Self-regulation and the intention behaviour gap. Exploring dietary behaviours in university students

The aim of this study was to explore whether two aspects of self-regulation (impulsivity and temporal orientation) could reduce the intention–behaviour gap for two dietary behaviours: fruit and vegetable consumption and saturated fat consumption. Australian undergraduate students (N = 154) completed questionnaires (the Barratt impulsiveness scale and the consideration of future consequences scale) and intention measures, and 1 week later behaviour was measured using the Block rapid food screener. After controlling for demographics, intention was associated with fruit and vegetable consumption, but the self-regulation measures did not further improve the variance accounted for. For saturated fat, gender was associated with consumption, such that males tended to consume more saturated fat. Intention was significantly associated with consumption, and impulsivity further improved the model such that those who were more impulsive tended to consume more saturated fat. These findings suggest that health protective and health risk behaviours, such as those investigated in the current study, may have different determinants.

Analysing stillbirth data using dynamic self organizing maps

Even with the presence of modern obstetric care, stillbirth rate seems to stay stagnant or has even risen slightly in countries such as England and has become a significant public health concern [1]. In the light of current medical research, maternal risk factors such as diabetes and hypertensive disease were identified as possible risk factors and are taken into consideration in antenatal care. However, medical practitioners and researchers suspect possible relationships between trends in maternal demographics, antenatal care and pregnancy information of current stillbirth in consideration [2]. Although medical data and knowledge is available appropriate computing techniques to analyze the data may lead to identification of high risk groups. In this paper we use an unsupervised clustering technique called Growing Self organizing Map (GSOM) to analyse the stillbirth data and present patterns which can be important to medical researchers.

The course of uveitis in pregnancy and postpartum

Aim
To examine the course of non-infectious uveitis during pregnancy.

Methods
This is a retrospective case series. The medical records of 47 subjects with a previous history of non-infectious uveitis pre-dating their pregnancy were reviewed. Uveitis activity during the periods 1 year before pregnancy, during pregnancy and 1 year postpartum, were recorded. Information on patient demographics, type of uveitis, medication use, sex of child and breastfeeding status were also collected. The main outcome measures were the events of flare-ups during the prepregnancy, pregnancy and postpartum periods.

Results
The rate of flare-up was 1.188 per person year prior to pregnancy, 0.540 per person year during pregnancy and 0.972 per person year in postpartum (p<0.001 for comparison between prepregnancy and pregnancy; p=0.009 for comparison between pregnancy and postpartum). Rates of flare-up only began to decrease in the second trimester. After delivery, rates of flare-up rebounded and within 6 months postpartum, flare-up rates were not significantly different from prepregnancy levels (p=0.306). Even so, 40% of subjects were found to have remained inactive within 1 year postpartum.

Conclusions
Uveitis activity decreased by mid-pregnancy, but returned to prepregnancy levels within 6 months postpartum. These findings may be used to adjust uveitis management during pregnancy and the postpartum period.

An update of Murrayan needs: A pilot study among American college students

Much research work on motives has been based on the taxonomy of psychogenic needs originally proposed by Murray and his colleagues in 1938. However, many of these needs have received little attention, and some of them may be less relevant now than they were 70 years ago. Two studies were conducted to investigate current motives. In Study 1, we used the Striving Assessment to elicit the personal strivings of 255 undergraduate university students. Murray’s taxonomy was unable to account for 50% of the 2,937 strivings. These strivings were thematically groups into 11 new categories and combined with 7 Murrayan needs to form the Comprehensive Motivation Coding System (CMCS). In Study 2, Thematic Apperception Test (TAT) stories produced by 143 undergraduate student participants were coded by these two systems. Murray’s system was unable to fully account for 42% of motives identified in the TAT stories, but the CMCS was able to account for 89%. These findings suggest that Murrayan needs may not adequately describe contemporary motivations and that the CMCS has the potential to do so. However, due to the limited demographics of our sample, further investigations are needed.

Public sector residential aged care: identifying novel associations between quality indicators and other demographic and health-related factors

Objective : To explore associations among quality indicators (QI; e.g. pressure ulcers, falls and/or fractures, physical restraint, use of multiple medications, unplanned weight loss) of the Victorian Public Sector Residential Aged Care Services (VPSRACS) with other demographic and health-related factors.

Methods : Data for 380 residents over a 3-month period were extracted retrospectively from client databases at four VPSRAC facilities.

Results : Four significant logistic regression models were developed. The strongest models related to falls and polypharmacy. Significant associations for these models included the following: (1) residents with a higher body mass index were 6% less likely (95% confidence interval (CI) 1%–11%) to fall, whereas high levels of cognitive impairment increased the risk of falling by 8% (95% CI 2%–14%); (2) being ambulant with a gait aid more than doubled the risk of falling compared with non-ambulant residents (95% CI 19%–546%); and (3) higher cognitive impairment was associated with a 6% (95% CI 1%–11%) reduction in the likelihood of polypharmacy.

Conclusions : Identification of significant relationships between the VPSRACS QI and other demographic and health-related factors is a preliminary step towards a more in-depth understanding of the factors that influence the QI and predict adverse events.

International survey of rigid contact lens fitting

To determine the extent of rigid contact lens fitting worldwide and to characterize the associated demographics and fitting patterns. Survey forms were sent to contact lens fitters in up to 40 countries between January and March every year for five consecutive years (2007 to 2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Survey data collected between 1996 and 2011 were also analyzed to assess rigid lens fitting trends in seven nations during this period. Data were obtained for 12,230 rigid and 100,670 soft lens fits between 2007 and 2011. Overall, rigid lenses represented 10.8% of all contact lens fits, ranging from 0.2% in Lithuania to 37% in Malaysia. Compared with soft lens fits, rigid lens fits can be characterized as follows: older age (rigid, 37.3 ± 15.0 years; soft, 29.8 ± 12.4 years); fewer spherical and toric fits; more bifocal/multifocal fits; less frequent replacement (rigid, 7%; soft, 85%); and less part-time wear (rigid, 4%; soft, 10%). High-Dk (contact lens oxygen permeability) (36%) and mid-Dk (42%) materials are predominantly used for rigid lens fitting. Orthokeratology represents 11.5% of rigid contact lens fits. There has been a steady decline in rigid lens fitting between 1996 and 2011. Rigid contact lens prescribing is in decline but still represents approximately 10% of all contact lenses fitted worldwide. It is likely that rigid lenses will remain as a viable, albeit increasingly specialized, form of vision correction.

An international survey of daily disposable contact lens prescribing

The aim was to determine the extent of daily disposable contact lens prescribing worldwide and to characterise the associated demographics and fitting patterns. Up to 1,000 survey forms were sent to contact lens fitters in up to 40 countries between January and March every year for five consecutive years (2007 to 2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Survey data collected since 1996 were also analysed for seven nations to assess daily disposable lens fitting trends since that time. Data were collected in relation to 97,289 soft lens fits, of which 23,445 (24.1 per cent) were with daily disposable lenses and 73,170 (75.9 per cent) were with reusable lenses. Daily disposable lens prescribing ranged from 0.6 per cent of all soft lenses in Nepal to 66.2 per cent in Qatar. Compared with reusable lens fittings, daily disposable lens fittings can be characterised as follows: older age (30.0 ± 12.5 versus 29.3 ± 12.3 years for reusable lenses); males are over-represented; a greater proportion of new fits versus refits; 85.9 per cent hydrogel; lower proportion of toric and presbyopia designs and a higher proportion of part-time wear. There has been a continuous increase in daily disposable lens prescribing between 1996 and 2011. The proportion of daily disposable lens fits (as a function of all soft lens fits) is positively related to the gross domestic product at purchasing power parity per capita (r(2) = 0.55, F = 46.8, p < 0.0001). The greater convenience and other benefits of daily disposable lenses have resulted in this modality capturing significant market share. The contact lens field appears to be heading toward a true single-use-only, disposable lens market.

Different patterns of Australian adults' knowledge of foods and nutrients related to metabolic disease risk

A nationwide survey of 2022 consumers was conducted in Australia in late 2011. A short list of questions about knowledge of the nutrient composition of common foods was administered along with questions about the respondents’ food attitudes, demographics, school education and dieting practices. Overall, the results showed that nutrition knowledge was relatively high. Latent class analysis showed two groups of consumers with ‘high’ and ‘low’ knowledge of nutrition. Higher knowledge was positively associated with age, female sex, university education, experience of home economics or health education at school, having a chronic disease, and attitudes to food issues, and negatively with type 1 diabetes or the use of diabetes-control diets. The implications of the findings for nutrition communication are discussed.

Psychosocial and other working conditions in relation to body mass index in a representative sample of Australian workers

Background The aim of the study was to examine the relationship between psychosocial and other working conditions and body-mass index (BMI) in a working population. This study contributes to the approximately dozen investigations of job stress, which have demonstrated mixed positive and negative results in relation to obesity, overweight and BMI. Methods A cross-sectional population-based survey was conducted among working Australians in the state of Victoria. Participants were contacted by telephone from a random sample of phone book listings. Information on body mass index was self-reported as were psychosocial work conditions assessed using the demand/control and effort/reward imbalance models. Other working conditions measured included working hours, shift work, and physical demand. Separate linear regression analyses were undertaken for males and females, with adjustment for potential confounders. Results A total of 1101 interviews (526 men and 575 women) were completed. Multivariate models (adjusted for socio-demographics) demonstrated no associations between job strain, as measured using the demand/control model, or ERI using the effort/reward imbalance model (after further adjustment for over commitment) and BMI among men and women. Multivariate models demonstrated a negative association between low reward and BMI among women. Among men, multivariate models demonstrated positive associations between high effort, high psychological demand, long working hours and BMI and a negative association between high physical demand and BMI. After controlling for the effort/reward imbalance or the demand/control model, the association between physical demand and working longer hours and BMI remained. Conclusion Among men and women the were differing patterns of both exposures to psychosocial working conditions and associations with BMI. Among men, working long hours was positively associated with higher BMI and this association was partly independent of job stress. Among men physical demand was negatively associated with BMI and this association was independent of job stress.

Hepatitis C virus treatment in the 'real-world': how well do 'real' patients respond?

Background: Published clinical trials of the treatment of HCV are largely multicentre prospective pharmaceutical trials. Patients in clinical trials tend to have more favorable outcomes than patients in the 'real-world', due to strict patient selection and differences in treatment conditions and available resources. Objectives: To assess the outcomes of Hepatitis C infected patients treated at the Barwon Health Liver Clinic with combination Pegylated interferon (PEG-IFN) and Ribavirin (RBV) therapy and to determine factors associated with a treatment response. Methods: Retrospective review of patients who received treatment for Hepatitis C at our institution's Liver Clinic from January 2001-September 2011. Patient demographics, comorbidities, treatment-related parameters and side effects were extracted from medical records and analyzed. Results: A total of 190 patients (120 male, 70 female) with a mean age of 42.8 years (range 20-68 years) commenced treatment. The most common genotype was genotype 3 (48.9%), followed by genotype 1 (42.6%). 150 of 190 patients (78.9%) completed treatment and had end of treatment data available. 107 of 182 patients, (58.8%) for whom sustained virologic response (SVR) rate data was available achieved an SVR. Overall response rates were; 46.9%, 68.8% and 62.4% in genotypes 1, 2 and 3 respectively. The response rate was significantly lower in 29 patients with documented cirrhosis (20.7%). Age, diabetes and alcohol abuse did not predict treatment response in our cohort. Side effects reported in 81.6% of patients included general malaise, hematological disturbance and psychiatric issues, and necessitated cessation of therapy in 16 patients (8.4%) and dose reduction in 26 patients (13.7%). Conclusions: Response rates to combination PEG-IFN and RBV therapy at our institution are comparable to other 'real-world' and pharmaceutical registration trials. Side effects of combination therapy were prominent but resulted in fewer discontinuations of therapy compared to pharmaceutical trials.

Food insecurity among university students in Victoria: A pilot study

Aims: Susceptibility to food insecurity can vary over a life course; however, a potential period of particular vulnerability is while studying at a tertiary institution. This pilot study aimed to assess the prevalence, severity and potential determinants of food insecurity among tertiary students attending a Victorian-based institution. Methods: The present study employed a cross-sectional design, involving use of a self-reported questionnaire. The survey, conducted in 2012, was administered to a sample of 124 Deakin University students and contains measures of food insecurity status, demographics and other potential explanatory factors. Descriptive and regression analysis was undertaken to investigate the prevalence of food insecurity and associations with factors that may support or hinder a student's ability to procure food, such as living arrangements, income and knowledge of support services. Results: Food insecurity without hunger was reported by 18% of Deakin University students, while an additional 30% reported experiencing the more severe form of food insecurity (with hunger). A lower odds of being food insecure was reported among students living with their family (without hunger OR 0.35; 95% CI 0.12-0.99; with hunger OR 0.29; 95% CI 0.12-0.70), while a higher odds was found among those receiving government support (with hunger OR 2.52; 95% CI 1.05-6.04). Conclusions: The reported prevalence of food insecurity among the tertiary student sample was greater than the general Australian population, suggesting they are a vulnerable group. This may be attributable to financial pressures faced when students are not living with their parents.

Breastfeeding practices in women with type 1 diabetes: A discussion of the psychosocial factors and policies in Sweden and Australia.

Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion.