Validity of dietary questionnaires in Sri Lankan adults and the association of dietary intake with obesity

Traditionally, infectious diseases and under-nutrition have been considered major health problems in Sri Lanka with little attention paid to obesity and associated non-communicable diseases (NCDs). However, the recent Sri Lanka Diabetes and Cardiovascular Study (SLDCS) reported the epidemic level of obesity, diabetes and metabolic syndrome. Moreover, obesity-associated NCDs is the leading cause of death in Sri Lanka and there is an exponential increase in hospitalization due to NCDs adversely affecting the development of the country. Despite Sri Lanka having a very high prevalence of NCDs and associated mortality, little is known about the causative factors for this burden. It is widely believed that the global NCD epidemic is associated with recent lifestyle changes, especially dietary factors. In the absence of sufficient data on dietary habits in Sri Lanka, successful interventions to manage these serious health issues would not be possible. In view of the current situation the dietary survey was undertaken to assess the intakes of energy, macro-nutrients and selected other nutrients with respect to socio demographic characteristics and the nutritional status of Sri Lankan adults especially focusing on obesity. Another aim of this study was to develop and validate a culturally specific food frequency questionnaire (FFQ) to assess dietary risk factors of NCDs in Sri Lankan adults. Data were collected from a subset of the national SLDCS using a multi-stage, stratified, random sampling procedure (n=500). However, data collection in the SLDCS was affected by the prevailing civil war which resulted in no data being collected from Northern and Eastern provinces. To obtain a nationally representative sample, additional subjects (n=100) were later recruited from the two provinces using similar selection criteria. Ethical Approval for this study was obtained from the Ethical Review Committee, Faculty of Medicine, University of Colombo, Sri Lanka and informed consent was obtained from the subjects before data were collected. Dietary data were obtained using the 24-h Dietary Recall (24HDR) method. Subjects were asked to recall all foods and beverages, consumed over the previous 24-hour period. Respondents were probed for the types of foods and food preparation methods. For the FFQ validation study, a 7-day weight diet record (7-d WDR) was used as the reference method. All foods recorded in the 24 HDR were converted into grams and then intake of energy and nutrients were analysed using NutriSurvey 2007 (EBISpro, Germany) which was modified for Sri Lankan food recipes. Socio-demographic details and body weight perception were collected from interviewer-administrated questionnaire. BMI was calculated and overweight (BMI ≥23 kg.m-2), obesity (BMI ≥25 kg.m-2) and abdominal obesity (Men: WC ≥ 90 cm; Women: WC ≥ 80 cm) were categorized according to Asia-pacific anthropometric cut-offs. The SPSS v. 16 for Windows and Minitab v10 were used for statistical analysis purposes. From a total of 600 eligible subjects, 491 (81.8%) participated of whom 34.5% (n=169) were males. Subjects were well distributed among different socio-economic parameters. A total of 312 different food items were recorded and nutritionists grouped similar food items which resulted in a total of 178 items. After performing step-wise multiple regression, 93 foods explained 90% of the variance for total energy intake, carbohydrates, protein, total fat and dietary fibre. Finally, 90 food items and 12 photographs were selected. Seventy-seven subjects completed (response rate = 65%) the FFQ and 7-day WDR. Estimated mean energy intake (SD) from FFQ (1794±398 kcal) and 7DWR (1698±333 kcal, P<0.001) was significantly different due to a significant overestimation of carbohydrate (~10 g/d, P<0.001) and to some extent fat (~5 g/d, NS). Significant positive correlations were found between the FFQ and 7DWR for energy (r = 0.39), carbohydrate (r = 0.47), protein (r = 0.26), fat (r =0.17) and dietary fiber (r = 0.32). Bland-Altman graphs indicated fairly good agreement between methods with no relationship between bias and average intake of each nutrient examined. The findings from the nutrition survey showed on average, Sri Lankan adults consumed over 14 portions of starch/d; moreover, males consumed 5 more portions of cereal than females. Sri Lankan adults consumed on average 3.56 portions of added sugars/d. Moreover, mean daily intake of fruit (0.43) and vegetable (1.73) portions was well below minimum dietary recommendations (fruits 2 portions/d; vegetables 3 portions/d). The total fruit and vegetable intake was 2.16 portions/d. Daily consumption of meat or alternatives was 1.75 portions and the sum of meat and pulses was 2.78 portions/d. Starchy foods were consumed by all participants and over 88% met the minimum daily recommendations. Importantly, nearly 70% of adults exceeded the maximum daily recommendation for starch (11portions/d) and a considerable proportion consumed larger numbers of starch servings daily, particularly men. More than 12% of men consumed over 25 starch servings/d. In contrast to their starch consumption, participants reported very low intakes of other food groups. Only 11.6%, 2.1% and 3.5% of adults consumed the minimum daily recommended servings of vegetables, fruits, and fruits and vegetables combined, respectively. Six out of ten adult Sri Lankans sampled did not consume any fruits. Milk and dairy consumption was extremely low; over a third of the population did not consume any dairy products and less than 1% of adults consumed 2 portions of dairy/d. A quarter of Sri Lankans did not report consumption of meat and pulses. Regarding protein consumption, 36.2% attained the minimum Sri Lankan recommendation for protein; and significantly more men than women achieved the recommendation of ≥3 servings of meat or alternatives daily (men 42.6%, women 32.8%; P<0.05). Over 70% of energy was derived from carbohydrates (Male:72.8±6.4%, Female:73.9±6.7%), followed by fat (Male:19.9±6.1%, Female:18.5±5.7%) and proteins (Male:10.6±2.1%, Female:10.9±5.6%). The average intake of dietary fiber was 21.3 g/day and 16.3 g/day for males and females, respectively. There was a significant difference in nutritional intake related to ethnicities, areas of residence, education levels and BMI categories. Similarly, dietary diversity was significantly associated with several socio-economic parameters among Sri Lankan adults. Adults with BMI ≥25 kg.m-2 and abdominally obese Sri Lankan adults had the highest diet diversity values. Age-adjusted prevalence (95% confidence interval) of overweight, obesity, and abdominal obesity among Sri Lankan adults were 17.1% (13.8-20.7), 28.8% (24.8-33.1), and 30.8% (26.8-35.2), respectively. Men, compared with women, were less overweight, 14.2% (9.4-20.5) versus 18.5% (14.4-23.3), P = 0.03, less obese, 21.0% (14.9-27.7) versus 32.7% (27.6-38.2), P < .05; and less abdominally obese, 11.9% (7.4-17.8) versus 40.6% (35.1-46.2), P < .05. Although, prevalence of obesity has reached to epidemic level body weight misperception was common among Sri Lankan adults. Two-thirds of overweight males and 44.7% of females considered themselves as in "about right weight". Over one third of both male and female obese subjects perceived themselves as "about right weight" or "underweight". Nearly 32% of centrally obese men and women perceived that their waist circumference is about right. People who perceived overweight or very overweight (n = 154) only 63.6% tried to lose their body weight (n = 98), and quarter of adults seek advices from professionals (n = 39). A number of important conclusions can be drawn from this research project. Firstly, the newly developed FFQ is an acceptable tool for assessing the nutrient intake of Sri Lankans and will assist proper categorization of individuals by dietary exposure. Secondly, a substantial proportion of the Sri Lankan population does not consume a varied and balanced diet, which is suggestive of a close association between the nutrition-related NCDs in the country and unhealthy eating habits. Moreover, dietary diversity is positively associated with several socio-demographic characteristics and obesity among Sri Lankan adults. Lastly, although obesity is a major health issue among Sri Lankan adults, body weight misperception was common among underweight, healthy weight, overweight, and obese adults in Sri Lanka. Over 2/3 of overweight and 1/3 of obese Sri Lankan adults believe that they are in "right weight" or "under-weight" categories.

Martha and her sisters : women in films about journalism

HBO's Hemingway and Gellhorn (Philip Kaufman, 2012), broadcast in May on US television and starring Nicole Kidman as the pioneering female foreign correspondent, hasn't been well reviewed by the majority of critics. Variety described the biopic (with Clive Owen as Hemingway) as “swollen and heavy-handed”, while the Huffington Post declared it an “expensive misfire … a gigantic missed opportunity, a jaw-droppingly trying waste of time”. Regardless of whether such criticisms are fair—as this essay went to press I had been unable to see the film, so I cannot judge one way or the other—Hemingway and Gellhorn should be viewed as a significant addition to the filmography of journalism, retrieving from history as it does the achievements of one of the most significant of the early female practitioners. Gellhorn was a pioneer in a patriarchal press universe, a foreign and war correspondent at a time when this branch of the profession was seen very much as man's work. She covered the Spanish Civil War and the Second World War, and with just as much viscerality as any man.

The Arab Spring and its social media audiences : English and Arabic Twitter users and their networks

2011 ‘Arab Spring’ are likely to overstate the impact of Facebook and Twitter on these uprisings, it is nonetheless true that protests and unrest in countries from Tunisia to Syria generated a substantial amount of social media activity. On Twitter alone, several millions of tweets containing the hashtags #libya or #egypt were generated during 2011, both by directly affected citizens of these countries, and by onlookers from further afield. What remains unclear, though, is the extent to which there was any direct interaction between these two groups (especially considering potential language barriers between them). Building on hashtag datasets gathered between January and November 2011, this paper compares patterns of Twitter usage during the popular revolution in Egypt and the civil war in Libya. Using custom-made tools for processing ‘big data’, we examine the volume of tweets sent by English-, Arabic-, and mixed-language Twitter users over time, and examine the networks of interaction (variously through @replying, retweeting, or both) between these groups as they developed and shifted over the course of these uprisings. Examining @reply and retweet traffic, we identify general patterns of information flow between the English- and Arabic-speaking sides of the Twittersphere, and highlight the roles played by users bridging both language spheres.

The Arab Spring on Twitter: Language Communities in #egypt and #libya

Building on hashtag datasets gathered since January 2011, this paper will compare patterns of Twitter usage during the popular revolution in Egypt and the civil war in Libya. Using custom-made tools for processing ‘big data’ (boyd & Crawford, 2011), we will examine the volume of tweets sent by English-, Arabic-, and mixed-language Twitter users over time, and examine the networks of interaction (variously through @replying, retweeting, or both) between these groups as they developed and shifted over the course of these uprisings. Examining @reply and retweet traffic, we will identify general patterns of information flow between the English- and Arabic-speaking sides of the Twittersphere, and highlight the roles played by key boundary riders connecting both language spheres. Further, we will examine the URLs shared in these hashtags by Twitter participants, to identify the most prominent overall information sources, examine differences in the information diet experienced by English- and Arabic-language users, and investigate whether there are any online sources whose URLs are transcending language boundaries more frequently than others.

Historiebruk kring Nådendal : och den kommemorativa anatomin av klostrets minnesplats

This thesis examines the ruins of the medieval Bridgettine (Birgittan) monastery of Naantali (Vallis Gratiae, f. 1443) in Finland and the transformation of the site into a national heritage and a memory landscape. It was archaeologically surveyed in the 19th century by Professor Sven Gabriel Elmgren (1817 1897). His work was followed by Dr. Reinhold Hausen (1850 1942), who excavated the site in the 1870s. During this time the memories of Saint Bridget (Birgitta) in Sweden were also invented as heritage. Hausen published his results in 1922 thus forming the connection with the next generation of actors involved with the Naantali site: the magnate Amos Anderson (1878 1961), the teacher Julius Finnberg (1877 1955) and the archaeologist Juhani Rinne (1872 1950). They erected commemorative monuments etc. on the Naantali site, thus creating a memory landscape there. For them, the site represented the good homeland in connection with a western-oriented view of the history of Finland. The network of actors was connected to the Swedish researchers and so-called Birgitta Friends, such as state antiquarian Sigurd Curman (1879 1966), but also to the members of the Societas Sanctae Birgittae and the Society for the Embellishment of Pirita, among others. Historical jubilees as manifestations of the use of history were also arranged in Naantali in 1943, 1993 and 2003. It seems as if Naantali is needed in Finnish history from time to time after a period of crisis, i.e. after the Crimean War in the 1850s, the civil war of 1918, during World War II and also after the economic crisis of the early 1990s. In 2003, there was a stronger focus on the international Saint Bridget Jubilee in Sweden and all over Europe. Methodologically, the thesis belongs to the history of ideas, but also to research on the use of history, invented traditions and lieux de mémoire. The material for the work consists of public articles and scholarly texts in books or newspapers and letters produced by the actors and kept in archives in Finland, Sweden and Estonia, in addition to pictures and erected commemorative monuments in situ in the Western Finnish region. Keywords: Nådendal, Naantali monastery, Bridgettines, St. Bridget, use of history, lieux de mémoire, invented traditions, commemorative anatomy, memory landscape, Saint Bridget jubilees , S. G. Elmgren, R. Hausen, A. Anderson, J. Finnberg, J. Rinne, S. Curman, High Church Movement, Pirita, Vadstena.

Teatteri liikkeessä : Työväenteatterit Suomen teatterikentällä ja työväenliikkeessä kaksiteatterijärjestelmän syntyyn asti vuonna 1922

Workers' theatres in Finland until 1922 The topic of this dissertation is the workers' theatres in Finland before the year 1922. The main question is: why did these amateur theatres within the workers' associations become part of the professional theatre field in the 1910s by getting state subsidy as local theatre institutions? How is it possible that they received this status even after the civil war in 1918 when new professional theatres were founded all over the country? The study also asks, what kind of position did workers' theatres have in the workers' associations and in the workers' movement, what did the Social Democrats and Communists think of theatre and in particular of workers' theatre, and what kind of repertoire did the workers' theatres perform? It is a particular feature of Finland that the professional theatre field was not organised and that the workers’ movement had a relatively strong political position. The study concludes that some workers' theatres were the only steady theatre institutions in their surroundings, and thus functioned as local popular theatres performing to all social groups. Although amateur-based, they started to resemble professional theatres. Even though the Social Democratic Party did not have a specific theatre policy, the leaders of the Party appreciated and supported the workers' theatres as educational institutions and worked for their artistic improvement. The workers' theatres were also largely approved of and seen as people's theatres thought to unite and educate the nation and the working class. This reveals the need for national consensus, in the 1910s against the Russian government who worked to dissolve the autonomous position of the Finnish state, and after the civil war (1918) against the threat of a communist revolution. A wave of agitating proletarian theatre was felt in Finland in the early 1920s but it was marginalised by the large anti-communist majority.

Teollisuuden ja yhteiskunnan palveluksessa : Arkkitehti Bertel Liljequist (1885 - 1954) tuotantolaitosten suunnittelijana maailmansotien välisenä aikana

My thesis concerns the plans drawn up by architect Bertel Liljequist (1885 1954) for an industrial corporation and a city in Finland during the interwar years. These were two quite different clients: the Kymi Company operating in Kuusankoski and the City of Helsinki. My study includes the micro-examination of the wider social issues involved. That the industrial community and factories in Kuusankoski be constructed correctly in a way supporting corporate strategy was of primary importance for the company s operations. Through the planning process for Helsinki s abattoirs, I show how a city dealt with the twin problems of hygiene and increasing demand for food resulting from a growth in population. I clarify how society and its economic, political and class structures affected the practice of architecture and its expression in the built environment. I analyse how the different backgrounds and starting points of the clients affected the construction projects under study and architect Bertel Liljequist s work. In studying Liljequist as an industrial designer, I have considered it vital to ascertain the client s intentions and objectives within the framework of the prevailing social situation. I examine the meanings the client wished the architecture to express and also to communicate to those working in the factory and the area as well as to the workers living on company land. The social outlook of the owners and management of Kymi Company implicitly affected the appearance of the factory. A brick fairface for the factories was a safe and natural material at the beginning of the 1920s when taking into consideration the events of the 1918 Civil War. To have built a White factory in the style of a defence building would have been provocative. Outside the factory gates, however, the company supported White architecture. The company used the factory buildings to manifest its power and the dwellings to bind the workers and make them loyal to the company. Architecture was thus one way in which the company manifested its position as the higher and undisputed authority. The role of the City of Helsinki within the planning process was for its officials to provide expert opinions but also to arrange study trips for the architect and the abattoir s general manager. The city also decided on the standard of the design. The city s responsibility for the health of its inhabitants and the requirements of modern meat production can be seen in the minimal architecture and clear functionality of the plant. The architecture left no doubt about the trustworthiness of the modern city. Translation: Michael Wynne-Ellis

Miraculous Survival 1939-1982

Description of war years in France and Spain, including experiences in internment camps, life in hiding, etc.; emigration to USA.

Selma's saga [1916-1948]

The memoirs were written in 1982 in Sydney, Australia and include excerpts of letters from various relatives during the years 1938-1941. Early childhood recollections of World War One. The family was living in the 6th district of Vienna. Description of domestic life with maids, laundresses and a French governess. Death of her mother in 1918. Trip with her stepmother Ida Plohn to Prague. Recollections of a stay in the countryside at their maid's family, where Selma and her older sister Martha awaited the birth of their younger sister Trude. Memories of Christmas celebrations. Summer vacations in the mountains. Description of the extended family. Inflation and economic depression in the 1920s. Strict upbringing by her stepmother. Children recreation trip to Grado, Italy in 1925. Selma was accepted at the "Bundeserziehungsanstalt" for gifted students. Only few fellow Jewish students. Religious education with beloved rabbi Diamant. Recovery from tonsilitis in a senatorium in Aflenz, Austria. Celebration of Jewish holidays and visits at the Synagogue on Yom Kippur. Transfer to Realschule. Due to a sudden onset of various illnesses Selma was unable to continue school and had put an end to her father's dream of an university education for her. Difficult to find a position in the depression times of the early 1930s. Only few working options for a Jewish woman. Position as a secretary in a Jewish firm. Outings in the Vienna Woods. Membership in the Zionist group Betar.

Dancer Casablanca 1930

A seated figure dressed in pink against a background of vegetation. Titled in lower left corner.

GURS:'Stamps' from the Concentration Camp, a-l.

The design of each are drawn in the miniature style of postage stamps and include mock postage prices. Presumably the method was inspired by the shortage of paper in the camp.GURS in Southern France, where these works were done, but the format is also used to stress the Irony of the content, especially in the Trio of designs marked "Liberte-Egalite-Fraternite. Aside from one marked "Avion de Gurs", all other are simply labelled "GURS" at the bottom, as is this were the country of origin of a postal system.

GURS: "Stamps" from the concentrationcamp, m-p.

The designs are drawn in the miniature style of postage stamps and include mock postage prices. Presumably this method was inspired by the shortage of paper at the camp in Gurs, Southern France, where these works were done; but specially this format is also used to stress the irony of the content, especially in the trio of design marked "Liberte-Egalite-Fraternite", aside from one marked "Avion de Gurs", all others are labelled simply " Gurs ", at the bottom as if this were the country of origin of a postal system.

Gurs: 'Stamps' from the concentration camp,q-v.

The designs are drawn in the miniature style of postage stamps and include mock postage prices. Presumably this method was inspired by the shortage of paper at the camp in Gurs, Southern France, where these works were done; but specially this format is also used to stress the irony of the content, especially in the trio of design marked "Liberte-Egalite-Fraternite", aside from one marked "Avion de Gurs", all others are labelled simply " Gurs ", at the bottom as if this were the country of origin of a postal system.

Max James Kohler papers, 1888-1934.

Contains scrapbooks, correspondence and reports relating to Kohler's extensive activities on behalf of liberal immigration and naturalization laws in the United States, his opposition to the registration of aliens, the problems of Chinese immigration to the United States, his opposition to the use of the term "Hebrew Race" in the classification of immigrants, the drafting of minority clauses at the Paris Peace Conference in 1919, Jewish and Christian relations in the U.S., and the condition of Jews in Russia, Roumania, Poland and Nazi-Germany with the following institutions: the American Civil Liberties Union, 1926-1934, the American Jewish Committee, 1909-1934, B'nai Brith, 1930-1933, the Union of American Hebrew Congregations - Board of Delegates on Civil Rights, the Committee on Ellis Island, the Foreign Language Information Service, the Hebrew Benevolent Society of Baltimore, the Hebrew Sheltering and Immigrant Aid Society, the Jewish Immigrants' Information Bureau in Galveston, Texas, the Industrial Removal Office, the National Conference of Jews and Christians, the National Council of Jewish Women, the National Council on Naturalization and Citizenship, the Bureau of Immigration to the United States Department of Laborm the United States Department of Commerce and Labor, the Department of State and individual United States Congressmen.

Editorial of "International Journal of Critical Indigenous Studies Volume 3, Number 2, 2010"

In this of the International Journal of Critical Indigenous Studies, the articles reveal how competing economies of knowledge, capital and values are operationalised through colonising power within inter-subjective relations. Writing in the Australian context, Greg Blyton demonstrates how tobacco was used by colonists as a means of control and exchange in their relations with Indigenous people. He focuses on the Hunter region of New South Wales, Australia, in the early to mid-nineteenth century to reveal how colonists exchanged tobacco for food, safe passage and Indigenous services. Blyton suggests that these colonial practices enabled tobacco addiction to spread throughout the region, passing from one generation of Indigenous people to another. He asks us to consider the link between the colonial generation of Indigenous tobacco consumption and addiction, and Indigenous mortality rates today whereby twenty percent of deaths are attributed to smoking.