Older adults' quality of life - exploring the role of the built environment and social cohesion in community-dwelling seniors on low income

The built environment and social cohesion are increasingly recognized as being associated with older adults' quality of life (QoL). However, limited research in this area still exists and the relationship has remained unexplored in the area of Metro Vancouver, Canada. This study examined the association between the built environment and social cohesion with QoL of 160 community-dwelling older adults (aged ≥ 65 years) on low income from Metro Vancouver. Cross-sectional data acquired from the Walk the Talk (WTT) study were used. Health-related QoL (HRQoL) and capability wellbeing were assessed using the EQ-5D-5L and the ICECAP-O, respectively. Measures of the environment comprised the NEWS-A (perceived built environment measure), the Street Smart Walk Score (objective built environment measure), and the SC-5PT (a measure of social cohesion). The primary analysis consists of Tobit regression models to explore the associations between environmental features and HRQoL as well as capability wellbeing. Key findings indicate that after adjusting for covariates, older adults' capability wellbeing was associated with street connectivity and social cohesion, while no statistically significant associations were found between environmental factors and HRQoL. Our results should be considered as hypothesis-generating and need confirmation in a larger longitudinal study.

Perceptions of individuals living with spinal cord injury toward preference-based quality of life instruments : a qualitative exploration

BACKGROUND: Generic preference-based health-related quality of life instruments are widely used to measure health benefit within economic evaluation. The availability of multiple instruments raises questions about their relative merits and recent studies have highlighted the paucity of evidence regarding measurement properties in the context of spinal cord injury (SCI). This qualitative study explores the views of individuals living with SCI towards six established instruments with the objective of identifying 'preferred' outcome measures (from the perspective of the study participants). METHODS: Individuals living with SCI were invited to participate in one of three focus groups. Eligible participants were identified from Vancouver General Hospital's Spine Program database; purposive sampling was used to ensure representation of different demographics and injury characteristics. Perceptions and opinions were solicited on the following questionnaires: 15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index (HUI), Quality of Well-Being Scale Self-Administered (QWB-SA), and the SF-36v2. Framework analysis was used to analyse the qualitative information gathered during discussion. Strengths and limitations of each questionnaire were thematically identified and managed using NVivo 9 software. RESULTS: Major emergent themes were (i) general perceptions, (ii) comprehensiveness, (iii) content, (iv) wording and (v) features. Two sub-themes pertinent to content were also identified; 'questions' and 'options'. All focus group participants (n = 15) perceived the AQoL-8D to be the most relevant instrument to administer within the SCI population. This measure was considered to be comprehensive, with relevant content (i.e. wheelchair inclusive) and applicable items. Participants had mixed perceptions about the other questionnaires, albeit to varying degrees. CONCLUSIONS: Despite a strong theoretical underpinning, the AQoL-8D (and other AQoL instruments) is infrequently used outside its country of origin (Australia). Empirical comparative analyses of the favoured instruments identified in this qualitative study are necessary within the context of spinal cord injury.

"When I saw walking I just kind of took it as wheeling": interpretations of mobility-related items in generic, preference-based health state instruments in the context of spinal cord injury

Background : In health economic analyses, health states are typically valued using instruments with few items per dimension. Due to the generic (and often reductionist) nature of such instruments, certain groups of respondents may experience challenges in describing their health state. This study is concerned with generic, preference-based health state instruments that provide information for decisions about the allocation of resources in health care. Unlike physical measurement instruments, preference-based health state instruments provide health state values that are dependent on how respondents interpret the items. This study investigates how individuals with spinal cord injury (SCI) interpret mobility-related items contained within six preference-based health state instruments.

Methods : Secondary analysis of focus group transcripts originally collected in Vancouver, Canada, explored individuals’ perceptions and interpretations of mobility-related items contained within the 15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index (HUI), Quality of Well-Being Scale Self-Administered (QWB-SA), and the 36-item Short Form health survey version 2 (SF-36v2). Ritchie and Spencer’s ‘Framework Approach’ was used to perform thematic analysis that focused on participants’ comments concerning the mobility-related items only.

Results : Fifteen individuals participated in three focus groups (five per focus group). Four themes emerged: wording of mobility (e.g., ‘getting around’ vs ‘walking’), reference to aids and appliances, lack of suitable response options, and reframing of items (e.g., replacing ‘walking’ with ‘wheeling’). These themes reflected item features that respondents perceived as relevant in enabling them to describe their mobility, and response strategies that respondents could use when faced with inaccessible items.

Conclusion : Investigating perceptions to mobility-related items within the context of SCI highlights substantial variation in item interpretation across six preference-based health state instruments. Studying respondents’ interpretations of items can help to understand discrepancies in the health state descriptions and values obtained from different instruments. This line of research warrants closer attention in the health economics and quality of life literature.

Moral rights: a brief excursion into Canadian history

In 1931, Canada was the first of the copyright countries to adopt a moral rights provision, closely modeled on Article 6bis of the Berne Convention, into its legislation. But this was not the first step that Canada had taken towards the legislative protection of moral rights. Not only had certain provisions protective of the non-economic interests of authors been included in the federal Criminal Code and in the legislation of Quebec prior to 1920, but during the 1920s a sustained effort had been made to give these interests more explicit and systematic protection under the Copyright Act. The present article focuses on a series of bills put to the Canadian Parliament from 1924 onwards. Not only would they have provided increased protection for the non-economic interests of authors but they would have given a legislative definition to the term "moral right". These bills, framed in the absence of any influence from Article 6bis, provide a glimpse of what "moral rights" might have been. They support the view that Canada was moving towards the express legislative protection of these rights significantly earlier that is commonly thought.

Recent amendment to section 197- is it acceptable?

The majority decided in Hanel v O’Neill that directors of trustee companies
could be held personally liable to discharge the debts incurred by a
company pursuant to s 197(1) of the Corporations Act 2001 (Cth). On
18 November 2005, legislation was passed to amend s 197(1); this was to
overturn the decision. This article evaluates other relevant cases and
argues that the recent amendment to s 197 is unsatisfactory as it leaves
potential for abuse by directors of certain trustee companies. The article
suggests further reform to the section and to this end, suggests ways for
s 197 to reconcile with other parts of corporate law, such as insolvent
trading and directors’ duties.

Calibration and reliability of a school food checklist: a new tool for assessing school food and beverage consumption

There is a pressing need in Australia and other countries to develop systems for monitoring secular trends in childhood obesity and related behavioural and environmental determinants. Energy from foods and beverages consumed at school is an accessible indicator of children’s eating patterns and we have developed a school food checklist (SFC) to measure this. The SFC records the number of serves and source (home, canteen, vending machine) of 20 food and beverage categories. This study aims to assess the accuracy and to calibrate the SFC by comparing it to a weighed record (WR) and to evaluate inter-recorder reliability. Participants were 910 primary school children aged 5 to 12 years from a rural township in Victoria, Australia. WR were collected from a nonrandom sub-sample of 106 and a second sub-sample (n=46) had intake measured twice using the SFC to assess inter-recorder reliability. Mean energy values were 2992 kJ ± 924 and 3008 kJ ± 952 for the SFC and WR respectively and the correlation coefficient was strong (Pearson r = 0.77). The mean difference between the WR and SFC methods was 15 kJ (95% CI, -107 kJ to 138 kJ) and the limits of agreement (+2 standard deviations) were ± 1270 kJ. The SFC overestimated the energy/serve of breads and fruit drinks and under-estimated energy/serve from fat spreads, biscuits/crackers, muesli/fruit bars and fruit. Inter-recorder reliability was good (kappa 0.51). The SFC was designed to measure energy from food and beverages in schools. It has good accuracy and reliability and the revised version should further improve accuracy of the instrument.

Legal regulation and corporate governance in China`s top 100 listed companies

This article reports findings from an empirical study of corporate governance in China's top 100 listed companies. It examines the effectiveness of legal regulation, enforcement and remedies, finding that China's company and securities laws have not provided as string a legal framework for the protection of stakeholders im China's stock exchange listed companies as might be expected by investors.

A new era in United States cooperation in international insolvency adminstrations?

Cross-border insolvency laws are increasingly being influenced by the UNCITRAL Model Law on Cross-border Insolvency provisions. The United States has recently enacted domestic legislation based on these provisions by way of Ch 15 of the Bankruptcy Abuse Prevention and Consumer Protection Act 2005, which inserted Ch 15 into USC, Title 11. This article briefly explains the provisions of this United States legislation and draws attention to the important case law commenting and explaining same. It further attempts to alert local practitioners to the changes, benefits and detriments they may encounter when acting pursuant to this legislation.

Embodied energy in buildings : wood versus concrete - reply to Börjesson and Gustavsson

We analyse the wood and concrete designs of the Wälludden building described by Börjesson et al. (Energy Policy 28 (2000) 575) in terms of their embodied energy, employing an environmentally extended input–output framework in a tiered hybrid life-cycle assessment, and in a structural path analysis. We illustrate the complexity of the inter-industry supply chains underlying the upstream energy requirements for the building options, and demonstrate that higher-order inputs are difficult to capture in a conventional process analysis. Our calculations show that Börjesson and Gustavsson's estimates of energy requirements and greenhouse gas emissions are underestimated by a factor of about 2, and that corresponding greenhouse gas balances are positive at about 30 t C-eq. Nevertheless, Börjesson and Gustavsson's general result—the concrete-framed building causing higher emissions—still holds.

Obesity prevention and public health

More than 22 million children under five are now obese or overweight. Globally, an estimated 10% of school-aged children, between five and 17 years old, are overweight or obese, and the situation is getting worse. Although recognised clinically for some time as an important condition that increases risk of ill-health in affected individuals, it is only recently, that obesity has been recognised as a population-wide problem that requires preventive action. Obesity is a major contributor to diseases and disability, the associated health costs are enormous, obesity has already reached epidemic proportions in many countries, and incidence is continuing to increase in children and adults. Disturbingly the epidemic is not confined to developed countries, with many developing countries and those in transition affected. While recognised as a major population health problem, our understanding of the causes of the epidemic is poor, there has been relatively little population-based research that has focused on the prevention of unhealthy weight gain, and as a consequence knowledge regarding how and where best to intervene is limited. This book draws together the existing literature and expertise and with a view to helping set the agenda for public health action. The book is divided into three sections. Part 1 provides an overview of the context of the problem. It examines the epidemiology of obesity, the role of behavioural factors, socio-cultural factors and environmental factors in the obesity epidemic. Part 2 reviews interventions across a range of key settings and in different population groups - drawing on existing research that has aimed to increase physical activity, promote healthy eating and prevent obesity at a population level. Given how little research there is that has specifically examined the effectiveness of interventions aimed at preventing obesity per se, Part 3 explores potential opportunities to prevent obesity

Limited Liability Act of 1855

Examines the Limited Liability Act 1855 and highlights its significance in the formation of the modern company's legal framework. Looks at the background to the Act, which was repealed after a few months and incorporated in the Joint Stock Companies Act 1856 in an amended form. Considers the Act's legacy in extending the general principle of limited liability for corporate debts to shareholders of registered companies, including its implications in allowing a greater diversification of shareholders.