Relating food literacy to nutrition and health

This chapter describes the evolution of a model to propose the relationship between food literacy and nutrition. This model can also be used as a framework for program planning, implementation and evaluation. Practitioners and policy makers invest in food literacy with outcome expectations beyond diet quality. For this reason, a second model was developed to conceptualise the role of food literacy with respect to food security, body weight and chronic disease risk. This second model is useful in positioning food literacy within multi-strategic public health nutrition and chronic disease plans.

Is the mental wellbeing of young Australians best represented by a single, multidimensional or bifactor model?

Internationally there is a growing interest in the mental wellbeing of young people. However, it is unclear whether mental wellbeing is best conceptualized as a general wellbeing factor or a multidimensional construct. This paper investigated whether mental wellbeing, measured by the Mental Health Continuum-Short Form (MHC-SF), is best represented by: (1) a single-factor general model; (2) a three-factor multidimensional model or (3) a combination of both (bifactor model). 2,220 young Australians aged between 16 and 25 years completed an online survey including the MHC-SF and a range of other wellbeing and mental ill-health measures. Exploratory factor analysis supported a bifactor solution, comprised of a general wellbeing factor, and specific group factors of psychological, social and emotional wellbeing. Confirmatory factor analysis indicated that the bifactor model had a better fit than competing single and three-factor models. The MHC-SF total score was more strongly associated with other wellbeing and mental ill-health measures than the social, emotional or psychological subscale scores. Findings indicate that the mental wellbeing of young people is best conceptualized as an overarching latent construct (general wellbeing) to which emotional, social and psychological domains contribute. The MHC-SF total score is a valid and reliable measure of this general wellbeing factor.

A model of factors that influence meeting the needs of family with a relative in ICU

This thesis developed a model of factors that influence meeting the needs of family with a relative admitted to an adult intensive care unit. The results from the model indicate that several variables are significant in meeting the needs of families in ICU. The factors identified in this study should be considered when planning future intervention studies or implementing interventions into ICU clinical practice. Meeting the needs of families is an integral part of caring for a critically ill patient. ICU staff can minimise this stressful time for relatives by anticipating and addressing family needs.

Child sexual abuse: Raising awareness and empathy is essential to promote new public health responses

Child sexual abuse is a major global public health concern, affecting one in eight children and causing massive costs including depression, unwanted pregnancy and HIV. The gravity of this global issue is reflected by the United Nations’ new effort to respond to sexual abuse in the 2015 Sustainable Development Goals. The fundamental policy aims are to improve prevention, identification and optimal responses to sexual abuse. However, as shown in our literature review, policymakers face difficult challenges because child sexual abuse is hidden, psychologically complex, and socially sensitive. This article contributes significant new ideas for international progress. Insights about required strategies are informed by an innovative multidisciplinary analysis of research from public health, medicine, social science, psychology, and neurology. Using an ecological model comprising individual, institutional and societal dimensions, we propose that two preconditions for progress are the enhancement of awareness of child sexual abuse, and of empathic responses towards its victims.

Many disciplines-common approach: Experiences in the development and delivery of an interprofessional health subject

In 2004, the Faculty of Health Sciences at La Trobe University in Victoria, Australia, introduced a new, final-year subject ‘Interdisciplinary Professional Practice’. The subject is taught to all students enrolled in the 11 allied health and human service disciplines at La Trobe University across metropolitan and rural campuses. The delivery is online to overcome timetabling barriers and to provide time and geographic flexibility. The subject is presented using an enquiry-based learning model. Students are exposed to the concepts of interdisciplinary teamwork through shared learning across professional boundaries to enable a collaborative workforce. An outline of the background development and design of this subject, and its implementation and content areas is presented. A discussion of relevant literature and an analysis of the subject evaluations and focus groups that have guided subject development to enhance student learning over eight cohorts is included.

Methodological perspectives for register-based health system performance assessment : Developing a hip fracture monitoring system in Finland

The resources of health systems are limited. There is a need for information concerning the performance of the health system for the purposes of decision-making. This study is about utilization of administrative registers in the context of health system performance evaluation. In order to address this issue, a multidisciplinary methodological framework for register-based data analysis is defined. Because the fixed structure of register-based data indirectly determines constraints on the theoretical constructs, it is essential to elaborate the whole analytic process with respect to the data. The fundamental methodological concepts and theories are synthesized into a data sensitive approach which helps to understand and overcome the problems that are likely to be encountered during a register-based data analyzing process. A pragmatically useful health system performance monitoring should produce valid information about the volume of the problems, about the use of services and about the effectiveness of provided services. A conceptual model for hip fracture performance assessment is constructed and the validity of Finnish registers as a data source for the purposes of performance assessment of hip fracture treatment is confirmed. Solutions to several pragmatic problems related to the development of a register-based hip fracture incidence surveillance system are proposed. The monitoring of effectiveness of treatment is shown to be possible in terms of care episodes. Finally, an example on the justification of a more detailed performance indicator to be used in the profiling of providers is given. In conclusion, it is possible to produce useful and valid information on health system performance by using Finnish register-based data. However, that seems to be far more complicated than is typically assumed. The perspectives given in this study introduce a necessary basis for further work and help in the routine implementation of a hip fracture monitoring system in Finland.

Periodontal and dental health and oral self-care among adults with diabetes mellitus.

ABSTRACT Bakhshandeh, Soheila. Periodontal and dental health and oral self-care among adults with diabetes mellitus. Department of Oral Public Health, Institute of Dentistry, Faculty of Medicine, University of Helsinki, Helsinki, Finland. 2011. 49 pp. ISBN 978-952-10-7193-5(paperback). The aim of the present study was to assess oral health and treatment needs among Iranian adults with diabetes according to socio-demographic status, oral hygiene, diabetes related factors, and to investigate the relation between these determinants and oral health. Moreover, the effect of an educational oral health promotion intervention on their oral health and periodontal treatment needs was studied. The target population comprised adults with diabetes in Tehran, Iran. 299 dentate patients with diabetes, who were regular attendants to a diabetic clinic, were selected as the study subjects. Data collection was performed through a clinical dental examination and self-administered structured questionnaire. The questionnaire covered information of the subject s social background, medical history, oral health behaviour and smoking. The clinical dental examinations covered the registration of caries experience (DMFT), community periodontal index (CPI) and plaque index (PI). The intervention provided the adults with diabetes dental health education through a booklet. Reduction in periodontal treatment needs one year after the baseline examination was used as the main outcome. A high prevalence of periodontal pockets among the study population was found; 52% of the participants had periodontal pockets with a pocket depth of 4 to 5 mm and 35% had periodontal pockets with pocket depth of 6 mm or more. The mean of the DMFT index was 12.9 (SD=6.1), being dominated by filled teeth (mean 6.5) and missing teeth (mean 5.0). Oral self-care among adults with diabetes was inadequate and poor oral hygiene was observed in more than 80% of the subjects. The educational oral health promotion decreased periodontal treatment needs more in the study groups than in the control group. The poor periodontal health, poor oral hygiene and insufficient oral self-care observed in this study call for oral health promotion among adult with diabetes. An educational intervention showed that it is possible to promote oral health behaviour and to reduce periodontal treatment needs among adults with diabetes. The simplicity of the model used in this study allows it to be integrated to diabetes programmes in particular in countries with a developing health care system.

Functional outcome and health-related quality of life after traumatic brain injury in the framework of the International Classification of Functioning, Disability and Health (ICF)

Traumatic brain injury (TBI) affects people of all ages and is a cause of long-term disability. In recent years, the epidemiological patterns of TBI have been changing. TBI is a heterogeneous disorder with different forms of presentation and highly individual outcome regarding functioning and health-related quality of life (HRQoL). The meaning of disability differs from person to person based on the individual s personality, value system, past experience, and the purpose he or she sees in life. Understanding of all these viewpoints is needed in comprehensive rehabilitation. This study examines the epidemiology of TBI in Finland as well as functioning and HRQoL after TBI, and compares the subjective and objective assessments of outcome. The frame of reference is the International Classification of Functioning, Disability and Health (ICF). The subjects of Study I represent the population of Finnish TBI patients who experienced their first TBI between 1991 and 2005. The 55 Finnish subjects of Studies II and IV participated in the first wave of the international Quality of life after brain injury (QOLIBRI) validation study. The 795 subjects from six language areas of Study III formed the second wave of the QOLIBRI validation study. The average annual incidence of Finnish hospitalised TBI patients during the years 1991-2005 was 101:100 000 in patients who had TBI as the primary diagnosis and did not have a previous TBI in their medical history. Males (59.2%) were at considerably higher risk of getting a TBI than females. The most common external cause of the injury was falls in all age groups. The number of TBI patients ≥ 70 years of age increased by 59.4% while the number of inhabitants older than 70 years increased by 30.3% in the population of Finland during the same time period. The functioning of a sample of 55 persons with TBI was assessed by extracting information from the patients medical documents using the ICF checklist. The most common problems were found in the ICF components of Body Functions (b) and Activities and Participation (d). HRQoL was assessed with the QOLIBRI which showed the highest level of satisfaction on the Emotions, Physical Problems and Daily Life and Autonomy scales. The highest scores were obtained by the youngest participants and participants living independently without the help of other people, and by people who were working. The relationship between the functional outcome and HRQoL was not straightforward. The procedure of linking the QOLIBRI and the GOSE to the ICF showed that these two outcome measures cover the relevant domains of TBI patients functioning. The QOLIBRI provides the patients subjective view, while the GOSE summarises the objective elements of functioning. Our study indicates that there are certain domains of functioning that are not traditionally sufficiently documented but are important for the HRQoL of persons with TBI. This was the finding especially in the domains of interpersonal relationships, social and leisure activities, self, and the environment. Rehabilitation aims to optimize functioning and to minimize the experience of disability among people with health conditions, and it needs to be based on a comprehensive understanding of human functioning. As an integrative model, the ICF may serve as a frame of reference in achieving such an understanding.

Belief revision - an axiomatic approach

Belief revision systems aim at keeping a database consistent. They mostly concentrate on how to record and maintain dependencies. We propose an axiomatic system, called MFOT, as a solution to the problem of belief revision. MFOT has a set of proper axioms which selects a set of most plausible and consistent input beliefs. The proposed nonmonotonic inference rule further maintains consistency while generating the consequences of input beliefs. It also permits multiple property inheritance with exceptions. We have also examined some important properties of the proposed axiomatic system. We also propose a belief revision model that is object-centered. The relevance of such a model in maintaining the beliefs of a physician is examined.

Composite material and piezoelectric coefficient uncertainty effects on structural health monitoring using feedback control gains as damage indicators

This article addresses uncertainty effect on the health monitoring of a smart structure using control gain shifts as damage indicators. A finite element model of the smart composite plate with surface-bonded piezoelectric sensors and actuators is formulated using first-order shear deformation theory and a matrix crack model is integrated into the finite element model. A constant gain velocity/position feedback control algorithm is used to provide active damping to the structure. Numerical results show that the response of the structure is changed due to matrix cracks and this change can be compensated by actively tuning the feedback controller. This change in control gain can be used as a damage indicator for structural health monitoring. Monte Carlo simulation is conducted to study the effect of material uncertainty on the damage indicator by considering composite material properties and piezoelectric coefficients as independent random variables. It is found that the change in position feedback control gain is a robust damage indicator.

Damped Belief Propagation Based Near-Optimal Equalization of Severely Delay-Spread UWB MIMO-ISI Channels

In this paper, we present a belief propagation (BP) based equalizer for ultrawideband (UWB) multiple-input multiple-output (MIMO) inter-symbol interference (ISI) channels characterized by severe delay spreads. We employ a Markov random field (MRF) graphical model of the system on which we carry out message passing. The proposed BP equalizer is shown to perform increasingly closer to optimal performance for increasing number of multipath components (MPC) at a much lesser complexity than that of the optimum equalizer. The proposed equalizer performs close to within 0.25 dB of SISO AWGN performance at 10-3 bit error rate on a severely delay-spread MIMO-ISI channel with 20 equal-energy MPCs. We point out that, although MIMO/UWB systems are characterized by fully/densely connected graphical models, the following two proposed features are instrumental in achieving near-optimal performance for large number of MPCs at low complexities: i) use of pairwise compatibility functions in densely connected MRFs, and ii) use of damping of messages.

Health monitoring,of a helicopter rotor in forward flight using fuzzy logic

A fuzzy logic system is developed for helicopter rotor system fault isolation. Inputs to the fuzzy logic system are measurement deviations of blade bending and torsion response and vibration from a "good" undamaged helicopter rotor. The rotor system measurements used are flap and lag bending tip deflections, elastic twist deflection at the tip, and three forces and three moments at the rotor hub. The fuzzy logic system uses rules developed from an aeroelastic model of the helicopter rotor with implanted faults to isolate the fault while accounting for uncertainty in the measurements. The faults modeled include moisture absorption, loss of trim mass, damaged lag damper, damaged pitch control system, misadjusted pitch link, and damaged flap. Tests with simulated data show that the fuzzy system isolates rotor system faults with an accuracy of about 90-100%. Furthermore, the fuzzy system is robust and gives excellent results, even when some measurements are not available. A rule-based expert system based on similar rules from the aeroelastic model performs much more poorly than the fuzzy system in the presence of high levels of uncertainty.

Guided-wave based structural health monitoring of built-up composite structures using spectral finite element method

The paper discusses basically a wave propagation based method for identifying the damage due to skin-stiffener debonding in a stiffened structure. First, a spectral finite element model (SFEM) is developed for modeling wave propagation in general built-up structures, using the concept of assembling 2D spectral plate elements and the model is then used in modeling wave propagation in a skin-stiffener type structure. The damage force indicator (DFI) technique, which is derived from the dynamic stiffness matrix of the healthy stiffened structure (obtained from the SFEM model) along with the nodal displacements of the debonded stiffened structure (obtained from 2D finite element model), is used to identify the damage due to the presence of debond in a stiffened structure.

Context aware M-commerce services: C-IOB model approach

Context-aware computing is useful in providing individualized services focusing mainly on acquiring surrounding context of user. By comparison, only very little research has been completed in integrating context from different environments, despite of its usefulness in diverse applications such as healthcare, M-commerce and tourist guide applications. In particular, one of the most important criteria in providing personalized service in a highly dynamic environment and constantly changing user environment, is to develop a context model which aggregates context from different domains to infer context of an entity at the more abstract level. Hence, the purpose of this paper is to propose a context model based on cognitive aspects to relate contextual information that better captures the observation of certain worlds of interest for a more sophisticated context-aware service. We developed a C-IOB (Context-Information, Observation, Belief) conceptual model to analyze the context data from physical, system, application, and social domains to infer context at the more abstract level. The beliefs developed about an entity (person, place, things) are primitive in most theories of decision making so that applications can use these beliefs in addition to history of transaction for providing intelligent service. We enhance our proposed context model by further classifying context information into three categories: a well-defined, a qualitative and credible context information to make the system more realistic towards real world implementation. The proposed model is deployed to assist a M-commerce application. The simulation results show that the service selection and service delivery of the system are high compared to traditional system.

Solid-solid collapse transition in a two dimensional model molecular system

Solid-solid collapse transition in open framework structures is ubiquitous in nature. The real difficulty in understanding detailed microscopic aspects of such transitions in molecular systems arises from the interplay between different energy and length scales involved in molecular systems, often mediated through a solvent. In this work we employ Monte-Carlo simulation to study the collapse transition in a model molecular system interacting via both isotropic as well as anisotropic interactions having different length and energy scales. The model we use is known as Mercedes-Benz (MB), which, for a specific set of parameters, sustains two solid phases: honeycomb and oblique. In order to study the temperature induced collapse transition, we start with a metastable honeycomb solid and induce transition by increasing temperature. High density oblique solid so formed has two characteristic length scales corresponding to isotropic and anisotropic parts of interaction potential. Contrary to the common belief and classical nucleation theory, interestingly, we find linear strip-like nucleating clusters having significantly different order and average coordination number than the bulk stable phase. In the early stage of growth, the cluster grows as a linear strip, followed by branched and ring-like strips. The geometry of growing cluster is a consequence of the delicate balance between two types of interactions, which enables the dominance of stabilizing energy over destabilizing surface energy. The nucleus of stable oblique phase is wetted by intermediate order particles, which minimizes the surface free energy. In the case of pressure induced transition at low temperature the collapsed state is a disordered solid. The disordered solid phase has diverse local quasi-stable structures along with oblique-solid like domains. (C) 2013 AIP Publishing LLC.