Inequalities in diet and nutrition

The inequality of nutrition and obesity re-focuses concern on who in society is consuming the worst diet. Identification of individuals with the worst of dietary habits permits for targeting interventions to assuage obesity among the population segment where it is most prevalent. We argue that the use of fiscal interventions does not appropriately take into account the economic, social and health circumstances of the intended beneficiaries of the policy. This paper reviews the influence of socio-demographic factors on nutrition and health status and considers the impacts of nutrition policy across the population drawing on methodologies from both public health and welfare economics. The effects of a fat tax on diet are found to be small and while other studies show that fat taxes saves lives, we show that average levels of disease risk do not change much: those consuming particularly bad diets continue to do so. Our results also suggest that the regressivity of the policy increases as the tax becomes focused on products with high saturated fat contents. A fiscally neutral policy that combines the fat tax with a subsidy on fruit and vegetables is actually more regressive because consumption of these foods tends to be concentrated in socially undeserving households. We argue that when inequality is of concern, population-based measures must reflect this and approaches that target vulnerable populations which have a shared propensity to adopt unhealthy behaviours are appropriate.

Understanding the barriers to real estate investment in developing economies

Baum (2008a) related the number of real estate funds investing in developing economies to simple economic and demographic variables, and showed that, while the popularity of markets was explained by population and GDP per capita, some countries receive more or less investment than the model predicted. Why is this? In this paper we undertake a literature review to identify the barriers which inhibit international real estate investment. We test our initial findings by questioning property investment professionals through semi-structured interviews. By doing this we were able to verify our list of barriers, identify those barriers which are most likely to affect real estate investors, and to indicate whether there are any real estate-specific variables that create barriers which have not received any academic attention. We show that distortions in international capital flows may be explained by a combination of these formal and informal barriers.

Food health claims – What consumers understand

Issues pertaining to consumer understanding of food health claims are complex and difficult to disentangle because there is a surprising lack of multidisciplinary research aimed at evaluating how consumers are influenced by factors impacting on the evaluation process. In the EU, current legislation is designed to protect consumers from misleading and false claims but there is much debate about the concept of the ‘average consumer’ referred to in the legislation. This review provides an overview of the current legislative framework, discusses the concept of the ‘average consumer’ and brings together findings on consumer understanding from an international perspective. It examines factors related to the personal characteristics of individuals such as socio-demographic status, knowledge, and attitudes, and factors pertaining to food and food supplement products such as the wording of claims and the communication of the strength and consistency of the scientific evidence. As well as providing insights for future research, the conclusions highlight the importance of enhancing the communication of scientific evidence to improve consumer understanding of food health claims.

The relationship between entrepreneurial marketing and the characteristics of Thai hotels and their managers

Purpose – The purpose of this paper is to explore empirically whether there are meaningful relationships between key entrepreneurial marketing (EM) variables and the demographic characteristics of the organization and its manager. Design/methodology/approach – The data were gathered from a sample of 369 hotels from all regions of Thailand through the use of a postal survey. Several multiple regression models were used to test the relationships in the study. Interaction terms were added to some models to test the moderating effects of major demographic variables on various EM attributes. Findings – The study shows which types of hotels and which types of managers were associated with EM characteristics. The results indicate that demographic characteristics, such as age, size, location, experience, and gender, significantly explain sets of entrepreneurial marketing variables. It was found, for instance, that both a young hotel and a large hotel are positively associated with entrepreneurial marketing, while owner management is positively associated with market orientation and negatively associated with growth aspirations but has no significant relationship with entrepreneurial orientation. Originality/value – The paper provides a comprehensive overview of selected relationships between key EM dimensions in the existing literature. It is suggested that future research involves a more in-depth exploration of some of the relationships found in this study.

Profile of European adults interested in internet-based personalized nutrition: The Food4Me Study

Purpose Personalised intervention may have greater potential for reducing the global burden of non-communicable diseases and for promoting better health and wellbeing across the life-span than the conventional “one size fits all” approach. However, the characteristics of individuals interested in personalised nutrition (PN) are unclear. Therefore, the aim of this study was to describe the characteristics of European adults interested in taking part in an internet-based PN study. Methods Individuals from seven European countries (UK, Ireland, Germany, the Netherlands, Spain, Greece and Poland) were invited to participate in the study via the Food4Me website (http://www.food4me.org). Two screening questionnaires were used to collect data on socio-demographic, anthropometric and health characteristics as well as dietary intakes. Results A total of 5662 individuals expressed an interest in the study (mean age 40 ± 12.7; range 15-87 years). Of these 64.6% were female and 96.9% were Caucasian. Overall, 12.9% were smokers and 46.8% reported the presence of a clinically diagnosed disease. Furthermore, 46.9% were overweight or obese and 34.9% were sedentary during leisure time. Assessment of dietary intakes showed that 54.3% of individuals reported consuming at least 5 portions of fruit and vegetables per day, 45.9% consumed more than 3 servings of wholegrains and 37.2% limited their salt intake to less than 5.75g per day. Conclusions Our data indicate that individuals volunteering to participate in an internet-based PN study are broadly representative of the European adult population, most of whom had adequate nutrient intakes but who could benefit from improved dietary choices and greater physical activity. Future use of internet-based PN approaches is thus relevant to a wide target audience.

Cancer patients taking herbal medicines: a review of clinical purposes, associated factors, and perceptions of benefit or harm

Ethnopharmacological relevance: Cancer patients in all cultures are high consumers of herbal medicines (HMs) usually as part of a regime consisting of several complementary and alternative medicine (CAM) modalities, but the type of patient, the reasons for choosing such HM-CAM regimes, and the benefits they perceive from taking them are poorly understood. There are also concerns that local information may be ignored due to language issues. This study investigates aspects of HM-CAM use in cancer patients using two different abstracting sources: Medline, which contains only peer-reviewed studies from SCI journals, and in order to explore whether further data may be available regionally, the Thai national databases of HM and CAM were searched as an example. Materials and methods: the international and Thai language databases were searched separately to identify relevant studies, using key words chosen to include HM use in all traditions. Analysis of these was undertaken to identify socio-demographic and clinical factors, as well as sources of information, which may inform the decision to use HMs. Results: Medline yielded 5,638 records, with 49 papers fitting the criteria for review. The Thai databases yielded 155, with none relevant for review. Factors associated with HM-CAM usage were: a younger age, higher education or economic status, multiple chemotherapy treatment, late stage of disease. The most common purposes for using HM-CAM cited by patients were to improve physical symptoms, support emotional health, stimulate the immune system, improve quality of life, and relieve side-effects of conventional treatment. Conclusions: Several indicators were identified for cancer patients who are most likely to take HM-CAM. However, interpreting the clinical reasons why patients decide to use HM-CAM is hampered by a lack of standard terminology and thematic coding, because patients' own descriptions are too variable and overlapping for meaningful comparison. Nevertheless, fears that the results of local studies published regionally are being missed, at least in the case of Thailand, appeared to be unfounded.

Prevalence and severity of dental caries in schoolchildren of Porto, Portugal

Objectives: To measure the prevalence and severity of dental caries in adolescents of the city of Porto, Portugal, and to assess socioeconomic and behavioural covariates of dental caries experience. Methods: A sample of 700 thirteen-year-old schoolchildren was examined. Results from the dental examination were linked to anthropometric information and to data supplied by two structured questionnaires assessing nutritional factors, socio-demographic characteristics and behaviour related to health promotion. Dental caries was measured using the DMFT index, and two dichotomous outcomes, one assessing the prevalence of dental caries (DMFT>0); the other assessing the prevalence of a high level of dental caries (DMFT=4). Results: Consuming soft drinks derived from cola (irrespective of sugared or diet) two or more times per week, attending a public school, being female and having parents with low educational attainment were identified as risk factors both for having dental caries and for having a high level of dental caries. Conclusion: Caries levels were positively associated with frequency of intake of sweetened foods and drinks.

Untreated dental caries in children with cerebral palsy in the Brazilian context

Objectives. To assess the prevalence of untreated dental caries in children with cerebral palsy and to assess socio-demographic, behavioural, and clinical covariates. Design. Cross-sectional assessment of 200 children and adolescents with cerebral palsy (2-17 years old) enrolled in a specialized healthcare unit in Sao Paulo, Brazil. The dental examination followed the World Health Organization`s guidelines for oral health surveys; familial caretakers informed on socio-economic status and behaviour; the patient`s medical record informed their clinical status. Results. The proportion of children that presented at least one tooth affected by untreated caries was 49.5%. Poor socio-economic standings and a higher frequency of sugar consumption associated with a worse profile of dental health; different types of cerebral palsy (spastic, tetraparesis) did not. The prevalence of untreated caries was higher than reference values assessed for the overall population of the same age range. Conclusions. The high burden of untreated dental caries on cerebral palsy patients reinforces the importance of the dentist in the interdisciplinary healthcare team attending these children. Factors associated with this outcome are the same for the general population; these findings underscore the necessity of implementing effective caries prevention in this population of cerebral palsy children.

A PCR-RFLP assay for gender assignment in the three-toed sloths (Bradypus, Pilosa, Bradypodidae)

The three-toed sloths (Bradypus) are slow-moving arboreal neotropical mammals. Understanding demographic variables (such as sex ratio) of populations is a key for conservation purposes. Nevertheless, gender assignment of Bradypus is particularly challenging because of the lack of sexual dimorphism in infants and in adults, particularly B. torquatus, the most endangered of the three-toed sloths, in which sex is attributed by visual observation of the reproductively active males. Here, we standardized a method for sexing Bradypus individuals using PCR-RFLP of sex-linked genes ZFX/ZFY. This assay was validated with known-gender animals and proved accurate to assign gender on three Bradypus species.

Clinical significance of lifetime panic disorder in the course of bipolar disorder type I

Objectives: The aim of the study was to analyze the impact of lifetime panic disorder (PD) diagnosis in a sample of patients with bipolar disorder type I (BPI), evaluating clinical and demographic variables. Methods: Ninety-five outpatients from the Bipolar Disorder Research Program at the Institute of Psychiatry of the University of Sao Paulo Medical School were enrolled. Twenty-seven BPI patients with PD were compared to 68 BPI patients without any anxiety disorders regarding clinical and demographic variables. Results: Compared to BPI patients without any anxiety disorders, patients with BPI + PD presented significantly higher number of mood episodes (18.9 +/- 13.8 vs 8.5 +/- 7.8; P < .001), depressive episodes (10.8 +/- 8.2 vs 4.6 +/- 4,8; P = .001), and manic episodes (7.4 +/- 7.3 vs 3.6 +/- 3.6; P = .008). Patients with BPI + PD had more frequently a depressive episode as their first one compared to BPI patients without anxiety disorders (94.1% vs 57.5%; P = .011). Patients with BPI + PD had more comorbidity with lifetime diagnosis of drug abuse or dependence (33.3% vs 8.8%; P = .010) and eating disorders (29.6% vs 6.0%; P = .004). Conclusions: The higher number of mood episodes in general presented by patients with BPI + PD when compared with BPI patients without any anxiety disorders, along with the higher frequencies of drug misuse and eating disorders, indicates that PD comorbidity is associated with a poorer Course and outcome of BPI. The higher frequency of depression as the onset mood episode and the higher number of manic episodes in the group with PD may have important treatment implications and should be further investigated. (C) 2009 Elsevier Inc. All rights reserved.

PAIN IN FIBROMYALGIA AND DISCRIMINATIVE POWER OF THE INSTRUMENTS: VISUAL ANALOG SCALE, DOLORIMETRY AND THE MCGILL PAIN QUESTIONNAIRE

Objective: The aim of this study was to verify the discriminative power of the most widely used pain assessment instruments. Methods: The sample consisted of 279 subjects divided into Fibromyalgia Group (FM- 205 patients with fibromyalgia) and Control Group (CG-74 healthy subjects), mean age 49.29 +/- 10.76 years. Only 9 subjects were male, 6 in FM and 3 in CG. FM were outpatients from the Rheumatology Clinic of the University of Sao Paulo - Hospital das Clinicas (HCFMUSP); the CG included people accompanying patients and hospital staff with similar socio-demographic characteristics. Three instruments were used to assess pain: the McGill Pain Questionnaire (MPQ), the Visual Analog Scale (VAS), and the Dolorimetry, to measure pain threshold on tender points (generating the TP index). In order to assess the discriminative power of the instruments, the measurements obtained were submitted to descriptive analysis and inferential analysis using ROC Curve - sensibility (S), specificity (S I) and area under the curve (AUC) - and Contingence tables with Chi-square Test and odds ratio. Significance level was 0.05. Results: Higher sensibility, specificity and area under the curve was obtained by VAS (80%, 80% and 0.864, respectively), followed by Dolorimetry (S 77%, S177% and AUC 0.851), McGill Sensory (S 72%, S167% and AUC 0.765) and McGill Affective (S 69%, S1 67% and AUC 0.753). Conclusions: VAS presented the higher sensibility, specificity and AUC, showing the greatest discriminative power among the instruments. However, these values are considerably similar to those of Dolorimetry.

Childbirth self-efficacy inventory in Tanzania : a pilot study

Background. To give birth can be a stressful experience and women cope with thisstress in many different ways and have different personal outcomes. Self-efficacy orconfidence in ability to cope with labour can be considered as an important factoraffecting pregnant women’s motivation of normal childbirth and their interpretation ofthe childbirth event.The aim. The purpose of this study was to test the Chinese short form of theinstrument Childbirth self-efficacy instrument (CBSEI) in Tanzania, that measurepregnant women’s self-confidence and coping abilities during childbirth.Method. The Chinese short form of the CBSEI was used to pilot test the pregnantwomen’s confidence of childbirth to see if the questions were understood in theTanzanian culture. Besides this instrument socio-demographic data was collectedtogether with two open questions asking about attitudes and experiences of childbirth.The instrument was translated into Kiswahili. A sample of 60 pregnant women whowere visiting antenatal clinic (ANC) regularly were asked to participate and with helpfrom midwifes at two ANC places the questionnaires were filled out.Result. The result shows that the validity and reliability of the two subscales OE-16and EE-16 were established. The internal consistency reliability of the two subscaleswere high, suggesting that each of the subscale mean score provides a good overviewof self- reported belief in coping ability for childbirth.The results further show that the instrument, CBSEI in this pilot study is not able toidentify women who need extra support during childbirth.Conclusion. The reliability and validity of information presented in this pilot studysupport the use of the Chinese short form of the CBSEI as a research instrument in theTanzania culture. Further studies are recommended to get a wider understandingabout women’s coping abilities in a culture like Tanzania.

Os "sentidos do trabalho" em duas visões: São Paulo e Paris

Este relatório é o resultado de uma pesquisa exploratória sobre os sentidos do trabalho .O objetivo da pesquisa foi o de fazer uma sondagem de opinião, isto é, investigar, globalmente, os sentidos do trabalho para duas amostras de população oriundas de duas empresas distintas, de mesmo ramo de atividades. A sondagem foi feita através de um questionário composto de 36 questões com temas relativos à percepção do trabalho, seus significados e impactos sobre a saúde e a qualidade de vida, além de dados sócio-demográficos das pessoas que fizeram parte do estudo. O que é o Trabalho? e O que você pensa sobre do seu trabalho atual? foram as questões centrais de pesquisa, analisadas neste relatório. Elas foram propostas para uma amostra de funcionários de uma empresa pública de serviços localizada na Região Parisiense e para uma amostra de funcionários de uma empresa pública de serviços, localizada na Região Metropolitana de São Paulo e de atividades semelhantes. Uma abordagem comparativa São Paulo / Paris foi feita sobre a importância do trabalho e semelhanças e diferenças foram apontadas para as amostras analisadas, tanto globalmente, quanto divididas por sexo. Os dados foram tratados através do programa estatístico SPSS (Statistical Package for Social Science) e as duas questões principais, através de Análises Fatoriais. As análises fatoriais das duas principais questões permitiram condensar e resumir dados dos diversos itens das questões, possibilitando a obtenção de dimensões latentes agrupadas em fatores. A análise fatorial foi utilizada em uma perspectiva exploratória.

Fatores relevantes na geração de valor da marca PETROBRAS - um estudo com consumidores do segmento de combustíveis

The main purpose of this study is identify and select the assessment indicators for Brand Equity (BE), in the fuels segment. Within this perspective, we have chosen to assess the influences based on the following attributes: Brand Loyalty (Lealdade à Marca ( LM), Brand Recognition (Conhecimento da Marca ( CM), Perceived Quality (Qualidade Percebida ( QP) and Brand Associations (Associações à Marca ( AM), through perception of consumers in Rio de Janeiro and São Paulo States. Based on deep interviews in the qualitative phase and in surveys, in the quantitative phase, we began the data analysis through Multiple Linear Regression, according to Atilgan et al. (2005) model and Ha (1996). In the first model, the (CM) was considered non-explanatory to (BE¿, and we¿ve chosen to remove it from the following study model. In the final model, besides remaining variables, demographic variables were included, such as: Family Income (Renda Familiar ( RF) and Federation State (Estado da Federação ( EF), as independent variables. The main relevant findings, through perception of consumers, indicated that the (BE) of company analyzed was better ranked in Rio de Janeiro than in São Paulo and, as for the income, higher level classes tend to have less understanding on the value of (BE) of Petrobras BR. The study finish with mentions the contribution of the research and management implication, as well as limitations and suggestions to further researchers.

Capitanias hereditárias: herança colonial sobre desigualdade e instituições

Este trabalho tem como objetivo analisar em que aspectos a desigualdade histórica de formação dos municípios brasileiros foi determinante para as suas condições atuais de desigualdade de terra e renda e sobre qualidade das instituições. Em particular, emprega-se área, latitude, longitude e a data de fundação das Capitanias Hereditárias como determinantes históricos para as instituições atuais dos municípios brasileiros. Considerando controles, tais como área proporcional da capitania, ano de fundação do município, distância de Portugal, tipo de solo, quantidade de chuva, altitude, temperatura média, e variáveis sócio-econômicas municipais, os resultados sugerem que a herança colonial deixada pelas Capitanias Hereditárias foi maior concentração de terras. O resultado é robusto à inclusão de variáveis que capturam o ciclo da cana-de-açúcar, do ouro e efeitos estaduais. Além disso, estima-se efeito ambíguo sobre instituições para os municípios do país.