Dietetic practice by Australian and Canadian dietitians with people with Parkinson's disease

Although Parkinson’s disease (PD) is a complex disease for which appropriate nutrition management is important, limited evidence is currently available to support dietetic practice. Existing PD-specific guidelines do not span all phases of the Nutrition Care Process (NCP). This study aimed to document PD-specific nutrition management practice by Australian and Canadian dietitians. DAA members and PEN subscribers were invited to participate in an online survey (late 2011). Eighty-four dietitians responded (79.8% Australian). The majority (70.2%) worked in the clinical setting. Existing non-PD guidelines were used by 52.4% while 53.6% relied on self-initiated literature reviews. Weight loss/malnutrition, protein intake, dysphagia and constipation were common issues in all NCP phases. Respondents also requested more information/evidence for these topics. Malnutrition screening (82.1%) and assessment (85.7%) were routinely performed. One-third did not receive referrals for weight loss for overweight/obesity. Protein intake meeting gender/age recommendations (69.0%), and high energy/high protein diets to manage malnutrition (82.1%) were most commonly used. Constipation management was through high fibre diets (86.9%). Recommendations for spacing of meals and PD medications varied with 34.5% not making recommendations. Nutritional diagnosis (70.2%) and stage of disease (61.9%) guided monitoring frequency. Common outcome measures included appropriate weight change (97.6%) and regular bowel movements (88.1%). With limited PD-specific guidance, dietitians applied best available evidence for other groups with similar issues. Dietitians requested evidence-based guidelines specifically for the nutritional management of PD. Guideline development should focus on those areas reported as commonly encountered. This process can identify the gaps in evidence to guide future research.

Mouse estrous cycle regulation of vaginal versus uterine cytokines, chemokines, α-/β-defensins and TLRs

This study investigates the cyclic changes in innate immunity in the female reproductive tract (FRT) of mice during the estrous cycle. By examining uterine and vaginal tissues and secretions we show that innate immunity varies with the stage of the estrous cycle and site in the FRT. Secretions from the uterine lumen contained cytokines and chemokines that were significantly higher at proestrus and estrus relative to that measured at diestrus. In contrast, analysis of vaginal secretions indicated that only IL-1β and CXCL1/mouse KC changed during the cycle, with highest levels measured at diestrus and estrus. In contrast, vaginal α-defensin 2 and β-defensins 1-4 mRNA levels peaked at proestrus and estrus and are expressed 1-4 logs greater than that seen in the uterus. These studies further indicate that TLR5 and TLR12 in the uterus, and TLR1, TLR2, TLR5 and TLR13 in the vagina varies with stage of the estrous cycle, with some peaking at proestrus/estrus and others at diestrus. Overall, these studies indicate that innate immune parameters in the uterus and vagina are separate and discrete, and regulated precisely during the estrous cycle.

Innate and adaptive immunity at mucosal surfaces of the female reproductive tract : stratification and integration of immune protection against the transmission of sexually transmitted infections

This review examines the multiple levels of pre-existing immunity in the upper and lower female reproductive tract. In addition, we highlight the need for further research of innate and adaptive immune protection of mucosal surfaces in the female reproductive tract. Innate mechanisms include the mucus lining, a tight epithelial barrier and the secretion of antimicrobial peptides and cytokines by epithelial and innate immune cells. Stimulation of the innate immune system also serves to bridge the adaptive arm resulting in the generation of pathogen-specific humoral and cell-mediated immunity. Less understood are the multiple components that act in a coordinated way to provide a network of ongoing protection. Innate and adaptive immunity in the human female reproductive tract are influenced by the stage of menstrual cycle and are directly regulated by the sex steroid hormones, progesterone and estradiol. Furthermore, the effect of hormones on immunity is mediated both directly on immune and epithelial cells and indirectly by stimulating growth factor secretion from stromal cells. The goal of this review is to focus on the diverse aspects of the innate and adaptive immune systems that contribute to a unique network of protection throughout the female reproductive tract.

Sex hormone regulation of innate immunity in the female reproductive tract : the role of epithelial cells in balancing reproductive potential with protection against sexually transmitted pathogens

The immune system in the female reproductive tract (FRT) does not mount an attack against HIV or other sexually transmitted infections (STI) with a single endogenously produced microbicide or with a single arm of the immune system. Instead, the body deploys dozens of innate antimicrobials to the secretions of the female reproductive tract. Working together, these antimicrobials along with mucosal antibodies attack many different viral, bacterial and fungal targets. Within the FRT, the unique challenges of protection against sexually transmitted pathogens coupled with the need to sustain the development of an allogeneic fetus have evolved in such a way that sex hormones precisely regulate immune function to accomplish both tasks. The studies presented in this review demonstrate that estradiol and progesterone secreted during the menstrual cycle act both directly and indirectly on epithelial cells and other immune cells in the reproductive tract to modify immune function in a way that is unique to specific sites throughout the FRT. As presented in this review, studies from our laboratory and others demonstrate that the innate immune response is under hormonal control, varies with the stage of the menstrual cycle, and as such is suppressed at mid-cycle to optimize conditions for successful fertilization and pregnancy. In doing so, a window of STI vulnerability is created during which potential pathogens including HIV enter the reproductive tract to infect host targets.

Bayesian inference of traffic volumes based on Bluetooth data

The study of the relationship between macroscopic traffic parameters, such as flow, speed and travel time, is essential to the understanding of the behaviour of freeway and arterial roads. However, the temporal dynamics of these parameters are difficult to model, especially for arterial roads, where the process of traffic change is driven by a variety of variables. The introduction of the Bluetooth technology into the transportation area has proven exceptionally useful for monitoring vehicular traffic, as it allows reliable estimation of travel times and traffic demands. In this work, we propose an approach based on Bayesian networks for analyzing and predicting the complex dynamics of flow or volume, based on travel time observations from Bluetooth sensors. The spatio-temporal relationship between volume and travel time is captured through a first-order transition model, and a univariate Gaussian sensor model. The two models are trained and tested on travel time and volume data, from an arterial link, collected over a period of six days. To reduce the computational costs of the inference tasks, volume is converted into a discrete variable. The discretization process is carried out through a Self-Organizing Map. Preliminary results show that a simple Bayesian network can effectively estimate and predict the complex temporal dynamics of arterial volumes from the travel time data. Not only is the model well suited to produce posterior distributions over single past, current and future states; but it also allows computing the estimations of joint distributions, over sequences of states. Furthermore, the Bayesian network can achieve excellent prediction, even when the stream of travel time observation is partially incomplete.

GIS and qualitative data on young mothers’ use of urban neighbourhoods for physical activity

Public health research consistently demonstrates the salience of neighbourhood as a determinant of both health-related behaviours and outcomes across the human life course. This paper will report on the findings from a mixed-methods Brisbane-based study that explores how mothers with primary school children from both high and low socioeconomic suburbs use the local urban environment for the purpose of physical activity. Firstly, we demonstrate findings from an innovative methodology using the geographic information systems (GIS) embedded in social media platforms on mobile phones to track locations, resource-use, distances travelled, and modes of transport of the families in real-time; and secondly, we report on qualitative data that provides insight into reasons for differential use of the environment by both groups. Spatial/mapping and statistical data showed that while the mothers from both groups demonstrated similar daily routines, the mothers from the high SEP suburb engaged in increased levels of physical activity, travelled less frequently and less distance by car, and walked more for transport. The qualitative data revealed differences in the psychosocial processes and characteristics of the households and neighbourhoods of the respective groups, with mothers in the lower SEP suburb reporting more stress, higher conflict, and lower quality relationships with neighbours.

Greener workplace : understanding senior management's adoption decisions through the Theory of Planned Behaviour

Human Resources (HR) policies and practices have changed due to global environmental instability. These policies and practices are key factors for successful environmental management. Using the Theory of Planned Behaviour, this article aims to understand the critical factors which influence senior management’s decision to adopt ‘green’ HR practices. Data were collected from 210 organisations in Australia using two separate surveys. Survey one, which was addressed directly to HR managers and directors, contained questions relating to HR policies (the dependent variables), while survey two, which was addressed directly to CEOs and senior managers, contained questions about environmental-related attitudes, subjective norms and perceived control (the independent variables). Results indicated that senior management’s environmental-related attitudes, subjective norms from stakeholders and perceived green resource readiness influenced their decision to adopt green HR initiatives. However, attitudes and green resource readiness in particular had greater impacts than subjective norms. Limitations, implications and future research are also outlined.

The changing motivations of students’ use of lecture podcasts across a semester: An extended theory of planned behaviour approach

We extended the previous work of Moss, O’Connor and White, to include a measure of group norms within the theory of planned behaviour (TPB), to examine the influences on students’ decisions to use lecture podcasts as part of their learning. Participants (N = 90) completed the extended TPB predictors before semester began (Time 1) and mid-semester (Time 2) and reported on their podcast use at mid-semester (Time 2) and end of semester (Time 3). We found that attitudes and perceived social pressures were important in informing intentions at both time points. At Time 1, perceptions of control over performing the behaviour and, at Time 2, perceptions of whether podcast use was normative among fellow students (group norms) also predicted intended podcast use. Intentions to use podcasting predicted self-reported use at both Time 2 and Time 3. These results provide important applied information for educators to encourage student use of novel on-line educational tools.

Study protocol : a randomised controlled trial of a theory-based online intervention to improve sun safety among Australian adults

Background The effects of exposure to ultraviolet radiation are a significant concern in Australia which has one of the highest incidences of skin cancer in the world. Despite most skin cancers being preventable by encouraging consistent adoption of sun-protective behaviours, incidence rates are not decreasing. There is a dearth of research examining the factors involved in engaging in sun-protective behaviours. Further, online multi-behavioural theory-based interventions have yet to be explored fully as a medium for improving sun-protective behaviour in adults. This paper presents the study protocol of a randomised controlled trial of an online intervention based on the Theory of Planned Behaviour (TPB) that aims to improve sun safety among Australian adults. Methods/Design Approximately 420 adults aged 18 and over and predominantly from Queensland, Australia, will be recruited and randomised to the intervention (n = 200), information only (n = 200) or the control group (n = 20). The intervention focuses on encouraging supportive attitudes and beliefs toward sun-protective behaviour, fostering perceptions of normative support for sun protection, and increasing perceptions of control/self-efficacy over sun protection. The intervention will be delivered online over a single session. Data will be collected immediately prior to the intervention (Time 1), immediately following the intervention (Time 1b), and one week (Time 2) and one month (Time 3) post-intervention. Primary outcomes are intentions to sun protect and sun-protective behaviour. Secondary outcomes are the participants’ attitudes toward sun protection, perceptions of normative support for sun protection (i.e. subjective norms, group norms, personal norms and image norms) and perceptions of control/self-efficacy toward sun protection. Discussion The study will contribute to an understanding of the effectiveness of a TPB-based online intervention to improve Australian adults’ sun-protective behaviour. Trials registry Australian and New Zealand Trials Registry number ACTRN12613000470796

Looking back : students' perceptions of the relative enjoyment of primary and secondary school science

This paper reports and discusses a contentious result from an Australia-wide study of the influences on students' decisions about taking senior science subjects. As part of the Choosing Science study (Lyons and Quinn 2010) 3759 Year 10 students were asked to indicate which stage of their schooling (lower primary, upper primary, lower secondary, middle secondary) they had most enjoyed learning science. Crosstabulations of responses revealed that around 78% of students indicated that they had enjoyed learning science more in secondary than in primary school, and 55% enjoyed it the most during Years 9 and 10. The perception that school science was more enjoyable in high school was also found among students who did not intend taking science in Year 11, though to a lesser extent. These findings are unexpected and significant, challenging the prevailing view that enjoyment of school science steadily declines after primary school. The paper elaborates on the findings and suggests that the different conclusions arrived at by studies in this field may be due to the different methodologies employed.

Creation of a new evaluation benchmark for information retrieval targeting patient information needs

Searching for health advice on the web is becoming increasingly common. Because of the great importance of this activity for patients and clinicians and the effect that incorrect information may have on health outcomes, it is critical to present relevant and valuable information to a searcher. Previous evaluation campaigns on health information retrieval (IR) have provided benchmarks that have been widely used to improve health IR and record these improvements. However, in general these benchmarks have targeted the specialised information needs of physicians and other healthcare workers. In this paper, we describe the development of a new collection for evaluation of effectiveness in IR seeking to satisfy the health information needs of patients. Our methodology features a novel way to create statements of patients’ information needs using realistic short queries associated with patient discharge summaries, which provide details of patient disorders. We adopt a scenario where the patient then creates a query to seek information relating to these disorders. Thus, discharge summaries provide us with a means to create contextually driven search statements, since they may include details on the stage of the disease, family history etc. The collection will be used for the first time as part of the ShARe/-CLEF 2013 eHealth Evaluation Lab, which focuses on natural language processing and IR for clinical care.

Culture makes you stronger : Aboriginal women’s voices from the South Coast of NSW

This paper will describe a community based research project examining the health and wellbeing of a sample of Aboriginal women in Australia, and present preliminary findings of a community needs analysis. The Shoalhaven Koori Women’s Study (SKWS) is being led by an Aboriginal woman based within Waminda, an Aboriginal women’s community controlled service located on the South Coast of NSW. The community needs analysis is the first stage of the SKWS, and aims to explore Aboriginal women’s perceptions and experiences of wellness and wellbeing, including issues related to their personal strengths, health and social priorities, support needs and that of their families. Thirty Aboriginal women were interviewed using a survey that included closed and open ended questions. Methods used to administer the survey included yarning and Dadirri (deep listening), two valid and culturally safe approaches for data collection with Aboriginal people. Adopting these approaches ensured Aboriginal protocols were maintained and upheld throughout the research process. This enabled scientific rigour while also ensuring activities were culturally safe. Key findings of the survey will be presented, and how Waminda is modifying service delivery to better respond to the health and social priorities of Aboriginal women in the Shoalhaven region will be discussed. Community feedback of survey results will occur to validate the analysis from the community perspective.

Physical activity and determinants of physical activity in obese and non-obese children

OBJECTIVE To compare the physical activity (PA) patterns and the hypothesized psychosocial and environmental determinants of PA in an ethnically diverse sample of obese and non-obese middle school children. DESIGN Cross-sectional study. SUBJECTS One-hundred and thirty-three non-obese and 54 obese sixth grade children (mean age of 11.4 +/-0.6). Obesity status determined using the age-, race- and gender-specific 95th percentile for BMI from NHANES-1. MEASUREMENTS Objective measurements were collected of PA over a 7-day period using the CSA 7164 accelerometer: total daily counts; daily moderate (3-5.9 METs) physical activity (MPA); daily vigorous physical activity (greater than or equal to 6 METs; VPA); and weekly number of 5, 10 and 20 min bouts of moderate-to-vigorous physical activity (greater than or equal to 3 METs, MVPA). Self-report measures were collected of PA self-efficacy; social influences regarding PA, beliefs about PA outcomes; perceived PA levels of parents and peers, access to sporting and/or fitness equipment at home, involvement in community-based PA organizations; participation in community sports teams; and hours spent watching television or playing video games. RESULTS Compared to their non-obese counterparts, obese children exhibited significantly lower daily accumulations of total counts, MPA and VPA as well as significantly fewer 5, 10 and 20 min bouts of MVPA. Obese children reported significantly lower levels of PA self-efficacy, were involved in significantly fewer community organizations promoting PA and were significantly less likely to report their father or male guardian as physically active. CONCLUSIONS The results are consistent with the hypothesis that physical inactivity is an important contributing factor in the maintenance of childhood obesity. Interventions to promote PA in obese children should endeavor to boost self-efficacy perceptions regarding exercise, increase awareness of, and access to, community PA outlets, and increase parental modeling of PA.

Determinants of physical activity in middle school children

Objective To evaluate the theory of reasoned action (TRA) and planned behavior (TPB) in predicting moderate-to-vigorous physical activity (MVPA) in sixth-grade youth. Methods One hundred ninety-eight students completed a questionnaire measuring attitudes, subjective norms, perceived behavioral control, and intentions to be active. MVPA was measured using the CSA 7,164 accelerometer. Results Although demonstrating an acceptable fit, the TRA and TPB accounted for only a small percentage of the variance in MVPA. In support of the TPB: the addition: of control perceptions to the reasoned! action model! added to the prediction of intentions and MVPA. Conclusion Within our sample of sixth graders, the utility of the, TRA or TPB;as a framework for activity interventions appears to be limited.

Determinants of physical activity in Singaporean adolescents

Backgroun An understanding of the factors that influence physical activity behavior is an important prerequisite for the design and implementation of physical activity interventions in adolescents. To date, no studies have investigated the factors that influence physical activity participation in Singaporean adolescents. Purpose he purpose of this study was to identify the psychosocial and environmental factors that influence physical activity in a representative sample of Singaporean adolescents (N=1,814, 919 boys, 895 girls, mean age 14.4 +/- 1.1 years). Methods Participants completed the Three-Day Physical Activity Recall and a questionnaire measuring hypothesized psychosocial and environmental correlates of physical activity. Results Hierarchical regression revealed self-efficacy, enjoyment of physical activity, parental support, and participation in sport teams to be significant correlates of physical activity. Conclusion Interventions promoting physical activity in Singaporean adolescents should aim to increase self-efficacy perceptions by offering enjoyable, developmentally appropriate physical activity options that promote mastery and adopt policies that increase parental support and awareness of community physical activity programs.