Dissertations / Theses on the topic 'Middle-aged women Health and hygiene Australia'

This descriptive correlational study was designed to increase the knowledge needed to understand the relationship among health-related variables that facilitate or sustain health-promoting behaviours of midlife women. Specifically, this study investigated the relationship among self-esteem, health locus of control, and health-promoting behaviours of women in this age group. Pender's (1982) original Health Promotion Model provided the theoretical framework to structure this study. The sample included 84 midlife women volunteers who were current or prospective members of a Vancouver-based social networking group for mature women. Data were collected using the Rosenberg (1965) Self-Esteem Scale, the Multidimensional Health Locus of Control Scale -Form A, and the Health-Promoting Lifestyle Profile. Data were analyzed using descriptive statistics, Pearson's product-moment correlations, and stepwise multiple regression. Three significant predictors, self-esteem, chance health locus of control, and powerful others health locus of control, explained 24.5% of the variance for engaging in health-promoting behaviours. The study findings supported Pender's Model which postulated that individual perceptions of self-esteem and health locus of control, among other personal factors, influence one's likelihood of engaging in health-promoting behaviours. The findings also supported Pender's contention that selected demographic variables, as modifying variables, have an impact on health-promoting behaviours.
Applied Science, Faculty of
Nursing, School of
Graduate

This thesis examines the menopausal experiences of a non-clinical sample of lesbians living in Australia. Research on menopause to date has largely been conducted from a medicalised and heterosexual perspective: thus lesbians’ experiences remain unknown and invisible. Using a qualitative feminist multiple method research methodology combining content analysis and questionnaire/interview research, two hundred questionnaires were posted upon request to self-identified lesbians living in every Australian state and territory. Follow up in-depth interviews were conducted with twenty lesbians. Responses were grouped into four major themes: body image, sex and sexuality, hormone replacement therapy and health services and homophobia. The findings show that lesbians at menopause face some different and additional issues from those experienced by heterosexual midlife women. For many of the study participants, commonly discussed concerns at menopause such as weight gain and other physical signs of ageing, decreased fertility, lack of libido, sexual difficulties and hormone replacement therapy were of little relevance and importance. Lesbians in this study frequently raised other issues such as the universal assumption of heterosexuality and homophobia experienced when interacting with health professionals, which led to less than satisfactory health care and reinforced feelings of invisibility. In the Conclusion I argue that the study participants' views and experiences challenge negative, stereotypical views of both lesbians and menopause. The data thus add a new dimension to the presently narrow, heterosexist and medicalised view of women at midlife and contribute new knowledge to the body of literature on menopause. This thesis is a first important step in recording the experiences of lesbians regarding menopause in Australia. I include recommendations for further research in the area of lesbian health and improved practice, and discuss old and new obstacles lesbians face in a heteropatriarchal society in which lesbians continue to be invisible.

Numerous cross-sectional studies have reported an inverse relationship between VO2,,,ax and age. However, few longitudinal investigations have compared the rate of decline in VO2,,.x between women who did or did not report exercise habits consistent with the 1990 ACSM position stand for quantity and quality of exercise. The purpose of this study was to determine if changes in exercise habits and body composition affected age-related changes in VO2.x. Subjects were 91 women (age 40.9 ± 8.8 years at baseline) tested twice between 1973 and 1996 (range of 3.1 - 21.9 years, mean interval of 9.3 ± 4.2 years). The subjects were divided into four physical activity groups based on their reported exercise habits at baseline and follow-up as: non-exercise - exercise (NE-EX; n = 21), NE-NE (n=36), EX-EX (n=19), and EX-NE (n=15). Baseline VOz,,,ax (ml-kg-1-min-1) was significantly higher for the EX vs. NE ( 38.4 ± 8.4 vs.28.8 ± 5.7; f42.2; P<.0001). ANOVA revealed significant differences between the physical activity change groups and mean percent changes in VO2. (% A ml•kg'.min'-yr') (F =10.887; P<.0001) which are listed in the following:NE-NENE-EXEX-EXEX-NE-1.081.58*-1.25-2.21* NE-EX vs. EX-NE; NE-EX vs. EX-EX; and NE-EX vs. NE-NE (P<0.05)There were differences between the following groups: NE-EX vs. EX-NE; NE-EX vs. EX-EX; and NE-EX vs. NE-NE for percent change in VO2max (nl•kg'-min 1•yr 1) with the EX-NE group having the largest decline in VO2max during the follow-up period.Using a multiple regression model after adjusting for the exercise habit groups, the exercise group scheme accounted for 27.3 percent of the variance in percent change in VO2max at step 1 of the analysis (f = 1.09; P < 0.001). Change in percent body fat and change in maximal ventilation accounted for an additional 7.2 percent and 6.5 percent of the variance at steps 2 and 3, respectively. The change in maximal heart rate accounted for an additional 2.5 percent of the variance at step 4, although the statistical significance of the contribution was low (P = 0.057). Increases in body fat and decreases in pulmonary ventilation were found associated with declines in aerobic power while a decline in maximal heart rate between the tests was associated with a decline in percent change in aerobic power.In conclusion, these data demonstrate that: 1) adoption or maintenance of a regular exercise program is associated with less decline in VO2,,. during long-term follow-up compared to women who did not exercisers, and 2) changes in exercise habits, body composition, maximal ventilation, and maximal heart rate accounted for nearly half (43 %) percent of the percent decline per year.
School of Physical Education

While a great deal of research has been directed towards investigating the age-related decline in V02max, the effect of physical activity on the age-related decline in V02max has not been clearly established. Therefore, the purpose of this study was to examine the relationship between physical activity and the age-related decline in maximal oxygen consumption (VO2max) in apparently healthy individuals. In order to assess the effects of physical activity on the age-related decline in V02max, physiological data was obtained from 142 former participants (116 men and 26 women) (40 ± 8.0 years), in the Ball State University Adult Physical Fitness Program across an average of 12 ± 4.5 years. The subjects were divided into three physical activity group categories depending on their self-reported physical activity status at the time of the first and follow-up test. Those subjects who were sedentary at the first and last test were designated as SED-SED. Those who reported sedentary at the first test and active at the last test were designated as SEDACT and those who were physically active at the time of both tests were designated as ACT-ACT. The data from the analysis revealed that the rate of decline in V02mx expressed as change per year among adult men varied as a function of their reportedphysical activity habits. Those men designated as SED-SED and ACT-ACT experienced a statistically significant decline (p<0.05) in V02max during the follow-up period, while, those men designated as SED-ACT maintained their V°2max. The rates of the change in V02max (ml-kg- 1•min-1) for the men were -0.45, 0.03 and -0.22 ml•kg-l-min-1•yr1 for the SED-SED, SED-ACT and ACT-ACT groups respectively. The percent decline in V02max were 6%, 11% and 2% respectively. A statistical comparison of the rate of change among physical activity groups indicated a difference between the SED-SED and SED-ACT groups (p<0.05). Within the limitations of this study, these data suggested that there was no statistically significant difference in the rate of change in V02max (ml•kg-1•min-1-yr1) between the SED-SED and ACT-ACT physical activity groups. However, when presented as percent change per decade, the decline for those men who were sedentary at both time points was twice that of those men who reported an active lifestyle at both time points. Although the rates of change were not different for the SED-SED and ACT-ACT physical activity groups, those men with a physically active lifestyle maintained their aerobic power advantage as compared to sedentary men who remained sedentary. Furthermore, sedentary men who took up an active lifestyle had offset the decline in V02max (ml•kg-1•min-1) attributed to physical inactivity.The rates for the change in V02max (ml•kg-1•min-1-yr1) for the women were -0.36, 0.20 and -0.21 (ml•kg-1•min-1-yr1) for the SED-SED, SED-ACT and ACT-ACT groups respectively. While these changes were similar in direction and magnitude to those observed for the men, there were no statistically significant differences among the female groups (p>0.05). Therefore the results from the present study were inconclusive for women possibly due to the low sample size (n=26).
School of Physical Education

This ex post facto correlational study seeks to identify if a relationship between blood glucose values and vasomotor instability intensity exists. The population consisted of a convenience sample of seven type 2 diabetic postmenopausal women experiencing vasomotor instability living in Southern Alberta. This study hypothesizes that a significant negative correlation would be identified between these two variables based on research done by Dormire and Reame (2003). The correlational results suggest that a small to moderate significant positive relationship exists between blood glucose and vasomotor instability: increased vasomotor instability was associated with increased blood glucose values. Overall, this study suggests a relationship exists between blood glucose and vasomotor instability but causality or direction of this relationship cannot be determined. Further research studies are recommended to clarify and validate this research. In particular, such a study should include type 1 diabetic postmenopausal women, a larger sample size, and sampling a wider geographical area.
ix, 109 leaves ; 29 cm.

This research has been motivated primarily by a desire to extend and enrich existing research on women’s uses of information and communication technologies (ICTs) to manage relationships, and access and construct social support during their transitional midlife years. In doing so, this research addresses a gap in the literature on women’s consumption of such technologies. Since the late 1980s, when several landmark studies investigated women’s use of the telephone, there has been little systematic evaluation of the degree to which newer communication technologies have become integrated into women’s communication practices. Another key feature of this research is an examination of how ‘midlife’, as a stage of life characterised by several common transitions, is experienced by a group of women. These life experiences are modified by the availability of social support and, significantly for this research, by the communication conduits through which this support circulates. Given that midlife involves physical and emotional changes that may impact on a woman’s sense of self, this period of transition can be a source of stress. Numerous studies have identified the critical role social support plays in helping individuals cope with stress. For women, social support is commonly manifested through female networks, maintained through faceto- face encounters, and increasingly through mediated communication channels. In a region as geographically isolated as Western Australia, where over 27% of the population were born overseas, the importance of communication technologies in facilitating access to dispersed social support networks is arguably even more critical. The research procedure, drawing on a qualitative, interpretive methodological approach, involved 40 in-depth, one-on-one ethnographic interviews with women aged between 45 and 55. Initial findings indicated that while women are actively appropriating a range of online communication channels, there was a risk in limiting the research focus to women’s use of the Internet, in isolation from their broader communication practices. In particular, this research makes clear that one significant aspect of women’s uses of ICTs lies in how different communication channels meet the needs of women and their families at particular moments in their lives. At the midway mark in the lifecycle, many of the women interviewed are either consciously, or in some cases intuitively, employing particular communication channels to manage difficult or sensitive relationships; their choices often constrained by the communication needs and/or preferences of their aging parents and/or their own children. Despite such constraints, this research provides strong evidence to suggest that midlife women are as adept at strategically appropriating multiple communication technologies to satisfy their own needs, as are many younger people. This is manifested in a variety of ways, from women’s use of email as a safe conduit through which to maintain tenuous links with difficult siblings; to their strategic employment of email, instant messaging and webcam to foster a richer sense of connection with young adult children living thousands of kilometres away; through to their appropriation of a mix of ‘old’ and new channels such as face-to-face communication, the landline telephone, text messaging and email, as tools to help them manage their hectic lifestyles and sustain relationships with family and friends. Women’s active appropriation of multiple communication channels is therefore critical to the ongoing maintenance of relationships and, by extension, the health and emotional wellbeing not only of the women themselves, but also their loved ones and friends

Introduction: Cardiovascular disease affects a greater proportion of females than it does males, and is responsible for an estimated 52 percent of female deaths per annum, globally. Due to the loss of oestrogen associated with the menopause, post-menopausal females are at elevated risk for hypercholesterolaemia which is a primary risk factor for cardiovascular disease. It has not yet been conclusively established whether resistance training can be used to ameliorate hypercholesterolaemia. Aim: This randomized controlled trial investigated what effect 12 weeks of progressive resistance training would have on plasma lipoproteins in a sample of post-menopausal females. Methods: Caucasian women (n=30 intervention and n=18 control) between the ages of 55 and 65 years who were not taking hormone replacement therapy were recruited. Participants did not smoke, were sedentary, were not taking any form of cholesterol-lowering medication, had at least one cholesterol abnormality at baseline but were otherwise healthy and able to participate in a strength training programme. Following extensive medical pre-screening, information dissemination and voluntary consent, the sample was divided into two groups. The exercise sample undertook 12 weeks of resistance training on five days of the week. The control group received no intervention. Measurements were obtained at baseline and every four weeks thereafter and included measures of strength, biochemistry (oestradiol, testosterone, full blood lipid profile, glycated haemoglobin and sex hormone binding globulin), anthropometry, morphology and self-reports (dietary intake, energy expenditure and the profile of mood states questionnaire). Results: There was no change to low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride content or total cholesterol as a result of the intervention. Back, chest and leg strength increased significantly (p<0.01) (increases of 51 percent, 35 percent and 43 percent respectively from baseline); waist circumference dropped (p<0.01) by 5 percent overall and diastolic blood pressure decreased significantly (-9 percent, p<0.01) in the exercise cohort but no change was noted in the matched control. Dietary intake, energy expenditure and body mass remained unchanged in both samples. Morphology (sum of skinfolds, estimated body fat content and girth measures) did not change and nor did other biochemical measures (HbA1c and sex hormone binding globulin) or hormone levels (oestradiol and testosterone). Despite the lack of overall change, an important finding was noted in individual results where a clear indication of ‘responders’ and ‘non-responders’ emerged. Conclusion: Overall mean results suggest that 12 weeks resistance training undertaken five days of the week was ineffective in reducing hypercholesterolaemia in this sample. Despite there being no identifying characteristics determined in this sample, evidence of responders and non-responders to the intervention indicates that reliance on mean data may not be sufficient when analysing data from exercise interventions. Therefore, while progressive resistance training had a positive effect on strength, waist circumference and diastolic blood pressure, it did not positively influence the plasma lipoproteins in this cohort of post-menopausal women.
Maiden name: Kelly, Janet Erica

The main purpose of this study was to assess the effect of progressive resistance training on the blood lipid profile in post-menopausal women. Thirty-four female subjects aged 50 to 75 years were selected from the population of Grahamstown, South Africa. All participants were previously sedentary and possessed at least one lipid profile abnormality but were otherwise healthy. Pre-tests included a sub-maximal stress Electrocardiogram, measures of stature, mass, central and limb girths as well as an oral glucose tolerance test (OGTT) and a total blood lipid profile. Participants took part in a 24-week progressive resistance training programme, consisting of three supervised sessions per week, each lasting 45 minutes and were not permitted to lose more than 10% of initial body mass during the 24-week study. All pre-test measures, excluding the stress ECG and the OGTT, were repeated every four weeks for the duration of the study. Results were that body mass, body mass index and waist-to-hip ratio did not change. Girth measures at mid-humerus, chest, waist, hip, mid-quadricep and mid-gastrocnemius all decreased significantly (p=0.05). LDL-cholesterol increased significantly over the course of 24 weeks (3.61mmol.L-1 to 4.07mmol.L-1) as did total cholesterol (5.81mmol.L-1 to 6.24mmol.L-1). Triglyceride concentration remained unchanged and HDL-cholesterol decreased significantly between the pre-test measure (1.55mmol.L-1) and the measure after six months (1.42mmol.L-1). It can be concluded that the blood lipid profile in a sample of post-menopausal women was not positively affected by a progressive resistance training programme over a 24 week period.
Maiden name: Kelly, Janet Erica

Given the high risk of relapse during the first year of exercise involvement, it is important to determine the processes of self-motivation which enable novice exercisers to become long-term maintainers. This study was designed to extend previous Stages of Change (Prochaska & DiClemente, 1983) research by comparing the Possible Selves (Markus & Nurius, 1986) of individuals at different points within the Maintenance stage of exercise. Participants consisted of female university employees, spouses, and dependents age 35-59 years who volunteered for the study. Participants completed the Stage of Exercise Scale (SOES; Cardinal, 1995) and a self-administered form of the Possible Selves Inventory (Cross & Markus, 1991) which was adapted to address the exercise domain. Women classified by the SOES as being in the Maintenance stage of exercise V=92) were assigned to one of three groups based on the duration of their exercise maintenance (6 months-5 years, 6-10 years, and 11-20 years). The three maintenance groups were compared with regard to the number and category of open-ended and exercise-related possible selves and the self-efficacy and outcome expectancy associated with three focused selves (most important, exercise-related, and exercise-specific). The results indicated that the three maintenance groups did not differ significantly in their possible selves. These findings provide support for the current conceptualization of the Stages of Change Model (Prochaska & Di Clemente, 1983) and suggest that differences between novice and expert maintainers may be behavioral, rather than cognitive, in nature. Several implications for intervention design and suggestions for future research are discussed.
Graduation date: 1998

In order to develop effective interventions designed to encourage more middle-aged individuals to engage in regular exercise, there is a need to further understand the mechanisms involved in the decision to exercise. One appropriate conceptual framework involves future-oriented self-conceptions, or possible selves (Markus & Nurius, 1986). Possible selves, both hoped-for and feared, have been shown to vary over the lifespan in content and number (Cross & Markus, 1991), and to be predictive of future health behaviors (Hooker & Kaus, 1992,1994). The role of possible selves in the exercise context can be explored using the Stage of Change Model (Prochaska & DiClemente, 1983), which identifies participation as a process consisting of five identifiable stages. The purpose of this study was to examine the number and content of possible selves generated by individuals across stages of exercise behavior, in order to determine whether possible selves can differentiate those stages and be predictive of exercise-related behavior. Participants were 204 middle-aged women employed at a university in the U.S. Pacific Northwest. Results indicated that differences in the number and content of open-ended possible selves across stage of exercise were relatively few, although differences that did exist held potential for future interventions. Of particular interest was the significant finding of possible selves related to body image, which differed by stage for both hoped-for and feared selves. Responses to focused possible selves directly related to exercise behavior showed a number of differences between stage of exercise, providing support for previous literature as well as for the methodology employed in the present study. Individuals whose self-efficacy and outcome expectancy associated with a particular possible self related to exercise was high, were most likely to engage in exercise behavior. Finally, when the strongest predictor of exercise behavior was combined with exercise self-efficacy, the variance accounted for by the possible self was negligible. Findings support the conclusion that possible selves are worthy of future research in the exercise domain, including the role of possible selves as an antecedent to exercise self-efficacy. Results are discussed in terms of past research, practical applications, and future research directions.
Graduation date: 1998

Pau King-man.
Thesis submitted in: October 2001.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2002.
Includes bibliographical references (leaves 173-181).
Abstracts in English and Chinese.
Acknowledgements --- p.i
Abstract --- p.ii
Abstract (Chinese version) --- p.iii
Table of Contents --- p.iv
List of Figures --- p.xii
List of Tables --- p.xiii
List of Abbreviations --- p.xxiv
Chapter CHAPTER ONE: --- INTRODUCTION
Chapter 1.1 --- Women's Overweight and Obesity Prevalence and Trends --- p.1
Chapter 1.2 --- Etiology of Overweight and Obesity --- p.2
Chapter 1.3 --- Health Consequences of Obesity in Women --- p.4
Chapter 1.4 --- Dietary and Physical Activity Recommendations for Good Health for Adults --- p.6
Chapter 1.5 --- Health Behavior Change Theories --- p.8
Chapter 1.6 --- Weight Control/Loss Interventions for Women --- p.10
Chapter 1.7 --- Weight Loss Risks --- p.11
Chapter 1.8 --- Health Promotion Programs for Women --- p.12
Chapter 1.9 --- General Situation and Population Trends Among Hong Kong Middle- aged Women --- p.15
Chapter 1.10 --- Nutrition-related Morbidity and Mortality Among Hong Kong Women --- p.16
Chapter 1.11 --- Diet Composition of Hong Kong Middle-aged Women --- p.20
Chapter 1.12 --- Physical Activity Patterns of Hong Kong Middle-aged Women --- p.21
Chapter 1.13 --- Education and Health in Hong Kong Middle-aged Women --- p.23
Chapter 1.14 --- Attitudes Toward and Beliefs About Diet and Health of Hong Kong Middle-aged Women --- p.24
Chapter 1.15 --- Common Weight Loss Methods Among Hong Kong Middle-aged Women --- p.25
Chapter 1.16 --- Sources of Health Information Among Hong Kong Middle-aged Women --- p.25
Chapter 1.17 --- Summary --- p.26
Chapter 1.18 --- Study Purpose and Objectives --- p.26
Chapter CHAPTER TWO: --- METHODOLOGY
Chapter 2.1 --- Recruitment of Participants --- p.29
Chapter 2.2 --- Focus Groups --- p.29
Chapter 2.3 --- Survey Instrument --- p.30
Chapter 2.3.1 --- Questionnaire --- p.30
Chapter 2.3.2 --- Three-day Dietary Record --- p.35
Chapter 2.3.3 --- Anthropometric and Cholesterol Measurements --- p.35
Chapter 2.4 --- Intervention --- p.37
Chapter 2.5 --- Evaluation --- p.39
Chapter 2.5.1 --- Process Evaluation --- p.39
Chapter 2.5.2 --- Outcome Evaluation --- p.40
Chapter 2.6 --- Data Management --- p.40
Chapter 2.7 --- Statistics --- p.40
Chapter 2.8 --- Data Analysis --- p.41
Chapter 2.8.1 --- Physical Activity Patterns --- p.41
Chapter 2.8.2 --- Dietary Patterns --- p.44
Chapter 2.8.3 --- Nutrition Knowledge Score --- p.45
Chapter 2.8.4 --- Physical Activity Knowledge Score --- p.46
Chapter 2.8.5 --- Blood Total Cholesterol --- p.46
Chapter 2.8.6 --- Body Mass Index --- p.47
Chapter 2.8.7 --- Percent Body Fat --- p.47
Chapter 2.9 --- Ethics --- p.47
Chapter CHAPTER THREE: --- RESULTS
Chapter 3.1 --- Focus Group Results --- p.43
Chapter 3.1.1 --- General Description of Participants --- p.48
Chapter 3.1.2 --- Perceived Values and Views on 'Health' --- p.50
Chapter 3.1.3 --- Perceived Values and Views on 'Healthy Lifestyle' --- p.51
Chapter 3.1.4 --- Perceived Values and Views on 'Healthy Eating' --- p.52
Chapter 3.1.5 --- Perceived Values and Views on 'Physical Activity' --- p.53
Chapter 3.1.6 --- The Factors Motivating the Women to Adopt a Healthy Lifestyle --- p.53
Chapter 3.1.7 --- Sources of Information About Healthy Eating and Physical Activity --- p.55
Chapter 3.1.8 --- Suggestions for the Type and Content of Activities in a Health Promotion Program --- p.55
Chapter 3.2 --- Participation Rate in the Study --- p.56
Chapter 3.3 --- Pretest --- p.57
Chapter 3.3.1 --- General Participant Sociodemographic Description --- p.57
Chapter 3.3.2 --- Anthropometry --- p.59
Chapter 3.3.3 --- Health Conditions Reported --- p.60
Chapter 3.3.4 --- Meal Patterns --- p.61
Chapter 3.3.5 --- Nutrient Supplements Practices --- p.62
Chapter 3.3.6 --- Cooking Practices --- p.63
Chapter 3.3.7 --- Food Removal Behavior --- p.65
Chapter 3.3.8 --- Food Label Reading --- p.65
Chapter 3.3.9 --- Dietary Intake --- p.66
Chapter a. --- From the Three-day Dietary Records --- p.66
Chapter b. --- From the Food Frequency Questionnaire --- p.68
Chapter 3.3.10 --- Nutrition Knowledge --- p.69
Chapter 3.3.11 --- Physical Activity Habits --- p.72
Chapter 3.3.12 --- Physical Activity Knowledge --- p.73
Chapter 3.3.13 --- Intention and Confidence in Changing Behavior --- p.76
Chapter 3.3.14 --- Perceived Difficulties in Changing Behavior --- p.77
Chapter 3.3.15 --- Perceived Methods Facilitating Behavior Change --- p.79
Chapter 3.3.16 --- Health Information Desired --- p.80
Chapter 3.3.17 --- Areas of Health the Women Would Like to Improve --- p.81
Chapter 3.3.18 --- Summary Profile of the Women at Pretest --- p.82
Chapter 3.4 --- Outcome Evaluation --- p.85
Chapter 3.5 --- Posttest --- p.85
Chapter 3.5.1 --- General Participant Sociodemographic Description --- p.85
Chapter 3.5.2 --- Anthropometry --- p.86
Chapter 3.5.3 --- Health Conditions Reported --- p.87
Chapter 3.5.4 --- Meal Patterns --- p.88
Chapter 3.5.5 --- Nutrient Supplements Practices --- p.89
Chapter 3.5.6 --- Cooking Practices --- p.90
Chapter 3.5.7 --- Food Removal Behavior --- p.91
Chapter 3.5.8 --- Food Label Reading --- p.91
Chapter 3.5.9 --- Dietary Intake --- p.93
Chapter a. --- From the Three-day Dietary Records --- p.93
Chapter b. --- From the Food Frequency Questionnaire --- p.94
Chapter 3.5.10 --- Nutrition Knowledge --- p.95
Chapter 3.5.11 --- Physical Activity Habits --- p.98
Chapter 3.5.12 --- Physical Activity Knowledge --- p.99
Chapter 3.5.13 --- Analysis the Changes by Education Level --- p.102
Chapter 3.5.14 --- Analysis the Changes by Age Group --- p.104
Chapter 3.5.15 --- Intention and Confidence in Changing Behavior --- p.105
Chapter 3.5.16 --- Perceived Difficulties in Changing Behavior --- p.107
Chapter 3.5.17 --- Perceived Methods Facilitating Behavior Change --- p.109
Chapter 3.5.18 --- Health Information Desired --- p.110
Chapter 3.5.19 --- Areas of Health the Women Would Like to Improve --- p.111
Chapter 3.5.20 --- Summary Profile of the Women at Posttest --- p.112
Chapter 3.6 --- Participants' Evaluation of the Intervention Program --- p.113
Chapter 3.7 --- Follow-up --- p.118
Chapter 3.7.1 --- General Participant Sociodemographic Description --- p.118
Chapter 3.7.2 --- Anthropometry --- p.118
Chapter 3.7.3 --- Health Conditions Reported --- p.121
Chapter 3.7.4 --- Meal Patterns --- p.121
Chapter 3.7.5 --- Nutrient Supplements Practices --- p.122
Chapter 3.7.6 --- Cooking Practices --- p.123
Chapter 3.7.7 --- Food Removal Behavior --- p.125
Chapter 3.7.8 --- Food Label Reading --- p.126
Chapter 3.7.9 --- Dietary Intake --- p.127
Chapter a. --- From the Three-day Dietary Records --- p.127
Chapter b. --- From the Food Frequency Questionnaire --- p.129
Chapter 3.7.10 --- Nutrition Knowledge --- p.131
Chapter 3.7.11 --- Physical Activity Habits --- p.135
Chapter 3.7.12 --- Physical Activity Knowledge --- p.136
Chapter 3.7.13 --- Intention and Confidence in Changing Behavior --- p.140
Chapter 3.7.14 --- Analysis the Changes by Education Level --- p.142
Chapter 3.7.15 --- Analysis the Changes by Age Group --- p.143
Chapter 3.7.16 --- Perceived Difficulties in Changing Behavior --- p.144
Chapter 3.7.17 --- Perceived Methods Facilitating Behavior Change --- p.145
Chapter 3.7.18 --- Health Information Desired --- p.148
Chapter 3.7.19 --- Areas of Health the Women Would Like to Improve --- p.149
Chapter 3.7.20 --- Summary Profile of the Women at Follow-up --- p.150
Chapter CHAPTER FOUR: --- DISCUSSION
Chapter 4.1 --- Implications of Findings --- p.154
Chapter 4.1.1 --- Current Situations in Diet and Physical Activity of Hong Kong Middle-aged Women --- p.154
Chapter 4.1.2 --- Overall Effects of the Program --- p.161
Chapter a. --- Changes in Knowledge --- p.161
Chapter b. --- Changes in Awareness and Intention --- p.163
Chapter c. --- Changes in Behavior --- p.164
Chapter d. --- Changes in Anthropometery --- p.166
Chapter 4.2 --- Strengths and Limitations of the Study --- p.167
Chapter 4.3 --- Implications and Recommendations for Meeting the Challenges of Improving Hong Kong Middle-aged Women's Nutrition and Physical Activity Habits --- p.169
Chapter 4.4 --- Suggestions for Future Research --- p.170
Chapter CHAPTER FIVE: --- CONCLUSIONS --- p.172
References --- p.173
Appendices
Chapter A --- Consent form (Chinese version) --- p.182
Chapter B --- Consent form (English version) --- p.183
Chapter C --- Questionnaire (Chinese version) --- p.184
Chapter D --- Questionnaire (English version) --- p.196
Chapter E --- Photos for food amount quantities and household measures (Chinese version) --- p.210
Chapter F --- Photos for food amount quantities and household measures (English version) --- p.213
Chapter G --- Sample of dietary record (Chinese version) --- p.216
Chapter H --- Sample of dietary record (English version) --- p.217
Chapter I --- Three-day dietary record (Chinese version) --- p.218
Chapter J --- Three-day dietary record (English version) --- p.221
Chapter K --- Pamphlets for health talks (Chinese version) --- p.224
Chapter L --- Pamphlets for health talks (English version) --- p.236
Chapter M --- Pamphlets for physical activity demonstration (Chinese version) --- p.248
Chapter N --- Pamphlets for physical activity demonstration (English version) --- p.253
Chapter O --- Process evaluation questionnaire (Chinese version) --- p.258
Chapter P --- Process evaluation questionnaire (English version) --- p.260
Chapter Q --- Overall evaluation questionnaire (Chinese version) --- p.262
Chapter R --- Overall evaluation questionnaire (English version) --- p.263
Chapter S --- Focus group questionnaire (Chinese version) --- p.264
Chapter T --- Focus group questionnaire (English version) --- p.265
Chapter U --- Focus group question guides (Chinese version) --- p.266
Chapter V --- Focus group question guides (English version) --- p.268
Chapter W --- The food consumption patterns of women in the Education and Control Groups --- p.270

Conclusion. We observed a small but independent effect of soy intake and lipid lowering effect, even after taking into account the other important predicting factors - initial cholesterol, body composition, physical activity, dietary intake and age. The beneficial effect between soy protein intake and lipid profile were observed even with this relatively low level of soy protein consumption suggests that the effect of soy protein supplement use on lipid profile may be much greater than those observed here. The results of our study add to the existing evidence that soy protein may be beneficial in human lipid profile. Our data will be useful for planning effective education programs as well as providing background information for further interventional studies to prevent coronary heart disease.
Coronary Heart Disease (CHD) is the major cause of death in most developed countries and is rapidly increasing in developing countries. Recent studies showed that natural menopause confers a threefold increase in CHD risk. While many risk factors, such as hypertension, diabetes mellitus, obesity and physical inactivity contribute to the risk for CHD, lipid abnormalities are the major factor. Hyperlipidemia plays a central role in the atherosclerotic process. Recent studies showed that consuming soy, a food containing large amounts of soy protein, improves the plasma lipoprotein profile by decreasing total cholesterol, LDL cholesterol, triglycerides as well as increasing HDL level. Although soy is a main component of traditional Asian food, many of the studies on soy consumption have been conducted in Caucasian populations (table 1.2), among whom soy intake is rather low or almost nil, it was difficult to explore the association of soy protein intake and lipid profile in those populations. Soy products such as tofu and soymilk are traditional Chinese foods. With the changing dietary pattern, it gives rise to a range of intake from traditional to modern and increasing incidence of cardiovascular disease Hong Kong poses a unique opportunity for the investigation of the relation between soy protein intake and lipid profile.
For baseline age stratified subgroup analysis, our study results showed no association between soy protein intake and lipid pro file in women whose baseline age younger than 55.3 years old, but we did observe a positive association in women belonging to older subgroup. In the 12-month follow up analysis, for women whose baseline age was older than 55.3 years (mean age=58.4+/-2.1), after controlling for the potential confounders, soy protein intake was significantly associated with HDL cholesterol concentration (Linear Regression p=0.033, ANCOVA=0.011, P value for trend p=0.014), total cholesterol/HDL ratio (Linear Regression p=0.045) and LDL/HDL ratio (Linear Regression p=0.037). Similar observation was observed in the yearly change rate of HDL in 24-month follow up (Linear Regression p=0.047, P value for trend p=0.043).
For women whose initial cholesterol level was higher or equal to 200mg/dL, in our 2-year longitudinal analysis, after controlling for the potential confounders, soy protein intake was significantly associated with HDL (Linear Regression p=0.041) and cholesterol/HDL ratio (ANCOVA=0.022). We also observed a statistically significant trend for higher HDL cholesterol (p=0.038), with an increase of 11.4g in soy protein intake between the 1st and 3rd tertiles, our data showed a 3.8% increase in HDL.
In the 12-month longitudinal analyses, after controlling for the potential confounders, soy protein intake was significantly associated with HDL concentration (Linear Regression p=0.036). We also observed a statistically significant trend for higher HDL cholesterol (p=0.036), with an increase of 10.9g in soy protein intake between the 1st and 3rd tertiles, our data showed a 7.9% increase in HDL.
Methods. 307 women aged between 48 to 62 years were recruited from community subjects residing in housing estates in Shatin. Women within the first 12 years of menopause, with no history of malabsorption syndromes, chronic liver kidney diseases, parathyroid diseases, gastric operation or cancer and without currently taking lipid lowering therapy were included in the study. We estimated the dietary intake of soy foods and other key nutrients by using quantitative food frequency method. We recorded serum values of fasting cholesterol, LDL cholesterol, HDL cholesterol and triglycerides as well as other covariance measurement. Soy protein consumption was categorized as tertiles of intake and related to lipid profile.
Objectives. In order to study the relation between soy protein intake and lipid profile in the early postmenopausal Chinese women in Hong Kong, we conducted the study from February 2000 to February 2002, as a part of the population-based soy consumption and bone mineral density study. The hypothesis to be tested is that high intake of dietary soy protein has a beneficial effect on lipid profile in the early postmenopausal Chinese women in Hong Kong.
Results. In our cross-sectional analysis, our findings showed that habitual dietary soy protein intake had a weak but statistically significant correlation with triglyceride concentration (Linear Regression p=0.045, ANCOVA p=0.045 P value for trend p=0.023), and the soy protein beneficial effects were more pronounced in women whose % of total body fat were higher than 33.4%. After controlling for the potential confounders, soy protein intake was significantly associated with triglyceride concentration (Linear Regression p=0.048, P value for trend =0.021), the average decrease in triglycerides were 24.6% and 29.1 % in the 2nd and 3rd tertile compared with the 1st tertile respectively.
Lam Siu Hung.
"February 2006."
Adviser: Ho Suzanne Sutying.
Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6300.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (p. 181-191).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.

Background and objective. Ultrasonic evaluation of carotid intima media thickness (IMT) has been widely used as a surrogate of atherosclerosis. Few studies have specifically examined risk factors related to subclinical atherosclerosis (SA) among early postmenopausal women, in particular in the Chinese population. There is also little information on the distribution of IMT in Asian midlife women. We described the prevalence of SA, as determined by IMT and carotid plaque, and the associated risk factors in early postmenopausal Chinese women in Hong Kong.
Conclusions. Our findings showed that age, SBP, HDL-C, and LDL-C were independent predictors of IMT, while age, LDL-C, and abdominal obesity were independent predictors of the presence of plaque. The optimal IMT cutoff of 0.783 mm was defined and that a prevalence of SA (IMT ≥ 0.783 mm) of 38.6% was found among 'healthy' early postmenopausal Chinese women in Hong Kong.
Methods. 518 women aged 50 to 64 years, and within 10 years since menopause were recruited from random telephone dialing. Women with surgical menopause, established cardiovascular diseases (CVD), and severe disease conditions such as cancer and renal failure were excluded. Sociodemographic, anthropometric and lifestyle factors were obtained based on standardized questionnaires. Fasting blood sample was also obtained. B-mode ultrasound was used for measuring IMT at 12 sites of the carotid arteries and plague index, which is the sum of the grades (ranged from 0 to 3) at the 6 segments. The relations between traditional risk factors, and other potential risk factors such as inflammatory markers, as well as lifestyle factors including physical activity, dietary intake, and psychological factors with SA were also assessed.
Results. The mean IMT +/- SD was 0.76 +/- 0.12 mm, with a range from 0.53 to 1.00 mm. IMT was higher on the far wall than on the near wall (P<0.01), and differ among segments (greatest at the bulb and least at the ICA) (P<0.01). One-fifth of women had at least 1 plaque in the carotid artery with most of the plaque occurred in the bulb area. IMT increased with age, and was positively associated with carotid plaque. With the use of receiver operating characteristic curve (ROC) analysis, the optimal cutoff IMT for diagnostic plaque was 0.783 mm, at which sensitivity and specificity was 80.5% and 75.1%, respectively. The prevalence of SA was 38.6%. Among the traditional risk factors, systolic blood pressure (SBP), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were associated with high IMT. Abdominal obesity assessed by waist circumference (WC) and waist hip ratio (WHR) was also found to be positively associated with IMT. Stepwise multiple regression showed that age, SBP, HDL-C, and LDL-C were independent predictors of IMT. Multiple logistic regression showed that women with LDL-C ≥ 130 mg/dL were associated with a 2.4-fold (95% CI 1.5-3.7) higher risk of having plaque compared to those with LDL-C < 130 mg/dL. In addition, women with abdominal obesity (WHR ≥ 0.85) had a 1.7-fold (95% CI 1.08-2.67) higher risk of having plaque than women with WHR < 0.85 after adjustment for age, and potential confounders including physical activity, dietary intakes etc. Significant inverse associations were observed between physical activity and indices of obesity, as well as fasting blood glucose, while psychological perceived stress and trait anxiety were independent risk factors for both total cholesterol and LDL-C.
Yu Ho-yan.
"February 2006."
Adviser: Suzanne C. Ho.
Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6350.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (p. 220-256).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.

Postmenopausat women on hormone replacement therapy (HRT) have been reported to be stronger when compared to women who are not using HRT. The first goal of this study was to investigate whether muscle morphology was altered in women who use HRT when compared to women who do not use HAT. In addition, this study examined the combined effects of a 6-month moderate-intensity strength training (ST) routine and HRT on the neuromuscular system of early postmenopausal women. Because not all the women completed the ST, this study was separated into two separate analyses, baseline (n=17; 7 HRT, 10 non-HRT) and training (n=14; 6 HRT, 8 non-HRT). ST consisted of two exercises (squat and dead lift), two days a week, for 6-months. Vastus lateralis muscle biopsies were taken at baseline and 6-months after exercise training. Biopsy samples were sectioned and analyzed histochemically for muscle fiber type and fiber cross-sectional area (CSA). In addition, voluntary knee extension strength was assessed at 30��/sec using an isokinetic dynamometer at these two time points. At baseline there were no significant differences in knee extensor strength between groups (HRT: 443 �� 121 N, non-HRT: 490 �� 106 N). Regardless of hormone status, Type I fibers were significantly larger (p=.005) in GSA (Type I=3705 �� 877��m��; Type II=2790 �� 756��m��). However, there were significantly more Type II fibers (p<.0001) (61.5 �� 7.9% of total) and consequently, Type II fibers occupied significantly more total fiber area p=.00l2) (Type I=45.3 �� 7.4%; Type II=54.7 �� 7.4%). No significant differences were found in the fiber type distributions of the HAT (37.9 �� 2.5% Type I, 62.1 �� 2.5% Type II) and non-HRT (38.9 �� 2.9% Type I, 61.1 �� 2.9% Type II) groups. There were no significant differences in fiber CSA of Type I fibers (HRT: 3615 �� 886 ��m��, non-HRT: 3769 �� 912 ��m��) or Type II fibers (HRT: 2770 �� 722 ��m��, non-HRT: 2849 �� 804 ��m��) obtained from the two groups. Six months of ST had no effect on the strength, fiber CSA, and fiber type distribution for HRT and non-HRT subjects. These results suggest that HRT does not alter muscle strength, fiber type distribution, and fiber CSA in early postmenopausal women.
Graduation date: 2003

We investigated the relationship between calcium and protein intake and bone loss over a one-year period in 99 early postmenopausal women (1-36 months) aged 51.3 �� 0.31 years. Bone mineral density (g/cm��) of the left hip (total hip, femoral neck, greater trochanter) and lumbar spine (L1-L4) as well as body composition were assessed using dual energy x-ray absorptiometry. Dietary intake of calcium and protein was assessed using a 100-item Block Food Frequency Questionnaire. A physical activity questionnaire was also completed by the subjects to estimate energy expenditure. Paired t-tests revealed that there were no significant differences between baseline and month 12 physical characteristics except for percent fat which increased from 31.99 �� 0.60% to 32.44 �� 0.61% (p=.009). At month 12, bone mineral density decreased significantly at the femoral neck (-0.97 �� 0.31%) and total hip (-0.55 �� 0.24%). The average calcium, protein and calcium to protein ratio intake for the group was 1129.88 �� 46.22mg/day, 57.88 �� 1.93g/day and 20.10 �� 0.71m/g, respectively. Partial correlation analyses showed no significant relationships between change in bone mineral density and average intakes for calcium, protein, or the calcium to protein ratio. After adjusting for hormone replacement status, lean body mass and months post menopause, analysis of covariance revealed that there were no significant differences between groups when intakes of calcium, protein and the calcium to protein ratio were separated into "above recommended" and "below recommended" categories (above or below 1000/1500mg/day, 50g/day, 20:1 mg/g/day, respectively). Our results suggest that consuming adequate amounts of calcium and protein does not appear to significantly slow bone loss after 12 months in early postmenopausal women.
Graduation date: 2003

There is conclusive evidence that regular physical activity produces both physical and psychological benefits. People engaged in sedentary work who avoid physical activity, or have physical or psychological obstacles to being physically active, forgo the substantial benefits that being physically active provides. In Australia, many middle-aged women (45 to 59 years) are especially at risk of ill-health due to their physically inactive lifestyles. In this dissertation, I report on a mixed-method research approach that incorporated the LIFE: Live It Up (LLIU) intervention. Adopting a multi-theoretical perspective I drew on strategies from Transtheoretical Model, Social Cognitive Theory, the Theory of Planned Behaviour, and Self-Determination Theory. In the first study, participants (71, sedentary, mid-life women) were assigned to either an adoption (3-hour workshop), maintenance (3-hour workshop plus extra maintenance session at 9 months) or control (usual activity) condition. Physical activity levels, psychological well-being, and moods were assessed (pre, post and at 4, 40 & 44 weeks) using the Scottish Physical Activity Questionnaire (SPAQ); the Medical Outcome Survey (MOS) Short Form, (SF36); and the Positive and Negative Affect Scale, (PANAS). Motivational messages (Treatment condition participants only) and reflective journals (all participants) tailored to conditions were delivered to participants across the intervention year. Quantitative analyses for the LLIU intervention study involved a series of Analyses of Variance (ANOVA). High attrition, however, across conditions resulted in only 27 participants remaining in the study at 52 weeks. No significant differences were from applying ANOVA to the SPAQ data for physical activity levels. Applying ANOVA to the vitality (SF-36 subscale) gain score data (SF-36) there was evidence of significant gains in vitality at 4 and 44 weeks for the treatment condition (TC) participants compared to the control condition. Feelings and emotions (mood) were measured with the PANAS (see appendix C). Applying ANOVA revealed positive affect was stable across the intervention for TC participants. Negative affect, however, was lowered at 52 weeks for TC participants. I interpreted all results cautiously, because of high attrition rates, particularly in the control condition, and a consequent loss in statistical power. Quantitative analyses for the LLIU intervention study involved a series of Analyses of Variance (ANOVA). High attrition, however, across conditions resulted in only 27 participants remaining in the study at 52 weeks. No significant differences were indicated from results of applying ANOVA to the SPAQ data for physical activity levels. Vitality, a construct assessing energy level and fatigue, was examined and applying ANOVA to the vitality (SF-36 subscale) gain score data (SF-36) showed evidence of significant gains in vitality at 4 and 44 weeks for the treatment condition (TC) participants compared to the control condition. Feelings and emotions were measured with the PANAS (see appendix C). Applying ANOVA revealed positive affect was stable across the intervention for TC participants. Negative affect, however, was lowered at 52 weeks for TC participants. I interpreted all results cautiously, because of high attrition rates, particularly in the control condition, and a consequent loss in statistical power. Qualitative analysis of the ejournals indicated that participation in the LLIU and elements of the ejournal were motivational for physical activity response. TC participants’ reported being encouraged through the workshops to focus on physical activity. Encouragement was associated with social aspects of the workshop, enjoyment, and the kind of information provided. In addition, TC participants reported that lack of time, family demands, and energy depletion were considerable obstacles to physical activity participation. In the second study, I conducted follow-up interviews with 11 of the intervention participants, between one and four months after their LLIU involvement ended. Using thematic content analysis I identified six themes expressed by the women within the treatment conditions. These were (i) commitment; (ii) change driving forces; (iii) positivity, “licence” to change, and guilt reduction; (iv) elements of choice, control, and capacity to follow through; (v) self-efficacy expectations; and (vi) social support issues. For instance, commitment involved participants in taking specific steps toward action and generated freedom from procrastination; change driving forces were internal and external with enjoyment greatly enhancing physical activity experiences; positivity led to a sense of licence to change, followed by guilt reduction. An additional three case studies drilled down into issues that mid-life women typically face when attempting physical activity change. Findings highlighted the frustration associated with wanting to change, being caught in an attempt-fail cycle, and being assigned to control condition; how change can happen (adoption condition) even when family values are highly prioritised and illustrated how the confidence gained through the LLIU developed sustainable efficacy for exercise (maintenance condition). Identification of “double benefits” such as engaging in physical activity while encouraging children to be active can be motivational for sustainable physical activity. Guilt metaphorically paralysed physical activity changes. Strategic thinking assisted with recycling through stages of change. Autonomous behaviour change in control participants who remained in the study raised key questions for future studies. In addition, my studies added to the evidence base that intervention research with sedentary participants requires additional strategies (e.g., overrecruitment, extra attention) to ensure sustained engagement. In conclusion, high attrition in the first study reduced the veracity of quantitative evidence for the effectiveness of multi-theory approaches for increasing physical activity. Findings reported for the second study have considerably expanded the evidence base concerning the debilitating effects of guilt and the usefulness of strategic thinking on motivation for physical activity. In addition, this study represents additional evidence for motivation for physical activity change being strengthened through workshops and reflective journals. Longitudinal research is especially difficult with sedentary cohorts especially in the context of recruiting and maintaining participant samples.