Perceived neighborhood environmental attributes associated with adults’ transport-related walking and cycling: Findings from the USA, Australia and Belgium

Background : Active transportation has the potential to contribute considerably to overall physical activity levels in adults and is likely to be influenced by neighborhood-related built environment characteristics. Previous studies that examined the associations between built environment attributes and active transportation, focused mainly on transport-related walking and were conducted within single countries, limiting environmental variability. We investigated the direction and shape of relationships of perceived neighborhood attributes with transport-related cycling and walking in three countries; and examined whether these associations differed by country and gender.

Methods Data from the USA (Baltimore and Seattle), Australia (Adelaide) and Belgium (Ghent) were pooled. In total, 6,014 adults (20–65 years, 55.7% women) were recruited in high-/low-walkable and high-/low-income neighborhoods. All participants completed the Neighborhood Environmental Walkability Scale and the International Physical Activity Questionnaire. Generalized additive mixed models were used to estimate the strength and shape of the associations.

Results Proximity to destinations, good walking and cycling facilities, perceiving difficulties in parking near local shopping areas, and perceived aesthetics were included in a ‘cyclability’ index. This index was linearly positively related to transport-related cycling and no gender- or country-differences were observed. The ‘walkability’ index consisted of perceived residential density, land use mix access, proximity of destinations and aesthetics. A non-linear positive relationship with transport-related walking was found. This association was stronger in women than in men, and country-specific associations were identified: the strongest association was observed in Seattle, the weakest in Adelaide. In Ghent, the association weakened at higher levels of walkability.

Conclusions For cycling, consistent correlates were found in the three countries, but associations were less straightforward for transport-related walking. Moreover, the identified neighborhood environmental correlates were different for walking compared to cycling. In order to further clarify the shape of these associations and reach more specific international guidelines for developing walkable and bikeable neighborhoods, future studies should include even more countries to maximize environmental variability.

Cross-cultural comparison of motor competence in children from Australia and Belgium

Motor competence in childhood is an important determinant of physical activity and physical fitness in later life. However, childhood competence levels in many countries are lower than desired. Due to the many different motor skill instruments in use, children's motor competence across countries is rarely compared. The purpose of this study was to evaluate the motor competence of children from Australia and Belgium using the Körperkoordinationstest für Kinder (KTK). The sample consisted of 244 (43.4% boys) Belgian children and 252 (50.0% boys) Australian children, aged 6-8 years. A MANCOVA for the motor scores showed a significant country effect. Belgian children scored higher on jumping sideways, moving sideways and hopping for height but not for balancing backwards. Moreover, a Chi squared test revealed significant differences between the Belgian and Australian score distribution with 21.3% Belgian and 39.3% Australian children scoring "below average." The very low levels reported by Australian children may be the result of cultural differences in physical activity contexts such as physical education and active transport. When compared to normed scores, both samples scored significantly worse than children 40 years ago. The decline in children's motor competence is a global issue, largely influenced by increasing sedentary behavior and a decline in physical activity.

How should Australia respond to media- publicised developments on euthanasia in Belgium?

This article considers the implications that recent euthanasia developments in Belgium might have for the Australian debate on assisted dying. Through media database and internet searches, four significant developments in Belguim were identified: three cases involving individuals who requested access to euthanasia, and recent changes to the Belgian Act on Euthanasia 2002, allowing children access to euthanasia. The article outlines these developments and then examines how they have been discussed in Australia by the different sides of the euthanasia debate. It concludes that these developments are important considerations that legislators and policy-makers in Australia should engage with, but argues that that engagement must be rational and also informed by the significant evidence base that is now available on how the Belgian (and other) assisted dying regimes operate in practice.

Early carboniferous athyridid brachiopods from the Qaidam Basin, Northwest China

Four new Early Carboniferous athyridid species in three genera, including one new genus, Bruntonathyris, are described from the Qaidam Basin, northwest China: Lamellosathyris qaidamensis, Bruntonathyris amunikeensis, Bruntonathyris? heijianshanensis, and Lochengia qinghaiensis. Based on the new material and also on published information, we also reviewed the taxonomic composition and the stratigraphic and paleogeographic distributions of the three genera. As a result, Lamellosathyris is considered to be indicative of late Famennian to Viséan age, originating in late Famennian in central North America and Armenia of Russia, respectively. Later, the genus appears to have two migratory directions: one branch rapidly dispersed over Mississippi Valley, Oklahoma, Texas and New Mexico of central North America in Tournaisian; alternatively, another branch from Armenia migrated westerly to Belgium, France, Spain, Britain, Ireland, via the Moscow Basin and Ural seaway, eastward to the Tienshan Mountains and Qaidam Basin of northwest China during the Tournaisian to Viséan, and easterly along the southern shelves of the Paleo-Tethys to Iran and western Yunnan of southwestern China in Tournaisian. Both Bruntonathyris and Lochengia are restrictedly Tournaisian to Viséan in age, and probably originated in the Qaidam Basin. Later, Bruntonathyris migrated easterly to South China and Japan, and westerly to Urals, Moscow Basin, Donetsk Basin and Britain; Lochengia migrated easterly to South China and westerly to the Urals seaway and the adjoined Russian Platform (i.e., both the Moscow and Donetsk Basins).

New evidence on purchasing power parity from 17 OECD countries

There is a large literature that investigates whether or not real exchange rates are stationary in an attempt to unravel support for purchasing power parity (PPP). At best, the empirical results are mixed. This paper applies a unit root test that allows for a simultaneous structural break in the intercept and slope, shown by Sen (2003) to minimize power distortions, to examine PPP for 17 OECD countries. Our results on PPP are mixed. When the real exchange rate is based on the US dollar, evidence is found of PPP for only France, Portugal and Denmark. When the real exchange rate is based on the Deutschmark, we find evidence of PPP for Austria, Belgium, Norway, Spain, Netherlands, Switzerland, and Denmark.

Untitled

This exhibition included 28 paintings. They were curated around the theme of my perceptions of self and place from the experience of being a new-comer to Australia. Evident in the works are imaginative Australian landscapes, with references to my prior home of Bruges, Belgium and ancestors who had been in Australia.

Nurses’ advice regarding sterile or clean urinary drainage bags for individuals with a long-term Indwelling urinary catheter

PURPOSE: The purpose of this study was to identify, compare, and explore advice nurses give to community-dwelling long-term indwelling catheter users on the use of sterile or clean urinary drainage bags, and to obtain information that would inform the design of a larger-scale international survey.


SUBJECTS AND SETTINGS: A survey was targeted to nurse members of the International Continence Society (n = 130). Respondents (n = 28; 21.5%) included nurses from Australia, Canada, Belgium, Switzerland, the United Kingdom, and the United States, who specialized in managing incontinence.


METHODS: The project was conducted as a descriptive, exploratory pilot study. Respondents completed an online anonymous survey that was distributed by the International Continence Society. The survey instrument was designed by the investigators and comprised 14 questions with both fixed and open-ended response options.


RESULTS: Most respondents in this survey advised indwelling catheter users to reuse their catheter bags (n = 15; 68%). Factors that influenced advice included concerns about the cost of catheter bags, an evaluation of the individual's infection risk, local and national policies, evidence-based guidelines, users' living arrangements, and their ability to clean the bags. Advice on decontamination methods varied; however, the most commonly recommended cleaning agent was water and vinegar, followed by a sterilizing or bleach solution or dishwashing detergent.


CONCLUSION: Nurses play a key role in educating and supporting indwelling catheter users. Results of this study highlight variability in the advice nurses give to community-dwelling long-term indwelling catheter users about sterile or clean urinary drainage bags. This variability requires further investigation and affirms the need for a larger-scale study that draws on a broader sample of nurses.

International contact lens prescribing in 2005

This article presents our fifth annual survey of international contact lens prescribing trends. In the first half of 2005, we analyzed prescribing habits in 15 countries: Australia, Belgium, Canada, the Czech Republic, Germany, Greece, Japan, the Netherlands, New Zealand, Norway, Singapore, Russia, Sweden, the United Kingdom and the United States. In each country, we sent 1,000 surveys (or fewer in countries where this exceeded the total number of practitioners) to contact lens clinicians who were randomly selected from appropriate national registers.

International contact lens prescribing in 2004

This article presents our fourth annual survey of international contact lens prescribing trends. In 2004, we analyzed prescribing habits in 14 countries: Australia, Belgium, Canada, Germany, Greece, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, the United Kingdom and the United States. To each, we sent 1,000 surveys (or a pro-rata number in countries with less than 1,000 practitioners) to clinicians randomly selected from appropriate national registers.

The surveys elicited prospective information about contact lenses and care products that respondents prescribed to up to 10 patients fit after the study began. We employed a weighting system to better reflect the trends of busier practices.

International contact lens prescribing in 2003

This is our third annual survey of international contact lens prescribing trends. Between January and March 2003, we analyzed prescribing habits in 10 countries: Australia, Belgium, Canada, Greece, Japan, the Netherlands, Norway, Singapore, the United Kingdom and the United States. In the larger countries, we randomly sent 1,000 surveys to contact lens practitioners selected from national registers of qualified clinicians (in the United States, we used the subscriber list of Contact Lens Spectrum). In Norway and Singapore, where the number of practitioners is less than 1,000, we mailed out a pro rata quantity of surveys.

Sharing good NEWS across the world: developing comparable scores across 12 countries for the neighborhood environment walkability scale (NEWS)

Background: The IPEN (International Physical Activity and Environment Network) Adult project seeks to conduct pooled analyses of associations of perceived neighborhood environment, as measured by the neighborhood Environment Walkability Scale (NEWS) and its abbreviated version (NEWS-A), with physical activity using data from 12 countries. As IPEN countries used adapted versions of the NEWS/NEWS-A, this paper aimed to develop scoring protocols that maximize cross-country comparability in responses. This information is also highly relevant to non-IPEN studies employing the NEWS/NEWS-A, which is one of the most popular measures of perceived environment globally.
Methods: The following countries participated in the IPEN Adult study: Australia, Belgium, Brazil, Colombia, Czech Republic, Denmark, Hong Kong, Mexico, New Zealand, Spain, the United Kingdom, and the United States. Participants (N = 14,305) were recruited from neighborhoods varying in walkability and socio-economic status. Countries collected data on the perceived environment using a self- or interviewer-administered version of the NEWS/NEWS-A. Confirmatory Factor Analysis (CFA) was used to derive comparable country-specific measurement models of the NEWS/NEWS-A. The level of correspondence between standard and alternative versions of the NEWS/NEWS-A factor-analyzable subscales was determined by estimating the correlations and mean standardized difference (Cohen’s d) between them using data from countries that had included items from both standard and alternative versions of the subscales.
Results: Final country-specific measurement models of the NEWS/NEWS-A provided acceptable levels of fit to the data and shared the same factorial structure with six latent factors and two single items. The correspondence between the standard and alternative versions of subscales of Land use mix – access, Infrastructure and safety for walking/cycling, and Aesthetics was high. The Brazilian version of the Traffic safety subscale was highly, while the Australian and Belgian versions were marginally, comparable to the standard version. Single-item versions of the Street connectivity subscale used in Australia and Belgium showed marginally acceptable correspondence to the standard version.
Conclusions: We have proposed country-specific modifications to the original scoring protocol of the NEWS/NEWS-A that enhance inter-country comparability. These modifications have yielded sufficiently equivalent measurement models of the NEWS/NEWS-A. Some inter-country discrepancies remain. These need to be considered when interpreting findings from different countries.

Designing and implementing a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study

The development of the ToyBox-intervention was based on the outcomes of the preliminary phase of the ToyBox-study, aiming to identify young children's key behaviours and their determinants related to early childhood obesity. The ToyBox-intervention is a multi-component, kindergarten-based, family-involved intervention with a cluster-randomized design, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families. The intervention was implemented during the academic year 2012–2013 in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. Standardized protocols, methods, tools and material were used in all countries for the implementation of the intervention, as well as for the process, impact, outcome evaluation and the assessment of its cost-effectiveness. A total sample of 7,056 preschool children and their parents/caregivers, stratified by socioeconomic level, provided data during baseline measurements and participated in the intervention. The results of the ToyBox-study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention. The aim of the current paper is to describe the design of the ToyBox-intervention and present the characteristics of the study sample as assessed at baseline, prior to the implementation of the intervention.

Legal issues: minors' decision-making capacity to refuse life-saving and life-sustaining treatment: legal and psychiatric perspectives

Laws in Belgium and the Netherlands permit euthanasia and assisted suicide for seriously ill children who experience "constant and unbearable suffering" – they have the capacity to request death by lethal injection if they convey a "reasonable understanding of the consequences" of that request. The child's capacity to understand death is therefore a prerequisite to the implementation of the request. However, modern neuro-psychological and fMRI (functional Magnetic Resonance Imaging) studies of the relationship between the neuro-anatomical development of the brain in human beings and their emotional and experiential capacity, demonstrates that both are not fully developed until the early 20s for girls and mid-20s for boys. Unlike Belgium and the Netherlands, the clinical and legal implications of the immaturity of the brain on medical decision-making of minors, in particular life and death decisions, have been implicit in the Australian courts' approach to the refusal of life-saving and life-sustaining treatment by minors. This approach is exemplified by X v Sydney Children's Hospitals Network [2013] NSWCA 320 (and a series of earlier cases).