"Tell us something new!" : the response of planning and transport professionals to public health guidance on the built environment and physical activity

A large proportion of non-communicable disease can be attributed to modifiable risk factors such as poor nutrition and physical inactivity. We present data on planning and transport practitioners' perceptions and responses to government public health guidance aimed at modifying environmental factors to promote physical activity. This study was informed by questions on the role of evidence-based guidance, the views of professionals towards the guidance, the links between guidance and existing legislation and policy and the practicality of guidelines. A key informant 'snowball' sampling technique was used to recruit participants from the main professional planning organisations across England. Seventy-six people were interviewed in eight focus groups. We found that evidence-based public health guidance is a new voice in urban and town planning, although much of the advice is already reflected by the 'accepted wisdom' of these professions. Evidence-based health guidance could be a powerful driver affecting planning practice, but other legislated planning guidance may take priority for planning and transport professionals.

Physical activity and environment programme guidance : fieldwork report

This quick reference guide presents the recommendations on ‘Promoting and creating built or natural environments that encourage and support physical activity’. It is for NHS and other professionals who have a direct or indirect role in – and responsibility for – the built or natural environment. This includes those working in local authorities and the education, community, voluntary and private sectors. It may also be of interest to members of the public. The guidance offers the first national, evidence-based recommendations on how to improve the physical environment to encourage physical activity. It demonstrates the importance of such improvements and the need to evaluate how they impact on the public’s health.

Identifying and managing low money laundering risk : perspectives on FATF's risk-based guidance

Purpose – The purpose of this paper is to investigate Financial Action Task Force (FATF)'s risk-based guidance to combat money laundering and terrorist financing to determine its approach to the identification and management of low-risk providers, products and transactions.

Design/methodology/approach – The paper analyses the relevant FATF recommendations and its guidance notes and reflects on key questions for regulators and financial institutions.

Findings – FATF has not defined “risk” for purposes of the risk-based approach. The absence of a clear definition complicates the identification of low-risk products. FATF do provide an example of a risk matrix that can be used to identify low-risk banks, but the example is based on assumptions and generalisations that are not sustainable. In addition, it identifies certain low-value transactions as “low risk” transactions. The paper reflects on the role of value as an indicator of risk and concludes with a number of suggestions to clarify the conceptual framework.

Originality/value – Low-risk products and transactions are often overlooked because the risk-based approach focuses attention on high-risk matters. Low-risk products are however crucial to the efforts to increase financial inclusion. The paper identifies gaps in the current conceptual framework and indicates ways in which they can be addressed.

Biometric, nutritional and sensory characteristic modifications in farmed Murray cod (Maccullochella peelii peelii) during the purging process

Intensively farmed, market-size Murray cod (~ 600 g), were purged (transferred into a clean water system and starved) and sampled at three day intervals for a total of 18 days (D0, D3, D6, D9, D12, D15 and D18). Purged fish lost from 6% (D3) to 14% (D18) body weight, and the weight loss was highly correlated to the number of days of purging/starvation. Condition factor and Hepatosomatic Index decreased significantly (P < 0.05) only after 18 days of purging compared to the control (D0). Fillet lipid content (%) did not vary during the trial. Eicosapentaenoic acid (EPA: 20:5 n−3) decreased and docosapentaenoic acid (DPA: 22:5 n−3) increased (P < 0.05) during the trial, while docosahexaenoic acid (DHA: 22:6 n−3) did not show any significant variation. Purging contributed positively to the improvement of the volatile flavour compound composition, with a significant (P < 0.05) reduction in total volatile aldehydes and an increase in total volatile hydrocarbons. Since no major differences were found between samples during the last stages of the purging process (D12, D15 and D 18), it is possible to conclude that, under these experimental conditions, 12 days is the minimum duration to obtain an improvement in the volatile compound profile of intensively farmed Murray cod whilst keeping body weight loss to a minimum.

Use of calcium, folate and vitamin D3-fortified milk for 6 months improves nutritional status but not bone mass or turnover, in a group of Australia aged care

In residential care, inadequate calcium and folate intakes and low serum vitamin D (25(OH)D) concentrations are common. We assessed whether daily provision of calcium, folate, and vitamin D3-fortified milk for 6 months improved nutritional status (serum micronutrients), bone quality (heel ultrasound), bone turnover markers (parathyroid hormone, C-terminal collagen I telopeptide, terminal propeptide of type I procollagen), and/or muscle strength and mobility in a group of Australian aged care residents. One hundred and seven residents completed the study (mean (SD) age: 79.9 (10.1) years; body weight: 68.4 (15.4) kg). The median (inter-quartile range) volume of fortified milk consumed was 160 (149) ml/day. At the end of the study, the median daily vitamin D intake increased to 10.4 (8.7) μg (P < .001), which is 70% of the adequate intake (15 μg); and calcium density (mg/MJ) was higher over the study period compared with baseline (161 ± 5 mg/MJ vs. 142 ± 4 mg/MJ, P < .001). Serum 25(OH)D concentrations increased by 23 ± 2 nmol/L (83 (107)%, P < .001), yet remained in the insufficient range (mean 45 ± 2 nmol/L). Consumption of greater than the median intake of milk (160 ml/day) (n = 54, 50%) increased serum 25(OH)D levels into the adequate range (53 ± 2 nmol/L) and reduced serum parathyroid hormone by 24% (P = .045). There was no effect on bone quality, bone turnover markers, muscle strength, or mobility. Consumption of fortified milk increased dietary vitamin D intake and raised serum 25(OH)D concentrations, but not to the level thought to reduce fracture risk. If calcium-fortified milk also was used in cooking and milk drinks, this approach could allow residents to achieve a dietary calcium intake close to recommended levels. A vitamin D supplement would be recommended to ensure adequate vitamin D status for all residents.

Visual guidance during competition performance and run-through training in long jumping

To ensure precise foot placement on the take-off board, long jumpers visually regulate their stride pattern during their run-up. A relationship between how much visual guidance they use and the horizontal distance they jump has not, however, been quantified. Run-up precision is often practiced using run-throughs, which exclude the take-off and, therefore, the high physical stress of the complete long jump. The validity with which this common training method simulates the long jump approach remains, however, to be verified. Four state-standard long jumpers and two heptathletes completed two sessions, each comprising six run-throughs and six competition long jumps. A 50 Hz video camera was manually panned from an elevated platform to film each trial, to enable subsequent gait characteristic evaluations. Linear regression analyses identified that a longer visual regulation phase, measured in time, distance or number of strides, was a key predictor of long jump distance. The number of strides that were visually regulated during the long jump approach was, accordingly, positively correlated with long jump distance (r = 0.67, p = 0.001). The amount of visual regulation used during run-throughs was, however, less than half (p = 0.001) of that observed during long jump approaches. Our results should compel long jump coaches to supplement run-through training with additional visual guidance exercises, to encourage their athletes to visually regulate more of their long jump approach.

Revisiting delta-6 desaturate regulation by C18 unsaturated fatty acids, depending on the nutritional status

Dietary polyunsaturated fatty acids (PUFA) play a key role in regulating delta-6 desaturase (D6D), the key enzyme for long-chain PUFA biosynthesis. Nevertheless, the extent of their effects on this enzyme remains controversial and difficult to assess. It has been generally admitted that C18 unsaturated fatty acids (UFAs) regulate negatively delta-6 desaturase (D6D). This inhibition has been evidenced in regard to a high glucose/fat free (HG/FF) diet used in reference. However, several nutritional investigations did not evidence any inhibition of desaturases when feeding fatty acids.

Because the choice of the basal diet appeared to be of primary importance in such experiments, our goal was to reconsider the specific role of dietary UFAs on D6D regulation, depending on nutritional conditions. For that, sixteen adult Wistar rats were fed purified linoleic acid, α-linolenic acid or oleic acid, included in one of two diets at 4% by weight: an HG/FF or a high starch base (HS) where the pure UFAs replaced a mixed vegetable oil. Our results showed first that D6D specific activity was significantly greater when measured in presence of an HG/FF than with an HS/4% vegetable oil diet. Secondly, we found that linoleic and alpha-linolenic acids added to HG/FF reduced the specific activity of D6D. In contrast, when pure UFAs were added to an HS base, D6D specific activities remained unchanged or increased. Concordant results were obtained on D6D mRNA expression.

Altogether, this study evidenced the importance of the nutritional status in D6D regulation by C18 UFAs: when used as control, HG/FF diet stimulates D6D compared with a standard control diet containing starch and 4% fats, leading to an overestimation of the D6D regulation by UFAs. Then, UFAs should be considered as repressors for unsaturated fatty acid biosynthesis only in very specific nutritional conditions.

Relationship of nutritional and metabolic factors to non-invasive indices of macrovascular disease in diabetes

Factors which may account for the high frequency of macrovascular disease in diabetics are age, sex, cigarette smoking, hypertension, obesity, lack of exercise, diet, hyperglycaemia, hyperinsulinaeroia, hypercholesterolaemia, hypertriglyceridaemia, low HDL-cholesterol concentration, elevated free fatty acid concentration and enhanced platelet aggregation. Twenty seven (13 men and 14 women) non-insulin-dependent diabetics and thirty eight age, height and weight matched healthy subjects (10 men and 28 women) were studied. None of the subjects were smokers, or hypertensive. No subject had any clinical evidence of peripheral arterial disease, coronary heart disease or cerebrovascular disease. All had apparently normal peripheral pulses and normal ankle/arm blood pressure indices. Methods for determining arterial compliance in the segment between the left subclavian artery and each common femoral artery, and proximal resistance at the common femoral artery and posterior tibial artery, have been reviewed and developed. An appropriate food intake methodology for deriving food indices from food records was developed. Biochemical determinants have been made of glucose tolerance, glycosylated haemoglobin, serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, plasma free fatty acid and insulin. A significant decrease in the arterial compliance, and a significant increase in the arterial proximal resistance at the common femoral artery and posterior tibial artery in non-insulin-dependent diabetics, compared with their healthy controls, have been found. Significant negative correlation between arterial compliance and proximal resistance and, a significant positive correlation between the arterial proximal resistance of common femoral artery and posterior tibial artery were found. Differences between control (healthy subjects) and non-insulin-dependent diabetic groups indicate that preclinical peripheral arterial disease can be recognised even in mild diabetics by non-invasive measurement of arterial compliance or proximal resistance. There were significant and negative correlations between arterial compliance and each of blood glucose, blood glycosylated haemoglobin (HbAlC), plasma free fatty acid and plasma insulin concentration. There were significant and positive correlations between arterial proximal resistance of common femoral artery and posterior tibial artery and each of blood glucose, glycosylated haemoglobin and plasma free fatty acid concentration. Multivariate analysis to examine each of the biochemical factors Including blood glucose, blood glycosylated haemoglobin (HbAlC), plasma free fatty acid, plasma Insulin and lipids, showed that the factor which most influenced the arterial compliance and the proximal resistance of posterior tibial artery was the glucose level in the fasting state or the glucose response after a glucose load. In addition, the factors which most influenced proximal resistance of the common femoral artery were free fatty acid -level in the fasting state or glucose response after a glucose load. The factors which most influenced arterial compliance were glucose level in men, and the insulin level in the fasting state or the plasma free fatty acid response after a glucose load in women. These findings indicate that blood glucose, plasma free fatty acid and plasma insulin are risk factors for changes in arterial wall characteristic at a stage when no clinical evidence of macrovascular disease is apparent. Arterial compliance was decreased and the proximal resistance of posterior tibial artery was increased in those with a low intake of protective foods compared with those with a high intake whether healthy subjects or non-insulin-dependent diabetics. Arterial compliance was decreased in non-fish eaters compared with the fish eaters whether healthy subjects or non-insulin-dependent diabetics. Proximal resistance of the posterior tibia! artery in non-fish eaters was increased compared with fish eaters in healthy subjects. Overall, food variety, a protective food score consumption and fish consumption emerge as importance determinants of arterial wall characteristics at a stage when no clinical evidence of macrovascular disease is apparent.

Relationship between alcohol abuse upper gastro-intestinal haemorrhage and nutritional status during acute hospital admission

This thesis is concerned with the effect of alcohol consumption on the pathogenesis of bleeding from the upper gastrointestinal tract via nutritional pathways. Altered nutritional status is a frequently recognised clinical accompaniement of heavy alcohol consumption in hospitalized patients. Similarly, upper gastrointestinal bleeding is frequently accompanied by the presence of heavy alcohol consumption. Nevertheless, the clinical quantification of alcohol intake is often descriptive, so that a link between alcohol use and upper gastrointestinal haemorrhage via nutritional mechanisms has been only generally defined. In the literature review, the methods of defining alcohol use and abuse, using interview, biochemical and haematological techniques are noted. The relationship between alcohol abuse and nutrient imbalances is reviewed, especially in relation to possible effects on the gastrointestinal tract, appetite and eating habits. A further section reviews the relationship between alcohol use and anatomical lesions of the upper gastrointestinal tract likely to lead to bleeding. Following the chapter in which the methods used in this thesis are described. Chapter 4 seeks to describe the study population and its subgroups in this thesis in relation to interview, biochemical and haematological methods. Alcohol use is defined in relation to (1) a clinical classification of heavy or light drinking, based on a questionnaire administered in Casualty, (2) a quantified method of determining alcohol consumption during a subsequent ward dietetic assessment, (3) in relation to a biochemical definition (recent drinking and non-drinking), and a classification of (1) and (2) called, for the purposes of this thesis, 'alcohol abusers' and 'nonabusers'. Heavy, regular and recent drinkers and alcohol abusers tend to be male and younger than light, infrequent and nonrecent drinkers and nonabusers. Chapter 5 relates the nutritional status of those patients admitted acutely to hospital in relation to the groups defined in Chapter 4, Nutritional status is defined in terms of food intake, anthropometry, biochemical and haematological parameters. Different methods of defining alcohol use give rise to different patterns of nutritional impairment. Chapter 6 relates the nutritional status of those patients admitted acutely to hospital in relation to the presence or absence of an endoscopically defined site of upper gastrointestinal bleeding. A difference is seen between those bleeding from a Mailory-weiss tear and other sites of bleeding, similarly, biochemical differences in nutritional status emerge between those patients who presented in shock, and those who did not. Chapter 7 explores the relationships between biochemical markers of nutritional status and haemostatic variables in the groups of abusers/non-abusers, the various sites of primary bleeding/controls, and shock/non-shock. Serum copper appears to be related to altered haemostasis in a manner not apparently described elsewhere.

Nutritional related aspects of the artificial propagation and larval rearing of Macquarie perch, Macquaria Australasica (Cuvier, 1830)

Studies the underlying role of nutrition in the lack of response of captive fish to hypophysation. Aspects studied include morphological characteristics, histology of ovaries, proximate analysis, fatty and amino acid profiles of oocytes, muscle, liver and diets of wild and tank-reared fish, egg and larval quality, amino acid composition of eggs and larvae at different developmental stages, larval feeding and hormone treatments.

Improving health with nutritional interventions in residential aged care

In a group of Australian aged care residents, dietary energy and nutrient intakes were generally inadequate, despite sufficient energy being served. Six months of multivitamin supplementation improved nutritional status and bone quality; and six months of fortified milk consumption improved serum 25(OH)D and folate levels, and increased vitamin D and folate intakes.

Implementation strategies and effectiveness of nutritional messages for improving health

There are missed opportunities for General Practitioners to assist overweight patients with dietary and exercise weight management and additional assistance may be required. An online weight loss program has potential, although no difference in weight loss was observed whether the participants received exercise advice only or exercise plus dietary advice.

Nutritional and organoleptic quality in intensively farmed Murray cod

This research aimed to determine the nutritional and organoleptic changes associated with different purging procedures in farmed Murray cod. Murray cod, a highly valuable species from a nutritional point of view, greatly benefits from a period of purging in clean water before being consumed.

Depression, nutritional risk and eating behaviour in older caregivers

Objective
This study investigated the relationship between depression, nutritional risk and dietary intake in a population of older caregivers.

Design
Mailed questionnaire with sub group participating in a home-based interview.

Participants and setting
Seventy-six community dwelling caregivers aged 50 y or over from Victoria, Australia.

Measurements
Questionnaires provided information on weight, height, hours of care, depressive symptoms, nutritional risk and appetite. The home-based interview assessed dietary intake and shopping, cooking and meal consumption habits.

Results
The sample had a mean±SD age of 70.3±12.8 y, BMI of 27.2±4.8 kg/m2 and the time spent caring was 101.8±68.1 h/wk. Overall, 32% of caregivers had depressive symptoms, 21% were at risk of malnutrition and 21% reported their appetite was fair/bad/very bad. Caregivers with depressive symptoms (32%) compared to those with no depressive symptoms (53%) had a poorer appetite (p<0.05). Of the 20 caregivers who participated in the home interview, 25% reported they ate their meals alone.

Conclusion
A significant proportion of community dwelling older caregivers had depressive symptoms, were at risk of malnutrition and had poor appetites, although the majority were overweight or obese.