the United States. In many ways, obesity can be considered a “disease state” itself due to the changes it causes on the body. High-intensity exercise also places acute stress the body, putting humans in recovery from exercise in a state that may be analogous to a temporary disease state. The purpose of this study was to examine biomarkers associated with obesity (CRP and Leptin) before and after continuous and intermittent bouts of exercise in an obese but otherwise healthy sample vs. a healthy, non-obese sample. This investigation focused on examining the obese sample’s biomarkers at rest compared to those of the healthy group immediately and 1 hour-post exercise. Eighteen male subjects participated, with nine in each group. Each subject performed a VO2 max test and a series of three anaerobic Wingate tests at least one week apart in a cross-over study design. Blood was taken at baseline, immediately-post, and 1-hour post for each exercise mode. A significant difference was noted between groups for CRP at baseline on the VO2 testing day. A significant difference between groups existed in leptin levels at baseline on both testing days. The only significant change was the decrease in leptin from post to 1- hour post for during the VO2 in the obese group. However, both exercise protocols demonstrated various effects on the subjects and groups. Healthy participants were examined individually, and two of them showed possible signs of being at risk for obesity and its subsequent disease states based on post exercise “spikes” in CRP and leptin that caused the levels of the biomarkers to be closer to those in the obese group at rest. Another three subjects saw at least two spikes. Thus, a total of five subjects could potentially be “at-risk” based on the assumptions of the present study. These results suggest CRP and Leptin could potentially hold the ability to classify someone in a “preobesity state.” Further investigations are warranted based on these initial results and should focus on biomarkers more specific to obesity.

This dissertation presents three separate studies investigating elementary school personnel's perceptions of and recommendations for managing child obesity. First, a systematic literature review will be presented with an assessment of the very limited current body of literature related to elementary school personnel's perceptions of child obesity to determine the direction of the second and third studies. The systematic review presents personnel's perspectives of (1) the extent of child obesity, (2) contributing factors of child obesity, (3) solutions for child obesity, and (4) barriers to overcoming child obesity. Second, drawing upon the systematic review, a qualitative investigation of elementary school personnel's perceptions of and recommendations for managing child obesity will be presented. Utilizing an emergent design, data collection comprised one-on-one interviews with 31 elementary school personnel. A thematic analysis was employed on raw data and a socioecological model was utilized to explain emergent themes. Participating school personnel identified the home environment and parental factors as the leading factors contributing to child obesity. Personnel also emphasized child control of dietary and physical activity choices, most notably within the home environment. Third, a qualitative case study examining an elementary physical education (P.E.) teacher's perspectives of the impact of obesity on her obese students' experiences in her classroom will be presented. A narrative framework was employed, utilizing both thematic and structural analyses to examine the narratives elicited during the interview. The thematic analysis illuminated a participation refusal pattern of obese students within this P.E. teacher's classroom. The structural analysis highlighted the participating P.E. teacher's customized intervention for her obese students' participation refusals. The combination of thematic and structural methodologies resulted in a preliminary model of the behavioral impact of obesity in this P.E. classroom, which provided a more holistic view than either method alone. Prior to this study, just seven studies had investigated elementary school personnel's perceptions of and recommendations for managing child obesity; only three of which were published in the past decade. Thus, this study is both timely and desperately needed. The valuable insights gained from participating elementary school personnel in this study provide a justification for their inclusion in future studies addressing child obesity.

The purpose of this research was to examine the impact of self-management on daily net calories consumed by women who are overweight. Four white females between the ages of 35 and 41 with a self-reported BMI between 25 and 29.9 completed this study. A multiple baseline across participants design was used to demonstrate a functional relation between the independent variable (i.e., self-management) and the dependent variable (i.e., net calories consumed) for each participant. Three of the four participants decreased their daily net calories consumed after beginning the self-management intervention. This was the first single case research study to examine the effectiveness of self-management on daily net calories consumed (i.e., caloric intake minus caloric expenditure) and extended previous literature on white females who were overweight.

BAKGRUND: Övervikt är ett folkhälsoproblem som påverkar människors hälsa och ger även en ökad risk för kroniska sjukdomar som exempelvis diabetes. Andelen överviktiga ungdomar har ökat de senaste 20 åren och övervikt i unga år är ofta ett ihållande problem som fortgår upp i vuxen ålder. Därför behöver föräldrarna involveras i barnets vård eftersom de ska tillgodose grundläggande behov. SYFTE: Syftet är att beskriva begreppet motivera för att se hur sjuksköterskan kan främja hälsa och motivera barn och ungdomar med övervikt till livsstilsförändringar. METOD: En begreppsanalys där datamaterial inhämtats från ordböcker, vetenskapliga artiklar och fack- och läroböcker. RESULTAT: Begreppet motivera har många betydelser som kan ses på olika sätt. Familjens stöd är avgörande för ungdomar när de ska genomgå en beteendeförändring och nå en sundare livsstil och bör involveras i förändringsarbetet med barnet. Det framkom även att det är betydelsefullt att upprätthålla en god relation med ungdomarna och familjen för att kunna genomföra motiverande samtal och att olika redskap kan användas i samtalet. DISKUSSION: Föräldrar behöver ha ett intresse för att förändra sina barns situation. Sjuksköterskan behöver vara öppen för olika åsikter om hälsa. Vård av överviktiga ungdomar ger både fysiskt och psykiskt förbättrad hälsa. Begreppet motivera kan både stimulera och hämma en patient till förändring av beteende. / BACKGROUND: Overweight is a public health problem that affects people’s health and with overweight come risks for chronic diseases such as diabetes. The number of overweight adolescents has increased the last 20 years in Sweden and is often a persistent problem that will continue even as an adult. Parents need to be involved in their child´s care because they are responsible for the child´s basic needs. AIM: The aim of this study is to describe the concept of motivation and to investigate how the nurse can promote health and motivate children and adolescents with overweight to make lifestyle changes. METHOD: A concept analysis with materials collected from dictionaries, scientific articles and technical literature. RESULT: The concept of motivate has many meanings that can be viewed in different ways. The support of the family is vital to the adolescent in order to reach good result in having a healthier lifestyle and should be involved in the child´s behavioral changes. It also revealed that it is important to maintain a good relationship with the adolescents and family to conduct motivational conversations and that different tools can be used in conversation. DISCUSSION: Parents need to have an interest in changing their children’s situation. The nurse needs to be open for different opinions about health. Care of adolescent’s overweight provides both physical and mental health. The concept of motivate can both stimulate and inhibit a patient to change behavior.

Syftet med denna deskriptiva och komparativa tvärsnittsstudie var att belysa vilka attityder till överviktiga patienter det fanns hos en grupp sjuksköterskor tjänstgörande på en operationsavdelning, detta då patientgruppen överviktiga blir allt vanligare inom sjukvården och patienter som genomgår överviktskirurgi opereras på den berörda avdelningen. Frågeställningarna var: Vilka attityder har sjuksköterskorna på operationsavdelningen till överviktiga patienter? Är det någon skillnad mellan åldersgrupperna hur de ser på patientgruppen, yngre än 36 år, 36-50 år samt 50 år och äldre. Är det någon skillnad mellan sjuksköterskor som arbetat längre eller kortare tid hur de ser på patientgruppen, från och med 10 år, 11-25 år samt från och med 26 år. För att få svar på frågeställningarna lämnades en enkät Attityder till överviktiga personer, ut till samtliga 85 sjuksköterskor anställda på operationsavdelningen. Resultatet visade att det var övervägande positiva attityder till överviktiga som framkom. En signifikant skillnad i sjuksköterskornas attityder till överviktiga i förhållande till ålder framkommer mellan åldersgrupperna 36-50 år och >50 år. En signifikant skillnad i sjuksköterskornas attityder till överviktiga i förhållande till hur länge de varit verksamma i yrket framkom mellan gruppen som arbetat kortast <10 år och gruppen som arbetat längst >26 år. Slutsats: Studien visar att sjuksköterskor i denna studie har en övervägande positiv attityd till överviktiga patienter. Skillnader i attityder varierar mellan åldersgrupper. Det finns även varierande attityder jämfört med hur länge sjuksköterskorna har varit yrkesverksamma. Nyckelord: övervikt, sjuksköterskor, attityder och enkät / The purpose of this study was to show which attitudes nurses working on an operating room unit have towards people with overweight. Patients with overweight are becoming more common and on this particular operating room unit patient undergoing overweight surgery are treated. The questions asked was: What are the nurse’s attitudes towards overweight patients. Are there a difference in attitudes regarding to the nurse’s age and how long they had been working in the occupation. The study contained of a questioner that was given out too all the 85 nurses on one operating room unit. The result shows that it was mainly positive attitudes towards people with overweigh. The study shows a significant difference in the nurse’s attitudes between age groups 36-50 and >50years old. A significant difference in attitudes towards overweight people also shows between the nurses that had been working <10years and >26years. The conclusion is that nurses mainly have a positive attitude towards overweight people. A variation in attitudes towards overweight people can be shown between age groups. There is also a variation in attitudes compared to how many years the nurses had in the occupation. Keywords: overweight, nurses, attitudes and questioner

I ett internationellt perspektiv har Sverige hög amningsfrekvens, men under 2000-talet har amningsfrekvensen sjunkit och stora regionala skillnader ses. Kvinnorna rekommenderas att helamma sex månader. Mödravårdcentralen (MVC) informerar om bröstmjölkens hälsoeffekter som till exempel att bröstmjölken skyddar barn mot allergier. Forskning visar att överviktiga och feta kvinnor har kortare amningsduration, men få studier behandlar svenska förhållanden. Syfte: Syfte med fördjupningsarbetet är att studera samband mellan mammans BMI relaterat till amningsduration och mammans skattning av barnets hälsa de tre första levnadsåren. Metod: Studien är en kvantitativ retrospektiv tvärsnittstudie. Data insamlades via enkäter, 418 deltagare inkluderades. Data har analyserats med Statistical Package for the Social Sciences (SPSS). För deskriptiv och jämförande analys har parametriska och icke-parametriska analyser genomförts. Resultat: De kvinnor som inte ammade skattade sitt barns hälsa sämre vid tre års ålder i jämförelse med kvinnor som ammat någon period. Vid tre års ålder skattade kvinnor med övervikt och fetma sitt barns hälsa sämre. Slutsats: Det är viktigt att kunna identifiera kvinnor som är behov av stöd för att initiera amning och kunna bidra till anpassat stöd till dem. AbstractSweden reports high duration of breastfeeding compared to international findings. During the last century, the frequency of breastfeeding duration has decreased in Sweden, with large regional differences. Recommendation for exclusive breastfeeding is six months. Midwives provide information about healthy benefits of breast milk, such as breast milk protecting baby´s against allergies. Research has presented associations between obesity and short duration of breastfeeding. However, there is a lack of knowledge regarding women in a Swedish context. Aim: To investigate the relation between mothers BMI, duration of breastfeeding and maternal valuation of the baby´s health during the first three year of life. Method: The study is a quantitative retrospective cross-sectional study. Data was collected through questionnaires, 418 participants were included. Data was analyzed using the SPSS. For descriptive and comparative analysis parametric and nonparamateric statistics have been used.Results: Women who did not breastfed perceived their baby´s health worse at three years compared with women who did breastfeed. Women with overweight and obesity also perceived the health of their three year old worse than the other maternal group. Conclusions: It´s important to identify women who need support to initiate breastfeeding and give them customized support.

Childhood overweight/obesity (CHO) is a serious health concern for children and adolescents. Despite increased efforts to prevent CHO, prevalence rates have actually increased. Evidence suggests that parents are critical to successful interventions to reduce CHO among children. While research efforts aimed at parental inclusion have increased, limited research has been conducted to investigate fathers’ perception of CHO, or their influences on their children’s health. The objective of this two-phase study was to answer three research questions: a) How does the extant literature operationalize African American parental perceptions of childhood overweight/obesity? b) What are African American fathers’ perceptions of CHO? and c) How do African American fathers perceive CHO in relation to their own child’s weight status? Evidence-based studies reveal that fathers have the potential to play a significant role in CHO prevention. Phase one (literature review) revealed that published studies on parental perception of CHO either exclude fathers, include them only in data collection, and/or report no results specific to paternal perception. Thus, an exploratory qualitative study was needed to explore African American fathers’ perceptions of CHO. In phase two (qualitative study), four fathers were interviewed about their perceptions of CHO and how they contextualize this problem. The results indicated fathers believe that weight categories are racially & culturally insensitive and do not account for individual health status or differences in body/bone structure, and that parents with overweight children are financially disadvantaged, irresponsible and overworked. Fathers also indicated that colloquial terms (e.g., chunky, husky, big-boned, thick) were commonly substituted medical definitions for overweight and that child/teen sports participation was motivated by health, as well as non-health related benefits (e.g., competitiveness, educational scholarships). Further, fathers’ identification of CHO is subjective and includes visual means and parental assessment of health status (e.g., child mobility/activity levels). Implications of this study are that additional studies are needed to clarify fathers’ roles in CHO and that future studies should consider complex familial structures, as well as reframe prevention efforts to focus on optimal child health as opposed to weight labeling and focusing on parents’ accuracy in identifying weight categories.

<p> </p><p>Like adult obesity, childhood obesity prevalence is rising, especially in the Western World.</p><p>As many as 20 – 25 percent of the ten years old children are overweight in Sweden. It is</p><p>important to early identify overweight, since overweight could lead into diabetes, mental</p><p>suffering, hypertension and cardiovascular disease.</p><p>The aim of this study was to describe how nurses experience and perceive the conversation</p><p>with parents of overweight children. A qualitative method with a content analysis has been</p><p>used. Six nurses working in child health centre have been interviewed.</p><p>The result shows that the conversation between the nurse and the parents of an overweight</p><p>child can be very difficult. The nurse has to bring up the subject very carefully. It might</p><p>happen that the parent will react with anger. The nurses expressed a need for more time</p><p>allocated for taking care of this issue more satisfying. She also is looking for more education</p><p>according to conversation methods. Finally, parents carry most of the responsibility for their</p><p>children. They are the best placed to change the situation. The nurse´s important work is to</p><p>support parents and help them identify the problems and thus find the solutions that suit the</p><p>individual family.</p><p> </p> / <p>Övervikt och fetma är ett växande problem hos vuxna och barn, speciellt i västvärlden. I</p><p>Sverige är 20 - 25 % av alla tioåringar överviktiga. Det är av största vikt att tidigt identifiera</p><p>övervikt. Detta eftersom övervikt kan leda till diabetes, psykiska problem, hypertoni och</p><p>hjärt- kärl sjukdomar.</p><p>Syftet med studien var att beskriva sjuksköterskans erfarenheter av att samtala med föräldrar</p><p>till överviktiga barn. En kvalitativ metod med innehållsanalys har använts. Sex stycken</p><p>barnsjuksköterskor/ distriktssköterskor verksamma inom barnhälsovården har intervjuats.</p><p>Resultatet visar att barnsjuksköterskans/ distriktssköterskans samtal med föräldrar till</p><p>överviktiga barn inte alltid är helt problemfria. Hon måste vara försiktig då hon för ämnet på</p><p>tal. Det händer att föräldrar reagerar med ilska. Barnsjuksköterskan/ distriktssköterskan</p><p>behöver mer tid för att samtala med föräldern på ett mer tillfredsställande sätt.</p><p>Barnsjuksköterskan/ distriktssköterskan efterfrågar också utbildning i samtalsteknik. Föräldrar</p><p>är ansvariga för sina barns hälsa. Det är de som bäst lämpar sig till att förändra situationen för</p><p>sina barn. Barnsjuksköterskan/ distriktssköterskans viktiga arbete består i att stötta föräldern</p><p>och hjälpa denne att identifiera problemet och därmed hitta de lösningar som passar den</p><p>enskilda familjen.</p>

<p><p>Bakgrund: Övervikt och fetma är den största folkhälsosjukdomen i dagens samhälle. Överviktiga patienter blir allt vanligare i hälso- och sjukvården och vårdpersonal upplever det svårt att behandla dem korrekt. Sjuksköterskor använder sig av olika strategier för att nå dessa patienter men är osäkra på hur patienterna uppfattar deras råd. Patienter med övervikt står inför allvarliga hälsorisker. Syfte: Syftet med studien är att belysa överviktiga patienters upplevelser av mötet med vården. Metod: Metoden är litteraturöversikt och tio vetenskapliga artiklar ligger till grund för resultatet i studien. Resultat: Fyra teman framkom vid analysen, och dessa var kränkning, behov av stöd, okunskap och att undvika sjukvård. Temat kränkning innehåller tre subteman, diskriminering, att bli anklagad och att bli avvisad. Behov av stöd innehåller två subteman, bristande stöd och tillfredställande stöd. Diskussion: Patienterna upplever mötet med vårdpersonalen både positivt och negativt. Det diskuteras om vikten av utbildning till vårdpersonalen i detta ämne.</p></p> / <p><p>Background: Obesity is the biggest national disease in the world today. Though these patients are becoming more common in the health service, nurses doesn’t know how to treat them correctly. Nurses develop different strategies to reach these patients but they are insecure on what the patients will think about their advice. The patients are facing serious health concerns. Purpose: This study aims to investigate how overweight and obese patients experience the encounter with health services. Method: The method is literature review and ten different articles are included in the result of this study. Result: Four themes emerged from the analysis; they were violation, the need of support, ignorance and health care avoidance. The theme violation has three subthemes, discrimination, too be accused and too avoid health care. Need for support has two subthemes, inadequate support and satisfied with the support. Discussion: Patients experience the encounter with health care both positive and negative. It’s discussed around the importance of education to health care professionals about this subject.</p></p>

<p>Övervikt och fetma är ett stort hälsoproblem i hela världen och associeras många gånger till social diskriminering. Under de senaste 35 åren har övervikt och fetma ökat i Sverige och kostar sjukvården tre miljarder varje år. Patienter med övervikt kan känna sig otrygga samt kan känna ett obehag att söka vård på grund av rädsla för stereotypa attityder från sjukvårdspersonal. Syftet var att identifiera och beskriva forskning om sjuksköterskors och sjuksköterskestudenters attityder gentemot vuxna patienter med övervikt/fetma. En litteraturstudie har gjorts för att sammanställa vad forskningen påvisar. Sammanlagt har 9 artiklar, både kvalitativa och kvantitativa analyserats och valts ut. Artiklarnas resultat delades in i likheter och olikheter. Därefter utvecklades resultatet till fem olika områden/attityder. Resultatet visade att det finns delade meningar om attityder då vissa studier visade olika resultat. Attityder som sjuksköterskor kan ha är att patienter kan vara lata, oattraktiva, långsamma och sällan uttrycker sina riktiga känslor har påvisats. Sjuksköterskestudenter visade sig ha mindre negativa attityder än sjuksköterskor. Sjuksköterskors BMI kan ha en betydelse för vilka attityder och fördomar hon eller han har i mötet med patienten. På grund av ett ojämt och motsägelsefullt resultat är det svårt att dra en slutsats om sjuksköterskors och sjuksköterskestudenters attityder.</p> / <p>Overweight and obesity is a major health problem worldwide and many times associated to social discrimination. Over the past 35 years, overweight and obesity has increased in Sweden and costs the healthcare three billion crowns each year. Patients with obesity can feel insecure and discomfort to seek treatment because of fear of stereotypical attitudes from health professionals. The aim was to identify and describe research on nurses and nursing students´ attitudes towards adult patients who are overweight/obese. A literature review was used to compile what the research shows. A total of nine articles, both qualitative and quantitative studies was selected and analyzed. Results of all articles were divided into similarities and differences. Thereafter five different areas were developed from the result. The results showed that there are differing views on attitudes when some studies showed different results. That the patients can be lazy, unappealing, slow and rarely express their true feelings are some of the attitudes that have been found. Nursing students were found to have less negative attitudes than nurses. The nurse BMI may have significance for the attitudes and prejudices that she or he has in the meeting with the patient. Because of uneven and contradictory results, it is difficult to draw a conclusion about nurses and nursing students.</p>